Metabolic Effects of Insulin and Glucagon. Flashcards

1
Q

What are 5 key organs that are involved in energy metabolism?

A

The brain.

The liver.

Adipose tissue.

Muscle tissue.

The pancreas.

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2
Q

What organ is involved in the most key pathways in energy metabolism?

A

The liver.

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3
Q

What organs involved in metabolic processes require the most energy?

A

The brain and muscles.

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4
Q

What metabolic organs are responsible for storing excess energy?

A

Adipose tissue.

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5
Q

How does adipose tissue store energy?

A

In a way that facilitates quick release of that energy.

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6
Q

What organ makes many of the hormones that control the various processes of energy metabolism?

A

The pancreas.

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7
Q

What are the 2 main hormones that will control the various processes of metabolism?

A

Insulin and glucagon.

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8
Q

What organ is responsible for releasing glucagon and insulin?

A

The pancreas.

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9
Q

What hormone that isn’t made in the pancreas will affect metabolism?

A

Epinephrine.

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10
Q

Where is epinephrine made?

A

It is made under specific conditions by the nervous system.

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11
Q

The metabolic processes of all the organs in energy metabolism are controlled by at least 1 of what 3 factors?

A

The availability of key substrates.

By hormones.

The nervous system.

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12
Q

What are the 2 types of cells that make up the pancreas known as?

A

Endocrine cells.

Exocrine cells.

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13
Q

Which pancreatic cells secrete their zymogens into the bloodstream?

A

Endocrine cells.

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14
Q

Insulin and glucagon are secreted by what portion of the pancreas?

A

The endocrine portion.

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15
Q

Where will the exocrine cells of the pancreas release their products or zymogens to?

A

Into the pancreatic duct where they will enter the lumen of the small intestine.

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16
Q

What makes up the endocrine portion of the pancreas?

A

Islets of Langerhans.

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17
Q

Where are the islets of Langerhans found in the pancreas?

A

They surround blood vessels and are embedded in the exocrine portion of the organ.

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18
Q

Islets of Langerhans cells account for what percentage of all pancreatic cells?

A

1-2%.

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19
Q

Islets of Langerhans are made up of what 3 cell types?

A

Alpha.

Beta.

Delta.

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20
Q

What are the alpha cells of the islets of Langerhans responsible for?

A

They are responsible for secreting glucagon.

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21
Q

What are the beta cells of the islets of Langerhans responsible for?

A

They will secrete insulin and amylin.

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22
Q

What are the delta cells of the islets of Langerhans responsible for?

A

They secrete somatostatin.

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23
Q

What will usually induce the release of insulin from the pancreas?

A

A meal.

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24
Q

How long after a meal has been consumed will there be a rise in blood glucose levels?

A

Around 10 minutes.

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25
Q

What will a rise in blood glucose levels trigger?

A

A release of insulin.

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26
Q

What glucose transporters will bring glucose in to the pancreas?

A

GLUT-2 transporters.

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27
Q

What enzyme is triggered by the entry of glucose into the pancreas?

A

Glucokinase.

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28
Q

What metabolic process is triggered by the entry of glucose into the pancreas?

A

Insulin stimulates glycolysis which causes a rise in ATP across the body.

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29
Q

How will the presence of glucose in the cytoplasm of beta cells trigger the release of insulin?

A

Its presence closes a potassium channel in the plasma membrane.

This causes a depolarisation of the plasma membrane, allowing calcium to enter the cytoplasm.

Cytoplasmic calcium allows insulin vesicles to fuse to the cell membrane so they can be released.

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30
Q

How many chains make up an insulin molecule?

A

2 chains.

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31
Q

What links the 2 chains that make up insulin together?

A

2 intermolecular disulphide bonds.

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32
Q

What are the 2 chains that make up insulin called?

A

The A and the B chain.

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33
Q

Are there any intramolecular bonds in the insulin molecule?

A

Yes.

The A chain contains 1 intramolecular disulphide bond.

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34
Q

What are the monomers that make up insulin?

A

Amino acids, so it is effectively a protein.

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35
Q

Are the disulphide bridges important for the structure and behaviour of insulin?

