- The fxn of glucocorticoid is to keep_____________relatively constant - It can also maintain blood pressure by increasing the action of___________

- blood sugar levels - vasoconstrictors

Module 12 Flashcards by Anson Lam

_____cells secrete insulin

Beta

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Prolonged high cortisol is known as__________syndrome

Cushing

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Too little cortisol is known as_________disease

Addison

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Long term stress lead to retention of _____&_____by kidneys

Na & thus water

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Cortisol & Aldosterone are produced in_________of kidney

Adrenal Cortex

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_________is the most potent mineralcorticoid

Aldosterone

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Prolactin is produced by which gland ?

Anterior Pituatary

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(T3/T4) has stronger activity

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Only ~_____% of Thyroid hormones are free & unbound

0.5

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Thyroid hormones are (hydrophilic/lipophilic)

lipophilic

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Parathyroid hormones increase_____ion absorption

Ca2+

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Rise in blood glucose after meal is detected by_____cells & they release more INSULIN

Beta

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~______% of cortisol exist as free hormone

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What are the 2 advantages of hormones being bound to plasma proteins ?

inc half-life of hormone
reduce hormone loss into urine

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What are the 3 main types of hormones

Peptides
Amines
Steroids

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Thyroid gland is anatomically inferior to which structure

larynx

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Normal Cortisol (inc./dec.) blood glucose

inc.

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T/F, normal cortisol regulates circadian cycle and blood pressure

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Mineralcorticoids are made in zona_________

glomerulosa

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Glucocorticoids are made in zona________

fasciculata

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The fxn of glucocorticoid is to keep_____________relatively constant
It can also maintain blood pressure by increasing the action of___________

blood sugar levels
vasoconstrictors

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What dental disease is the leading oral complication in diabetes patients

Periodontitis

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Thyroid hormones (inc./dec.) basal metabolic rate

inc.

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- Which part of thyroid makes thyroxine ? - Which cell of thyroid makes calcitonin

- Follicular Epithelium - Parafollicular cell

Thyroid hormone inc._____&______of mitochondria

number & size

Thyroid hormones lead to protein synthesis but if T3 & T4 are too high, this will lead to protein_________

break down

- Thyroid hormone helps w/ the absorption of vitamin____ - Thyroid hormone helps conversion of carotene into vitamin____

- B - A

Excess Thyroid hormones lead to (stronger/weaker) bones

weaker

Graves dz is a (hyper/hypo)thyroid disorder

hyper

Burning mouth syndrome can be a consequence of (hypo/hyper)thyroidism

hyper

- If >_____% of HbA changed to HbA1c, it gives the diagnosis of diabetes - between__________& is PRE diabetes

- 6.5 - 6.0-6.4

obesity in (subcutaneous/visceral) fat inc. the risk of type 2 diabetes

visceral

What are the 2 causes of insulin deficiency

1. glucose toxicity 2. amylin build ups in pancreas

- ________inc. the no. of prolactin secreting cells during pregnancy - ________suppress prolactin release

- oestrogen - dopamine

Chronic rise in cortisol can inc._______, dec._______, leading to obesity

ghrelin, leptin

_________insulin covers the inc. in blood glucose lvl after meals

prandial

- Metformin belongs to the_________class of diabetic drug - How long it takes up to_______weeks to see the effects of the drug ?

- Biguanide - 2 weeks

The mechanism of metformin is reducing_____________&increasing_____________

liver glucose pdtion, peripheral utilisation of glucose

The drug names of sulphonylureas drugs usually start w/ a suffix of_____

gli

Which 2 diabetes drug classes target incretins ?

DPP4 inhibitors & GLP-1 analogues

incretin responses are reduced in ppl w/ type____diabetes

_________is a major incretin in the body that stimulates________secretion in response to glucose & delays________emptying

GLP-1, insulin, gastric

The drug names of DPP4 inhibitor drugs usually end in_______

gliptin

DPP4 enzyme breaks down__________

incretin

Which diabetes drug class should not be used in patients w/ heart failure

DPP4 inhibitors

The drug names of GLP-1 analouges drugs usually end in_______

tide

The drug names of SGLP2 inhibitor drugs usually end in_______

gliflozin

Hypoglycemia happens when blood sugar lv <_____mmol/L

List 4 hormones that enter the circulation as inactive precursors

Insulin Vitamin D Testosterone Thyroxine

How does long term stress affect blood volume & pressure ?

inc. both

Cortisol is a (Glucocorticoid/Mineralcorticoid)

Glucocorticoid

Gluconeogenesis is the formation of___________from____________

glucose from fats & proteins

Aldosterone and electrolytes: - Retention of____________ - elim. of__________

- Na+ & thus water - K+

Cortisol is released in response to_________

ACTH

T/F, bound Thyroid hormone lead to physiological effect.

