Week 7 - Endocrine Talks

Question 1

The Pancreas, Insulin, & Glucagon:

What are the major target tissues of insulin?

Answer 1

1. Liver
2. Adipose tissue
3. muscle
4. satiety center of hypothalamus

Question 2

The Pancreas, Insulin, & Glucagon:

What happens to a glucose molecule once it enters the cell?

Answer 2

It is either used to make ATP
OR
can be stored as potential fuel for later
(glycogen, triglyceride, depending on cell stimulated)

Question 3

The Pancreas, Insulin, & Glucagon:

Why can taking too much insulin be a problem?

Answer 3

1. It can lead to hypoglycemia
2. Insufficient fuel will be available leading to insulin shock

Question 4

The Pancreas, Insulin, & Glucagon:

What is the major target organ of glucagon?

Answer 4

Liver

Question 5

The Pancreas, Insulin, & Glucagon:

How does the ANS affect blood glucose levels?

Answer 5

1. Sympathetic activity will increase blood sugar levels
2. Parasympathetic will decrease it

Question 6

The Pancreas, Insulin, & Glucagon:

Give a factor that increases insulin reaction

Answer 6

1. Increased blood sugar due to eating
2. GH action
3. ACTH/cortisol action

Question 7

The Pancreas, Insulin, & Glucagon:

What regulates the secretion of glucagon?

Answer 7

Alpha cells in the pancreas

Question 8

The Pancreas, Insulin, & Glucagon:

Identify three functions of insulin

Answer 8

1. increase glucose transport to cells
2. conversion of glucose to glycogen (glycogenesis)
3. decrease glycogen breakdown (glycogenolysis)
4. slow formation of new glucose (gluconeogenesis)

Question 9

The Pancreas, Insulin, & Glucagon:

Identify three functions of glucagon

Answer 9

1. breakdown glycogen to glucose (glycogenolysis)
2. increase conversion of other nutrients to glucose (gluconeogenesis)
3. release glucose to blood from liver cells

Question 10

The Pancreas, Insulin, & Glucagon:

What type of stimulus will stimulate the pancreas to begin insulin secretion?

a. hormonal
b. neural
c. humoral
d. all of the above

Answer 10

c. humoral (cells will secrete in response to change in concentration of glucose in blood)

Question 11

The Pancreas, Insulin, & Glucagon:

Glucagon causes the breakdown of _____ and increase glucose synthesis in the ________.

a. sodium…kidneys
b. bile…pancreas
c. glycogen…liver
d. CSF…meninges
e. fatty acids…liver

Answer 11

c. glycogen…liver

Question 12

The Pancreas, Insulin, & Glucagon:

When insulin activity is absent or deficient, blood sugar levels remain high after a meal because:

a. the pancreas did not receive the proper signal to disassemble the protein and fats
b. too much was eaten and the body does not have adequate enzymatic resources to handle the large quantities of food
c. the glucose from the meal is unable to enter most tissue cells
d. the body has a certain amount for each transaction and if too much sugar is eaten then there simply is not enough insulin

Answer 12

c. the glucose from the meal is unable to enter most tissue cells

Question 13

Two Types of Diabetes:

What are some of the latest treatments for type 1 diabetes?

Answer 13

This will change over time, so do not memorize, but you could include:

1. new forms of insulin
2. insulin pump technology
3. artificial pancreas (delivering both insulin/glucagon in balance)
4. immune system based treatments examining antibody functions

Question 14

Two Types of Diabetes:

List four S/S that someone might have who has not been diagnosed with diabetes but has it:

Answer 14

1. Polyuria - frequent urination
2. weight loss
3. fatigue
4. vomiting
5. Polydipsia - Thirst
   Polyphagia - hunger

Question 15

Two Types of Diabetes:

Give several causes for NIDDM

Answer 15

1. family history
2. genetic predisposition
3. gestational diabetes
4. ethnicity

Question 16

Two Types of Diabetes:

What is the goal of treatment in both types of diabetes?

Answer 16

Control of blood sugar through:
1. treatment
2. diet
3. activity
4. or other lifestyle adjustments

Question 17

Two Types of Diabetes:

Why is it so important to maintain the goal of controlling blood sugar?

Answer 17

When uncontrolled diabetes leads to many complications and increased risk of dying

Question 18

Two Types of Diabetes:

What other ways do diabetics have to control their blood glucose levels besides taking insulin?

Answer 18

1. exercise
2. weight loss
3. improving diet
4. stress management
5. improving sleep
6. drinking water

Question 19

Two Types of Diabetes:

Compare and contrast Type I and Type II diabetes

Answer 19

Type I –
1. lack of production of insulin
2. caused by autoimmune response
3. early inset is common

Type II – related more to:
1. diet
2. exercise
3. family behavior/history

Question 20

DKA:

What is the ultimate cause of DKA?

Answer 20

Poorly controlled diabetes, or loss of regulation

Question 21

DKA:

What is the relationship between increased fat metabolism and hyperglycemia?

Answer 21

The body can breakdown fat to free up energy sources to make ATP in the instance where a lack of insulin makes it impossible to move enough glucose into cells to make ATP.

So, glucose will remain high, as the body attempts to mobilize fat

Question 22

DKA:

Why does a patient in DKA have a fruity-smelling breath?

