Week 2 Flashcards by Ginelle Zimmerman

What is the primary glucocorticoid?

cortisol

-negative feedback control of hypothalamic (CRF) and anterior pituitary (POMC/ACTH) release

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What enzyme is responsible for converting progesterone to glucocorticoids?

21 hydroxylase

defective = lack of glucocorticoids and mineralocorticoids and excess of androgens
hypotension

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What enzyme converts deoxycorticosteroids to glucocorticoids and mineralocorticoids?

11B-hydroxylase

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What are the 3 zones of the adrenal glands from outside to inside?

Zona glomerulosa (mineralocorticoids/aldosterone)
Zona fasciculata (glucocorticoids/ cortisol)
Zona reticularis (androgens)

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What cells are found in the adrenal medulla and secrete epinephrine or norepinephrine?

chromaffin cells

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What amino acid are norepinephrine and epinephrine made from?

tyrosine

tyrosine to dopa to dopamine

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What cell is dominant in pheochromocytomas?

chromaffin cells of the adrenal medulla

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What adrenal zones are activated by ACTH?

all three layers of adrenal cortex (release aldosterone, cortisol, glucocorticoids, and androgens)

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Which of the 3 sets of adrenal capillaries empties into the veins of a capsule without picking up hormone?

capsular plexus

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Which of the 3 sets of adrenal capillaries drains into veins of medulla?

cortical sinusoidal (fenestrated)

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Which of the 3 sets of adrenal capillaries empties into medullary venules?

medullary capillaries (fenestrated)

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Which part of the pancreas has more islets?

tail

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What are the products of pancreatic alpha, beta, and delta cells?

alpha- glucagon
beta- insulin
delta- somatostatin

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What is the rate limiting step in adrenal steroid synthesis?

ACTH binding and promoting side chain cleavage enzyme (CYP11A=P450scc) synthesis
-required to convert cholesterol to pregnenolone

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What enzyme converts inactive steroids to active?

11 beta hydroxylase type 1

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What is the effect of high versus normal ACTH?

-normal = ACTH is tonic 
high = ACTH is stimulatory

What type of receptor is the insulin receptor?

tyrosine kinase

What substance is made with insulin by beta-cells in pancreas and down-regulates alpha cells (glucagon)?

amylin

-also induces satiety

What is made by distal small bowel and colon in response to glucose presence?

GLP-1 (receptors in beta pancreatic cells and brain)

What is made by intestinal K cells in response to glucose presence?

GIP (receptors in beta pancreatic cells and brain)

Which GLUT is the glucose sensor for pancreatic beta cells?

GLUT 2

-also present in hepatocytes and found on basolateral epithelia of kidneys and intestines

What does FOXO1 do?

transcription factor for expression of key gluconeogenesis genes
-inactivated by PKB (Akt)

What effect does glucagon signaling have on the liver?

reduces fructose 2,6-bisphosphate (inhibiting glycolysis and promoting gluconeogenesis)

What does aromatase do?

converts testosterone to estradiol; active in adipocytes

What is the main side effect of insulin?

hypoglycemia

What drugs decrease hepatic glucose production by inhibiting gluconeogenesis?

Biguanides (metformin)

What drugs increase uptake of skeletal muscle insulin and increase cell responsiveness?

PPAR agnists (thiazolidinedione)

What drugs promote insulin secretion by closing K+ channels?

Sulfonylureas (Glimepiride) and Meglitinides (Repaglinide, Nateglinide)

What drugs promote insulin secretion by activating adenlyate cyclase?

GLP analogs and Dipeptidase IV inhibitors (which increase GLP)

Which diabetes drugs may cause weight gain? loss?

Gain: insulin, pioglitazone, sulfonylureas Loss: Liraglutide/Exenatide

Which 3 diabetes drugs are more expensive?

Pioglitazone ($7.20/ day) Liraglutide/ Exenatide ($9/day) Gliptins ($6.20/day) (insulin is also expensive)

Which 2 types of diabetic drugs (other than insulin) are injected?

- GLP-1 analogs (Exenatide, Uraglutide) | - amylin analog (Pramlintide)

What are the role of incretins?

increase insulin production, speeds insulin release, decreases glucagon production, slows gastric emptying, promotes satiety

Where are paraganglia and what do they secrete?

in adrenal medulla; secrete epinephrine | -aortic chromaffin bodies

What do PP (F) cells of the pancreas secrete?

pancreatic polypeptide (relaxes gall bladder and inhibits enzyme secretions from exocrine pancreas)

What is the ranges for prediabetes and diabetes with plasma glucose and HbA1C?

- prediabetes: A1c 5.7-6.4% and 100-125 gm/dL | - diabetes: A1c >6.5% usually means diabetes