A

Yes.

The hormone will not work without them.

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36
Q

How is insulin synthesised?

A

As a much larger protein that contains an additional C chain and a leader or signal terminus at the amino end.

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37
Q

What is newly synthesised insulin known as?

A

Preproinsulin.

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38
Q

Where is insulin synthesised?

A

In the endoplasmic reticulum of beta cells.

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39
Q

What does the signal terminus of preproinsulin allow for?

A

The secretion of insulin from the ER into the lumen of the ER.

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40
Q

What happens to preproinsulin once it is in the lumen of the ER?

A

The signal terminus is removed.

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41
Q

What molecule is formed when the signal terminus is removed from preproinsulin?

A

Proinsulin.

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42
Q

What is proinsulin made up of?

A

The A chain.

The B chain.

The C chain.

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43
Q

What happens once proinsulin has been formed?

A

The disulphide bridges are formed between the A and B chain.

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44
Q

What happens as proinsulin moves through the lumen of the ER?

A

It is packaged into golgi vesicles, where the C chain is removed and insulin is formed.

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45
Q

What happens to the C chain once it is removed from proinsulin?

A

It is secreted from the body in urine.

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46
Q

What happens to the signal terminus of preproinsulin?

A

It is recycled in the ER.

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47
Q

What activates insulin synthesis?

A

Glucose in the blood (activates glucokinase in β cells).

Amino acids in the blood (especially arginine).

Secretin from the intestine (response to food intake).

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48
Q

What inhibits insulin synthesis?

A

Scarcity of food.

Epinephrine.

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49
Q

How will insulin travel to cells throughout the body?

A

Through the bloodstream.

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50
Q

What receptors will insulin bind to on cells?

A

Insulin receptors.

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51
Q

How many subunits does the insulin receptor have?

A

4.

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52
Q

Where are the subunits of the insulin receptor located on the cell?

A

2 alpha subunits on the extracellular side.

2 beta subunits on the cytoplasmic side.

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53
Q

What are the 4 subunits of an insulin receptor?

A

2 alpha subunits.

2 beta subunits.

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54
Q

Will an insulin receptor recognise any other molecules other than insulin?

A

No.

It only recognises insulin.

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55
Q

What portion of an insulin receptor will insulin bind to?

A

The alpha portion.

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56
Q

What happens when an insulin molecule binds to the alpha portion of an insulin receptor?

A

It will elicit changes in the the beta portion.

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57
Q

When is the beta subunit of an insulin receptor activated?

A

When insulin binds to the alpha subunit.

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58
Q

What changes will the beta subunit carry out once insulin binds to the alpha subunit of an insulin receptor?

A

The beta subunit will phosphorylate a tyrosine kinase which will phosphorylate other proteins leading to a cascade of intracellular responses.

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59
Q

What will the intracellular responses that are induced by insulin lead to?

A

To increased glucose uptake.

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60
Q

When blood glucose levels are high, what cells will take up a large amount of glucose?

A

Muscle and adipose cells.

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61
Q

Will gene transcription also lead to glucose uptake?

A

Yes.

It will lead to an up regulation or down regulation of specific enzymes such as PFK-2.

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62
Q

Will insulin phosphorylate or de-phosphorylate enzymes?

A

Insulin will de-phosphorylation enzymes.

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63
Q

The phosphorylation of enzymes by insulin will lead to the inhibition of what processes?

A

Glucose producing processes such as gluconeogenesis.

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64
Q

The phosphorylation of enzymes by insulin will lead to the activation of what processes?

A

Glucose consuming pathways such as glycolysis.

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65
Q

How is the insulin receptor de-activated?

A

By the de-phosphorylation of tyrosine kinase.

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66
Q

Are the any 2nd messengers involved in insulin signals?

A

No.

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67
Q

Which tissues are particularly sensitive to insulin?

A

Muscle and adipose tissues.

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68
Q

Why are muscle and adipose tissues particularly sensitive to insulin?

A

So they can pick up glucose for energy needs, glycogen synthesis or energy storage.

