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Physio #2 > Endocrinology of growth and diabetes > Flashcards

Endocrinology of growth and diabetes Flashcards

1
Q

What is the principle factor controlling potential for growth?

A

Genetics (non-endocrine factor)

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2
Q

What are the Endocrine factors for regulation for growth?

A

The hormones of the growth axis (GHRH—> GH —-> IGF-1) control growth by their actions in somatic tissue and the liver.

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3
Q

________ is necessary for fetal growth.

A

IGF-1

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4
Q

_______ becomes important later in development after IGF-1.

A

GH

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5
Q

_________ is required for synthesis of GH and manifestation of GH effects.

A

thyroid hormone

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6
Q

________ inhibit GHRH secretions.

A

Glucocorticoids

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7
Q

T or F, glucose regulating hormones also control growth.

A

True

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8
Q

_______ has actions that opposes GH and IGF-1.

A

Insulin

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9
Q

Which gonadal steroids have a role in growth?

A

Testosterone and E2

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10
Q

How do long bones grow?

A

They grow as epiphyseal plate cartilage is replaced by bone. This adds bone to both ends go the diaphysis

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11
Q

When do the epiphyseal plates ossify? How?

A

At puberty, due to the actions of E2

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12
Q

What two hormones regulate Growth hormone (GH) secretion?

A

Somatostatin (SS)

GHRH

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13
Q

T or F, GH has direct and indirect effects on growth.

A

True

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14
Q

GH is a _______. (method of action)

A

Mitogen = will stimulate cell division .

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15
Q

GH acts in opposition to _______.

A

Insulin

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16
Q

GH also acts in somatic tissue (muscle and bone) to do what?

A

stimulate protein synthesis

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17
Q

What is the principal effect of GH on growth?

A

To stimulate the secretion go insulin-like growth factor 1 (IGF-1) from the liver and other tissues.

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18
Q

______ and _____ inhibit GH and GHRH secretion.

A

IGF-1 and GH

*They also stimulate SS secretion!

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19
Q

_________ is elevated during sleep.

A

GHRH

20
Q

______ is elevated during the day.

A

SS

21
Q

_____ stimulates the maturation of chondroblasts in cartilage.

A

GH

22
Q

________ stimulates cell division.

A

IGF-1

23
Q

What do deficits in IGF-1 and GH lead to?

A

Reduced growth

24
Q

T or F, there are many known deficits in IGF-1 synthesis.

A

False, there are no known deficits (Malnutrition impairs IGF-1 synthesis independent of GH)

25
Q

GH is high during _____ and low during _______.

A

High during adolescence and low during adulthood.

26
Q

_______ regulates GH synthesis.

A

Thyroid hormone

27
Q

_________ has anti-growth effects.

A

Cortisol/glucocorticoids

28
Q

What causes Gigantism?

A

Prepubertal onset of excess GH

29
Q

What causes Acromegaly?

A

Post-pubertal onset of excess GH

30
Q

What are the symptoms of Excess of GH?

A
  • diabetic-like condition
  • Macroglossia
  • increased teeth spacing
  • enlarged salivary glands
  • excess cementum
31
Q

What does GH insufficiency cause?

A

Abnormally reduced growth (common, but treated prepubertally with exogenous GH)

32
Q

GH insensitivity or Dwarfism, is due to _______.

A

Absence of a functional GH receptor (no diabetes or cancer, but often obese) * treated with exogenous IGF-1

33
Q

What is Achodontroplasia?

A

reduced growth due to constitutive activation of the fibroblast growth factor receptor (FGF).

34
Q

What does the FGF receptor do?

A

Normally inhibits or regulates bone growth, and continued activation of its receptor results in abnormally impaired development of cartilage.

35
Q

What dental effects will patients with GH insufficiency have?

A
  • delayed tooth shedding and replacement

- decreased salivary function leading to more caries and periodontal disease.

36
Q

Diabetes is caused by what?

A

A disruption in the normal function of insulin.

37
Q

What does insulin do?

A

It is a peptide hormone produced in the pancreases that normally regulates glucose transport into cells, particularly muscle, fat and liver. Insulin is an anabolic hormone that acts to store nutrients.

38
Q

What are the consequences of loss of insulin function?

A

Can be fatal when it leads to ketoacidosis.

39
Q

Insulin is released in response to _______..

A

an increase in blood glucose or amino acids, and signals form the parasympathetic nervous system.

40
Q

Insulin secretion is inhibited by ______.

A

SNS

41
Q

What is the difference between Type 1 and 2 diabetes?

A

Type 1 = autoimmune disorder in which pancreatic beta cells are destroyed -> reduced insulin production.

Type 2 = combination of insulin resistance and insulin deficiency. The onset is usually later in life and can be managed with dietary and lifestyle monitoring.

42
Q

Common symptoms of diabetes relate to _______.

A

Increases in circulating glucose.

  • Polyuria
  • fatigue
  • blurred vison
43
Q

Symptoms Chronic hyperglycemia are primarily due to ________.

A

increased plasma glucose.

  • kidney failure
  • vascular disease
  • blindess
  • skin and mucosal infections
  • periodontal disease
44
Q

What are the considerations for dental patients with diabetes?

A
  • Dehydration can reduce salivary flow.
  • Vascular disease affects teeth
  • Increased risk of periodontal disease with a diminished immune response.
45
Q

For Type 1 diabetics, you could…..

A

give snacks or insulin during prolonged procedures if necessary

46
Q

For Type 2 diabetics you could….

A

Emphasize the importance of maintain glycemic controls.

47
Q

Type 2 diabetics also frequently have ______ and ______.

A

Cardiovascular and renal disease.

Physio #2 (10 decks)

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