Pharmacology 2060A/B Lecture Notes - Lecture 15: Glucose Tolerance Test, Diabetes Mellitus Type 1, Gestational Diabetes

30 views18 pages

sapphirebear815

15 May 2018

School

Department

Course

Professor

For unlimited access to Class Notes, a Class+ subscription is required.

Module 15 – Drugs to Treat Diabetes

15.1 – Introduction to Diabetes

- Diabetes is a chronic disease characterized by elevated blood levels of glucose (i.e. sugar)

- Normally glucose is efficiently reabsorbed in the proximal tubule of the kidney so it is not found

in the urine

- In untreated diabetes, blood glucose rises so high that the transporters that reabsorb it are

saturated and significant amounts of glucose are found in the urine

- In fact, many years ago diabetes was diagnosed by the sweet smell AND TASTE of the urine!

- High blood sugar in diabetes results from either not enough insulin produced in the body OR

eause the ody’s ells do ot respod to the insulin that is produced

- The classic symptoms of diabetes are polyuria (increased urination), polydipsia (increased

thirst), polyphagia (increased hunger) and weight loss

- Insulin is a hormone produced by the pancreas that is involved in tightly regulating blood

glucose

- Diaetes ours he isuli leels are too lo or he the ody’s ells are resistat to the

effects of insulin

Insulin: the basics

- Isuli is a peptide horoe sythesized y the β eta ells of the islets of Langerhans of the

pancreas (endocrine function)

- Pancreas is an exocrine organ made of pancreatic acini (not involved in diabetes)

- Insulin is rapidly released from the pancreas into the blood in response to increases in blood

glucose (when we eat a meal)

- When insulin is secreted, it causes glucose uptake into muscle, liver, and fat cells

- In liver cells, glucose uptake results in glycogen synthesis (a storage form of glucose)

- In muscle cells, glucose is used as energy and promotes protein synthesis

- In fat cells, insulin causes increased synthesis of fatty acids, which results in increased

triglyceride synthesis

- Extracellular potassium is important in the action of insulin as it helps insulin to drive glucose

into the cell

find more resources at oneclass.com

Unlock document

This preview shows pages 1-3 of the document.
Unlock all 18 pages and 3 million more documents.

Already have an account? Log in

Healthy pancreas

- Regulates levels of blood glucose (maintain normal levels in the body)

- Eat a meal → stomach converts food to glucose and glucose is absorbed and enters blood

stream → pancreas secretes insulin into blood

- Insulin drives glucose out of blood and into tissues

15.2 – Types of diabetes

- Diabetes can be classified into one of three distinct groups:

o 1. Type I diabetes – Also called insulin dependent diabetes mellitus

o 2. Type II diabetes – Also called non-insulin dependent diabetes mellitus

o 3. Gestational diabetes – Diabetes that occurs in pregnancy

Type I diabetes

- Approximately 10% of diabetics have type I diabetes

- Type I diabetes is usually diagnosed in children or adolescents but symptoms may not appear

until early adulthood

find more resources at oneclass.com

Unlock document

This preview shows pages 1-3 of the document.
Unlock all 18 pages and 3 million more documents.

Already have an account? Log in

- Type I diabetes is caused by an autoimmune reaction where the body’s o iue ells attak

and destroy the isuli seretig β ells

- As a result, the body makes too little or no insulin at all and requires insulin replacement

- Type I diabetes is not preventable and it is not caused by eating too much sugar

- Glucose is absorbed in the blood stream but the pancreas does not make enough insulin to

balance the glucose = very little glucose leaves the blood and enters cells of body

o = more glucose remains in blood stream = blood glucose levels rise

Type II diabetes

- Approximately 90% of all diabetics have type II diabetes

- In type II diabetes the pancreas makes sufficient insulin, however, the insulin produced is

resistant to use

- Over the course of the disease, insulin synthesis may also decrease

- There are many risk factors for developing type II diabetes including age, having a family

member with diabetes, previous gestational diabetes in females, lack of exercise, heart disease,

obesity, ethnicity (African and Native descent are at higher risk)

- Is seen as preventable with proper diet and exercise

- It is important to note that in Canada, ~ 80% of all patients with type II diabetes are obese or

overweight = decrease obesity to decrease diabetes

- Type II diabetes was typically diagnosed later in life (50-55) but there is a trend towards younger

people getting type II diabetes

- There is insulin that is secreted into the blood but the body is resistant to its effect and glucose

is not reabsorbed = remains in the blood = blood glucose levels rise

find more resources at oneclass.com

Unlock document

This preview shows pages 1-3 of the document.
Unlock all 18 pages and 3 million more documents.

