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endocrine > Growth hormone, Oxytocin, ADH > Flashcards

Growth hormone, Oxytocin, ADH Flashcards

1
Q

Another name for growth hormone is _

A

Another name for growth hormone is somatotropin

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2
Q

Growth hormone is a _ type hormone that plays a role in the regulation of bone growth

A

Growth hormone is a peptide hormone that plays a role in the regulation of bone growth
* It is hydrophilic and can freely travel in the serum

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3
Q

GH is produced by _ cells in the _ pituitary

A

GH is produced by somatotrophs in the anterior pituitary

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4
Q

The GH receptors on hepatocytes are linked to _ which phosphorylate the _ transcription factors; these TFs are then transported into the nucleus to induce gene transcription to make IGF-1

A

The GH receptors on hepatocytes are linked to JAKs which phosphorylate the STAT transcription factors; these TFs are then transported into the nucleus to induce gene transcription to make IGF-1

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5
Q

When concerned about a lack of growth we generally measure _ hormone

A

When concerned about a lack of growth we generally measure IGF-1
* IGF-1 is more stable than GH, which is released in a pulsatile manner

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6
Q

The epiphyseal plate is a plate of _ that is located at the end of a growing long bone

A

The epiphyseal plate is a plate of hyaline cartilage that is located at the end of a growing long bone
* This is where new growth takes place

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7
Q

By age _ (males) and _ (females) the epiphyseal plate closes

A

By age 20 (males) and 18 (females) the epiphyseal plate closes

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8
Q

GH and IGF-1 stimulate skeletal muscle growth by _ and _

A

GH and IGF-1 stimulate skeletal muscle growth by stimulating myocyte hypertrophy and increasing protein synthesis

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9
Q

GH and IGF-1 (increase/decrease) the serum glucose concentration

A

GH and IGF-1 increase the serum glucose concentration
* Increase hepatic gluconeogenesis
* Increase lipolysis
* Antagonize insulin

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10
Q

Two hormones secreted from the hypothalamus to regulate GH are _ and _

A

Two hormones secreted from the hypothalamus to regulate GH are GH-releasing hormone (GHRH) and GH-inhibiting hormone (GHIH)

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11
Q

Aging, obesity, and glucose will _ GHRH

A

Aging, obesity, and glucose will inhibit GHRH

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12
Q

Sleep, hypoglycemia, and stress will _ GHRH

A

Sleep, hypoglycemia, and stress will stimulate GHRH

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13
Q

Somatostatin will _ GH release from the anterior pituitary

A

Somatostatin will inhibit GH release from the anterior pituitary

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14
Q

During periods of starvation, fasting, and weight loss, GH is secreted to maintain blood sugar; this is triggered by the gastric hormone _

A

During periods of starvation, fasting, and weight loss, GH is secreted to maintain blood sugar; this is triggered by the gastric hormone ghrelin

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15
Q

Signs of acquired GH deficiency in adults may involve:

A

Signs of acquired GH deficiency in adults may involve:
* Decreased muscle mass
* Increased fat mass
* Decreased BMD
* Increased rate of fractures

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16
Q

_ syndrome is an autosomal recessive disorder that involves a mutation in the GH receptor; children present with growth failure, small head circumference, prominent foreheads, saddle nose, small genitalia

A

Laron syndrome is an autosomal recessive disorder that involves a mutation in the GH receptor; children present with growth failure, small head circumference, prominent foreheads, saddle nose, small genitalia
* They may also have hyperlipidemia, hypoglycemia

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17
Q

_ is an inherited deletion on chromosome 15 that causes childhood obesity and impaired growth

A

Prader-Willi syndrome is an inherited deletion on chromosome 15 that causes childhood obesity and impaired growth

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18
Q

In a true GH deficiency we expect IGF-1 to be _ and bone age to be _

A

In a true GH deficiency we expect IGF-1 to be low and bone age to be lower than expected

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19
Q

We can test for GH deficiency with a GH stimulation test; we adminster _ or IV _ to attempt to stimulate GH production

A

We can test for GH deficiency with a GH stimulation test; we adminster insulin or IV arginine to attempt to stimulate GH production
* Insulin decreases glucose levels –> should increase GH

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20
Q

Excess GH in childhood causes a condition called _

A

Excess GH in childhood causes a condition called gigantism
* Results in tall children

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21
Q

Excess GH in adulthood causes a condition known as _

A

Excess GH in adulthood causes a condition known as acromegaly
* This refers to GH excess that occurs after the fusion of the epiphyseal growth plates

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22
Q

Clinical features of acromegaly:

