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HRM > Week 2 > Flashcards

Week 2 Flashcards

1
Q

What is the primary glucocorticoid?

A

cortisol

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

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2
Q

What enzyme is responsible for converting progesterone to glucocorticoids?

A

21 hydroxylase

  • defective = lack of glucocorticoids and mineralocorticoids and excess of androgens
  • hypotension
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3
Q

What enzyme converts deoxycorticosteroids to glucocorticoids and mineralocorticoids?

A

11B-hydroxylase

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4
Q

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

A 
Zona glomerulosa (mineralocorticoids/aldosterone)
Zona fasciculata (glucocorticoids/ cortisol)
Zona reticularis (androgens)
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5
Q

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

A

chromaffin cells

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6
Q

What amino acid are norepinephrine and epinephrine made from?

A

tyrosine

tyrosine to dopa to dopamine

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7
Q

What cell is dominant in pheochromocytomas?

A

chromaffin cells of the adrenal medulla

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8
Q

What adrenal zones are activated by ACTH?

A

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

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9
Q

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

A

capsular plexus

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10
Q

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

A

cortical sinusoidal (fenestrated)

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11
Q

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

A

medullary capillaries (fenestrated)

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12
Q

Which part of the pancreas has more islets?

A

tail

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13
Q

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

A

alpha- glucagon
beta- insulin
delta- somatostatin

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14
Q

What is the rate limiting step in adrenal steroid synthesis?

A

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

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15
Q

What enzyme converts inactive steroids to active?

A

11 beta hydroxylase type 1

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16
Q

What is the effect of high versus normal ACTH?

A 
-normal = ACTH is tonic 
high = ACTH is stimulatory
17
Q

What type of receptor is the insulin receptor?

A

tyrosine kinase

18
Q

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

A

amylin

-also induces satiety

19
Q

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

A

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

20
Q

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

A

GIP (receptors in beta pancreatic cells and brain)

21
Q

Which GLUT is the glucose sensor for pancreatic beta cells?

A

GLUT 2

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

22
Q

What does FOXO1 do?

A

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

23
Q

What effect does glucagon signaling have on the liver?

A

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

24
Q

What does aromatase do?

A

converts testosterone to estradiol; active in adipocytes

25
Q

What is the main side effect of insulin?

A

hypoglycemia

26
Q

What drugs decrease hepatic glucose production by inhibiting gluconeogenesis?

A

Biguanides (metformin)

27
Q

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

A

PPAR agnists (thiazolidinedione)

28
Q

What drugs promote insulin secretion by closing K+ channels?

A

Sulfonylureas (Glimepiride) and Meglitinides (Repaglinide, Nateglinide)

29
Q

What drugs promote insulin secretion by activating adenlyate cyclase?

A

GLP analogs and Dipeptidase IV inhibitors (which increase GLP)

30
Q

Which diabetes drugs may cause weight gain? loss?

A

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

31
Q

Which 3 diabetes drugs are more expensive?

A

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

32
Q

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

A
  • GLP-1 analogs (Exenatide, Uraglutide)

- amylin analog (Pramlintide)

33
Q

What are the role of incretins?

A

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

34
Q

Where are paraganglia and what do they secrete?

A

in adrenal medulla; secrete epinephrine

-aortic chromaffin bodies

35
Q

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

A

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

36
Q

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

A
  • prediabetes: A1c 5.7-6.4% and 100-125 gm/dL

- diabetes: A1c >6.5% usually means diabetes

HRM (6 decks)

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