F. ONLY FREE thyroid hormone is active

Lipotoxicity occurs when there is an INCREASE in__________w/ DECREASE in___________&__________

NEFA, Insulin sensitivity & glucose utilisation

Why is DAG lipotoxic ?

It impairs docking between insulin receptor & substrate

- Adiponectin is anti-____________

- hyperglycaemic

T/F, Glucose uptake is insulin dependent ?

F, it can either be insulin dependent OR independent

GLUT 1 & 2 glucose transporters are glucose (dependent/independent)

independent

Skeletal muscles & adipose tissue have GLUT___

Glycated LDLs are not recognized by receptors & are trapped in_________

ECM & arteries

Parathyroid hormone acts to regulate serum levels of calcium, phosphate and magnesium. What are the principal tissues in which it acts directly to achieve these actions? Kidneys and parathyroid glands Bones and kidneys Bones and small bowel Kidneys and small bowel Bones and parathyroid glands

Bones and kidneys

Which of the following will produce low levels of both free T 4 and thyroid stimulating hormone (TSH)? Surreptitious use of thyroxine for weight loss Excessive use of antithyroid medications which reduce thyroid hormone synthesis Autoimmune destruction of thyroid gland tissue Lack of iodine leading to reduced synthesis of thyroid hormone in the thyroid gland Surgical removal of the pituitary gland

Surgical removal of the pituitary gland

An antibody to which of the following auto-antigens is responsible for Graves' disease? Tissue transglutaminase Peroxidase Thyroglobulin Glutamic acid decarboxylase (GAD) Thyroid stimulating hormone (TSH) receptor

Thyroid stimulating hormone (TSH) receptor

Oxidative stress is associated with activation of the polyol pathway through which of the following mechanisms? Reduced bioavailability of NADPH Enhanced lipid biosynthesis Osmotic pressure from elevated sorbitol Increased cellular ATP production

Reduced bioavailability of NADPH

How is the basal metabolic rate (BMR) best defined? In proportional to physical activity level The rate of energy usage at rest in the fasting state In proportional to amount of fat tissue The rate of energy usage while asleep The rate of energy usage at rest

The rate of energy usage at rest in the fasting state

All of the following are true about Type 1 diabetes, EXCEPT: Symptoms include excessive thirst and dehydration It is an autoimmune disease where the body attacks the pancreas. It is caused by the body not producing insulin It is mostly diagnosed in children/adolescents It is preventable through healthy diet and exercise

It is preventable through healthy diet and exercise

In diabetic ketoacidosis, which of the following is the primary reason for the decrease in blood pH? Decreased renal clearance of bicarbonate Increased protein degradation releasing acidic amino acids Excessive breakdown of glycogen in the liver Accumulation of ketone bodies, which are acidic Accumulation of lactic acid from anaerobic metabolism q

Accumulation of ketone bodies, which are acidic

For which of the following infections is diabetes a risk factor? HIV HCV HBV Candida Tuberculosis

Candida

Vascular complications in chronic hyperglycaemia are linked to which of the following molecules which is enhanced by protein kinase C (PKC) activation? Insulin growth factor Vascular endothelial growth factor (VEGF) Glutamate receptor Nitric oxide synthase

Vascular endothelial growth factor (VEGF)

Which of the following statements best describes the physiologic action of glucagon? Inhibits hepatic gluconeogenesis Promotes hepatic glycogen synthesis Promotes hepatic glycogenolysis Facilitates insulin release by the islets of Langerhans Inhibited by hypoglycaemia

Promotes hepatic glycogenolysis

Regarding blood glucose regulation, which of the following statements is CORRECT ? Insulin secretion is inhibited by sympathetic nerve activity Glucagon secretion is inhibited by sympathetic nerve activity During exercise blood glucose levels increase After a heavy carbohydrate meal, the plasma concentration of glucagon rises Glucagon inhibits the pancreatic secretion of insulin

Insulin secretion is inhibited by sympathetic nerve activity

Oxidative stress is associated with activation of the polyol pathway through which of the following mechanisms? Increased cellular ATP production Reduced bioavailability of NADPH Enhanced lipid biosynthesis Osmotic pressure from elevated sorbitol

Reduced bioavailability of NADPH

Diabetes affect____-_____% of population

5-10

- Thyroid disorder affect____% of population - It is_____times more common in women

- 5 - 5

________% of men over age 45 have low testosterone

40%

Osteoporosis affect >______% ppl over age 70

50%

Type 1 or type 2 diabete is more common

type 2

What is the pathogenesis of type 1 diabetes

Autoimmune dz > pancreatic damage to beta cells > no insulin secretion > high sugars

What is the pathogeneis of type 2 diabetes

insulin RESISTANCE (dec. glucose utilisation in skeletal muscle, inc. glucose pdtion from liver, inc. fatty acid from adipocytes)

T/F, type 2 diabetes is a lifestyle dz

Genetics play a bigger role in which type of diabetes

Diabetes if: - fasting >____mmol - Random >______mmol

- 7.0 - 11.1

Which condition is half-way towards diabetes ?

