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Physiology > 4.4 Endocrine diabetes > Flashcards

4.4 Endocrine diabetes Flashcards

1
Q

what are other names for hyperthyroidism?

A

1) graves disease
2) toxic goiter
3) thyrotoxicosis

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2
Q

causes of hyperthyroidism? which one is most common?

A

1) tumor = over-secretion of T4 and T3

2) autoimmune response

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3
Q

describe the autimmune causation for hyperthyroidism. How is this tested?

A

**Called LATS= Long Acting Thyroid Stimulator; hypertrophy gioter
antibody is formed against TSH receptor. SO when antibody binds to receptor, the receptor treats it like TSH so you’ll see lots of T3/T4 produced. BUT LOW LEVELS OF TSH!!!
**test with an assay, - feedback with T3/T4 causes low TSH, but T3/T4 still being produced due to antibody interaction

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4
Q

general effects of hyperthyroidism

A

opposite of hypo

  • early eruption and shedding of primary teeth
  • early epiphyseal plate closure
  • osteoporosis
  • weight loss
  • increased:
  • –metabolic rate
  • –heat production
  • –protein synthesis
  • –potentiation of GH and somatomedin –effects on tissue growth
  • –nutrient utilization
  • –oxygen consumption
  • –synaptic activity
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5
Q

define exophthalamos

A

BUG EYES
an autoimmune response to 1/3 of cases of hyperthyroidism. It is an immune attack of soft tissue in the orbit associated with high levels of T3T4
–can even happen with hypo

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6
Q

location of pancreas

A

abdominal cavity, behind stomach, near duodenum

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7
Q

describe the 2 portions of the pancreas

A

1) exocrine = 98%
- -secretes bicarbonate solution (ducts) and digestive enzymes (acinar cells) into duedenum
2) endocrine = 2%
- -secrete hormones from clusters of cells, scattered throughout pancreas= pancreatic islets or islats of langerhans

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8
Q

pancreatic islets or islets of Langerhans

A

part of 2% endocrine portion of pancreas

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9
Q

acinar cells in what part of pancreas?

A

in 98% exocrine portion

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10
Q

insulin comes from?

A

endocrine beta cells in pancreas

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11
Q

what are the 4 types of cells in islets of Langerhans (endocrine pancreas)? what do they secrete? amount?

A

1) alpha cells 20%
- secrete glucagon
2) beta cells 75%
- secrete insulin
3) delta cells 4%
- somatostatin
4) phi cells 1%
- pancreatic polypeptide

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12
Q

what is the importance of the 4 islets of Langerhans cells being close together?

A

they proabably regulate each other or have sort of effect on eatch

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13
Q

what two cell types of islets of Langerhan regulate glucose levels?

A

alpha with glucagon secretion and beta with insulin secretion

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14
Q

pancreatic hormone is what type of hormone?

A

paptide; 29 AA long

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15
Q

main function of glucagon? stimulates

A
  • increase blood glucose levels

* stimulats glycogenolysis, gluconeogenesis, ketogenesis ALL TO KEEPPROTEIN SPARING

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16
Q

what is the main thing that simtulates glucagon secretion?

A

low plasma glucose

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17
Q

automatically think what when you hear protein hormone?

A
  • membrane receptors
  • 2nd messenger
  • -maybe couple to a G-protein
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18
Q

glucagon mechanisms of action

A

binds to membrane receptors and acts via caMP

-glocagon’s glycogenolysis research is the discovery of cAMP

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19
Q

how was cAMP discovered?

A

thru the research of the relationship between glucogenolysis and glucagon

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20
Q

how do you regulate glucagon secretion?

A

1) primarily on plasma glucose concentration
- -low glucose = stimulate alpha cells
- -high glucose= inhibits alpha cells
2) low blood glucose > nervous system via both branches of autonomics to stimulate alpha cells
3) low blood glucose stimulates the adrenal gland to release epi and nor which in turn stimulates alpha cells to release glucagon

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21
Q

low or high glucose effect on alpha cells

A
  • -low glucose = stimulate alpha cells

- -high glucose= inhibited alpha cells

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22
Q

idiopathic hypoglycemia is correlated with?

A

abnormal secretion of glucagon

  • may involve lack of alpha cells
  • uncommon and not much known
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23
Q

insulin is what type of hormone?

A

peptide with two chains connected by two disulfide bridges

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24
Q

general effects of insulin

A

-lowers blood glucose levels
=promotes nutrient storage
-HORMONE of ABuNDANCE

25
Q

main job of insulin?

A

lower plasma glucose levels by storing it in cells

26
Q

insulin carbohydrate metabolism?

A

1) hepatic cells: inhibits glycogenolysis and glucose release
2) extrahepatic cells: stimulates glucose transport; facilitated diffusion of glucose

27
Q

what cells do NOT require insulin for glucose uptake?

A

1) intestine
2) kidney
3) liver
4) nervous system
5) SOME skeletal muscles

28
Q

do cells that do NOT require insulin for glucose uptake still have insulin receptors?

A

Yes! insulin can still help in the uptake of glucose, but it is not dependent on it

29
Q

insulin in fat metabolism?

