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Y1 - MEH > Metabolic And Endocrine Control During Special Circumstances > Flashcards

Metabolic And Endocrine Control During Special Circumstances Flashcards

1
Q

What are the 2 normal fuel sources that are available in the blood?

A

Glucose
Fatty acids

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2
Q

There is normally little free glucose available in the blood, how is glucose normally stored?

A

As Glycogen in the liver and muscles

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3
Q

How are fatty acids usually stored?

A

As Triacylglycerols in adipose tissue

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4
Q

What are the 3 fuel sources that are only available under special conditions?

A

Amino acids
Ketone bodies
Lactate

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5
Q

What are amino acids converted into in order to be utilised as a fuel source?

A

Glucose
Ketone bodies

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6
Q

Where were ketone bodies usually produced from?

A

Fatty acids

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7
Q

How is lactate produced in an individual?

A

Anaerobic respiration

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8
Q

What are the time frames for using glucose after feeding?

A

First 2 hrs glucose available from gut
Between 2-8 hrs glucose and fat being obtained from glycogen and Triacylglycerol stores
Between 8-10 hrs glycogen store’s depleted (Gluconeogenesis happens, more ketone bodies made, brain utilises ketone bodies for fuel)

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9
Q

What are the anabolic hormones?

A

Insulin
Growth hormone

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10
Q

What are the effects of insulin?

A

Promote fuel storage

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11
Q

What are the anabolic affects of growth hormone?

A

Stimulates protein synthesis
Stimulates Gluconeogenesis

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12
Q

What are the catabolic hormones?
(Promote release from stores and utilisation)

A

Glucagon
Adrenaline
Cortisol
Growth Hormone
Thyroid hormones

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13
Q

What are the catabolic affects if Growth hormone?

A

Increased lipolysis
Glycogenolysis

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14
Q

What does insulin inhibit?

A

Gluconeogenesis
Glycogenolysis
Lipolysis
Ketogenesis
Proteolysis

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15
Q

What does insulin stimulate?

A

Glucose uptake in muscle and adipose via GLUT4
Glycolysis
Glycogenesis
Protein synthesis

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16
Q

What effects does feeding cause?

A

Increased blood glucose stimulates insulin release causing:

-increased glucose uptake and utilisation by muscle and adipose via GLUT4
-promotes storage of glucose as glycogen in liver and muscle
-promotes amino acid uptake and protein synthesis in liver and muscle
-promotes lipogenesis and storage of FA as TAGs in adipose

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17
Q

What are the effects of fasting?

A

Blood glucose falls, insulin stops being released and glucagon is released stimulating:

-glycogenolysis
—lipolysis
-Gluconeogenesis

-

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18
Q

During starvation, what hormones are produced?

A

Cortisol
Glucagon

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19
Q

Which gland in the body produces Cortisol?
Which gland in the body produces Glucagon?

A

Adrenal cortex (Zona Fasiculata)
Pancreas (Alpha cells)

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20
Q

How does cortisol affect insulin?

A

It has an anti insulin affect

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21
Q

In energy starvation what is preferentially metabolised as fuel and why?

A

Fatty acids are preferentially metabolised
Anti insulin effect of cortisol and reduced insulin levels prevents cells taking up glucose

22
Q

In energy starvation, which processes happen in what order?

A

Gluconeogenesis (glycerol from TAGs used reducing need to breakdown muscle protein)

Ketogensis in liver, brain utilises this sparing glucose requirement from protein

Once fat stores depleted, proteolysis must occur to use glucogenic and ketogenic amino acids for fuel for Gluconeogenesis and ketogenesis

23
Q

When does the majority of Fetal growth take place?

A

3rd trimester (the last 1/3 of the pregnancy

24
Q

What are the 2 main phases of metabolic adaptation during pregnancy?