Already have an account? Log in

Document Summary

Diabetes is a chronic disease characterized by elevated blood levels of glucose (i. e. sugar) Normally glucose is efficiently reabsorbed in the proximal tubule of the kidney so it is not found in the urine. In untreated diabetes, blood glucose rises so high that the transporters that reabsorb it are saturated and significant amounts of glucose are found in the urine. In fact, many years ago diabetes was diagnosed by the sweet smell and taste of the urine! High blood sugar in diabetes results from either not enough insulin produced in the body or (cid:271)e(cid:272)ause the (cid:271)ody"s (cid:272)ells do (cid:374)ot respo(cid:374)d to the insulin that is produced. The classic symptoms of diabetes are polyuria (increased urination), polydipsia (increased thirst), polyphagia (increased hunger) and weight loss. Insulin is a hormone produced by the pancreas that is involved in tightly regulating blood glucose. Dia(cid:271)etes o(cid:272)(cid:272)urs (cid:449)he(cid:374) i(cid:374)suli(cid:374) le(cid:448)els are too lo(cid:449) or (cid:449)he(cid:374) the (cid:271)ody"s (cid:272)ells are resista(cid:374)t to the effects of insulin.

Related Questions

6. The site for countercurrent multiplier and exchange in the nephron is ________.
a. proximal tubule b. nephron loop and vasa recta c. distal tubule & collecting duct

7. The function of the kidneys is evaluated by measuring the
a. tubular reabsorption b. tubular secretion c. glomerular filtration rate

8. Abnormal amount of leukocytes in urine is termed _____.
a. ketonuria b. hematuria c. pyuria d. glycosuria e. nitrituria

9. In diabetes mellitus the clinical term for the abnormal urinalysis is called ________.
a. ketonuria b. hematuria c. pyuria d. glycosuria e. proteinuria

10. The possible cause of increase ____________ in urine is liver pathology o gallstones.
a. bile b. erythrocytes c. nitrites d. glucose e. protein

11. Proteinuria is caused by increase glomerular permeability due to kidney trauma, heavy mental, toxins, exertion, hypertension or glomerular nephritis.
a. True b. False

12. The normal pH of urine ranges from _____ to _____.
a. 2.2, 4.5 b. 10.3, 13.5 c. 8.0, 10.2 d. 4.5, 8.0 e. 6.0, 7.0

13. The average specific gravity of urine is slightly higher than 1.000 because the solutes it contains.
a. True b. False

14. __________ is the term for the normal smell of fresh urine.
a. Asparagus b. Nitrites c. Urinoid d. Ammonia

15. The concentration of this pigment in urine change the color of it.
a. Urinoid b. Nitrites c. Urobilin d. Calcium

16. The failure of a kidney to develop is termed _________________.
a. renal agenesis b. horseshoe kidney
c. supernumerary kidney d. pelvic kidney

17 Renal ptosis refers to the ___________ movement of the kidney within the abdominal cavity.
a. anterior b. posterior c. superior d. inferior

18. Renal failure refers to the diminish o absent renal function caused by the destruction of about ___ of the kidney.
a. 20% b. 40% c. 60% d. 90%

19. Renal calculus may occur from crystallized glucose after high levels in blood.
a. True b. False

20. An untreated UTI that spread to the kidneys is termed ____________.
a. urethritis b. cystitis c. pyelonephritis d. dysuria

21. Pain is an associated symptom of an UTI, and this is termed as __________.
a. urethritis b. cystitis c. pyelonephritis d. dysuria

22. Incontinence refers to ___________ whereas retention refers to____________
a. inability to involuntary control urination, failure to eliminate urine normally.
b. failure to eliminate urine normally, inability to voluntary control urination
c. inability to voluntary control urination, failure to eliminate urine normally
d. failure to eliminate urine normally, inability to involuntary control urination

