Growth and Diabetes

Question 1

T/F: The endocrine system is the principle factor controlling growth.

Answer 1

FALSE

Genetics

Question 2

What determines final height?

Answer 2

Rate of bone growth

Question 3

Various factors effecting growth include…

Answer 3

1. Genetics
2. Nutrition
3. Freedom from disease
4. Endocrine

Question 4

What are the hormones in the growth axis?

Answer 4

GHRH -> GH -> IGF-1

Question 5

____ is necessary for fetal growth, while ____ becomes important later in development.

Answer 5

IGF-1; GH

Question 6

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

Answer 6

Thyroid hormone

Question 7

Which glucose-regulating hormones help control growth?

Answer 7

1. Glucocorticoids: inhibit GHRH

2. Insulin: oppose GH and IGF-1

Question 8

T/F: Gonadal steroids (T and E2) have a role in growth.

Answer 8

True

Question 9

At puberty, the epiphyseal plates ossify due to actions of which hormone?

Answer 9

E2

Question 10

To promote GH secretion the hypothalamus will _______ GHRH secretion and ________ SS secretion.

Answer 10

increase; decrease

Question 11

What are the effects of GH?

Answer 11

1. Stimulates cell division
2. Stimulates protein synthesis
3. Acts in opposition to insulin

Question 12

What is the principle indirect effect of GH on growth?

Answer 12

Stimulate secretion of IGF-1 from the liver and other tissues

Question 13

What is the short-loop feedback effect on GH?

Answer 13

IGF-1 inhibits GH secretion

Question 14

What is the long-loop feedback effect on GH?

Answer 14

IGF-1 inhibits GHRH and stimulates SS

Question 15

_____ is elevated during sleep, while _____ is elevated during the day.

Answer 15

GHRH; SS

Question 16

How can malnutrition impede growth?

Answer 16

Impairs IGF-1 synthesis independent of GH

Question 17

What is the result of sex steroids on GH and IGF-1?

Answer 17

Sex steroids stimulate GH and IGF-1, but ultimately cause the fusion of epiphyseal plates

Question 18

What effects do cortisol/glucocorticoids have on growth?

Answer 18

Inhibit growth

Question 19

What is the key determinant of the effects of GH?

Answer 19

AGE

Effective early on; negligent or maybe detrimental later in life

Question 20

______ results from prepubertal onset of excess GH; _______ results from postpubertal onset of excess GH.

Answer 20

Gigantism; Acromegaly

Question 21

What dental effects can excess GH have?

Answer 21

Macroglossia, increased spacing and tilting, enlarged salivary glands, excess cementum

Question 22

How can you treat someone with GH insensitivity/Dwarfism?

Answer 22

Exogenous IGF-1

Question 23

What are some considerations for dental patients with GH insufficiency?

Answer 23

Delayed tooth shedding and replacement, decreased salivary function leading to more caries and perio problems

Question 24

T/F: Insulin is an anabolic hormone that acts to store nutrients.

Answer 24

True

Question 25

What causes insulin to be released in normal patients?

Answer 25

Increase in blood glucose and signals from parasympathetics

Question 26

What inhibits insulin secretion?

Answer 26

Sympathetic nervous system

Question 27

Which diabetes is an autoimmune disorder where pancreatic beta cells are destroyed resulting in reduced production of insulin?

Answer 27

Type I

Question 28

What is Type II diabetes?

Answer 28

Combination of insulin resistance and deficiency

Question 29

What are some common symptoms of diabetes?

Answer 29

1. Elevated glucose concentrations 2. Polyuria 3. Fatigue 4. Blurred vision

Question 30

What are some common complications with diabetes?

Answer 30

1. Kidney failure 2. Vascular disease 3. Blindness 4. Skin and mucosal infections 5. Perio disease

Question 31

What might help Type I diabetics during long procedures?

Answer 31

Snacks