Pancreas & Catecholamines-Edwards

Front 1

What are the types of pancreatic cells & what do they produce? (4)

Back 1

1. Alpha-- Glucagon
2. Beta-- Insulin
3. Delta-- Somatostatin
4. F cell-- Pancreatic polypeptide

Front 2

What is the principal stimulus for insulin release?

Back 2

Glucose

Front 3

How does glucose enter beta cells?

Back 3

GLUT-2

Front 4

What enzyme acts as glucose sensor for GLUT-2?

Back 4

Glucokinase

Front 5

In order for insulin to be released, glucose must first be?

Back 5

Metabolized

Front 6

Where are the GLUT-2 transporters located?

Back 6

Pancreas & liver

Front 7

Which GLUT transporters are sensitive to insulin?

Back 7

GLUT-2= NOT sensitive to insulin

GLUT-4= SENSITIVE to insulin

Front 8

Where are GLUT-4 transporters located?

Back 8

Muscle & adipose tissue

Front 9

What are the 2 major actions of insulin?

Back 9

1. Growth factor
2. Metabolic actions

Front 10

The beta chain of the insulin receptor exhibits what type of second messenging system?

Back 10

Tyrosine kinase

Front 11

When IRS pathway is stimulated by insulin receptor, what happens?

Back 11

Signal transduction causes metabolic actions of insulin

Front 12

When MAP kinase pathway is stimulated by insulin receptor, what happens?

Back 12

Gene expression & growth regulation

Front 13

What effects overall does insulin have on liver? (4)

Back 13

1. Storage of glucose as glycogen
2. Promote glycolysis & carb oxidation
3. Synthesis & storage of fats
4. Promote protein synthesis & inhibit breakdown

Front 14

How does insulin promote glycogenesis? (4)

Back 14

Glycogen synthesis from glucose
1. Enhance glucokinase transcription
2. Activate glycogen synthase
3. Inhibit glycogen breakdown (inhibit glycogen phosphorylase & glucose-6-phosphatase)

Front 15

How does insulin promote glycolysis & carbohydrate oxidation? (4)

Back 15

1. Increase glucokinase
2. Increase glycolytic enzymes
2. Increase pyruvate dehydrogenase
4. Inhibit gluconeogenesis --> decrease gluconeogenesis enzymes

Front 16

How does insulin promote synthesis & storage of fats? (2)

Back 16

1. increase acetyl-CoA carboxylase
2. Increase fatty acid synthase

Front 17

Action of insulin on muscle? (4)

Back 17

1. Promote glucose uptake (Increase GLUT-4)
2. Promote glycogen synthesis
3. Promote glycolysis & carb oxidation
4. Promote protein synthesis & inhibit breakdown

Front 18

What enzyme works w/ GLUT-4?

Back 18

Hexokinase

Front 19

Action of insulin in adipocytes? (4)

Back 19

1. Promote glucose uptake (GLUT-4)
2. Promote glycolysis & formation of alpha-glycerophosphate
3. Promote esterification of alpha-glycerophosphate --> form triglycerides
4. Promote synthesis of lipoprotein lipase

Front 20

Where does lipoprotein lipase act once sythesized in response to insulin?

Back 20

Exported to endothelial cells --> breaks down triglycerides in chylomicrons & VLDL --> produce FA which enter adipocyte --> converted to triglycerides & stored

Front 21

Most products of glycolysis in adipocytes are converted to?

Back 21

Alpha-glycerophosphate

Front 22

What is most common cause of Type I diabetes?

Back 22

Autoimmune destruction of beta cells or environmental toxins

Front 23

Insulin levels of person w/ Type I diabetes?

Back 23

Absolute deficiency

Front 24

How is Type I diabetes treated?

Back 24

Insulin, diet & exercise

Front 25

What 2 things must be present in Type II diabetes?

Back 25

1. Insulin resistance
2. Beta cell dysfunction

Front 26

Ketoacidosis is common in which type of diabetes?

Back 26

Type I diabetes
Ketoacidosis --> coma & death

Front 27

Is insulin present in type II diabetes?

Back 27

Insulin present at normal or high levels but low relative to glucose levels

Front 28

How is type II diabetes treated?

Back 28

Weight loss, diet, oral hypoglycemic agents & sometimes insulin

Front 29

Genetic components are more important for which type of diabetes?

