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Flashcards in Pancreas Deck (57):
1

Head of pancreas has more of a ___ function, near which organ

Tail of pancreas has more __ function, near what

What is present throughout

Exocrine, duodenum

Endocrine, spleen

Endo and exo function

2

Pancreas is anatomically ___ in abdomen

Retroperitoneal

3

Islets of langerhands
____ cells
3 types, which most prevalent, what they produce

Endocrine
Alpha, glucagon
Beta, insulin, 75%
Delta, somatostatin

4

Insulin secretion stimulated by what

Glucagon secretion inhibited by what

Glucose

Insulin

5

Glucagon producing cells have high conc of what if beta cells secreting insulin

Insulin

6

Glucose does not control what

Alpha cells that make glucagon

7

Beta cells respond to changes in what

Bg to release insulin

8

Overall effect of insulin is ___

Promotes synthesis of what

Anabolic

Carb, fat, protein

9

____ is cleave to form insulin

C peptide

10

Synthesis of insulin:
____ to ___ to __ and __

Preproinsulin
Proinsulin
Insulin and c peptide

11

Insulin leads to __ hormone composed of __ and ___, linked by ___

Peptide
A and b chains
Disulfide (strong)

12

__ and __ __ are stored and released together

Insulin and c peptide

13

Insulin circulates in __ form, half life of what, degraded by what

Free
3-8 min
Liver and kidney

14

What is measured as an index of endocrine capacity of pancreas

C peptide

15

Physiologic effect of c peptide

Decreases gfr to uptake more glucose by body

16

Glucose uptake is by ___ transporter which leads to cell depolarization, ca influx, and release of insulin from storage

Glut 2

17

What happens if drug blocks atp sensitive k channel

Cell stays depolarized (no k leaving), more insulin release

18

If drug makes atp sensitive k channel more sensitive to being blocked what happens

Quicker insulin release when bg rises

19

What happens if born w less sensitive k channel

Need more atp to block channel, need more glucose before insulin will be realeased. Higher bg set point, 150-170

20

What happens to bg after bolus dose of insulin

Bg rises, stored insulin was used and body has to make more

21

Limiting factor for glycolysis, in which cells

Glucose, beta

Not in cardiac cells or neurons

22

Glucagon increases what 3 things in blood

Glucose, FA, ketoacids

23

Glucagon

Structure
Synthesized as what, then what happens to it

Straight chain polypeptide

Preproglucagon, cleaved to glucagon and stored in secretory vesicles

24

Glucagon release increased when

Main target organ of glucagon

Fasting, when insulin levels low

Liver

25

Receptor of glucagon, stimulated what, increases what, __ to phosphorylate target proteins

GPCR (Gs)
Adenylyl cyclase, cAMP
PKA

26

Liver functions to increase BG 3

Glycogenolysis (breakdown glycogen)
Gluconeogenesis (glucose synthesis)
Synthesis of ketoacids from fatty acids

27

Cant convert __ into glucose but can convert fat into __ __

Fat
Ketone bodies

28

What two things are antagonists

Glucagon and insulin

29

Transporter that moves to cell surface, always open, when glucose high on outside

Glut 4

30

What enhances glucose response and does what

AA plus glucose, enhances protein synthesis and muscle growth

31

Glut 1
Distribution
Does what

Widely distributed

Supplies many cells w glucose. High affinity, low capacity, passive

32

Glut 2
Where they are 4
About

B cells, kidney, intestines, liver

Low affinity, high capacity, passive

33

Glut 3
Where they are

Supplies neurons w glucose
Passive

34

Glut 4
Where they are
Dependent on what

Muscle and fat
Insulin dependent

35

Glut 5

Where

Transports what

Intestines

Fructose transporter, passive

36

Sglt 1 and 2

Where

__-__ ___ transporters

Intestines and kidney

Na glucose co transporters. Active

37

Insulin
Decreases 2
Increases 6

Appetite and glucagon

Increases glucose uptake by tissue, glycolysis, glycogen syth, tg synth, aa uptake, protein synth

38

Lack of insulin/glucagon

Increases 8

Decreases 2

Inc appetite, glucagon, bg, gluconeogenesis, lipolysis, protein breakdown, glycogenolysis, Ketone body production (ketoacidosis)

Decreases glucose uptake by tissues and protein synthesis

39

Just ate: __ and __ high, __ low. __ lowers then __ lowers. __ starts to increase

Bg and insulin. Glucagon

Bg then insulin, glucagon

40

After meal when glucagon goes up stim ___, __ and __ release

Liver converts __ to __ bodies.

Glycolysis,
Ffa and tg

Ffa to ketone

41

Right after we eat liver __ is high when bg high. Use more __ when bg lowers.

Glycogen
Glycogen

42

Type 1 dm
Prevalence
What happens

10%
Autoimmune destruction of b cells

43

Type 2 dm
Prevalence
What happens

90%
Insulin resistance

44

MODY
What happens
Prevalent in who

Genetic defect in insulin production or release

2% of less than 15 year old diabetics

45

Endocrine disorders that cause diabetes

Cushing, acromegaly, pheocromocytoma

46

Hormones that raise bg

Mainly cortisol and glucagon

Gh and epi do as well

47

__ transporter sees chronic hyperglycemia in cell, leads to __ cell loss, __ production decreases

Glut 2
Beta
Insulin

48

Type 1 dm is a type __ hypersensitivity

4

49

Type 2 dm is progressive loss of what

Insulin sensitivity of muscle and fat cells

50

Type 1 onset
What age
Weight
Insulin
Anti islet cell bodies
Ketoacidosis

<20
Normal
Decreased
Present
Common

51

Type 2 onset
Age
Weight
Insulin
Anti islet cell antibodies
Ketoacidosis

>30
Obese
Increase
None
Rare

52

Genetics type 1 vs type 2

Type 1, <50% accordance in twins, HLA D linked

>90% accordance in twins, no HLA assoc

53

Pathogenesis type 1

Autoimmunity, immunopathic. Insulin deficiency severe

54

Pathogenesis type 2

Insulin resistance and relative insulin deficiency

55

Islet cells type 1

Insulitis early
Atrophy and fibrosis
B cell depletion

56

Islet cells type 2

No insulitis
Atrophy and amyloid deposits
Mild b cell depletion

57

Gestational dm
-what it is
-increased risk of what after pregnancy
-caused by what

Undiagnosed dm that presents in pregnancy

Subsequent gestational dm and type 2 dm

Chorionic somatomammotropin