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69
Q

How does type-1 diabetes affect glucose uptake?

A

It reduces the uptake of glucose into muscle and fat cells which results in the person becoming hyperglycaemic.

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70
Q

What are insulin effectors?

A

Molecules that can be phosphorylated by phosphorylated tyrosine residues to produce a cellular cascade.

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71
Q

What are 3 insulin effectors?

A

One of the 4 insulin receptor substrates (IRS).

Adaptors.

Enzyme effectors.

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72
Q

What are 7 common cellular responses to insulin?

A

Specific gene expression.

Protein synthesis.

Up regulation of enzymes.

Regulation of transcription.

Activation of GLUT-4 transporters in muscle and adipose tissue.

Increased glucose uptake in muscle and adipose tissue.

Activation of enzymes by covalent modification.

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73
Q

What 2 processes activate the insulin receptor?

A

Insulin binding to the receptor.

By auto-phosphorylation.

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74
Q

What inhibits the insulin receptor?

A

De-phosphorylation of the tyrosine kinase residue.

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75
Q

Which insulin sensitive cells will use facilitated glucose transport?

A

Most tissues.

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76
Q

Which insulin insensitive cells will use active glucose transport?

A

Epithelia of the intestine.

Renal tubules.

Choroid plexus.

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77
Q

Which insulin insensitive cells will use facilitated glucose transport?

A

Erythrocytes.

Leukocytes.

Lens of eye.

Cornea.

Liver.

Brain.

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78
Q

Are insulin sensitive cells activated by the presence of insulin in diabetics?

A

No.

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79
Q

Is insulin an anabolic or catabolic hormone?

A

Anabolic.

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80
Q

Why is insulin considered to be an anabolic hormone?

A

It will stimulate the synthesis of;

Glycogen from glucose.

Proteins from amino acids.

TAGs from fatty acids.

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81
Q

What processes will insulin inhibit?

A

Gluconeogenesis.

Glycogenolysis.

Lipolysis.

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82
Q

The consumption of carbohydrates will inhibit which pathways in the liver?

A

Gluconeogenesis and glycogenolysis.

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83
Q

The consumption of carbohydrates will activate which pathways in the liver?

A

Glycogenesis and glycolysis.

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84
Q

The consumption of carbohydrates will activate which pathways in the muscle?

A

Glycogenesis and glycolysis.

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85
Q

Does the liver ever use GLUT-4 transporters?

A

No.

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86
Q

What transporters bring glucose from the bloodstream into the liver?

A

GLUT-2 transporters.

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87
Q

What will adipose tissue use glucose for?

A

To synthesise dihydroxyacetone which is converted to glycerol phosphate which is the backbone for TAGs.

88
Q

What do GLUT-4 transporters do?

A

They bring glucose from the blood into muscle and adipose tissue.

89
Q

What do GLUT-2 transporters do?

A

They bring glucose from the blood into the liver.

90
Q

What hormone will insulin inhibit in adipose tissue?

A

Hormone sensitive lipase.

91
Q

What will the inhibition of hormone sensitive lipase result in?

A

The inhibition of TAG synthesis.

92
Q

What will increased glucose uptake in adipose tissue result in?

A

Increased levels of glycerol-3-phosphate and DHAP which will increase TAG synthesis.

93
Q

What enzyme in the endothelial cells will increase due to the presence of insulin?

A

Lipoprotein-lipase.

94
Q

What is the job of lipoprotein lipase?

A

It will break down chylomicrons and VLDL to release fatty acids.

95
Q

What effects will insulin have on protein uptake in various tissues?

A

In increased uptake of amino acids which results in increased protein synthesis.

96
Q

Will the liver, muscle or adipose tissue experience increased glucose uptake as an effect of insulin?

A

Liver. No.

Muscle. Yes.

Adipose. Yes.

97
Q

Will the liver, muscle or adipose tissue experience increased cellular respiration as an effect of insulin?

A

Liver. Yes.

Muscle. Yes.

Adipose. Yes.

98
Q

Will the liver, muscle or adipose tissue experience increased glycogenesis as an effect of insulin?

A

Liver. Yes.

