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Dental Physio > Endocrine - Pt 3 Pancreas/Adrenal > Flashcards

Endocrine - Pt 3 Pancreas/Adrenal Flashcards

1
Q

Rank the pancreas in cells in quantity relative to the pancreas: Delta Cells, Alpha, Beta, remaining pancreatic peptides

A

Beta Cells - 65%

Alpha Cells - 20%

Delta Cells - 10%

Remainder - 5%

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2
Q

[] is used as a marker of insulin secretion in.

A

C-peptide is used as a marker of insulin secretion in

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3
Q

GLUT transporters

  • GLUT-1 and GLUT-3: [] expressed in most cells
  • GLUT-2: Found in hepatic, renal tubule, and pancreatic [] cells
  • GLUT-4: [] sensitive glucose transporter
    • found in [] and [] muscle, and [] tissue
A
  • GLUT-1 and GLUT-3: Constitutively expressed in most cells
  • GLUT-2: Found in hepatic, renal tubule, and pancreatic beta cells
  • GLUT-4: Insulin sensitive glucose transporter
    • found in skeletal and cardiac muscle, and adipose tissue
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4
Q

Signaling Pathway for Insulin from Beta Cells:

  • Glucose diffuses into Beta cell via []-[]Transporters (which are [] diffusion transporters)
  • Glucose goes through cellular respiration producing []
  • []-[] [] channels close due to the elevated presence of ATP
  • Increase of [] K+ causes [] of membrane
  • Depolarization opens []-[] [] channels
  • Ca2+ causes [] of Insulin from [] []
A
  • Glucose diffuses into Beta cell via GLUT-2 Transporters (which are facilitated diffusion transporters)
  • Glucose goes through cellular respiration producing ATP
  • ATP-Sensitive K+ channels close due to the elevated presence of ATP
  • Increase of intracellular K+ causes depolarization of membrane
  • Depolarization opens voltage-gated Ca2+ channels
  • Ca2+ causes exocytosis of Insulin from secretory vesicles
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5
Q
  • [] can be cleaved at two sites to produce insulin and C-peptide.
  • T/F - only insulin is released from Beta cells
A
  • Proinsulin can be cleaved at two sites to produce insulin and C-peptide.
  • F - both the insulin and C-peptide are released from the Beta cells
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6
Q

Insulin acts to [] nutrients from the bloodstream and convert them into [] forms

A

Insulin acts to remove nutrients from the bloodstream and convert them into storage forms

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7
Q

Insulin [] the uptake of glucose at muscle and adipose tissue through the insertion of [] transporters into the plasma membrane

A

Insulin stimulates the uptake of glucose at muscle and adipose tissue through the insertion of GLUT-4 transporters into the plasma membrane

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8
Q

Diabete Mellitus:

  • Patient has a fasting glucose of >[] mg/dL on [] occasions
  • Patient has a random glucose of > [] mg/dL with other [] symptoms
  • Patient has an increase in glucose >[] mg/dL following a glucose [] []
A
  • Patient has a fasting glucose of >126 mg/dL on two occasions
  • Patient has a random glucose of > 200 mg/dL with other classic symptoms
  • Patient has an increase in glucose >200 mg/dL following a glucose tolerance test
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9
Q

Diabetes Mellitus Type 1

  1. Also called: Insulin-[]; []-onset Diabetes
  2. []-mediated selective destruction of the [] cells of the pancrease
  3. Diabetic [] can lead to death
  4. Typical patient
    1. Aged []-[] years
    2. Non-[]
A
  1. Also called: Insulin-dependent; Juvenile-onset Diabetes
  2. Immune-mediated selective destruction of the B cells of the pancrease
  3. Diabetic ketoacidosis can lead to death
  4. Typical patient
    1. Aged 10-14 years
    2. Non-obese
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10
Q

Diabetes Mellitus Type 2

  1. Also called: []-[] dependent; or []-onset Diabetes
  2. Cells are [] to the actions of insulin
    1. As glucose levels are extremely high for extended times => the body [] the production of insulin receptor production
  3. Sever ketoacidosis [] [] typically occur
  4. Adverse affects on [] []
  5. Typical Patient
    1. Aged []
    2. Obese
A
  1. Also called: Non-insulin dependent; or Adult-onset Diabetes
  2. Cells are resistant to the actions of insulin
    1. As glucose levels are extremely high for extended times => the body downregulates the production of insulin receptor production
  3. Sever ketoacidosis does not typically occur
  4. Adverse affects on blood vessels
  5. Typical Patient
    1. Aged >40
    2. Obese
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11
Q

Diabetes Mellitus Type 1…High levels?

