PANCREAS REVIEW Dr. Ayisha Qureshi

A patient came to a clinician with a past 2-3 weeks history of muscle weakness with tetanic condition. His urine coloration is intense with polyuria. He is suffering from polydypsia and lethargic condition. Patient also complains of sudden weight loss. After suggestion by the doctor for Lab tests, following are the test values: RBCs: Normal- slight increase WBCs: Normal Platelets: Normal- slight decrease Plasma Glucose: greater than 200 mg/dl pH: 7 Scenario I (Usman) Thyroid Profile: TSH levels slightly increased Bound T4: Normal Bound T3: Normal Urine test: RBC: None Pus cells: None Glucose: Present Ketone Bodies: Present Urea: Increase Which is the most likely diagnosis: a.Hypothyroidism b.Hyperthyroidism c.Hyperinsulinemia d.Hypoinsulinemia e.Ketoacidosis f.Anemia g.Glucosuria

Scenario II (Aqueel) A 40-year old man came to the hospital with a case of excessive bleeding and increased clotting time after an injury. Lab. Report suggest increased levels of fasting blood glucose levels. The patient tells that he was not suffering from high glucose level earlier in his life. What is the likely cause of his excessive bleeding? a.Diabetes Type I b.Hypoinsulinemia c.Carcinoma of Pancreas d.Diabetes Type II e.Cirrhosis of Liver Scenario III (Asif) A 50-year old obese woman presents to the hospital complaining of increased urination, increased thirst and hunger. The Lab. reports showed: Increase Glucose in blood Increased Glucose in Urine Low blood pH She is most likely suffering from? a.Ketoacidosis b.Diabetes Mellitus c.Hyperinsulinemia d.Diabetes Inspidus

Scenario IV (?) An over-weight patient reported to a doctor with increased urination, having vision problems with prolonged period of wound healing. He is complaining of weakness and increased thirst (polydipsia). After clinical examination increased level of glucose found in blood and urine. What do you think that which hormone deficiency is present in the patient? a.Thyroid hormone b.Insulin c.ADH d.Glucagon Scenario V (Khizra) A 50-year old patient reported to the doctor with increased urine output and increased thirst and hunger. Lab reports show increased glucose in blood as well as presence in urine. What would be the most likely diagnosis? a.Diabetes mellitus b.Hypothyroidism c.Hyperinsulinism d. carcinoma of Pancreas

Scenario VI (Hana) A 50-year old woman comes in complaining that she has polyphagia, frequent urination and numbness in the peripheries. The doctor advices her to get a blood and urine test. The result showed that her fasting glucose levels were 200 mg/ dl and there was glucose present in her urine. Which hormone is the patient deficient in? a.FSH b.Glucagon c.Growth hormone d.Insulin

Name the hormone (Glucagon/ Insulin) responsible for the processes listed below: glucose to glycogen amino acids to glucose protein to amino acids glucose to fats (triglycerides) glycogen to glucose low blood glucose to high blood glucose high blood glucose to low blood glucose fats (triglycerides) to fatty acids fats (triglycerides)

Question 1 "Three meals a day" is our routine, but how is periodic eating handling internally? Specifically, how does the endocrine system maintain internal homeostatic processes, such as blood glucose, in the face of our "feast or famine" pattern of eating? Explain.

Question 2 What are glucose transporters (GLUT), how are they important, and where are they found? How does insulin act on these transporters to increase glucose uptake by insulin-sensitive cells? Are all cells insulin- sensitive? Defend your answer.

Question 3 Rosemary was asked to drink a solution containing glucose, and blood samples were taken periodically over a few hours to measure her plasma glucose concentration; this is an oral glucose tolerance test. The results were normal. How would drinking a glucose solution affect then secretion of insulin and glucagon? If Rosemary had type 2 diabetes mellitus, how would that have affected the GTT.

Which of the following are characteristic of the POSTABSORPTIVE/ FED state? a.Glycogenolysis b.Gluconeogenesis c.Lipolysis d.Glycogenesis e.protein synthesis f.triglyceride synthesis g.protein degradation h.increased insulin secretion i.increased glucagon secretion j.glucose sparing