Impaired Glucose Tolerance

T/F, impaired glucose tolerance is a risk factor for atherosclerosis & heart dz

T (especially silent myocardial infarction)

- Type___diabete is more prone to hyperosmolar coma - Type___diabete is more prone to ketoacidosis

- 2 - 1

-Type___diabete gets more microvascular dz Type___diabete gets more macrovascular dz

- 1 - 2

Which cardiovascular procedure is not as successful in type 2 diabetes patients due to macrovascular complication

angioplatsy

______% of diabetes is type 1

Diabetes is more common in (male/female)

male

What are the 3 types of insulin dosing

1. correction 2. prandial 3. basal

Which insulin dosing suppress glucose pdtion by liver between meals & overnight

basal

What is the mechanism of metformin

Reduce liver glucose pdtion & inc. peripheral glucose usage

Does metformin cause weight gain & hypoglycemia ?

Which diabetes drug can causes malabsorption of vitamin B12

metformin

What is the mechanism of sulphonylureas

stimulate pancreas insulin secretion

Does sulphonureas cause weight gain & hypoglycemia

Yes

Does DPP4 inhibitors cause weight gain & hypoglycemia

What are 4 effects of the hormone incretin

1. Stimulate insulin secretion responding to food 2. dec. glucagon secretion 3. delay gastric emptying 4. Anorexic (dec. apatite)

Which diabetes drug cannot be used in patients w/ heart failure

DPP4 inhibitor

Does GLP 1 analogues cause weight gain & hypoglycemia

No (causes weight loss instead)

Which diabetes drugs can have cardiovascular & renal benefits

GLP 1 analogue, SGLT 2 inhibitor

What is the mechanism of SGLT 2 inhibitor

dec. glucose reabsorption from kidney, inc. glucose excretion from kidney

Does SGLT 2 inhibitor cause weight gain & hypoglycemia

No (weight loss instead)

SGLT 2 can cause genital infection because____________

increased sugar excretion in urine

Which diabetes drug can cause fournier's gangrene

SGLT 2

Describe the management of hypoglycemia

Quick source simple carb then w/ substantial carb. If blood sugar not raising after this, call ambulance or give injection of glucagon if available

What is the fxn of glucagon ?

inc. liver glucose pdtion, dec. glucose breakdown

Metformin has a (fast/slow) onset of action

slow

Vascular complications in chronic hyperglycaemia are linked to which of the following molecules which is enhanced by protein kinase C (PKC) activation? Insulin growth factor Glutamate receptor Vascular endothelial growth factor (VEGF) Nitric oxide synthase

Vascular endothelial growth factor (VEGF)

Which of the following statements regarding choice of antihyperglycaemic agent is CORRECT? Insulin is preferred in an obese patient. An SGLT2 inhibitor is a good choice for a patient with hypertension. The first choice agent for a patient at high risk of hyperglycaemia is insulin. A GLP-1 inhibitor is a good choice for a patient at risk of gastrointestinal conditions. A thiazolidinedione is preferred in a patient with established cardiovascular disease.

An SGLT2 inhibitor is a good choice for a patient with hypertension.

Parathyroid hormone acts to regulate serum levels of calcium, phosphate and magnesium. What are the principal tissues in which it acts directly to achieve these actions? Bones and kidneys Bones and small bowel Kidneys and parathyroid glands Bones and parathyroid glands Kidneys and small bowel

Bones and kidneys

Which advanced glycation end product (AGE) mechanism contributes to a pro-inflammatory environment? By binding to AGE specific receptors (RAGEs) on macrophages Stimulating glucose transport into cells, to reduce extracellular glucose levels Direct increases in insulin production in beta cells By increasing protein digestibility under the control of matrix metalloproteinases (MMPs)

By binding to AGE specific receptors (RAGEs) on macrophages

What is a distinguishing feature of an apical abscess compared to a periodontal abscess? Chronic and slow progression of symptoms Presence of pus drainage via a sinus tract Swelling and tenderness around the gingival area Vitality of the associated tooth Discoloration of the tooth crown

Vitality of the associated tooth

All of the following are ways to lower the Glycaemic Index (GI) of foods except: Combine a high GI food with a lower GI food Add protein to the meal Eat a smaller portion Increase fibre content of the meal Choose minimally processed foods

Eat a smaller portion

Insulin secretion is inhibited by (sympathetic/parasympathetic) activity

sympathetic

Glucagon secretion is inhibited by (sympathetic/parasympathetic) activity

parasympathetic

Which hormone is most critical for the regulation of calcium and phosphate metabolism during development?

Parathyroid

Which one of the following statements about triidothyronine (T3) is correct? It activates plasma membrane receptors on its target cells It circulates partly bound to thyroid binding globulin It is only metabolised by the liver It is converted to thyroxine (T4) in the peripheral tissues It is less metabolically active than T4

Module 12 Flashcards

(122 cards)