  • Plasma Glucose:
  • Urine Volume:
  • ADH levels:
  • Insulin Levels:
  • Severe Ketoacidosis:
A
  • Plasma Glucose: Yes
  • Urine Volume: Yes
  • ADH levels: Possibly if untreated
  • Insulin Levels: No
  • Severe Ketoacidosis: Yes
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12
Q

Central Diabetes Insipidus…High levels?

  1. Plasma Glucose:
  2. Urine Volume:
  3. ADH levels:
  4. Insulin Levels:
  5. Severe Ketoacidosis:
A
  1. Plasma Glucose: No
  2. Urine Volume: Yes
  3. ADH levels: No
  4. Insulin Levels: No
  5. Severe Ketoacidosis: No
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13
Q

Diabetes Mellitus Type 2…High levels?

  • Plasma Glucose:
  • Urine Volume:
  • ADH levels:
  • Insulin Levels:
  • Severe Ketoacidosis:
A
  • Plasma Glucose: Yes
  • Urine Volume: Yes
  • ADH levels: Possibly if untreated
  • Insulin Levels: Yes
  • Severe Ketoacidosis: No
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14
Q

Glucagon:

  • Inhibited by []
  • Operates through a G-protein ([]) coupled receptor using adenylyl cyclase
  • Main goal is to [] plasma glucose concentrations
    • cuases []olysis, gluconeogenesis, and lipolysis
A
  • Inhibited by somatostatin
  • Operates through a G-protein (Gs) coupled receptor using adenylyl cyclase
  • Main goal is to increase plasma glucose concentrations
    • cuases glycogenolysis, gluconeogenesis, and lipolysis
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15
Q

Somatostatin

  • Release stimulated by the ingestion of nutrients and release of hormones from the [] []
  • Acts in a [] fashion to [] the secretion of both insulin and glucagon
A
  • Release stimulated by the ingestion of nutrients and release of hormones from the GI tract
  • Acts in a paracrine fashion to decrease the secretion of both insulin and glucagon
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16
Q
  • The adrenal [] comprises approximately 80% of the gland and releases hormones essential for life
  • The adrenal medulla functions in a manner similar to [] [] neurons
A
  • The adrenal cortex comprises approximately 80% of the gland and releases hormones essential for life
  • The adrenal medulla functions in a manner similar to postganglionic sympathetic neurons
17
Q

Adrenal Cortex:

  • Zona Glomerulus - produces [] such as []
  • Zona Fasciculata - produces [] such as []
  • Zona Reticularis - produces [] such as [] and []
A
  • Zona Glomerulus - produces mineralcorticoids such as aldosterone
  • Zona Fasciculata - produces glucocorticoids such as cortisol
  • Zona Reticularis - produces androgens such as DHEA and androstenedione
18
Q

Adrenal Medulla

  • Makes catecholamines such as [] and []
A

Makes catecholamines such as epinephrine and norepinephrine

19
Q

Aldosterone, 3 effects:

  1. increaes the synthesis and activity of []/[] pump in the basolateral membrane
  2. Increases the synthesis of [] leak channels in the apical membrane
  3. Increases synthesis of [] channels in the apical membrane
  4. Net effect - increase potassium [] and sodium [].
A
  1. increaes the synthesis and activity of sodium/potassium pump in the basolateral membrane
  2. Increases the synthesis of potassium leak channels in the apical membrane
  3. Increases synthesis of sodium channels in the apical membrane
  4. Net effect - increase potassium secretion and sodium reabsorption.
20
Q
  • Cortisol has a high affinity for []reeptors in the renal system
  • However, the renal cells are able to convert cortisol to [], which has a much lower affinity for the receptors.
A
  • Cortisol has a high affinity for mineralcorticoid reeptors in the renal system
  • However, the renal cells are able to convert cortisol to cortisone, which has a much lower affinity for the receptors.
21
Q
  • ACTH, cortisol, and adrenal andorgens exhibit [] and [] patterns
    • Cortisol is highested in the []
    • Cortisol is lowest after [] []
  • Cortisol release can be triggered by [], [], or [] stress
A
  • ACTH, cortisol, and adrenal andorgens exhibit pulsatile and diurnal patterns
    • Cortisol is highested in the morning
    • Cortisol is lowest after falling asleep
  • Cortisol release can be triggered by physical, physcological, or biochemical stress
22
Q

Cortisol

  • Classifed as [] hormone, that is helpful during [] state
  • it works to [] blood nutrient levels
A
  • Classifed as catabolic hormone, that is helpful during fasting state
  • it works to increase blood nutrient levels
23
Q

Cortisol has tons of functions….