23. All of the following are physical characteristics of urine except:
a. Color and transparency b. Odor c. pH d. specific gravity e. taste

24. Preformed water includes the water absorbed from food and drink whereas metabolic water includes the water from cellular respiration and dehydration.
a. True b. False

25. Sensible water los is not measured. In contrast insensible water loss is measured and includes sweat and transpiration.
a. True b, False

26. ____________ water loss is dependent upon the degree of hydration and is hormonally regulated in the tubules and collecting ducts of the kidney.
a. Sensible b. Insensible c. Obligatory d. Facultative
27. ___________ water loss is a loss of water that always occur regales of the state of hydration of the body.
a. Sensible b. Insensible c. Obligatory d. Facultative

28. Fluid is lost from the body through the following normal mechanism except:
a. breathing b. sweating c. defecation d. urination e. vomiting

29. Â¬Â¬Â¬Â¬Â¬Â¬Â¬Â¬Â¬Â¬Â¬Â¬Â¬Â¬Â¬Â¬The stimuli that activates the thirst center include all of the following except:
a. decreased salivary secretions b. distention of the stomach
c. increased blood osmolality d. decreased blood pressure

30. Stimuli for inhibiting the thirst center are produced when fluid intake is greater than fluid output.
a. True b. False

31. Fluid balance is regulated by monitoring blood volume, blood pressure, and blood plasma osmolarity.
a. True b. False

32. This electrolyte imbalance can lead to confusion, coma, paralysis of breathing muscles, and death.
a. hypenatremia b. hyperkalemia c. hypercalcemia d. hypocalcemia

33. _____________ may cause muscle weakness and irregular heart beat that can lead to cardiac arrest.
a. Hyponatremia b. Hyperkalemia c. Hypercalcemia d. Hypokalemia

34. Numbness, tingling, increase heat rate, and muscle spasm that can lead to tetany is caused by _____.
a. hypenatremia b. hyperkalemia c. hypercalcemia d. hypocalcemia

35. If a patient needs IV fluids like 0.9% saline solution it means the solution contains 0.9 gr of _______ to every 100 ml of sterile water.
a. glucose chloride b. calcium chloride c. potassium chloride d. sodium chloride

36. Which of the following individual will be more vulnerable to dehydration?
a. Young adults b. Middle-aged adults c. Elderly d. Infants e. c & d

37. Diabetes insipidus refers to:
a. hypersecretion of insulin b. hyposecretion of antidiuretic hormone
c. hyposecretion of insulin d. hypersecretion of antidiuretic hormone
e. none of the above

38. During vomiting the major loss is ___________ whereas in diarrhea there is an extensive loss of ________.
a. hydrochloric acid (HCl), bicarbonate (HCO3) b. bicarbonate (HCO3), hydrochloric acid (HCl)
c. bicarbonate (HCO3), glucose d. hydrochloric acid (HCl), sodium

39. Lactic acidosis results from:
a. prolongs intense exercise b. congestive heart failure
c. insufficient insulin production d. a & b e. a, b & c

40. Ketoacidosis results from:
a. prolongs intense exercise b. congestive heart failure
c. insufficient insulin production d. a & b e. a, b & c

41. In respiratory alkalosis, respiratory rate increases and blood __________ _____________.
a. CO2 increases b. CO2 decreases
c. O2 increases d. O2 decreases e. none of the above

42. Metabolic acidosis compensate with _____________ ______________.
a. respiratory acidosis b. respiratory alkalosis
c. metabolic acidosis e. metabolic alkalosis e. none of the above

43. The step in the digestive process that deals with a series of catabolic steps in which complex food molecules are broken down into their chemical building blocks by enzymes secreted into the lumen of the alimentary tract is called
a. Propulsion b. Ingestion c. Chemical digestion d. Defecation e. Absorption

44. ________________ is the passage of digestive end products from the lumen of the GI tract by active or passive transport into the blood or lymph.
a. Propulsion b. Ingestion c. Chemical digestion d. Defecation e. Absorption