Answer 22

Acetone

One of the ketones produced during DKA causes the fruity-smelling breath of DKA patients

Question 23

DKA:

What is glycosuria?
Why do diabetics have it?
What does it result in?

Answer 23

1. Glucose in urine
2. Since insulin is not available or the target cells are insensitive to it, there is an excess in the blood
3. the kidney filters the blood and cannot reabsorb all this excess due to limitations in transport processes.
4. So, glucose stays in the filtrate of the kidney as does the excess after and this makes its way to the bladder and becomes urine

Question 24

DKA:

What can cause an increase in protein catabolism in diabetics and explain the connection between increased glucose production and increased protein catabolism?
Next, explain the relationship of increased protein catabolism to osmotic diuresis.

Answer 24

1. OSMOTIC DIURESIS can occur any time when there are solutes from the filtrate (thus the solute will remain in the filtrate and become urine and water will remain in the filtrate and become urine and water will remain behind in the urine pathway as well = polyuria
2. IN DIABETES, the body tends to go after other nutrients to provide to the starving cells since glucose cannot enter properly. However, harvesting lipids from the triglycerides stored in fat, or amino acids used in proteins (protein catabolism) causes even more solutes to be in the blood and thus filtered at the kidney. This exacerbates osmotic diuresis.

Question 25

DKA: What can osmotic diuresis lead to?

Answer 25

Dehydration

Question 26

DKA: What factors ultimately lead to decreased serum pH?

Answer 26

Increased sugar and fat metabolism

Question 27

DKA: What leads to decreased brain function and death?

Answer 27

Hyperglycemia

Question 28

DKA: Which of the following classic symptoms of diabetic ketoacidosis is characterized by excessive thirst? a. polyuria b. polydipsia c. hypotonica d. polyphagia e. hyperpnea

Answer 28

b. polydipsia

Question 29

Complications of Diabetes: What is the leading cause of blindness in the US?

Answer 29

Diabetes

Question 30

Complications of Diabetes: Describe the progression of diabetic retinopathy:

Answer 30

MILD - non-prolific, causes aneurism where blood vessels break MODERATE - non-prolific, blood vessels that nourish retina get blocked SEVERE - many vessels are blocked, several areas lose blood supply triggering growth of vessels PROLIFIC - triggers growth of more vessels, but normal in structure/function leading to macular edema, swelling, and blurred vision

Question 31

Complications of Diabetes: What are some nerve problems that face diabetics?

Answer 31

1. Diabetic neuropathy - leads to muscle weakness, pain in extremities, and impotence 2. Foot Damage - from decreased blood flow and loss of sensation can lead to foot deformities, ulcers, and amputations due to gangrene infection

Question 32

Complications of Diabetes: What problems are created by high blood sugar?

Answer 32

1. Blood vessel damage 2 Leading cause of blindness 3. Retropy (black spots in visual field) 4. Dental problems 5. Dry skin

Question 33

Complications of Diabetes: Why are diabetics more susceptible to developing gangrene?

Answer 33

1. Less blood flow to the area due to atherosclerosis 2. Less sensation 3. inflammation 4. But not feeling pain associated with damage or injury can lead to open wounds becoming infected 5. Associated with high concentrations of nutrients for bacterial growth

Question 34

Complications of Diabetes: What are some of the vascular changes that occur in diabetics at a faster rate than in the normal population?

Answer 34

1. Macrovascular disease 2. Microvascular disease 3. Atherosclerosis 4. Aneurysms

Question 35

Complications of Diabetes: List and describe four complications of diabetes.

Answer 35

1. DEHYDRATION - stimulates thirst centers of brain, leading to excessive thirst (polydipsia) 2. EXCESS GLUCOSE filtered at the kidneys, leads to polyuria or the high volume as osmotic diuretic impacts of excess glucose cause bot the sugar and excess water to be lost. Thus the blood volume decreases and dehydration results 3. GLUCOSE AVAILABLE IN BODY FLUIDS but not available in the cells. Cause cells to starve and turn to other nutrients such as fat and protein for fuel. Theses other fuels can be limited value since many metabolic cascades are interconnected and will remain limited by CHO metabolism problems. OVERALL, this leads to weight loss and constant hunger (polyphagia) 4. KETOACIDOSIS leads to faster buildup of ketones and pH drops

Question 36

Complications of Diabetes: Diabetic retinopathy occurs when there is: a. cloudiness or dots cover the lens of the eye b. damage to the blood vessels in the retina c. there is increased fluid pressure inside the eye d. a blunt blow to the back of the head e. damage to the optic nerve

Answer 36

b. damage to the blood vessels in the retina

Question 37

Complications of Diabetes: The F/F response involves all of the following except: a. increased blood sugar b. increased lipolysis c. increased cardiac output d. increased urine output e. increased basal metabolic rate

Answer 37

d. increased urine output

Question 38

Complications of Diabetes: Mr. M, who has proliferative diabetic retinopathy, was asked to volunteer for his son's school carnival. Which of the following activities would be safest for his eye condition? a. blowing up balloons for the dart time b. testing the speed on the Swings of Terror c. grilling the hot dogs on the BBQ

Answer 38

c. grilling the hotdogs on the BBQ