Muscle. Yes.

Adipose. No.

99
Q

Will the liver, muscle or adipose tissue experience an inhibition of glycogenolysis as an effect of insulin?

A

Liver. Yes.

Muscle. Yes.

Adipose. No.

100
Q

Will the liver, muscle or adipose tissue experience increased amino acid uptake as an effect of insulin?

A

Liver. No.

Muscle. Yes.

Adipose. No.

101
Q

Will the liver, muscle or adipose tissue experience a stimulation of protein synthesis as an effect of insulin?

A

Liver. Yes.

Muscle. Yes.

Adipose. Yes.

102
Q

Will the liver, muscle or adipose tissue experience a inhibition of protein degradation as an effect of insulin?

A

Liver. Yes.

Muscle. Yes.

Adipose. Yes.

103
Q

Will the liver, muscle or adipose tissue experience a stimulation of fatty acid and TAG synthesis as an effect of insulin?

A

Liver. Yes.

Muscle. No.

Adipose. Yes.

104
Q

Will the liver, muscle or adipose tissue experience a inhibition of lipolysis as an effect of insulin?

A

Liver. Yes.

Muscle. No.

Adipose. Yes.

105
Q

Will the liver, muscle or adipose tissue experience an up regulation of lipoprotein lipase as an effect of insulin?

A

Liver. No.

Muscle. No.

Adipose. Yes.

106
Q

What cells will release glucagon?

A

The alpha cells of the islets of Langerhans in the pancreas.

107
Q

When is glucagon released into the blood?

A

When blood glucose levels are low.

108
Q

How is insulin synthesised?

A

It is made as a much larger protein which is then modified to give glucagon.

109
Q

How many amino acids make up glucagon?

A

29 amino acids.

110
Q

What organ in the body will sense a drop in blood glucose levels?

A

The hypothalamus of the brain has glucose sensors which will sense a drop in blood glucose.

111
Q

When will glucagon be produced?

A

When blood glucose drops to around half its normal level.

112
Q

What happens once blood glucose levels drop to around half of their usual level?

A

The hypothalamus sends signals to the pancreas to stop producing insulin and to start producing glucagon and norepinephrine?

113
Q

When will epinephrine be produced in the well fed state?

A

During stressful situations or during intense exercise.

114
Q

How is cortisol produced in the fasting state or in the well fed state?

A

The hypothalamus sends signals to the pituitary to produce ACTH which leads to the production of cortisol.

115
Q

What does the release of cortisol stimulate?

A

The release of norepinephrine and activates PDP carboxykinase.

116
Q

What 4 steps does cortisol use to stimulate genetic changes?

A

It travels into the cytoplasm and will bind to a specific receptor to form the activated complex.

The activated complex travels into the nucleus and binds to an enhancer region of DNA.

It then finds a specific gene and activates the promoter region of that gene.

The gene will then make more mRNA which is translated into enzymes.

117
Q

Can glucagon cause glycogenolysis and gluconeogenesis on its own?

A

Yes.

118
Q

What will cause the release of epinephrine, norepinephrine and cortisol?

A

Stressful situations, such as fight or flight scenarios and extreme exercise.

119
Q

Will epinephrine, norepinephrine and cortisol inhibit the synthesis of glucose storage products in the well fed state?

A

Yes.

They will initiate the breakdown of glycogen stores etc.

120
Q

What activates glucagon synthesis?

A

A decrease of blood glucose.

An increase in amino acids in the blood after a protein rich meal.

An increase in epinephrine or norepinephrine.

121
Q

What inhibits glucagon synthesis?

A

High glucose.

Insulin.

Food intake in the form of carbohydrates.

122
Q

What kind of receptors do glucagon receptors tend to be?

A

GPCRs.

123
Q

What 2 systems can a GCPR activate?

A

The adenylate cyclase system.

Thephosphoinositide system.

124
Q

When is the adenylate cyclase system activated?

A

When a stimulus binds to a GPCR.

125
Q

What stimulus will activate the adenylate cyclase system?

A

Epinephrine.

Norepinephrine.

Glucagon.