A

Clinical features of acromegaly:
* Enlarged hands and feet
* Enlarged head circumference
* Enlarged vocal cords (hoarse voice)
* Snoring from airway obstruction
* Joint pain, muscle fatigue
* Coarse facial features
* Enlarged jaw (widely spaced teeth)

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23
Q

GH excess can result in constant elevation of blood glucose levels and can lead to _ and _

A

GH excess can result in constant elevation of blood glucose levels and can lead to secondary diabetes mellitus and accelerated atherosclerosis

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24
Q

Complications of agromegaly:

A

Complications of agromegaly:
* Diabetes
* Atherosclerosis
* Hypertension
* Sleep apnea
* Hypogonadism
* Carpal tunnel
* Colon cancer

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25
Q

What is a GH suppression test?

A

GH suppression test can be given when IGF-1 is elevated and GH excess is suspected; we administer glucose which normally inhibits GH

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26
Q

_ is a somatostatin analog that can be used to decrease GH release

A

Octreotide is a somatostatin analog that can be used to decrease GH release
* Oct-treo-tide

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27
Q

_ is a GH receptor antagonist that can be used to treat excess GH

A

Pegvisomant is a GH receptor antagonist that can be used to treat excess GH
* Peg-viso-mant

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28
Q

_ is a dopamine analog which can be used to suppress GH release (second-line option)

A

Cabergoline is a dopamine analog which can be used to suppress GH release (second-line option)
* Caber-goline

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29
Q

Oxytocin is a _ type hormone

A

Oxytocin is a neuropeptide hormone
* It is water soluble and travels freely in the bloodstream

30
Q

Oxytocin is mostly made in the _ of the hypothalamus

A

Oxytocin is mostly made in the paraventricular nucleus of the hypothalamus
* Made in smaller amounts in the peripheral tissues like the ovaries, placenta, pancreas, etc

31
Q

Oxytocin is synthesized as an inactive precursor protein which must be cleaved by enzymes; _ is one of these enzymes that is dependent on _

A

Oxytocin is synthesized as an inactive precursor protein which must be cleaved by enzymes; PAM is one of these enzymes that is dependent on vitamin C

32
Q

Oxytocin secretion is stimulated by _ trigger from the hypothalamus

A

Oxytocin secretion is stimulated by an action potential delivered from the hypothalamus

33
Q

Oxytocin binds its receptor (in the breast and brain) –> activates _ –> initates a signaling cascade and altered gene expression

A

Oxytocin binds its receptor (in the breast and brain) –> activates MAP kinase –> initates a signaling cascade and altered gene expression

34
Q

Oxytocin promotes _ of smooth muscle during childbirth

A

Oxytocin promotes contraction of smooth muscle during childbirth
* Pushes fetus towards the cervix

35
Q

Rising levels of _ during the third trimester of pregnancy increases oxytocin receptor expression in the uterus

A

Rising levels of estradiol during the third trimester of pregnancy increases oxytocin receptor expression in the uterus

36
Q

Cervical dilation during labor activates _ which stimulates (positive/negative) feedback

A

Cervical dilation during labor activates stretch receptors which stimulates positive feedforward signaling to increase oxytocin
* Oxytocin release even continues after baby is born to reduce bleeding and return uterus to normal size

37
Q

Pitocin is a synthetic form of _ that is given to initate labor and cause stronger contractions during delivery

A

Pitocin is a synthetic form of oxytocin that is given to initate labor and cause stronger contractions during delivery

38
Q

Milk _ is caused by prolactin while milk _ is caused by oxytocin

A

Milk production is caused by prolactin while milk letdown is caused by oxytocin

39
Q

Oxytocin (increases/decreases) CRH

A

Oxytocin decreases CRH release from the hypothalamus
* This decreases ACTH, decreases cortisol release, reduces stress

40
Q

The main stimuli for oxytocin release are _ and _ (both positive feedback mechanisms)

A

The main stimuli for oxytocin release are suckling by the infant and dilation of the uterine cervix (both positive feedback mechanisms)

41
Q

Vasopressin is produced in the hypothalamus by _ and _ nuclei

A

Vasopressin is produced in the hypothalamus by paraventricular and supraoptic nuclei

42
Q

Vasopressin’s principal functions are _ and _

A

Vasopressin’s principal functions are vasoconstriction of arterial smooth muscle and increasing water absorption in the kidney

43
Q

Vasopressin binds to _ receptors in the vasculature, liver, and brain to stimulate smooth muscle contraction

A

Vasopressin binds to V1A receptors in the vasculature, liver, and brain to stimulate smooth muscle contraction

44
Q

ADH binds to _ receptors in the principal cells of the collecting ducts to increase water reabsorption