A

1.) Anabolic phase
2.) Catabolic phase

25
What occurs in the anabolic phase of pregnancy?
Increase in maternal fat sores Small increase in insulin sensitivity
26
What occurs in the catabolic stage of pregnancy?
Increased insulin resistance so decreased insulin sensitivity Increased maternal glucose and free fatty acids (Greater substrate available for Fetal growth
27
How do most substrates transfer across the placenta?
Simple diffusion Glucose via GLUT1
28
What is the fetoplacental unit?
A new endocrine entity consisting of: -placenta -Fetal adrenal glands -Fetal liver
29
How does the fetus control maternal metabolism?
Via the fetoplacental unit
30
In terms of the anabolic stage of pregnancy, what is the goal?
To increase the amount of nutrients stored in preparation for: -rapid growth of fetus -birth -lactation
31
What is the goal of the catabolic stage of pregnancy?
Keep concentration of nutrients in maternal circulation high
32
What happens in the catabolic stage of pregnancy to keep the conc of nutrients high?
Reduced maternal utilisation of glucose (uses fatty acids) Release of fatty acid stores from the anabolic stage of pregnancy Maternal insulin levels increase but fetoplacental anti insulin hormones increasae faster
33
What is the main anti insulin hormone produced by the fetoplacental unit?
Corticotropin Releasing Hormone (CRH) Leads to cortisol production
34
How is insulin secretion affected in pregnancy?
Increased synthesis and secretion B cell Hyperplasia B cell Hypertrophy
35
What can occur if B cells don’t produce more insulin in pregnancy to cope with the increased glucose intake?
Gestational Diabetes
36
What are the clinical implications of gestational diabetes?
Miscarriage Congenital malformation Macrosomia (big baby) Shoulder dystopia (increased fat on shoulders, get stuck at birth) Gestational hypertension and preeclampsia
37
What’s the risk factors for gestational diabetes?
Maternal age> 25 years BMI > 25kg/m^2 Face/ethnicity History of diabetes History of macrosomia
38
How do we manage gestational diabetes?
Diet (reduce calorie intake of obese patients) Insulin injection if persistence of hyperglycaemia Ultrasounds to access Fetal growth
39
In exercise, what does the rate of ATP re synthesis depend on?
The rate of ATP hydrolysis (so the intensity of exercise)
40
How do ATP stores get replenished?
From Creatine Phosphate Glycolysis Oxidative phosphorylation
41
How can muscle glycogen stores sustain intensive exercise for a couple of mins?
Glycogen broken down into glucose 6 phosphate and can enter glycolysis Pyruvate gets converted to lactate to regenerate the NAD+ needed for glycolysis
42
Which organ acts as a major buffer for blood glucose levels and how?
Liver Exercise causes increased hepatic glycogenolysis and Gluconeogenesis Liver recycles lactate
43
In what type of exercise can fatty acids be used as fuels?
Low intensity Aerobic conditions needed
44
Describe metabolism in short high intensity exercise like a 100m sprint
Anaerobic production of ATP Need muscle store of glycogen Creatin phosphate used
45
Describe metabolism in a middle distance 1500m run
Some O2 delivered to muscles but anaerobic metabolism still happens 1. Creatine phosphate and anaerobic glycogen metabolism 2. ATP produced aerobically from muscle glycogen and fatty acids 3. Anaerobic metabolism of glycogen makes lactate
46
Describe metabolism in long duration low intensity exercise
Mostly aerobic Muscle glycogen Liver glycogen Fatty acids
47
What is the hormonal response to long exercise?
Insulin slowly decreases Glucagon rises Adrenaline and GH rise rapidly Cortisol slowly rises
48
What is the affect of glucagon levels rising in prolonged exercise?
Inc glycogenolysis (glycogen phosphorylase activated) Inc Gluconeogenesis (PEPCK and Fructose 1,6-bisphosphatase activated) Inc lipolysis (Hormone sensitive Lipase activated)
49
What is the affect of the rapid rise in adrenaline and GH in prolonged exercise?
Adrenaline inc glycogenolysis and lipolysis GH inc lipolysis and Gluconeogenesis
50
What is the affect of cortisol rising in prolonged exercise?
Inc lipolysis and Gluconeogenesis
51
What are the benefits of exercise?
Body comp changes (less adipose more muscle) Improved glucose tolerance Tissues sensitivity to insulin increases Blood Triglycerides decrease BP falls Psychological effects of wellbeing

Y1 - MEH (33 decks)

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