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Anatomy
Physiology
Diabetes
Management
Ethanol
100
Which parts of the pancreas are not retroperitoneal?
Tail
100
List 3 classes of pancreatic secretions
Water, electrolytes, enzymes
100
List 5 risk factors for type 2 diabetes.
Genetic predisposition, Family history, Inactivity, Obesity, Age >45, Hypertension, Dyslipidaemia, Polycystic ovarian syndrome
100
How much alcohol should diabetics be limited to?
4sd for men and 2 for women per day, with 2 days of no drinking per week
100
List 3 enzymes involved in alcohol metabolism
Alcohol dehydrobenase, Microsomal EtOh Oxidising System (MEOS) and Aldehyde dehydrogenase
200
Which pancreatic cells stain basophilic and which stains eosinophilic?
Exocrine (Acini) stains basophilic, and endocrine (islets of langerhans) stain eosinophilic
200
What are the 4 types of endocrine cells in the pancreas and what do they secrete
β cells: insulin α cells: glucagon γ-cells: somatostatin F-cells: pancreatic polypeptide
200
What does metabolic syndrome comprise of?
Atherogenic dyslipidaemia Hyperglycaemia Hypertension Pro-inflammatory state Pro-thrombotic state
200
What is the three legged approach to management of Type II diabetes?
Healthy diet, exercise, medications
200
List 3 broad acute effects of alcohol
Intoxication, Metabolic changes, Alcoholic steatosis
300
What are the sympathetic and parasympathetic innervations of the pancreas?
PNS: Vagus Nerve SNS: T6-T10 (Celiac plexus & thoracic splanchnic nerves)
300
What is a common marker of endogenous insulin production and why?
C peptide as it is cleaved off proinsulin in insulin formation and both are released into the blood stream at the same time.
300
What are three common diagnostic test for diabetes?
Fasting plasma glucose test, Oral glucose tolerance test, Random plasma glucose test
300
What are 4 classes of hypoglycaemic drugs currently used in Australia?
Biguanides, Sulfonulureas, Thiazolidinediones, α- glucosidase inhibitors
300
What are the three phases of alcoholic liver diease?
Alcoholic steatosis, Alcoholic hepatis, Alcoholic cirrhosis
400
List the path of pancreatic secretions from the pancreas to the small intestines and the ducts that it joins with, as well as the sphincter that it passes through
Pancreatic duct + bile duct → ampulla of Vater → descending duodenum; Sphincter of Oddi
400
List 5 stimulants of insulin release
Glucose levels >5mM, amino acid, fatty acd, GIP, CCJ, sulfonylurea compounds, beta-sympathetic fibres
400
What are some clinical manifestations of diabetic ketoacidosis?
Severe dehydration Kassmaul respiration/rapid, deep sighing breathing Nausea, vomiting and abdominal pain Obtundation/ loss of mental capacity
400
After how long does short acting insulin begin to act?
0.5 to 1hr
400
What is the difference between ethanol metabolism during normal circumstances and binge drinking
Under normal circumstances, alcohol dehydrogenase removes most ethanol, but in binge drinking MEOS accounts for greater percentage of ethanol metabolism
500
Name 3 arteries that supply to the pancreas
Superior mesenteric artery, common hepatic artery, gastroduodenal artery, splenic artery
500
Explain the antagonistic effects of insulin and glucagon
Insulin inhibits glucagon secretion Insulin stimulates production of phosphodiesterase → cAMP breakdown → reduced effects of glucagon Insulin stimulates production of phosphatase 2A → dephosphorylate and deactivate PKA
500
List 5 difference between type 1 & 2 diabetes
Acute vs insidious Patient lean vs overweight Young vs middle aged No family history vs family history Insulin absent vs present Ketoacidosis vs no ketoacidosis
500
What are 3 parameters that have to be corrected in management of diabetic ketoacidosis?
Fluid loss (with IV) Hyperglycaemia (with insulin) Electrolyte disturbances Acid-base balance infection
500
Why is MEOS less active at low blood alcohol levels?
MEOS has high Km, ie low affinity, so if blood alcohol is low, it wouldn’t be active