126
Q

Will epinephrine and glucagon activate the adenylate cyclase system from the same receptors?

A

No.

Glucagon uses a glucagon receptor and epinephrine uses the beta-adrenergic receptor and glucagon but they activate the same pathway.

127
Q

The glucagon receptor and beta-adrenergic receptor are what kind of receptors?

A

GCPRs.

128
Q

What is the 2nd messenger in the adenylate cyclase system?

A

Cyclic AMP (cAMP).

129
Q

What is step 1 of the adenylate cyclase system?

A

A hormone binds to the extracellular side of the membrane and this will activate the GPCR.

130
Q

What is step 2 of the adenylate cyclase system, once the GCPR has been activated?

A

The GPCR relays the message to the G protein in the cytoplasm.

The alpha subunit of the G protein is bound to GDP and once activated by the signal, the GDP will be replaced with GTP.

131
Q

How many subunits make up the G protein that is used in the adenylate cyclase system?

A

3 subunits.

Alpha.

Beta.

Gamma.

132
Q

When the GDP of the G protein in the adenylate cyclase system is replaced with GTP, what does it become known as?

A

The GS-alpha subunit.

133
Q

What happens in step 3 of the adenylate cyclase system, once the G protein is bound to GTP?

A

The GS-alpha subunit dissociates from the beta and gamma subunits and moves to the target enzyme and bind activate it it.

134
Q

What is the target enzyme of the GS alpha subunit?

A

Adenylate cyclase.

135
Q

What happens in step 4 of the adenylate cyclase system, once adenylate cyclase has been activated?

A

Adenylate cyclase uses an ATP to catalyse the formation of cAMP which is the 2nd messenger.

136
Q

What happens in step 5 of the adenylate cyclase system, once cAMP has been formed?

A

cAMP will then travel through the cytoplasm to activate protein kinase A.

137
Q

What happens in step 6 of the adenylate cyclase system, once PKA has been activated by cAMP?

A

PKA will phosphorylate and activate other enzymes within the cell. This is when a cellular response is produced.

138
Q

What part of the adenylate cyclase system produces a cellular response?

A

The phosphorylation of enzymes by PKA.

139
Q

How is the adenylate cyclase system stopped?

A

Phosphodiesterase will hydrolyse cAMP to 5-AMP and PKA will be deactivated.

140
Q

What is the stimulus for the beta adrenergic receptor?

A

Epinephrine/norepinephrine.

141
Q

What is the G protein for the beta adrenergic and glucagon receptor?

A

GS alpha.

142
Q

What is the effector enzyme for the beta adrenergic and glucagon receptor?

A

Adenylate cyclase.

143
Q

What is the second messenger for the beta adrenergic and glucagon receptor?

A

cAMP.

144
Q

What is the second messenger target for the beta adrenergic and glucagon receptor?

A

Protein kinase A.

145
Q

What is the stimulus for the glucagon receptor?

A

Glucagon.

146
Q

Is the alpha-1 adrenergic receptor is distinct from the beta adrenergic receptor?

A

Yes.

147
Q

What do the alpha-1 adrenergic receptor and the beta adrenergic receptor have in common?

A

They are both GCPRs.

148
Q

What activates the alpha-1 adrenergic receptor?

A

Epinephrine or norepinephrine.

149
Q

What is the major difference between the beta adrenergic receptor and the alpha-1 adrenergic receptor?

A

The alpha-1 adrenergic receptor activates a different G-protein which activates a different target enzyme and produces a different 2nd messenger.

150
Q

What pathway is activated by the alpha-1 adrenergic receptor?

A

The phosphoinositide system.

151
Q

What is the phosphoinositide system called the phosphoinositide system?

A

Because it uses phosphoinositol 4,5-bisphosphate, this can be abbreviated to PIP-2.

152
Q

Where is PIP-2 found?

A

As part of the plasma membrane.

153
Q

What will cleave PIP-2?

A

Phospholipase C.

154
Q

What is formed when PIP-2 is cleaved?

A

IP3 and DAG.

155
Q

What is step 1 of the phosphoinositide system?

