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Endo Repro 1 > Intermediary Metabolism > Flashcards

Intermediary Metabolism Flashcards

1
Q

CNS needs a constant supply of

must maintain constant ___ for use by brain, which is ___ independent

major homeostatic variable is control of

if BG falls below ___, brain fxn is compromised

if BG remains above ___, leads to morbidity/shortened LE

A

glucose

BG, insulin

BG

50

110

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2
Q

Carbs provide ___ kcal
stored as ___ in liver/muscle
___ days need

Fat kcal
stored as ___ in adipose
___ abundant energy store
___ efficient energy reserve

Protein kcal
Stored in
major source of __ when fasting

A

4kcal
glycogen
1

9
TG
most, most

4
muscle
BG

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3
Q

Gluco only occurs in

forms glucose from

in most tissues, neither ___ can be converted to glucose

A

liver/kidney

AA, lactate, glycerol (not FA)

prot/fat

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4
Q

Absorptive rxn occur after__, glucose is ___, used for ____

TG broken down into glycerol/FA by

Fat storage depends on

A

meal, plenty, fuel storage

lipoprotein lipase (cap endo)

activity of LPL, glucose uptake

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5
Q

Post absorptive rxn occur bw ____, tissues switch to ___ met, used for ___

Breakdown of TG to FA by

Insulin synth/sec by

___/___ sec in equal amounts

little ___ degraded by liver, indicating B ells

A

meals, FA/ketone, fuel utilization

hormone sensitive lipase

B cells of panc islets

insulin/c peptide

C peptide, secretory capacity

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6
Q

Insulin release in __ phase
1 is
2 is

brings about rxn of

Insulin receptor- IC portion has ___ activity, similar to ___ receptor

A

2
stored insulin
newly formed

absorptive phase

tyrosine kinase
IGF

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7
Q

Insulin involved in

Translocates ____ from IC to PM

activates/inhibits enzymes mediating ____ metabolism

Alters gene expression for

indirectly inc ____ in liver

liver/B cells us

activates ____ enzyme

main target

A

numerous cell responses

GLUT4

carb/lipid/prot

cell growth

glucose uptake

insulin insensitive GLUT2

glucokinase enzyme

muscle/adipose

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8
Q

Insulin effects

___ glucose uptake in muscle/adipose via

does not afect

___ glycolysis, glycogen synth (synthease)

___ glycogen breakdown (inhibits phosphorylase), gluco, ketogenesis

___ TG synth (activates LPL)
___ TG breakdown (inhibits HSL)

Inc ____, ____
Dec

Net result- ___ plasma glucose/FA/AA
____ glycogen/TG storage/protein synth

A

inc, GLUT4

CNS, kidney medulla, RBC, exercising muscle, SI

inc

dec

inc
Dec

aa uptake, prot synth
protein breakdown

dec
inc

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9
Q

____ is primary regulator of insulin sec

Stim signals
___ plasma glucose/aa/FA/ketones
____ PNS activity (Ach)
___ gut hormones (incretins, GLP1)

Pharm agents

Inhib signals
___ symp activity (NE/Epi)
___ somatostatin (used to treat insulinomas)

A

inc plasma glucose

inc
inc
inc

SFU, DPP4 inhib, GLP1 analog

inc
Inc

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10
Q

Absence of insulin

mimics events of ___
mobilizes ____

inc
dec
stimulates

long term fasting- once BG falls below a certain level, the CNS begins to

only after ___ days are plasma ketone levels high enough to provide brains energy needs

