Anesthesia pharmacology Chapter 29: Diabetes Practice Questions

Human insulin is a:
1. Phospholipid
2. Protein
3. Nucleic acid
4. Short peptide (10 amino acids)
Human insulin may be described as which one(s) of the following?
1. A small protein consisting of two chains (A and B)
2. Formed by processing proinsulin within beta-cell Golgi apparatus
3. Both
4. Neither
Proinsulin:
1. Is transformed into insulin by the endoplasmic reticulum.
2. Is processed into insulin within beta-cell Golgi apparatus following packaging into granules, the site of hydrolysis into insulin.
3. Both
4. Neither
Both amino acid modifications as well as differences in insulin A and B chains account for:
1. Rapid acting insulin preparations (e.g. lispro)
2. Long-acting insulin preparations (e.g. glargine, degludec, detemir)
3. Both
4. Neither
C-peptide is a residual "connecting segment" produced along with insulin during granule-mediated hydrolysis.
1. True
2. False
Insulin along with C-peptide both produce hypoglycemic effects.
1. True
2. False
Insulin release from pancreatic beta cells occurs at a high stimulated rate in the presence of:
1. Glucose
2. Glucagon
3. Glucagon -like polypeptide 1
4. A & B
5. B & C
6. A, B & C
Cholecystokinin, fatty acids (high amounts) and elevated beta-adrenergic sympathetic nervous system activity promote insulin release from pancreatic beta cells at substantially higher rates compared to the low basal rate.
1. True
2. False
Drugs that stimulate insulin release include/includes:
1. Sulfonylureas
2. Acetylcholine
3. Isoproterenol
4. A & B
5. B & C
6. A & C
7. A, B & C
Some drugs that inhibit insulin release include/includes:
1. Clonidine
2. Diazoxide
3. Both
4. Neither
Stimulated insulin release may be initiated by glucose uptake by the beta-cell. Resulting hyperglycemia increases intracellular ATP levels that close ATP-dependent potassium channels. Reduced outward potassium flow depolarizes the beta-cell membrane and increases voltage-gated calcium channel conductance. Increased intracellular calcium induces insulin secretion.
1. True
2. False
Two principal organs remove insulin from the circulation: the kidney and the liver
1. True
2. False
The liver removes about 60% of pancreatic insulin release (due to the pancreas location near portal vein blood flow). The kidney removes about 40% of endogenous insulin. In insulin-treated diabetic patients, the above ratio is reversed?
1. True
2. False