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Human physiology > Endocrine system 4 > Flashcards

Endocrine system 4 Flashcards

1
Q

What is whole body metabolism?

A

Co-ordinated regulation of etabolic pathways in different organs to maintain adequate energy supply to all cells

1 - Storage of nutrients/break down of stores when required

2 - Maintenance of blood glucose = primary energy source of the brain

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2
Q

What is anabolism?

A

The use of chemical energy to build up macromolecules from precursors

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3
Q

What is catabolism?

A

The breakdown of macromolecules to generate chemical energy

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4
Q

What can whole body metabolism be divided into?

A
  • Fed (or absorptive) state → Anabolic
  • Fasted (or post-absorptive) state → Catabolic
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5
Q

Summarise the bimolecule processing (how it is used) of carbohydrates:

A

Carbohydrates –> glucose

Glucose —> glycoen (via glycogenesis)
Glycogen —> glucose (via glycogenolysis)
(In the liver, Skeletal muscle)

Total energy store = 1%

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6
Q

Summarise the bimolecule processing (how it is used) of lipids:

A

Lipids –> free fatty acids glycerol

Free fatty acids glycerol —> triglycerides (via lipogenesis)
Trigylcerides —> free fatty acids glycerol (via lipolysis)
(Adipose)

Total energy store = 77%

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7
Q

Summarise the bimolecule processing (how it is used) of proteins:

A

Proteins –> amino acids

Amino acids —> proteins (via protein synthesis)
Proteins —> amino acids (via protein breadown)
(Skeletal muscle)

Total energy store = 22%

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8
Q

Describe the energy balance formula:

A

Energy input = energy output

Energy input = work performed + heat produced

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9
Q

What can each of the part sof this formula be broken down into:

Energy input = work performed + heat produced

A

Energy input = food intake & energy from nutrients

Work performed = ~40% - mechanical, chemical, transport

Heat produced = ~60% - maintain body temp

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10
Q

What is positive energy balance?

A

Energy input > energy output
- Energy in excess of output gets stored

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11
Q

What is negative energy balance?

A

Energy input < energy output
- Net breakdown of macromolecules to provide energy

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12
Q

What is energy metabolism during fed (absorptive) state like?

A
  • 3-4 hours following meal, nutrients in the bloodstream are plentiful
  • Energy input > energy output
  • Hormonal control: insulin = anabolic
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13
Q

What is metabolism during fasted (post-absorptive) state like?

A
  • Between meals, energy stores must be mobilised = catabolic
  • Energy input < energy output
  • Hormonal control: glucagon & other counter-regulatory hormones to insulin
  • Maintain energy source for brain and other neuronal tissue
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14
Q

Regulation of insulin release:

A

The picture needs to be inserted here

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15
Q

What can happen to glucose in the liver?

A
  • Glycogen synthesis (inc glucose levels)
  • Glycogen breakdown (dec glucose levels)
  • Gluconeogenesis (dec glucose levels)
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16
Q

What can happen to glucose in the muscle?

A
  • Glucose uptake - via GLUT-4 (inc glucose)
  • Protein synthesis (inc glucose)
  • Protein breakdown (dec glucose)
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17
Q

What can happen to glucose in adipose tissue?

A
  • Glucose uptake - via GLUT-4 (inc glucose)
  • Lipogenesis (inc glucose)
  • Lipolysis (dec glucose)
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18
Q

What is the main action of insulin?

A

Red blood glucose

Mediated by insulin receptors (tyrosine kinase receptor family)

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19
Q

Effect of insulin on glucose uptake (SkM, adipose)

A

Inser image here pls c

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20
Q

What is the release of glucagon stimulated by?

A
  • Stimulated by low blood glucose (<3.5mmol/L or mM) para- and sympathetic NSs
  • Inhibited by high blood glucose
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21
Q

What are the actions of glucagon?

A

Raise blood glucose

  • Stimulate hepatic glycogenolysis
  • Stimulate hepatic gluconeogenesis
  • Simulate lipolysis
22
Q

Describe the actions of how blood glucose is lowered when too high:

A
  • alpha-cell produces less glucagon
  • beta-cell produces more insulin

Dec blood glucose = back to normal

23
Q

Describe the actions of how blood glucose in increased when too low:

A
  • alpha cell produces more glucagon
  • beta-cell produces less insulin

Inc blood glucose = back to normal

24
Q

What is the normal range of blood glucose?

A

4-8mmol/L

25
Q

What happens when blood glucose in raised?

A
  • Glucose production dec
  • Glucose utilisation inc (glucose uptake & use)
  • Insulin lowers blood glucose
26
Q

What happens when blood glucose is too low?

A
  • Glucose utilisation dec
  • Glucagon, adrenaline, growth hormone & cortisol produce glucose vie glycogenolysis & gluconeogenesis
  • Counter-regulatory hormomes to insulin raise blood glucose
27
Q

Why is insulin & glucagon working together important?

