Anesthesia Pharmacology: Diabetes Management

Secretory product associated with pancreatic alpha cells:
1. insulin
2. proglucagon
3. somatostatin
4. pancreatic polypeptide
5. A & C
Major manifestations of diabetes mellitus:
1. inappropriate hyperglycemia
2. disordered metabolism
3. both
4. neither
Type I diabetes:
1. most often presents in adults
2. anabolic metabolic disorder
3. circulating insulin is virtually absent
4. glucagon levels are low
5. ketoacidosis is rarely seen
Extrinsic factors which may affect pancreatic B cell function:
1. mumps virus
2. toxic chemicals
3. coxsackievirus
4. A & B
5. A, B & C
Consistent with the idea that autoimmune processes are a major factor in pathogenesis of Type I diabetes is the observation that of this/these drug(s) may diminish pancreatic B cell damage:
1. metaproterenol
2. azathioprine
3. propranolol
4. A & C
5. A, B & C
Ketoacidosis really occurs in this Type I diabetes because of adequate circulating endogenous insulin:
1. Type I diabetes
2. Type II diabetes
Characteristic(s) of Type II diabetes
1. absence of endogenous insulin
2. tissue supersensitivity to insulin
3. most patients are obese
4. hyper-responsiveness of pancreatic B cell-response to insulin
5. ketoacidosis
Somatostatin -- secreted from this pancreatic islets cell type:
1. alpha cells
2. beta cells
3. delta cells
4. F cells
Drugs used to correct hyperglycemia associated with Type II diabetes:
1. insulin
2. sulfonylureas
3. both
4. neither
Stimulants of insulin release from pancreatic B cells:
1. leucine
2. vagal activity
3. mannose
4. B & C
5. A, B & C
Ion influx mow strictly associated with insulin secretion:
1. potassium
2. sodium
3. calcium
4. magnesium
5. chloride
The two main organs that remove insulin from circulation:
1. liver and GI tract
2. kidney and pancreas
3. pancreas and liver
4. liver and kidney
5. GI tract and kidney
Most of ENDOGENOUSLY secreted insulin is cleared from the blood by:
1. liver
2. kidney
3. pancreas
4. GI tract
5. lung
Most of EXOGENOUSLY administered insulin is cleared from the blood by:
1. liver
2. kidney
3. GI tract
4. pancreas
5. lung
Glucose transporter is most important to in terms of lowering blood glucose:
1. GLUT-1
2. GLUT-2
3. GLUT-3
4. GLUT 4
5. GLUT-5
Postprandial insulin release induces phosphorylations which activate:
1. pyruvate carboxylase
2. glucose 6-phosphatase
3. glucokinase
4. fructose bisphosphatase
5. phosphoenolpyruvate carboxykinase
Insulin endocrine effect(s):
1. anabolic action: promotes glucose storage as glycogen
2. anabolic action: increases triglyceride synthesis
3. muscle effect: increases protein synthesis
4. adipose tissue: increases triglyceride storage
5. all of the above
Mechanism(s) by which insulin reduces circulating free fatty acids and promotes adipocytes triglyceride storage:
1. induces lipoprotein lipase
2. promotes generation of glycerophosphate
3. inhibits intracellular lipase
4. A & C
5. A, B and C
Chemical characteristics of insulin:
1. small polypeptide
2. has two chains (A & B)
3. insulin is a hydrolysis product
4. A & B
5. A,B & C
More common form of diabetes:
1. Type I diabetes (IDDM)
2. Type II diabetes (NIDDM)