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AU14 Physiology > EX 2; Growth and Diabetes > Flashcards

EX 2; Growth and Diabetes Flashcards

1
Q

This is the principle factor that regulates growth

A

genetics

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2
Q

This is a critical factors in regulating growth

A

nutrition; begins in utero

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3
Q

This is an often forgetting factor of growth

A

freedom from disease

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4
Q

What are four important growth regulating endocrine factors

A

hormones of the growth axis
thyroid hormones
glucose-regulating hormones
gonadal steroids

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5
Q

What are some hormones of the growth axis

A

IgF1 and IgF2; insulin-like growth factor
GHRH
GH

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6
Q

chronic elevation of this rill inhibit growth (GHRH/GH)

A

cortisol

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7
Q

What are the two basic requirements of growth

A

cell division/replication

protein synthesis

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8
Q

The final height is determined by what

A

growth of the long bones

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9
Q

Long bones grow as this is replaced by bone

A

epiphyseal plate cartilage

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10
Q

Cartilage replacement adds bone to where

A

the ends of both diaphysis

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11
Q

GH increases what on the chondrocytes, stimulating replication

A

IgF1 receptors

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12
Q

Epiphyseal plates ossify when?

A

at puberty

which is why males are generally taller because puberty is later/longer

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13
Q

What are two hypothalamic hormones that regular GH secretion

A

GHRH

somatostatin

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14
Q

Pituitary GH has these three effects

A

mitogenic peptide hormone
has some direct effects on somatic tissues
stimulates secretion of IGF1 from liver and other tissues

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15
Q

What are two direct effects on somatic tissues of pituitary GH

A

stimulates protein synthesis

anti-insulin effects

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16
Q

Feedback regulation of GH secretion by long and short loop negative feedbacks have what three effects

A

inhibition of GHRH and GH secretion
stimulation of SS secretion
both GHRH and SS exhibit contrasting diurnal patters of secretion (GHRH increases during early sleep)

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17
Q

GH induces precursor cells in bone and other tissues to differentiate and do what

A

secrete IGF-1 which stimulates cell division

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18
Q

The anti-insulin effects by GH have what three consequences

A

renders adipocytes more responsive to stimuli that induce the breakdown of triglycerides, releasing FA into blood
stimulates gluconeogenesis
reduces ability of insulin to stimulate glucose uptake

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19
Q

Somatic growth is the result of the interactions between what

A

GH and IGF-1

Example; GH stimulates maturation of chondroblasts and IGF-1 stimulates cell division

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20
Q

Deficits in either GH or IGF-1 cause what

A

reduced growth

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21
Q

What can be two defects in GH of IGF-1

A

genetic mutations

defects caused by malnutrition

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22
Q

Why are there no genetic mutations for IGF-1/receptor

A

The fetus needs it to grow, if there is a mutation, the fetus will die

23
Q

GH production is affected by what

A

age

24
Q

When is GH production the highest/lowest

A

highest = adolescence
lowest = adult
effects of GH decrease on somatic tissues

25
Q

GH synthesis and activity is regulated by what

A

other hormones like sex steroids, thyroid hormones

26
Q

What four effects do the sex steroids have on GH synthesis and activity

A

stimulate GH synthesis
stimulate IGF-1 synthesis
skeletal growth; stimulates prepubertal bone growth
causes fusion of epiphyseal plates inhibiting growth

27
Q

What two effects do thyroid hormones have on GH synthesis and activity

A

regulates GH synthesis

required for GH effects

28
Q

These have anti-growth effects

A

cortisol/glucocorticoids

29
Q

Excess production of GH results in what

A

acromegaly and gigantism

30
Q

What typical causes excess GH

A

pituitary tumor

31
Q

Gigantism results from what

A

pre-pubertal onset of excess GH

32
Q

Acromegaly results from what

A

post-pubertal onset of excess GH

33
Q

What are two considerations from patients with excess GH

A

remove tumor or give SS

34
Q

Which is more common, GH excess or GH deficiency

A

deficiency; relatively common

35
Q

What causes dwarfism

A

lack of GH receptor which leads to no IGF synthesis

36
Q

This is when fibroblast growth factor receptor constitutively active which results in abnormal cartilage development

A

achondroplasia

37
Q

What are some considerations for patients with GH deficiency

A

macroglossia, enlarged salivary glands, excess cementum, delayed shedding and replacement, etc.

38
Q

What becomes of athletes that take GH

A

they don’t get taller, the build muscle (including heart muscle)

39
Q

What are some symptoms of GH abuse

A

they resemble acromegaly

also consider the anti-insulin actions of GH; bones thicken, cardiovascular problems, diabetic symptoms, etc.

40
Q

This involves a disruption in the normal function of insulin

A

diabetes

41
Q

This is a peptide hormone produced in the pancreas

A

insulin

42
Q

What does insulin normally regulate

A

glucose transport into the cells

43
Q

What kind of hormone does insulin act as

A

an anabolic hormone, stimulating mitosis, cell growth, etc.

44
Q

Loss of insulin function can lead to what

A

ketoacidosis and can be fatal

45
Q

This type of diabetes is an autoimmune disorder with onset early in life, destroys pancreatic β cells. (5-8% diabetics)

A

Type 1

46
Q

This type of diabetes is a combination of insulin resistance and insulin deficiency, onset later in life

A

type II

47
Q

How can you manage diabetes type I and II

A

type I; insulin supplementation

type II; dietary and lifestyle controls

48
Q

What is the treatment for type II

A

can also include insulin sensitizers and insulin supplemental enhance the insulin receptor and cells

49
Q

What are four symptoms of diabetes, linked to the increase of circulating glucose

A

elevated fasting glucose levels
polyuria
fatigue
blurred vision

50
Q

What are five common complications of diabetes, linked to the chronic hyperglycemia

A 
kidney failure
vascular disease
blindless
skin/mucosal infections
periodontal diseases
51
Q

what are three considerations to keep in mind with a dental patient with diabetes

A

vascular diseases affect teeth
dehydration can reduce salivary flow
increased risk of periodontal disease

52
Q

What should the dental provider be aware of with type I

A

be familiar with history

increased risk of periodontal disease

53
Q

What should the dental provider be aware of with type II

A

emphasize the importance of maintaining glycemic control

frequently have cardiovascular and renal disease

AU14 Physiology (24 decks)

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