A

Insulin & glucagon work as a team = most important regulators of normal fuel metabolism

28
Q

What is overall involved in glucose homeostasis?

A

Glucose production: GLUCAGON, adrenaline, growth hormone & cortisol via;
- Glycogenolysis
- Gluconeogenesis

Glucose utilisation: INSULIN via;
- Glucose uptake & use

29
Q

When does hypoglycaemia occur?

A

< 4mmol/L of glucose

30
Q

What are the symptoms of hypoglycaemia?

A

Palpitation, tremors, sweating, anxiety
- Counter-regulatory activity of SNS

Loss of concentration, slurred speech, seizures, loss of conciousness, coma
- Glucose deficiency in brain

31
Q

When does hyperglycaemia occur?

A

> 7 mmol/L fasted
11mmol/L

32
Q

What are the symptoms of hyperglycaemia (include acute & chronic)?

A

Increased volume/frequencey of urination, thirst, dehydration

  • ACUTE (>40 mmol/L): confusion, high temperature, seizure, come
  • CHRONIC: Long-term complications, such as CVD (MI, stroke), nephropathy, retinopathy, neuropathy
33
Q

What does inappropriate glucose homeostasis lead to?

A

Diabetes mellitus (chronic hyperglycaemia)

This is the most common endocrine disorder

34
Q

What is diabetes mellitus?

A

Chronic metabolic disorder charaterised by hyperglycaemia, cased by:

  • Insulin deficiency (Type 1) 5-15%
  • Impaired beta-cell function and/or loss of insulin sensitivity (insulin resistance) (Type 2) 85-95%
35
Q

What are the 2 types of diabetes mellitus?

A
  • Insulin deficiency (Type 1) 5-15%
  • Impaired beta-cell function and/or loss of insulin sensitivity (insulin resistance) (Type 2) 85-95%
36
Q

What are the clinical features of Diabetes mellitus?

A
  • Direct concequences of high blood glucose levels
  • Metabolic concequences of imapired glucose utilisation
  • Long-term complications of diabetes
37
Q

What are the direct concequences of high blood glucose levels in diabetes?

A
  • Glucosuria (glycosuria), polyuria (due to osmoticc diuresis), polydipsia (thirst)
  • Visual disturbance (altered refracted index of lens)
  • Inc urinogenital infections
38
Q

What are the metabolic concequences of impaired glucose utilisation in diabetes?

A
  • Lethargy, weakness
  • Weight loss (T1DM)
  • Ketoacidosis (increased fat metabolism, T1DM)
39
Q

What are the long term complications of diabetes?

A
  • Microvascular: nephropathy, neuropathy, retinopathy
  • Macrovascular: ischaemic heart disease, stroke, peripheral vascular disease
40
Q

What is type 1 diabetes caused by?

A

Autoimmune - autoantibodies

  • Progressvie destruction of islet of beta-cells
41
Q

When is the onset of diabetes?

A

Usually <40 years

Rapid onset = pathophysiological changes occur much earlier

Suceptibility genes & environemental triggers = virus & toxins

42
Q

What is the treatment for type 1 diabetes?

A

Treatment w insulin

Regular exercise & healthy diet

43
Q

What is the cause of type 2 diabetes?

A
  • Relative insulin deficiency (impaired beta-cell function) and/or insulin resistance complex
  • Impaired insulin signalling pathways
  • Nutrient oversupply, cellular stress & inflammation
44
Q

When is the onset of type 2 diabetes?

A

Onset ususally >40 (>25 years black, S. asian)

Graudal onset –> suceptibility genes & environmental triggers, reduce physical activity, in calorie consumption

45
Q

What is the treatment for type 2 diabetes?

A
  • Diet 10-20%
  • Drugs 20-90% –> ~20% insulin
46
Q

What are other possible causes of diabetes?

A
  • Gestational
  • Loss of pancreatic function/surgery
  • Excess of some hormones?
47
Q

What are the healthy diet & lifestyle changes needed for diabetes?

A
  • Healthy diet, regular meals
  • Lifestyle
  • Exercise (improve insulin sensitivity, weight loss)
  • Smoking cessation (dec CV risk)
48
Q

What are the 2 main drug treatments for diabetes?

A
  • T2DM
  • T1DM (type 2)
49
Q

What do T2DM drugs do to treat diabetes?

A

Improve insulin action
- Metformin, pioglitazone(PPARy agonist)

Promote insulin release
- Sulphonylureas/post-prandial glucose regulators and incretin-based therapies

SGLT-2 inhibitors - decrease renal reabsorption of glucose

50
Q

What do T1DM drugs do to treat diabetes?

A

(Inadequate control wiht drugs, pregnancy)

Insulin - exogenous; subcutaneous injection (infusion for emergency/fine control)

Human physiology (43 decks)

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