A

Epinephrine or norepinephrine binds to the alpha-1 adrenergic receptor and will signal the G protein.

156
Q

What is step 2 of the phosphoinositide system once epinephrine has bound to the receptor?

A

The alpha subunit of the G protein is swaps GDP for GTP.

The alpha subunit then dissociates from the G protein.

157
Q

What is the dissociated alpha subunit known as in the phosphoinositide system?

A

GQ alpha.

158
Q

When does the GQ alpha subunit become activated?

A

When it is bound to GTP.

159
Q

What is step 3 of the phosphoinositide system once the GQ alpha subunit has dissociated from the G protein?

A

GQ alpha travels to its target enzyme which is phospholipase C.

160
Q

What is step 3 of the phosphoinositide system once phospholipase C has been activated?

A

Phospholipase C travels through the cell membrane until it finds PIP-2.

161
Q

What happens when phospholipase C cleaves PIP-2?

A

It cleaves it to form 2 second messengers which are IP3 and DAG.

162
Q

What does IP3 do in the phosphoinositol system?

A

It travels into the cytoplasm and binds to the ER which causes a release of calcium ions from the ER.

163
Q

What does DAG do in the phosphoinositol system?

A

DAG and the calcium ions from the ER will activate protein kinase C.

164
Q

Are the calcium ions in the phosphoinositol system considered to be a 2nd messenger?

A

Yes.

165
Q

What does protein kinase C do once it is activated by the phosphoinositol system?

A

It will phosphorylate specific enzymes which leads to a cellular response.

166
Q

What is the stimulus for the alpha-1 adrenergic receptor?

A

Epinephrine/norepinephrine.

167
Q

What is the G protein for the alpha-1 adrenergic receptor?

A

GQ alpha subunit.

168
Q

What is the effector enzyme for the alpha-1 adrenergic receptor?

A

Phospholipase C.

169
Q

What is the effector enzyme target for the alpha-1 adrenergic receptor?

A

PIP-2.

170
Q

What are the 2nd messengers for the alpha-1 adrenergic receptor?

A

Calcium ions.

DAG.

IP-3.

171
Q

What is the 2nd target in the alpha-1 adrenergic receptor?

A

Protein kinase C.

172
Q

Will epinephrine and glucagon be produced when blood glucose levels are low?

A

Yes.

173
Q

What pathways are shut down by the presence of glucagon?

A

The major pathways that utilise glucose such as glycolysis.

174
Q

What pathways are activated by the presence of glucagon?

A

The pathways that synthesise glucose within the body such as glycogen degradation and gluconeogenesis.

175
Q

Glucagon prompts the release of energy from where?

A

From energy that is already in the body.

176
Q

Is glucagon an anabolic or catabolic hormone?

A

A catabolic hormone.

177
Q

What hormone activates lipolysis?

A

Glucagon.

178
Q

Does glucagon stimulate amino acid uptake in cells?

A

Yes.

179
Q

Where are the amino acids that are taken up by cells as a response to glucagon taken from?

A

The turnover of proteins in the muscle

180
Q

What are the amino acids that are taken up by cells as a response to glucagon used for?

A

They are used as gluconeogenic precursors.

181
Q

What will happen to stored carbohydrates in the fasting state?

A

The liver will break them down to release glucose via gluconeogensis.

182
Q

What happens to lipids in the fasting state?

A

Glucagon leads to TAG breakdown in the liver and will also stimulate the β oxidation of fatty acids and ketone synthesis.

183
Q

What cells does beta oxidation take place in?

A

In cells that have mitochondria.

184
Q

What happens to proteins in the fasting state?

A

There will be an increase in amino acid uptake from muscle degradation.

185
Q

Will the amount of amino acids in the blood decrease in the fasting state?

A

Yes.

As they are being used as precursors for gluconeogenesis.

186
Q

What amino acid is most often used as a gluconeogenic pre-cursor?

A

Alanine.

187
Q

Will glucagon stimulate glycogenolysis in the liver, muscle or adipose tissue?

A

Liver. Yes.

Muscle. No.

Adipose tissue. No.

