EX 2; Growth and Diabetes

Question 1

This is the principle factor that regulates growth

Answer 1

genetics

Question 2

This is a critical factors in regulating growth

Answer 2

nutrition; begins in utero

Question 3

This is an often forgetting factor of growth

Answer 3

freedom from disease

Question 4

What are four important growth regulating endocrine factors

Answer 4

hormones of the growth axis
thyroid hormones
glucose-regulating hormones
gonadal steroids

Question 5

What are some hormones of the growth axis

Answer 5

IgF1 and IgF2; insulin-like growth factor
GHRH
GH

Question 6

chronic elevation of this rill inhibit growth (GHRH/GH)

Answer 6

cortisol

Question 7

What are the two basic requirements of growth

Answer 7

cell division/replication

protein synthesis

Question 8

The final height is determined by what

Answer 8

growth of the long bones

Question 9

Long bones grow as this is replaced by bone

Answer 9

epiphyseal plate cartilage

Question 10

Cartilage replacement adds bone to where

Answer 10

the ends of both diaphysis

Question 11

GH increases what on the chondrocytes, stimulating replication

Answer 11

IgF1 receptors

Question 12

Epiphyseal plates ossify when?

Answer 12

at puberty

which is why males are generally taller because puberty is later/longer

Question 13

What are two hypothalamic hormones that regular GH secretion

Answer 13

GHRH

somatostatin

Question 14

Pituitary GH has these three effects

Answer 14

mitogenic peptide hormone
has some direct effects on somatic tissues
stimulates secretion of IGF1 from liver and other tissues

Question 15

What are two direct effects on somatic tissues of pituitary GH

Answer 15

stimulates protein synthesis

anti-insulin effects

Question 16

Feedback regulation of GH secretion by long and short loop negative feedbacks have what three effects

Answer 16

inhibition of GHRH and GH secretion
stimulation of SS secretion
both GHRH and SS exhibit contrasting diurnal patters of secretion (GHRH increases during early sleep)

Question 17

GH induces precursor cells in bone and other tissues to differentiate and do what

Answer 17

secrete IGF-1 which stimulates cell division

Question 18

The anti-insulin effects by GH have what three consequences

Answer 18

renders adipocytes more responsive to stimuli that induce the breakdown of triglycerides, releasing FA into blood
stimulates gluconeogenesis
reduces ability of insulin to stimulate glucose uptake

Question 19

Somatic growth is the result of the interactions between what

Answer 19

GH and IGF-1

Example; GH stimulates maturation of chondroblasts and IGF-1 stimulates cell division

Question 20

Deficits in either GH or IGF-1 cause what

Answer 20

reduced growth

Question 21

What can be two defects in GH of IGF-1

Answer 21

genetic mutations

defects caused by malnutrition

Question 22

Why are there no genetic mutations for IGF-1/receptor

Answer 22

The fetus needs it to grow, if there is a mutation, the fetus will die

Question 23

GH production is affected by what

Answer 23

age

Question 24

When is GH production the highest/lowest

Answer 24

highest = adolescence
lowest = adult
effects of GH decrease on somatic tissues

Question 25

GH synthesis and activity is regulated by what

Answer 25

other hormones like sex steroids, thyroid hormones

Question 26

What four effects do the sex steroids have on GH synthesis and activity

Answer 26

stimulate GH synthesis stimulate IGF-1 synthesis skeletal growth; stimulates prepubertal bone growth causes fusion of epiphyseal plates inhibiting growth

Question 27

What two effects do thyroid hormones have on GH synthesis and activity

Answer 27

regulates GH synthesis | required for GH effects

Question 28

These have anti-growth effects

Answer 28

cortisol/glucocorticoids

Question 29

Excess production of GH results in what

Answer 29

acromegaly and gigantism

Question 30

What typical causes excess GH

Answer 30

pituitary tumor

Question 31

Gigantism results from what

Answer 31

pre-pubertal onset of excess GH

Question 32

Acromegaly results from what

Answer 32

post-pubertal onset of excess GH

Question 33

What are two considerations from patients with excess GH

Answer 33

remove tumor or give SS

Question 34

Which is more common, GH excess or GH deficiency

Answer 34

deficiency; relatively common

Question 35

What causes dwarfism

Answer 35

lack of GH receptor which leads to no IGF synthesis

Question 36

This is when fibroblast growth factor receptor constitutively active which results in abnormal cartilage development

Answer 36

achondroplasia

Question 37

What are some considerations for patients with GH deficiency

Answer 37

macroglossia, enlarged salivary glands, excess cementum, delayed shedding and replacement, etc.

Question 38

What becomes of athletes that take GH

Answer 38

they don't get taller, the build muscle (including heart muscle)

Question 39

What are some symptoms of GH abuse

Answer 39

they resemble acromegaly | also consider the anti-insulin actions of GH; bones thicken, cardiovascular problems, diabetic symptoms, etc.

Question 40

This involves a disruption in the normal function of insulin

Answer 40

diabetes

Question 41

This is a peptide hormone produced in the pancreas

Answer 41

insulin

Question 42

What does insulin normally regulate

Answer 42

glucose transport into the cells

Question 43

What kind of hormone does insulin act as

Answer 43

an anabolic hormone, stimulating mitosis, cell growth, etc.

Question 44

Loss of insulin function can lead to what

Answer 44

ketoacidosis and can be fatal

Question 45

This type of diabetes is an autoimmune disorder with onset early in life, destroys pancreatic β cells. (5-8% diabetics)

Answer 45

Type 1

Question 46

This type of diabetes is a combination of insulin resistance and insulin deficiency, onset later in life

Answer 46

type II

Question 47

How can you manage diabetes type I and II

Answer 47

type I; insulin supplementation | type II; dietary and lifestyle controls

Question 48

What is the treatment for type II

Answer 48

can also include insulin sensitizers and insulin supplemental enhance the insulin receptor and cells

Question 49

What are four symptoms of diabetes, linked to the increase of circulating glucose

Answer 49

elevated fasting glucose levels polyuria fatigue blurred vision

Question 50

What are five common complications of diabetes, linked to the chronic hyperglycemia

Answer 50

``` kidney failure vascular disease blindless skin/mucosal infections periodontal diseases ```

Question 51

what are three considerations to keep in mind with a dental patient with diabetes

Answer 51

vascular diseases affect teeth dehydration can reduce salivary flow increased risk of periodontal disease

Question 52

What should the dental provider be aware of with type I

Answer 52

be familiar with history | increased risk of periodontal disease

Question 53

What should the dental provider be aware of with type II

Answer 53

emphasize the importance of maintaining glycemic control | frequently have cardiovascular and renal disease