A

fasting
fuels

BG, FFA, ketones
glyogen, fat
post aborptive rxn

metabolize ketones

4-5

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11
Q

T1DM is insulin ___
no
AI Destrxn of

T2DM has defective

sx

in Type 2, insulin is

A

dependent, insulin synth, b cells

insulin receptors

inc BG, dec glucose tolerance

inc, tissues insensitive

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12
Q

NIDDM caused by

Leads to adipose tissue ____ releasing adipocytokines ___

these block insulins actions, releasing ______ from macros to inc

dec number of ___ due to inc apoptosis

mito become

may lead to ___ due to exhausted B cells

Reversible w

A

overeating/obesity

macro infiltration, TNFA/IL6

resistin, insulin resistance

B cells

dysfxn

T1DM

diet/exercise

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13
Q

Hormones opposing insulin

____ synth by panc ____-

___ from AM

___ from AP

___ from AC

A

glucagon, alpha cells

Epi

GH

Cortisol

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14
Q

hormones opposing insulin leads to

inc ____, via ___ in liver, __ in muscle

Inc ___ by all 4 hormones

Inc ___ via all 4 &

cortisol is __ for both

dec __ into cells via

net result inc

A

glycogenolysis, glucagon, epi

gluco

lipolysis, HSL

permissive

glucose uptake, Epi/GH/cortisol

plasma Glucose/FA

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15
Q

Stimulatory control of glucagon

___ BG (most important), ie

___ symp activity, ie

____ plasma AA

____ gut hormones

____ PNS activity via

Inhib by ____ at pharm doses

A

dec, fasting hypogly

inc, stress/exercise/dec BP

inc

inc

inc, Ach, VIP

somatostatin

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16
Q

Epi sec inc by dec, inc

GH sec inc by dec, inc

cortisol sec inc by

A

plasma glucose, symp output

plasma glucose, symp output/plasma AA

stress, symp activity

17
Q

Food intake and energy expenditure are _____ regulated day to day and

obesity results when energy in >

BMI =

normal BMI
overweight BMI
obesity BMI>

A

highly, LT

energy out

weight kg/ht (m2)

20-25
25-30
30

18
Q

Short term control of appetite

learned via

___ avail

Gut __ signals sent via __ to brainstem

Gut \_\_\_ signals for satiety
CCK via
P
O
G
P, such as PP/A
A

behav, social cues, enviro, emotion

Nutrient

neural, vagus

hormonal
vagus
Peptide YY
Oxyntomodulin (OXM)
GLP1
Panc iselt satiety signals, Panc polypep, amylin
19
Q

LT control of appetite

Satiety signal
____ signals adiposity, dec appetite

___ sec by adipose tissue
plasma levels + correlate w
acts via __ receptors

A

insulin

Leptin
% body fat
Ob-Rb

20
Q

Hunger signals

____ released by stomach/GI

stimulates __ release

use ___ receptor

plasma levels inc ___ and when

negatively correlates w

A

Ghrelin

GH

GHS1a

pre-prandially/during fasting

% bf/weight

21
Q

Hypothalamic arcuate (infun) nucleus has orexigenic ___ neurons

anorexigenic ___ neurons

POMC acts via ____, acting on ___ receptors to inhibit food intake

____ is MC4 recep antag

Leptin activates
inhibits
dec ___ and inc

Ghrelin activates
inhibits
dec and inc

A

NPY/AgRP

POMC/CART

AMSH, MC4

AgRP

POMC/cart
NPY/AgRP
food intake, energy expend

NPY,AgRP
POMC/CART
energy expend, food intake

22
Q

Other areas of brain express ____ receptors

MCH in ___ is the hunger center

inc

inhibits ___ actions

MCH knockouts are

A

Ob-Rb, GHS1a

lateral hypo

food intake, obesity

MC4 receptor

lean

23
Q

Leptin defic leads to early onset
Hyper
Hypo
Defects in T cell

Leptin receptor mutant early onset

MC4R mutant dec ___ signaling

POMC def
dec ___, presents w

A

onset obesity
Insulin
gonad/thyroid
#/fxn

obesity

MSH

MSH/ACTH, hypocortisol

24
Q 
Conseq of obesity
Inc morbidity due to
D
A/C
S
O
Reduces \_\_ responsiveness
H
inc risk for \_\_\_ cancer in men
\_\_ in women
M
A 
Diabetes
Athero/CAD
stroke
osteoporosis
GH
hypogonad
prostate/colon
breast/endometrial/biliary
Metabolic syndrome
25
Q

Tx obesity w

difficult due to

exercise seems to lower the ___ to regulate ____

A

diet, exercise, drugs, bariatric surgery

hypothalmaic set point

set point, total body fat stores

Endo Repro 1 (24 decks)

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