A

ADH binds to V2A receptors in the principal cells of the collecting ducts to increase water reabsorption
* Increases the number of aquaporins

45
Q

ADH binding to the V1B receptors on the anterior pituitary gland causes _

A

ADH binding to the V1B receptors on the anterior pituitary gland causes ACTH release –> cortisol synthesis
* Cortisol will also support the blood pressure

46
Q

ADH binding V1A receptors will cause the release of _

A

ADH binding V1A receptors will cause the release of von Willebrand factor
* This stimulates platelet aggregation and blood clotting

47
Q

Release of ADH is stimulated by _ or _

A

Release of ADH is stimulated by increased serum osmolality or extracellular volume
* Increased osmolality is sensed by osmoreceptors in the hypothalamus
* Decreased effective circulating volume is sensed by baroreceptors in heart, vessels, lungs, liver, brain

48
Q

(True/False) Ang II also stimulates ADH release

A

True; Ang II also stimulates ADH release

49
Q

The two main hormones that inhibit ADH effects are _ and _

A

The two main hormones that inhibit ADH effects are cortisol and ANP
* Cortisol blocks ADH release; ANP blocks ADH effect on the collecting duct

50
Q

Acromegaly will cause (increased linear bone growth/ disproportionate growth)

A

Acromegaly will cause disproportionate growth
* Recall that acromegaly occurs after the fusion of epiphyseal plates
* Involves frontal bossing, jaw enlargement, large hands and feet

51
Q

The most common cause of death in patients with gigantism is _

A

The most common cause of death in patients with gigantism is heart failure

52
Q

Acromegaly is associated with _ syndrome due to the compression of the median nerve

A

Acromegaly is associated with carpal tunnel syndrome due to the compression of the median nerve

53
Q

Acquired GH deficiency may occur secondary to:

A

Acquired GH deficiency may occur secondary to:
* Brain tumor
* Surgery
* TBI
* Radiation to pituitary

54
Q

GH deficiency is associated with a short stature with (proportional/disporportional) measurements

A

GH deficiency is associated with a short stature with proportional measurements

55
Q

The most potent regulator of ADH secretion is _

A

The most potent regulator of ADH secretion is serum osmolality
* Other regulators include blood volume, blood pressure, angiotensin II, cortisol, ANP

56
Q

(High/Low) cortisol levels stimulate ADH release

A

Low cortisol stimulates ADH release

57
Q

Two regulators of oxytocin release are _ and _

A

Two regulators of oxytocin release are suckling at the breast and uterine stretching

58
Q

A patient with central DI will have:
_ serum sodium
_ serum osmolality
_ urine osmolality

A

A patient with central DI will have:
High serum sodium
High serum osmolality
Low urine osmolality

59
Q

A patient with SIADH will have:
_ serum sodium
_ serum osmolality
_ urine osmolality

A

A patient with SIADH will have:
Low serum sodium
Low serum osmolality
High urine osmolality

60
Q

SIADH can cause _ volemic hyponatremia

A

SIADH can cause euvolemic hyponatremia

61
Q

First line treatment for DI is _

A

First line treatment for DI is fluid administration
* In more severe cases, IV hydration may be needed
* Synthetic ADH can be used

62
Q

Synthetic ADH like _ can be given in cases of DI

A

Synthetic ADH like desmopressin can be given in cases of DI

63
Q

The first line therapy for SIADH is _

A

The first line therapy for SIADH is fluid restriction
* ADH antagonists can also be given

64
Q

_ can be given to restore sodium in patients with SIADH

A

Hypertonic saline can be given to restore sodium in patients with SIADH

65
Q

The most common cause of excess GH is _

A

The most common cause of excess GH is benign pituitary adenoma

66
Q

Benign pituitary adenomas are associated with which risk factors?

A

Benign pituitary adenomas are associated with:
* MEN-1 (multiple endocrine neoplasia)
* McCune Albright syndrome
* Familial isolated pituitary adenomas
* GNAS related (oncogene)

67
Q

Pituitary adenomas are associated with which MEN syndrome?

A

MEN-1

68
Q

Pseudoacromegaly is a condition in which an individual has features of acromegaly but shows no change in GH or IGF-1 axis; what can cause this?

A

Causes of pseudoacromegaly:
* Medication-induced insulin resistance
* Minoxidil
* Phenytoin
* Hypothyroid

69
Q

Why might medication induced insulin resistance cause pseudoacromegaly?

A

Insulin and GH normally oppose each other; without insulin, GH is left uninhibited

70
Q

Three medication options for GH excess include _ , _ , _

A

Three medication options for GH excess include octreotide, pegvisomant, cabergoline

endocrine (8 decks)

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