Back 29

Type II diabetes

Front 30

What are acute complications of diabetes? (3)

Back 30

1. Ketoacidosis
2. Kussmaul breathing (rapid & deep)
3. Acetone halitosis

Front 31

What is platelet plug formation and what are the 4 actions that take place?

Back 31

accumulation of platelets that seal up small breaks in blood vessels

1. platelet adhesion

2. platelet release reaction

3. Platelet aggregation

4. Activated platelets express platelet factor III and coagulation factor V

Front 32

What are the 1st symptoms of hypoglycemia? (adrenergic or sympathetic) (5)

Back 32

1. Nervousness
2. Sweating
3. Intense hunger
4. Trembling
5. Weakness, palpitations or difficulty speaking

Front 33

First symptoms of hypoglycemia occur when glucose falls to?

Back 33

Mid 60s

Front 34

What are the more severe symptoms of hypoglycemia? (neruoglycopenic range) (5)

Back 34

1. Confusion
2. Drowsiness
3. Coma
4. Seizure
5. Change in behavior

Front 35

For severe symptoms of hypoglycemia to occur glucose levels fall to?

Back 35

50 mg/dl

Front 36

How is hypoglycemia treated?

Back 36

Administer readily absorbable sugars (fruit juice, soda, table sugar) if able to swall
Injection of glucagon if patient can't swallow

Front 37

Which hormones oppose action of insulin & are active in hypoglycemia? (4)

Back 37

1. GH
2. Cortisol
3. Glucagon
4. EP

Front 38

What is the action of somatostatin?

Back 38

INHIBITORY
Act on pancreas to decrease endocrine/exocrine secretion

Front 39

What is the action of pancreatic polypeptide produced by F cells?

Back 39

Inhibit pancreatic enzyme secretion & gallbladder contraction

Front 40

Action of glucagon?

Back 40

Hyperglycemic:
Acts on liver & adipose tissue to raise blood glucose & FA concetrations

Front 41

What is the principal stimulus in glucagon release?

Back 41

Amino acids

Front 42

During mixed meals, what is secreted?

Back 42

Insulin & glucagon

Front 43

Which pancreatic cells are more senstive to glucose?

Back 43

Alpha cells

Front 44

Parasympathetic & sympathetic stimulation cause which hormone to be secreted by pancreatic cells?

Back 44

alpha cells secrete glucagon

Front 45

Epinephrine has what effect on pancreatic cells?

Back 45

1. Increases glucagon secretion
2. Inhibits insulin secretion
3. Reinforces glucagon action on hepatocyte

Front 46

Physiological effects of glucagon on liver? (4)

Back 46

1. Activate AC & initate phosphorylation
2. Activate glycogen phosphorylase
3. Glycogen synthase inactive
4. Hormone senstive lipase active
5. FA metabolized by ketogenesis & ketones

Front 47

What is the primary catecholamine synthesized by the adrenal medulla?

Back 47

Epinephrine

Front 48

Which cells of the adrenal medulla have enzyme for synthesizing epinephrine?

Back 48

Chromaffin cells

Front 49

What is the precursor for catecholamines?

Back 49

Tyrosine

Front 50

What are the 2 enzymes that break down catecholamines?

Back 50

COMT & MAO

Front 51

What is the enzyme that converts tyrosine to dihydroxyphenylalanine (DOPA)?

Back 51

Tyrosine hydroxylase

Front 52

What is the enzyme that converts dihyrodoxyphenylalanine to Dopamine?

Back 52

Amino Acid decarboxylase

Front 53

What is the enzyme that converts Dopamine to Norepinephrine?

Back 53

Dopamine-beta-hydroxylase

Front 54

What is the enzyme that converts norepinephrine to epinephrine?

Back 54

Phenylethanolamine-N-methyltransferase

Front 55

Why does epinephrine raise blood glucose levels?

Back 55

More glucose available for brain

Front 56

What is relaxed/inhibited by epinephrine?

Back 56

1. Bronchial smooth muscles
2. Smooth muscle in gut
3. Blood vessels to skeletal muscles

Front 57

What are the uses of epinnephrine in dentistry?

Back 57

1. Temporary hemostasis due to vasoconstrictor properties
2. Vasoconstrictor in local anesthetic to decrease absorption of anesthia (increases time of numbness)
3. Treat anaphylactic shock