45. In which part of the digestive tract is chemical digestion essentially completed?
a. stomach b. pancreas c. liver d. small intestine e. large intestine

46. The organ that carries most metabolic function in the body is the
a. stomach b. liver c. small intestine d. pancreas

47. The main function of these organs is propulsion: peristaltic waves move food bolus to stomach accomplishing the phase of deglutition
a. Mouth and associated accessory organs b. Pharynx and esophagus
c. Stomach d. Small intestine e. Large intestine

48. Which hormone will be secreted especially if the bolus contains proteins?
a. gastrin b. cholecystokinin c. secretin

49. The following target organs are stimulated by secretin except:
a. stomach b. pancreas c. liver d. gallbladder

50. The stimulus of chime containing amino acids and fatty acids entering the small intestine releases ____________.
a. gastrin b. cholecystokinin c. secretin

51. The cells that produce intrinsic factor, important in the absorption of B12, is the ______ cells.
a. surface mucous b. mucous neck c. parietal d. chief e. G-cells

52. The most numerous of the secretory cells within the gastric glands, which produce zymogen are:
a. surface mucous b. mucous neck c. parietal d. chief e. G-cells

53. The following are functions of hydrochloric acid except:
a. activates pepsinogen b. kills microorganism
c. prevents ulceration of the stomach d. denatures proteins

54. Barrett esophagus refers to an advance case of GERD in which the epithelium changes from columnar secretory to stratified squamous.
a. True b. False

55. Gastric and duodenal ulcer are both peptic ulcers; the difference is that one occurs in the stomach and the other in the first part of the duodenum respectively.
a. True b. False

56. The following are common complication of advanced liver cirrhosis except:
a. jaundice b. edema c. ascites d. gastritis e. intense itching

57. Most cases of appendicitis occurs because fecal matter obstructs the appendix. As the inflammation worsens the parietal peritoneum becomes inflamed as well.
A. True b. False

58. The majority of colorectal cancer appears in the following areas except:
a. descending colon b. sigmoid colon c. rectum d. proximal ileum

59. Polyps are outgrowths from the colon mucosa whereas diverticulosis are bulges in the intestinal lining.
a. True b. False

60. Celiac disease is an autoimmune disorder. The damage in the small intestine is the smooth muscle which interferes with absorption.
a. True b. False

olivedonkey40

1. Which hormone responsible for calcium absorption is synthesized by the kidneys?
a. Calcitriol b. Glucagon c. Erythropoietin d. Antidiuretic hormone

2. Which of the following regulations is not performed by the kidney?
a. acid-base balance b. blood pressure c. glycolysis d. blood production

3. The hormone require for blood pressure regulation and release by the kidney is _____.
a. erythropoietin b. renin c. calcitriol

4. Almost all nutrients and about 65% of sodium are actively reabsorbed in this part of the nephron, transported from the filtrate back to the plasma.
a. proximal tubule b. descending limb c. ascending limb d. collecting duct

5. Which site is where most regulation happens?
a. proximal tubule b. nephron loop and vasa recta c. distal tubule & collecting duct

6. The site for countercurrent multiplier and exchange in the nephron is ________.
a. proximal tubule b. nephron loop and vasa recta c. distal tubule & collecting duct

7. The function of the kidneys is evaluated by measuring the
a. tubular reabsorption b. tubular secretion c. glomerular filtration rate

8. Abnormal amount of leukocytes in urine is termed _____.
a. ketonuria b. hematuria c. pyuria d. glycosuria e. nitrituria

9. In diabetes mellitus the clinical term for the abnormal urinalysis is called ________.
a. ketonuria b. hematuria c. pyuria d. glycosuria e. proteinuria

10. The possible cause of increase ____________ in urine is liver pathology o gallstones.
a. bile b. erythrocytes c. nitrites d. glucose e. protein

11. Proteinuria is caused by increase glomerular permeability due to kidney trauma, heavy mental, toxins, exertion, hypertension or glomerular nephritis.
a. True b. False

12. The normal pH of urine ranges from _____ to _____.
a. 2.2, 4.5 b. 10.3, 13.5 c. 8.0, 10.2 d. 4.5, 8.0 e. 6.0, 7.0

13. The average specific gravity of urine is slightly higher than 1.000 because the solutes it contains.
a. True b. False

