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Exocrine Pancreas and Glucose
Clinical pathology
40
Veterinary Medicine
Undergraduate 4
04/21/2014

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Cards

Term
What is the difference between exocrine and endocrine?
Definition
Endocrine glands secrete into the body, while exocrine excretes to outside the body (remebering that the GIT is technically outside the body)
Term
Is the pancrease endocrine or exocrine?
Definition
It is both, acinar cells produce digestive enzymes (exocrine) while the Islets of Langerhans produce glucagon, insulin, somatostatin, gastrin and pancreatic polypeptids
Term
What are the 4 types of cells in the islets of langerhans and what do they produce?
Definition
Alpha - Glucagon
Beta - Insulin
Delta - Somatastatin and gastrin
F - pancreatic polypeptides
Term
What is the only simple sugar that circulates in the blood stream?
Definition
Glucose
Term
What are the hormones that control blood glucose?
Definition
Insulin, glucagon, catecholmines, glucocoritcoids
Term
What are the effects of insulin?
Definition
Released in reponse to high blood glucose. This increases the cellular uptake of glucose and therefore a decrease in blood glucose

Promotes lipogenesis in adipocytes
Glycogen synthesis in the liver and muscle
Protein synthesis
Inhibits gluconeogensis
Term
WHat does glucagon do?
Definition
Released in the face of decreased blood glucose, it sitmulates glycognolysis and gluconeogensis in the liver as wekk as lipolysis and ketogenesis. This leads to an increase in blood glucose
Term
What are some common catecholmines?
Definition
Adrenaline, noradrenaline and dopamine
Term
What hormones can also increase [glucose]?
Definition
Catecholmines
Glucocorticoids
Growth hormone
Progesterone
Term
How long should you fast a small animal prior to glucose sampling and why?
Definition
12 or more hours to avoid post prandial increases
Term
How long should you fast a small animal prior to glucose sampling and why?
Definition
12 or more hours to avoid post prandial increases
Term
Which species show the highest glucose increase as a result of stress?
Definition
Rabbit, horses and cats
Term
Which species show the highest glucose increase as a result of stress?
Definition
Rabbit, horses and cats
Term
How long after sampling should whole blood be examined for glucose?
Definition
No more than 20 mins post collection
Term
How long after sampling should whole blood be examined for glucose?
Definition
No more than 20 mins post collection
Term
If testing must be delayed for longer than 20mins, what should be done?
Definition
Either collected in grey top tubes (fluoride oxolate)or seperate plasma/serum and refridgerate
Term
If testing must be delayed for longer than 20mins, what should be done?
Definition
Either collected in grey top tubes (fluoride oxolate)or seperate plasma/serum and refridgerate
Term
Can lab and patient side measurements be compared?
Definition
No
Term
Can lab and patient side measurements be compared?
Definition
No
Term
Does post prandial hyperglycaemia occur in ruminants? Why?
Definition
No, due the constant microbe action, they are never postprandial
Term
Does post prandial hyperglycaemia occur in ruminants? Why?
Definition
No, due the constant microbe action, they are never postprandial
Term
What can cause a transient hyperglycaemia?
Definition
Postprandial, adreniline (fear, pain, stress), Moribund cows, iatrogenic (glucocoritcoids, progerterone, xyalzine, ketamine, morphine, furosamide), IV glucose fluids
Term
What can cause a transient hyperglycaemia?
Definition
Postprandial, adreniline (fear, pain, stress), Moribund cows, iatrogenic (glucocoritcoids, progerterone, xyalzine, ketamine, morphine, furosamide), IV glucose fluids
Term
In cats,could you see glucosuria from transient stress?
Definition
Yes, possibly, but not all the time
Term
What is Type 1 Diabetes ve Type 2 Diabetes?
Definition
Type 1: Absoulte insulin deficiency
Type 2: insulin resistance
Term
What causes type 1 DM?
Definition
Immunolocial destruction of beta cells
Term
What causes type 2 DM?
Definition
Insulin resitance of 'dysfunctional' beta cells
Term
In dogs, is Type 1 or 2 DM more common?
Definition
Type 1, or type 2 (but the insulin dependant form)
Term
What is a danger of chronic hyperglyceamia?
Definition
Low insulin secretion and peripheral insulin resistance
Term
What are the causes of DM?
Definition
Type 1 (idiopathic or immune mediated)
Type 2
Pancreatic DM (inflammation or neoplasia of the pancreas)
Endocrine (neoplasia)
Druc induced
Term
What are some of the causes of hypoglycaemia?
Definition
Incorrect sample management
Use of hand held glucometers
Iatrogenic insulin overdose
Functional beta cell tumours
Neoplasia (rare)
Sepsis
Extreme leukocytosis
Extreme physical exertion
Pre Tox
ketosis
Dietary
Decreased storage or production (hepatic disease, hypoadrenocorticism/hypopituitarism)
Term
What measurement can be used to look at glucose concentration without having to worry about a postprandial spike?
Definition
Fructosamine, indicates the average glucose conc of the last 2-3 weeks
Term
What is fructosamine?
Definition
Produced by irreversably binding glucose to protein molecules, it will be affected by anything that causes a drop in protein
Term
What are the ref ranges for fructosamine in dogs?
Definition
Prolones hypoglucaemia - <300umol/L
Excellent contol - 350-400umol/L
Good control - 400-450umol/L
Fair control - 450-500umol/L
Poor control - >500umol/L
Term
What is seen in the haematology in DM cases?
Definition
Stress leukogram in uncomplicated cases
In complicted, it may be a stress or an inflam leukogram
Evidence of dehydration
Pancretitis
Term
What does potassium need to enter cells?
Definition
Insulin, meaning that serum potassium may drop a lot following insulin admin
Term
Is specific gravity going to necessarily be accurate in DM cases?
Definition
No, there may be glucose in the urine, increasing the SG without the kidneys concentrating anythign
Term
Is proteinuria commonly seen?
Definition
It is expected if there is glomerular damage (which there will often be if the glucose is high)
Term
In a fasted patient the insulin is increased or a high normal what should you consider?
Definition
Insulinoma
Term
What is insuinoma?
Definition
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