A

indirect effect

-insulin increase glucose uptake by liver and adipose cells which then STORE fat and decrease fat utilization

30
Q

hepatocytes (liver) stores glucose as

A

glycogen or fat

31
Q

insulin in protein metabolism?

A

indirect effect

-insulin increases the action of GH’s AA uptake and protein synthesis

32
Q

why would insulin inhibit glycogenolysis?

A

bc it is a storage hormone; you don’t want to take stuff out when trying to store it

33
Q

regulation of insulin secretion is primarily bu?

A

plasma glucose concentration

  • high plasma glucose = increase B cell activity
  • low glucose= decreased beta cell activity
34
Q

what AA increase the effect of glucose on beta cells?

A

arginine and lysine

35
Q

when in excess, what does GH, glucagon and glucocorticoids do?

A

cause diabteogenic

-this can lead to hyperglycemia with increase of beta cells activity and secretion of insulin

36
Q

describe diabetes mellitus type 1?

caused by?

A
  • juvenile onset (early)
  • insulin deficiency
  • caused by
    1) virus or unknown environmental agent directly attacks beta cells
    2) autoimmune response to beta cells
37
Q

what is the most common cause of diabetes mellitus type 1?

A

autoimmune response to beta cells

–an attack of beta cells causing a deficiency in insulin

38
Q

describe diabetes mellitus type 2?

causes?

A

-maturity onset; after 40
-primarily decrease tissue sensitivity to insulin
caused by: (combined cause)
1) decrease # of receptors
2) decrease sensitivity of receptor

39
Q

big main difference between type 1 and type 2?

A 
1= deficient in insulin
2= decreased sensitivity to insulin in tissues, but insulin is present
40
Q

can type 2 become type 1?

A

yes. after a period of time they lose ability to secrete insulin

41
Q

what is “B cell burnout”

A

when beta cells of pancreas are no longer about to secrete insulin due to high levels of glucose for a long period of time
***type 2 becomse type 1

42
Q

treatment for type 2?

A

exercise and weight loss

  • increase # and sensitivity of insulin receptors
  • increase noninsulin-dependent glucose uptake by muscle cells
43
Q

what does obesity and weight gain do to the number and sensitivity of insulin receptors?

A

decreases it

44
Q

what are the 3 primary effects of diabetes?

A

1) decrease GLUCOSE uptake, utilization and storage
2) increased FAT mobilization and utilization
3) increased PROTEIN metabolism and decreased protein synthesis

45
Q

what are seconadry effects of diabetes?

A

1) hyperglycemia = polyuria
2) hyperlipidemia and ketosis= atherosclerosis and metabolic acidosis causing HYPERVENTILATION, CNS depression and diabetic coma
3) poor wound healing due to unavailibility of AA bc AA is being used as energy; caused periodontal disease and bone loss

46
Q

define polyuria

A

lots of urine output that is high in sugar (dehydrating tissues)

47
Q

causes of hypERinsulinemia?

A
  • pancreatic adenoma (rare)

* insulin overdose (usually)

48
Q

main reason to have TOO MUCH insulin?

A

exogenous overdose

49
Q

adenoma means?

A

benign tumor formed from galndular structures in epithleium causeing over-secretion of beta cells … TOO MUCH insulin

50
Q

primary effect of hyperinsulinemia?

A

increased glucose uptake by most cells

51
Q

secondary effect of hyperinsulinemia?

A

insulin shock!

-due to increase stimulus to sym NS, dizzy/weak/hungry/high HR causing lowered brain function and loss of consciousness

52
Q

diabetic coma symptoms? treatment?

A
  • *NEED insulin, electrolytes and bicarbonate due to high glucose, dehydration and acidosis**
  • acetone frutiy smell
  • hyperventilation
  • dry not sewaty skin
  • unconscieousness
53
Q

insulin shock symptoms? treatment?

A
  • NEED SUGAR, epi and glucagon administered due to high insulin and to simulate liver glycogenolysis*
  • no acetone frutiy smell
  • SWEATY skin
  • unconscious
54
Q

what is the same symptom for insulin shock and diabetic coma?

A

unconsciousness after a few hours

55
Q

what is normal fasting blood glucose? compared to diabetic and hyperinsulinemia?

A

70-
diabetic= higher
hyprinsulinemia= lower

56
Q

glucose tolerance test?

compare results for diabetic, normal, and islet tumor

A

give sugar and havepatient pee; see how long it takes glucose levels to rise and become normal

  • *normal= glucose won’t rise as high and returns to baseline easy
  • **diabetic= glucose level rises HIGHER and returns to baseline SLOWLY
  • **islet tumor= glucose levels do not rise high and returns to baseline quickly
57
Q

how can you test for diabetes diagnosis?

A

1) urinary sugar
2) fasting blood glucose
3) glucose tolerance test
4) insulin sensitivity test

58
Q

insulin sensitivity test

A

determines if eleveated blood glucose is due to insulin deficiency

59
Q

phi cells or secretion of pancreatic polypeptide is stimulated by?

A

CCK; not well understood; cause gall bladder contractions

Physiology (42 decks)

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