14. __________ is the term for the normal smell of fresh urine.
a. Asparagus b. Nitrites c. Urinoid d. Ammonia

15. The concentration of this pigment in urine change the color of it.
a. Urinoid b. Nitrites c. Urobilin d. Calcium

16. The failure of a kidney to develop is termed _________________.
a. renal agenesis b. horseshoe kidney
c. supernumerary kidney d. pelvic kidney

17 Renal ptosis refers to the ___________ movement of the kidney within the abdominal cavity.
a. anterior b. posterior c. superior d. inferior

18. Renal failure refers to the diminish o absent renal function caused by the destruction of about ___ of the kidney.
a. 20% b. 40% c. 60% d. 90%

19. Renal calculus may occur from crystallized glucose after high levels in blood.
a. True b. False

20. An untreated UTI that spread to the kidneys is termed ____________.
a. urethritis b. cystitis c. pyelonephritis d. dysuria

21. Pain is an associated symptom of an UTI, and this is termed as __________.
a. urethritis b. cystitis c. pyelonephritis d. dysuria

22. Incontinence refers to ___________ whereas retention refers to____________
a. inability to involuntary control urination, failure to eliminate urine normally.
b. failure to eliminate urine normally, inability to voluntary control urination
c. inability to voluntary control urination, failure to eliminate urine normally
d. failure to eliminate urine normally, inability to involuntary control urination

23. All of the following are physical characteristics of urine except:
a. Color and transparency b. Odor c. pH d. specific gravity e. taste

24. Preformed water includes the water absorbed from food and drink whereas metabolic water includes the water from cellular respiration and dehydration.
a. True b. False

25. Sensible water los is not measured. In contrast insensible water loss is measured and includes sweat and transpiration.
a. True b, False

26. ____________ water loss is dependent upon the degree of hydration and is hormonally regulated in the tubules and collecting ducts of the kidney.
a. Sensible b. Insensible c. Obligatory d. Facultative
27. ___________ water loss is a loss of water that always occur regales of the state of hydration of the body.
a. Sensible b. Insensible c. Obligatory d. Facultative

28. Fluid is lost from the body through the following normal mechanism except:
a. breathing b. sweating c. defecation d. urination e. vomiting

29. Â¬Â¬Â¬Â¬Â¬Â¬Â¬Â¬Â¬Â¬Â¬Â¬Â¬Â¬Â¬Â¬The stimuli that activates the thirst center include all of the following except:
a. decreased salivary secretions b. distention of the stomach
c. increased blood osmolality d. decreased blood pressure

30. Stimuli for inhibiting the thirst center are produced when fluid intake is greater than fluid output.
a. True b. False

31. Fluid balance is regulated by monitoring blood volume, blood pressure, and blood plasma osmolarity.
a. True b. False

32. This electrolyte imbalance can lead to confusion, coma, paralysis of breathing muscles, and death.
a. hypenatremia b. hyperkalemia c. hypercalcemia d. hypocalcemia

33. _____________ may cause muscle weakness and irregular heart beat that can lead to cardiac arrest.
a. Hyponatremia b. Hyperkalemia c. Hypercalcemia d. Hypokalemia

34. Numbness, tingling, increase heat rate, and muscle spasm that can lead to tetany is caused by _____.
a. hypenatremia b. hyperkalemia c. hypercalcemia d. hypocalcemia

35. If a patient needs IV fluids like 0.9% saline solution it means the solution contains 0.9 gr of _______ to every 100 ml of sterile water.
a. glucose chloride b. calcium chloride c. potassium chloride d. sodium chloride

36. Which of the following individual will be more vulnerable to dehydration?
a. Young adults b. Middle-aged adults c. Elderly d. Infants e. c & d

37. Diabetes insipidus refers to:
a. hypersecretion of insulin b. hyposecretion of antidiuretic hormone
c. hyposecretion of insulin d. hypersecretion of antidiuretic hormone
e. none of the above

