Pancreas

Question 1

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

Tail of pancreas has more __ function, near what

What is present throughout

Answer 1

Exocrine, duodenum

Endocrine, spleen

Endo and exo function

Question 2

Pancreas is anatomically ___ in abdomen

Answer 2

Retroperitoneal

Question 3

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

Answer 3

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

Question 4

Insulin secretion stimulated by what

Glucagon secretion inhibited by what

Answer 4

Glucose

Insulin

Question 5

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

Answer 5

Insulin

Question 6

Glucose does not control what

Answer 6

Alpha cells that make glucagon

Question 7

Beta cells respond to changes in what

Answer 7

Bg to release insulin

Question 8

Overall effect of insulin is ___

Promotes synthesis of what

Answer 8

Anabolic

Carb, fat, protein

Question 9

____ is cleave to form insulin

Answer 9

C peptide

Question 10

Synthesis of insulin:

____ to ___ to __ and __

Answer 10

Preproinsulin
Proinsulin
Insulin and c peptide

Question 11

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

Answer 11

Peptide
A and b chains
Disulfide (strong)

Question 12

__ and __ __ are stored and released together

Answer 12

Insulin and c peptide

Question 13

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

Answer 13

Free
3-8 min
Liver and kidney

Question 14

What is measured as an index of endocrine capacity of pancreas

Answer 14

C peptide

Question 15

Physiologic effect of c peptide

Answer 15

Decreases gfr to uptake more glucose by body

Question 16

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

Answer 16

Glut 2

Question 17

What happens if drug blocks atp sensitive k channel

Answer 17

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

Question 18

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

Answer 18

Quicker insulin release when bg rises

Question 19

What happens if born w less sensitive k channel

Answer 19

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

Question 20

What happens to bg after bolus dose of insulin

Answer 20

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

Question 21

Limiting factor for glycolysis, in which cells

Answer 21

Glucose, beta

Not in cardiac cells or neurons

Question 22

Glucagon increases what 3 things in blood

Answer 22

Glucose, FA, ketoacids

Question 23

Glucagon

Structure
Synthesized as what, then what happens to it

Answer 23

Straight chain polypeptide

Preproglucagon, cleaved to glucagon and stored in secretory vesicles

Question 24

Glucagon release increased when

Main target organ of glucagon

Answer 24

Fasting, when insulin levels low

Liver

Question 25

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

Answer 25

GPCR (Gs) Adenylyl cyclase, cAMP PKA

Question 26

Liver functions to increase BG 3

Answer 26

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

Question 27

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

Answer 27

Fat | Ketone bodies

Question 28

What two things are antagonists

Answer 28

Glucagon and insulin

Question 29

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

Answer 29

Glut 4

Question 30

What enhances glucose response and does what

Answer 30

AA plus glucose, enhances protein synthesis and muscle growth

Question 31

Glut 1 Distribution Does what

Answer 31

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

Question 32

Glut 2 Where they are 4 About

Answer 32

B cells, kidney, intestines, liver Low affinity, high capacity, passive

Question 33

Glut 3 | Where they are

Answer 33

Supplies neurons w glucose | Passive

Question 34

Glut 4 Where they are Dependent on what

Answer 34

Muscle and fat | Insulin dependent

Question 35

Glut 5 Where Transports what

Answer 35

Intestines Fructose transporter, passive

Question 36

Sglt 1 and 2 Where __-__ ___ transporters

Answer 36

Intestines and kidney Na glucose co transporters. Active

Question 37

Insulin Decreases 2 Increases 6

Answer 37

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

Question 38

Lack of insulin/glucagon Increases 8 Decreases 2

Answer 38

Inc appetite, glucagon, bg, gluconeogenesis, lipolysis, protein breakdown, glycogenolysis, Ketone body production (ketoacidosis) Decreases glucose uptake by tissues and protein synthesis

Question 39

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

Answer 39

Bg and insulin. Glucagon Bg then insulin, glucagon

Question 40

After meal when glucagon goes up stim ___, __ and __ release Liver converts __ to __ bodies.

Answer 40

Glycolysis, Ffa and tg Ffa to ketone

Question 41

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

Answer 41

Glycogen | Glycogen

Question 42

Type 1 dm Prevalence What happens

Answer 42

10% | Autoimmune destruction of b cells

Question 43

Type 2 dm Prevalence What happens

Answer 43

90% | Insulin resistance

Question 44

MODY What happens Prevalent in who

Answer 44

Genetic defect in insulin production or release 2% of less than 15 year old diabetics

Question 45

Endocrine disorders that cause diabetes

Answer 45

Cushing, acromegaly, pheocromocytoma

Question 46

Hormones that raise bg

Answer 46

Mainly cortisol and glucagon Gh and epi do as well

Question 47

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

Answer 47

Glut 2 Beta Insulin

Question 48

Type 1 dm is a type __ hypersensitivity

Answer 48

4

Question 49

Type 2 dm is progressive loss of what

Answer 49

Insulin sensitivity of muscle and fat cells

Question 50

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

Answer 50

``` <20 Normal Decreased Present Common ```

Question 51

``` Type 2 onset Age Weight Insulin Anti islet cell antibodies Ketoacidosis ```

Answer 51

``` >30 Obese Increase None Rare ```

Question 52

Genetics type 1 vs type 2

Answer 52

Type 1, <50% accordance in twins, HLA D linked >90% accordance in twins, no HLA assoc

Question 53

Pathogenesis type 1

Answer 53

Autoimmunity, immunopathic. Insulin deficiency severe

Question 54

Pathogenesis type 2

Answer 54

Insulin resistance and relative insulin deficiency

Question 55

Islet cells type 1

Answer 55

Insulitis early Atrophy and fibrosis B cell depletion

Question 56

Islet cells type 2

Answer 56

No insulitis Atrophy and amyloid deposits Mild b cell depletion

Question 57

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

Answer 57

Undiagnosed dm that presents in pregnancy Subsequent gestational dm and type 2 dm Chorionic somatomammotropin