Aashi
Forum Moderator
Topics: 114
Posts: 1,062
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B
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| dr_jojo
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! GLUCAGONOMA but no rash
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| huyniid
Forum Elite
Topics: 9
Posts: 195
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D. Insulin, due to insulin resistance. This pt is obesity, had FHx of DM II and serum Glu random >200 and HTN. He is belonged to metabolic syndrome
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| robin082006
Forum Hero
Topics: 471
Posts: 5,123
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D, this is DM 2
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| 92306
Forum Senior
Topics: 14
Posts: 126
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Production
The hormone is synthesized and secreted from alpha cells (α-cells) of the islets of Langerhans, which are located in the endocrine portion of the pancreas. The alpha cells are located in the outer rim of the islet.
Regulatory mechanism
Increased secretion of glucagon is caused by:
Decreased plasma glucose
Increased catecholamines - norepinephrine and epinephrine
Increased plasma amino acids (to protect from hypoglycemia if an all protein meal consumed)
Sympathetic nervous system
Acetylcholine
Cholecystokinin
Decreased secretion of glucagon (inhibition) is caused by:
Somatostatin
Insulin
Function
Glucagon helps maintain the level of glucose in the blood by binding to glucagon receptors on hepatocytes, causing the liver to release glucose - stored in the form of glycogen - through a process known as glycogenolysis. As these stores become depleted, glucagon then encourages the liver to synthesize additional glucose by gluconeogenesis. This glucose is released into the bloodstream. Both of these mechanisms lead to glucose release by the liver, preventing the development of hypoglycemia.
Increased free fatty acids and ketoacids into the blood
Increased urea production
Mechanism of action
Glucagon binds to the glucagon receptor, a G protein-coupled receptor located in the plasma membrane. The conformation change in the receptor activates G proteins, a heterotrimeric protein with alpha, beta and gamma subunits. The subunits breakup under GTP hydrolysis and the alpha subunit specifically activates the next enzyme in the cascade, adenylate cyclase.
Adenylate cyclase manufactures cAMP (cyclical AMP) which activates cAMP-dependent protein kinase. This enzyme in turn activates phosphorylase B kinase, which in turn, phosphorylates phosphorylase B. Phosphorylase B is the enzyme responsible for the release of glucose-1-phosphate from glycogen polymers.
wikipedia
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| Geroo
Forum Guru
Topics: 114
Posts: 799
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weight loss makes me think it's not DM.I go with B
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| dr_jojo
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doctors this Q looks so easy but it is really confusing
insulin or glucagon
if i didnot study for usmle i will say 100% insulin
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| dr in trouble
Forum Guru
Topics: 62
Posts: 610
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Geroo the most common presenting symptom in type 2 DM is weight loss despite good appetite, if it is glucagonoma u will find increase levels of both glucagon and insulin as insulin will try to lower blood sugar, if it is DM then in sum pts u can find increase level of insulin---so i will say itz D.
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| eaguin
Forum Senior
Topics: 9
Posts: 162
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I think is D
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