Endocrine - Pt 3 Pancreas/Adrenal

Question 1

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

Answer 1

Beta Cells - 65%

Alpha Cells - 20%

Delta Cells - 10%

Remainder - 5%

Question 2

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

Answer 2

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

Question 3

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

Answer 3

• 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

Question 4

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 [] []

Answer 4

• 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

Question 5

• [] can be cleaved at two sites to produce insulin and C-peptide.
• T/F - only insulin is released from Beta cells

Answer 5

• 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

Question 6

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

Answer 6

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

Question 7

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

Answer 7

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

Question 8

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 [] []

Answer 8

• 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

Question 9

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-[]

Answer 9

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

Question 10

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

Answer 10

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

Question 11

Diabetes Mellitus Type 1…High levels?

• Plasma Glucose:
• Urine Volume:
• ADH levels:
• Insulin Levels:
• Severe Ketoacidosis:

Answer 11

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

Question 12

Central Diabetes Insipidus…High levels?

1. Plasma Glucose:
2. Urine Volume:
3. ADH levels:
4. Insulin Levels:
5. Severe Ketoacidosis:

Answer 12

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

Question 13

Diabetes Mellitus Type 2…High levels?

• Plasma Glucose:
• Urine Volume:
• ADH levels:
• Insulin Levels:
• Severe Ketoacidosis:

Answer 13

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

Question 14

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

Answer 14

• Inhibited by somatostatin
• Operates through a G-protein (G_s) coupled receptor using adenylyl cyclase
• Main goal is to increase plasma glucose concentrations
  
  • cuases glycogenolysis, gluconeogenesis, and lipolysis

Question 15

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

Answer 15

• 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

Question 16

• The adrenal [] comprises approximately 80% of the gland and releases hormones essential for life
• The adrenal medulla functions in a manner similar to [] [] neurons

Answer 16

• 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

Question 17

Adrenal Cortex:

• Zona Glomerulus - produces [] such as []
• Zona Fasciculata - produces [] such as []
• Zona Reticularis - produces [] such as [] and []

Answer 17

• Zona Glomerulus - produces mineralcorticoids such as aldosterone
• Zona Fasciculata - produces glucocorticoids such as cortisol
• Zona Reticularis - produces androgens such as DHEA and androstenedione

Question 18

Adrenal Medulla

• Makes catecholamines such as [] and []

Answer 18

Makes catecholamines such as epinephrine and norepinephrine

Question 19

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 [].

Answer 19

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.

Question 20

• 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.

Answer 20

• 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.

Question 21

• 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

Answer 21

• 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

Question 22

Cortisol

• Classifed as [] hormone, that is helpful during [] state
• it works to [] blood nutrient levels

Answer 22

• Classifed as catabolic hormone, that is helpful during fasting state
• it works to increase blood nutrient levels

Question 23

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 []

Answer 23

• 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

Question 24

• In the women, the [] [] is the primary source of androgens.
  
  • Ex: [] and []

Answer 24

• In the women, the adrenal gland is the primary source of androgens.
  
  • Ex: DHEA and andostenedione

Question 25

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

Answer 25

* 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

Question 26

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

Answer 26

* 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

Question 27

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 **[]**

Answer 27

* 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**

Question 28

* 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)

Answer 28

* 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)

Question 29

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

Answer 29

**G-protein**

Question 30

Epinephrine works to **[]** plasma glucose and **[]** plasma free fatty acids. It would then inhibit things like []

Answer 30

Epinephrine works to **increase** plasma glucose and **increase** plasma free fatty acids. It would then inhibit things like **insulin**