Patho 3

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Patho 3
2010-05-04 18:11:23
endocrine diabetes

endocrine diabetes
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  1. What effect will insulin (normal vs. deficiency) have on cellular events -- protein synthesis, fat synthesis, and glycogen storage?
    • INSULIN (normal) -->
    • - synthesis of protein in muscle and other tissue
    • - storage of fat as TG in adipose tissue
    • - storage of CHO as glycogen in muscle and liver
  2. Pathogenesis of Type 1 diabetes.
    • autoimmunity
    • B-cell destruction
    • absolute insulin deficiency
  3. Pathogenesis of Type 2 diabetes.
    • insulin resistance (skeletal muscle, adipose tissue, liver)
    • relative insulin deficiency
  4. Etiology of Type 1 diabetes
    • B-cell depletion
    • marked atrophy and fibrosis
    • glucose approximately 600 (DKA)
    • plasma osmolality approximately 320
  5. Etiology of Type 2 diabetes
    • mild B-cell depletion
    • focal atrophy
    • amyloid deposits
    • glucose approximately 900-100 (NKH)
    • plasma osmolality approximately 400
  6. What effect would DKA have on intracellular K+ levels and why?
    • HYPERkalemia often occurs with DKA initially
    • masks true state of K+
    • decreased insulin --> decreased K+ entry into cells --> deficiency of intracellular K+
    • hypertonic extracellular fluids (high glucose and excess ketones) --> osmotic diuresis --> profound total K+ depletion
    • with treatment, hyperkalemia falls predictably
    • result = HYPOkalemia due to correction of acidosis (K+ moves back into cells)
  7. Insulin vs. glucagon
    • opposing regulator effects on glucose homeostasis
    • during fasting, low insulin and high glucagon facilitates hepatic gluconeogenesis and glycogenolysis
    • decreases glycogen synthesis
    • prevention of hypoglycemia
  8. Effect of insulin vs. glycogen on glycogenolysis
    • low insulin
    • high glucagon
    • increases blood glucose
  9. Effect of insulin vs. glycogen on gluconeogenesis
    glucagon increases the rate of amino acids to glucose
  10. Effect of insulin vs. glycogen on protein synthesis
    • insulin necessary for protein synthesis
    • insulin accelerates transport of some amino acids into cells --> could be stimulus for protein synthesis
  11. Effect of insulin vs. glycogen on ketogenesis
    conversion of amino acids to ketoacids
  12. Effect of insulin vs. glycogen on lipolysis
    • absence of insulin
    • free fatty acid concentration in plasma begins to rise
  13. Effect of insulin vs. glycogen on lipogenesis
    insulin promotes fatty acid synthesis