188
Q

Will glucagon inhibit glycogenesis in the liver, muscle or adipose tissue?

A

Liver. Yes.

Muscle. No.

Adipose tissue. No.

189
Q

Will glucagon stimulate gluconeogenesis in the liver, muscle or adipose tissue?

A

Liver. Yes.

Muscle. No.

Adipose tissue. No.

190
Q

Will glucagon stimulate lipolysis in the liver, muscle or adipose tissue?

A

Liver. Yes.

Muscle. No,

Adipose tissue. Sometimes, but this is due to epinephrine.

191
Q

Will glucagon stimulate of ketone formation in the liver, muscle or adipose tissue?

A

Liver. Yes.

Muscle. No.

Adipose tissue. No.

192
Q

Will glucagon stimulate of amino acid uptake in the liver, muscle or adipose tissue?

A

Liver. Yes.

Muscle. No.

Adipose tissue. No.

193
Q

When will someone become hypoglycaemic?

A

If blood glucose levels drop below half their usual concentration.

194
Q

What is around 1/2 the normal blood glucose concentration?

A

Around 40 mg/dl.

195
Q

How many sets of symptoms are associated with hypoglycaemia?

A

2.

196
Q

How can hypoglycaemia be resolved?

A

By the administration of glucose to the affected person.

197
Q

What are the 1st set of symptoms of hypoglycaemia called?

A

The adrenergic symptoms.

198
Q

What are the adrenergic symptoms of hypoglycaemia?

A

Increased anxiety.

Body tremors etc.

199
Q

The adrenergic symptoms of hypoglycaemia are considered to be a normal response to what?

A

A drop in blood glucose.

200
Q

What can cure the adrenergic symptoms of hypoglycaemia?

A

By the brain releasing glucagon which will lead to an increase of blood glucose levels.

201
Q

When will the brain start to release glucagon?

A

When blood glucose levels reach between 70-60 mg/dl.

202
Q

What are the 2nd set of symptoms of hypoglycaemia called?

A

The neuroglycopenic symptoms.

203
Q

What are the neruoglycopenic symptoms of hypoglycaemia?

A

An impairment of brain function.

Headaches.

Can result in a coma if left untreated.

204
Q

What is are the more serious symptoms of hypoglycaemia?

A

The neuroglycopenic symptoms.

205
Q

What causes the neuroglycopenic symptoms of hypoglycaemia?

A

When the brain does not register a drop in blood glucose levels and no glucagon is produced.

206
Q

What are 4 other factors other than low blood sugar that can induce hypoglycaemia?

A

Insulin induced.

Postprandrial.

Fasting.

Alcohol intoxication.

207
Q

What is insulin induced hypoglycaemia?

A

When a diabetic takes insulin and forgets to eat.

The insulin stimulates an uptake in glucose from the blood resulting in hypoglycaemia.

208
Q

What is postprandial hypoglycaemia?

A

When the pancreas over produces insulin after a meal.

This causes glucose in the blood to be removed and hypoglycaemia occurs.

209
Q

What is fasting hypoglycaemia?

A

When blood glucose drops below normal levels due to no food being consumed.

It can also occur via a disease, where the pancreas has a tumour that causes a production of insulin.

210
Q

What is alcohol intoxication hypoglycaemia?

A

Alcohol metabolism causes an NADH surplus which deprives the liver of precursors for gluconeogenesis.

If gluconeogenesis cannot occur, then hypoglycaemia will set in.

211
Q

What enzyme metabolises alcohol?

A

Alcohol dehydrogenase.

212
Q

What does alcohol dehydrogenase convert ethanol to?

A

Acetaldehyde which is converted to acetate by acetaldehyde dehydrogenase.

213
Q

What is does acetaldehyde and alcohol dehydrogenase produce in alcohol metabolism?

A

NADH.

214
Q

What happens to blood glucose levels and glucagon levels immediately after a meal?

A

Blood glucose levels rise and glucagon levels will rise with them.

215
Q

What causes glucagon levels to rise after a meal?

A

Amino acids in the blood.

216
Q

When will glucagon levels fall after a meal has been consumed?

A

When insulin levels rise.