Pancreas Flashcards

1
Q

where does the pancreas develop from?

A
  • foregut : coeliac trunk
  • midgut : superior mesenteric
  • hindgut : inferior mesenteric.

*pancreas if an outgrowth of the foregut.

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2
Q

what are the functions of the pancreas?

HINT : exocrine and endocrine

A
  • exocrine : produce and secrete digestive juices directly into duodenum. (alkaline secretions)
  • endocrine : hormone production from islets of langerhans located close to blood supply.
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3
Q

name some important hormones secreted by the pancreas.

A
  • insulin.
  • glucagon.
  • somatostatin.
  • ghrelin.
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4
Q

what are the major cell types in islets and what do they secrete? what function do they serve?

A
  • alpha cells : glucagon - raises blood glucose, catabolic.

- beta cells : insulin - lowers blood glucose, anabolic.

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5
Q

what is the importance of blood glucose levels?

A
  • brain uses glucose at fast rate and relies on blood for supply.
  • sensitive to falls or rise.
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6
Q

what is the significance of insulin and glucagon being water soluble?

A
  • able to be carries in plasma without special proteins.

- short half life allows ability to react quickly to dynamic environment.

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7
Q

describe the structure of insulin.

A
  • large peptide with alpha helical structure, 2 unbranched pp chains connected 2 disulphide bridges for stability
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8
Q

how is insulin synthesised?

A
  1. pre-proinsulin translated, cleaved and folded into proinsulin at RER.
  2. proinsulin to golgi, c-protein cleaved off and then turned to insulin and secreted in granules.
  3. marginised and exocytosed with calcium signals.
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9
Q

what is the significance of c-peptide?

A
  • type 1 diabetes who lack C-peptide shown improvements with c-peptide treatments as diminished glomerular hyperfiltration, reduced urinary albumin excretion and improved nerve function.
  • important in suspected insulin overdose deaths, if insulin>c peptide seen then external insulin high.
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10
Q

k+

A

DDD

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11
Q

how is insulin secretion regulated?

A
  • with feeding and rise in glucose there is a rise in ATP:ADP ratio.
  • ATP inhibits K+ATP and reduced K+efflux.
  • membrane depolarises activated voltage dependent Ca2+ channel and raise in intracellular calcium.
  • triggering exocytosis of insulin vesicles.
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12
Q

what systemic effects does insulin have?

A
  • increases glucose uptake and glycogen synthesis.
  • liver increases glycogen synthesis.
  • muscles increase uptake of AA and increases protein synthesis.
  • liver inhibits AA breakdown.
  • adipose increases TAG storage.
  • FA breakdown inhibited.
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13
Q

describe the structure of the insulin receptor?

A
  • dimer of two subunits of alpha and beta chains connected by a disulphide bond.
  • alpha exterior of cell membrane and beta span across membrane.
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14
Q

what are the effects of glucagon?

A
  • opposes insulin by raising glucose levels in blood.
  • glycogenolytic, gluconeogenic, lipolytic, ketogenic.
  • mobilises energy release.
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15
Q

how is glucagon synthesised and secreted?

A
  • in RER and transported in golgi.
  • packages in granules are effect on liver.
  • secreted by alpha cells, secreted at low glucose levels in alpha cells.
  • similar K-ATP mechanisms as beta cells seem to be involved in secretion.
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16
Q

describe the structure of glucagon.

A
  • 1 PP chain, no disulphide as structure already flexible.

- simpler precursor and undergoes post-translational processing.

17
Q

what are the effects of glucagon?

A
  • liver increases rate of glycogen breakdown (glycogenolysis).
  • stimulates synthesis of glucose from AA (gluconeogenic).
  • stimulates lipolysis to increase plasma FA.
18
Q

clinically whats the significance of glucangon?

A
  • in emergency medicine when person with diabetes is experiencing hypoglycaemia and cannot take sugar orally.
19
Q

what are the terms used to describe abnormal levels of insulin or glucagon?

A
  • high insulin : hypoglycaemia.
  • low insulin : hyperglycaemia/ diabetes mellitus.
  • high glucagon : makes diabetes worse.
  • low glucagon : hypoglycaemic effects.
20
Q

what causes type 1 diabetes and what is it?

A
  • resistance or deficiency in insulin.
  • absolute due to autoimmune destruction of pancreatic B-cells.
  • relative if secretory response impaired.
21
Q

what causes type 2 diabetes and what is it?

A
  • relative peripheral insulin resistance.
  • defective receptor mechanism and change in receptor number or affinity.
  • excessive glucagon amounts.
22
Q

why might insulin resistance be seen in young?

A
  • onset of hyperglycaemia and develop type 2.
  • initially : B cells compensate by increasing insulin.
  • eventually : unable to maintain high production.
  • finally : B-cells dysfunction leads to relative insulin deficiency.