  • Reduce []
  • Suppress the [] response
  • Maintain [] responsiveness to catecholamines
    • upregulates []-[] receptors
  • Inhibits [] formation
  • [] glomerular filtration rate
    • [] of afferent arteriole
  • Affects the []
A
  • Reduce inflammation
  • Suppress the immune response
  • Maintain vascular responsiveness to catecholamines
    • upregulates a1-adrenergic receptors
  • Inhibits bone formation
  • Increase glomerular filtration rate
    • Vasodilation of afferent arteriole
  • Affects the CNS
24
Q
  • In the women, the [] [] is the primary source of androgens.
    • Ex: [] and []
A
  • In the women, the adrenal gland is the primary source of androgens.
    • Ex: DHEA and andostenedione
25
Q

Andrenogenital Syndrome

  • Deficiency of the hormone [] in the steroid biosynthetic pathway = no aldosterone or [] production
  • Without that enzyme, cortisol levels cannot provide [] feedback to the hypothalamus/ant pituitary…so [] continues to be released
  • This causes more [] to be released and can lead to [] of females and [] in adult females
A
  • Deficiency of the hormone 21 B-hydroxylase in the steroid biosynthetic pathway = no aldosterone or cortisol production
  • Without that enzyme, cortisol levels cannot provide negative feedback to the hypothalamus/ant pituitary…so ACTH continues to be released
  • This causes more androgens to be released and can lead to masculinization of females and virilization in adult females
26
Q

Addison’s Disease:

  • Primary [] insufficiency
  • 70% of cases are [], 30% adrenal gland destroyed
  • Symptoms:
    • [] aldosterone - hypotension and hyperkalemia
    • [] cortisol - hypoglycemia
    • [] Andorgens - decreased pubic hair and libido
    • [] ACTH - hyperpigmentation
A
  • Addison’s Disease:
  • Primary adrenocortical insufficiency
  • 70% of cases are idiopathic, 30% adrenal gland destroyed
  • Symptoms:
    • Decreased aldosterone - hypotension and hyperkalemia
    • Decreased cortisol - hypoglycemia
    • Decreased Andorgens - decreased pubic hair and libido
    • Increased ACTH - hyperpigmentation
27
Q

Cushings Disease/Syndrome

  • Syndrome = excess of [] from adrenal cortex or [] sources
  • Disease = excess glucocorticoids due to ACTH [] from pituitary []
  • Symptom
    • [] Cortisol - hyperglycemia, central [], round faace, osteoporosis, muscle wasing, susceptibility to []
A
  • Syndrome = excess of glucocorticoids from adrenal cortex or exogenous sources
  • Disease = excess glucocorticoids due to ACTH hypersecretion from pituitary adenome​
  • Symptom
    • Increased Cortisol - hyperglycemia, central obesity, round faace, osteoporosis, muscle wasing, susceptibility to infections
28
Q
  • The adrenal medulla produces the amine hormones [], [], and [] in [] cells
  • The medulla is stimulated primarily due to [] output, although [] and [] also serve as triggers
  • Cortisol helps in the process of norepinephrin –> epinephrine synthesis by stimulating the hormone []-[]-[] (PNMT)
A
  • The adrenal medulla produces the amine hormones epiniephrine, norepinephrine, and dopamine in chromaffin cells
  • The medulla is stimulated primarily due to sympathetic output, although stress and hypoglycemia also serve as triggers
  • Cortisol helps in the process of norepinephrin –> epinephrine synthesis by stimulating the hormone Phenylehtanolamine-N-methyltransferase (PNMT)
29
Q

Both norepinephrine and epinephrine operate through [] signal transduction pathways.

30
Q

Epinephrine works to [] plasma glucose and [] plasma free fatty acids.

It would then inhibit things like []

A

Epinephrine works to increase plasma glucose and increase plasma free fatty acids.

It would then inhibit things like insulin

Dental Physio (36 decks)

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