38. During vomiting the major loss is ___________ whereas in diarrhea there is an extensive loss of ________.
a. hydrochloric acid (HCl), bicarbonate (HCO3) b. bicarbonate (HCO3), hydrochloric acid (HCl)
c. bicarbonate (HCO3), glucose d. hydrochloric acid (HCl), sodium

39. Lactic acidosis results from:
a. prolongs intense exercise b. congestive heart failure
c. insufficient insulin production d. a & b e. a, b & c

40. Ketoacidosis results from:
a. prolongs intense exercise b. congestive heart failure
c. insufficient insulin production d. a & b e. a, b & c

41. In respiratory alkalosis, respiratory rate increases and blood __________ _____________.
a. CO2 increases b. CO2 decreases
c. O2 increases d. O2 decreases e. none of the above

42. Metabolic acidosis compensate with _____________ ______________.
a. respiratory acidosis b. respiratory alkalosis
c. metabolic acidosis e. metabolic alkalosis e. none of the above

43. The step in the digestive process that deals with a series of catabolic steps in which complex food molecules are broken down into their chemical building blocks by enzymes secreted into the lumen of the alimentary tract is called
a. Propulsion b. Ingestion c. Chemical digestion d. Defecation e. Absorption

44. ________________ is the passage of digestive end products from the lumen of the GI tract by active or passive transport into the blood or lymph.
a. Propulsion b. Ingestion c. Chemical digestion d. Defecation e. Absorption

45. In which part of the digestive tract is chemical digestion essentially completed?
a. stomach b. pancreas c. liver d. small intestine e. large intestine

46. The organ that carries most metabolic function in the body is the
a. stomach b. liver c. small intestine d. pancreas

47. The main function of these organs is propulsion: peristaltic waves move food bolus to stomach accomplishing the phase of deglutition
a. Mouth and associated accessory organs b. Pharynx and esophagus
c. Stomach d. Small intestine e. Large intestine

48. Which hormone will be secreted especially if the bolus contains proteins?
a. gastrin b. cholecystokinin c. secretin

49. The following target organs are stimulated by secretin except:
a. stomach b. pancreas c. liver d. gallbladder

50. The stimulus of chime containing amino acids and fatty acids entering the small intestine releases ____________.
a. gastrin b. cholecystokinin c. secretin

51. The cells that produce intrinsic factor, important in the absorption of B12, is the ______ cells.
a. surface mucous b. mucous neck c. parietal d. chief e. G-cells

52. The most numerous of the secretory cells within the gastric glands, which produce zymogen are:
a. surface mucous b. mucous neck c. parietal d. chief e. G-cells

53. The following are functions of hydrochloric acid except:
a. activates pepsinogen b. kills microorganism
c. prevents ulceration of the stomach d. denatures proteins

54. Barrett esophagus refers to an advance case of GERD in which the epithelium changes from columnar secretory to stratified squamous.
a. True b. False

55. Gastric and duodenal ulcer are both peptic ulcers; the difference is that one occurs in the stomach and the other in the first part of the duodenum respectively.
a. True b. False

56. The following are common complication of advanced liver cirrhosis except:
a. jaundice b. edema c. ascites d. gastritis e. intense itching

57. Most cases of appendicitis occurs because fecal matter obstructs the appendix. As the inflammation worsens the parietal peritoneum becomes inflamed as well.
A. True b. False

58. The majority of colorectal cancer appears in the following areas except:
a. descending colon b. sigmoid colon c. rectum d. proximal ileum

59. Polyps are outgrowths from the colon mucosa whereas diverticulosis are bulges in the intestinal lining.
a. True b. False

60. Celiac disease is an autoimmune disorder. The damage in the small intestine is the smooth muscle which interferes with absorption.
a. True b. False

amaranthfrog191

Pharmacology 2060A/B Lecture Notes - Lecture 15: Glucose Tolerance Test, Diabetes Mellitus Type 1, Gestational Diabetes

Document Summary

Get access

Related Documents

Pharmacology 2060A/B Lecture 15: Module 15

Pharmacology 2060A/B Lecture 15: Module 15 Drugs to Treat Diabetes

Pharmacology 2060A/B Lecture Notes - Lecture 15: Proximal Tubule, Postprandial, Pancreatitis

Related Questions