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BRS Physio > Endocrine Physiology > Flashcards

Endocrine Physiology Flashcards

1
Q

Preprohormone

A

synthesis occurs in ER and is directed by mRNA

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2
Q

Prohormone

A

preprohormone with the signal peptides cleaved, transported to the Golgi apparatus

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3
Q

Hormone

A

finished being modified in Golgi

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4
Q

Amine hormones

A

derivatives of tyrosine

thyroid hormones, epinephrine, NE

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5
Q

Negative Feedback

A

hormone that can directly or indirectly inhibit further secretion of hormone

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6
Q

Positive Feedback

A

explosive and self-reinforcing

Ex. LH with estrogen

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7
Q

A hormone that decreased the number or affinity of receptors for itself or for another hormone

A

Down-regulation

Ex. Progesterone downreg its own receptor and receptor for estrogen

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8
Q

A hormone that increases the number or affinity of receptors for itself or for another hormone

A

Up-regulation

Ex. estrogen up-reg its own receptor and receptor for LH on ovaries

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9
Q

Hormones that use cAMP Mechanism

A

FSH, LH, ACTH, ADH (V2), HCG, MSH, CRH, B1 and B2, Calcitonin, PTH, Glucagon

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10
Q

Hormones that use IP3 Mechanism

A

GnRH, TRH, GHRH, AngII, ADH (V1), Oxytocin, alpha-1

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11
Q

Steroid Hormone Mechanism

A

Glucocorticoids, Estrogen, Testosterone, Progesterone, Aldosterone, Vit D, Thyroid Homrone

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12
Q

Activation of Tyrosine Kinase

A

Insulin and IGF-1

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13
Q

Uses cGMP

A

ANP, EDRF, Nitric Oxide

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14
Q

Uses Hypothalamic-hypophysial portal system

A

anterior lobe of pituitary

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15
Q

cell bodies for posterior lobe of pituitary

A

in hypothalamic nuclei

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16
Q

Produced by a single pro-opiomelanocortin (POMC)

A

ACTH, MSH, beta-lipotropin and beta-endorphin

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17
Q

Causes increased secretion of Growth Hormone

A

sleep, stress, puberty hormones, starvation, exercise, and hypoglycemia

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18
Q

Causes decrease in Growth Hormone

A

somatostatin, somatomedins, obesity, hyperglycemia, and pregnancy

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19
Q

Somatomedins

A

produces when GH acts on target tissues
inhibit the secretion of growth hormone by acting directly on anterior pituitary and stimulating secretion of somatostatin

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20
Q

Factors that increase Prolactin secretion

A

estrogen during pregnancy, breast-feeding, sleep, stress, TRH, DA antgonists

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21
Q

Factors that decrease Prolactin secretion

A

dopamine, bromocriptine, somatostatin, Prolactin from negative feedback

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22
Q

Supraoptic nuclei

A

where ADH originates

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23
Q

Paraventricular nuclei

A

where Oxytocin originates

CRH containing neurons

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24
Q

Causes ejection of milk from breat

A

Oxytocin

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25
Q

dilation of cervix and orgasm

A

increase secretion of oxytocin

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26
Q

Can be used to induce labor and reduce postpartum bleeding

A

Oxytocin

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27
Q

inhibit iodide pump and Na-I cotransport

A

thiocyanate and perchlorate anions

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28
Q

iodide into I2

A

peroxidase enzyme in the follicular cell membrane

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29
Q

propylthiouracil

A

inhibits peroxidase enzyme to treat hyperthyroidism

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30
Q

Organification

A

Tyrosine residues of thyroglobulin react with I2 to form MIT and DIT

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31
Q

Inhibits Organification

A

high levels of iodide (I-) inhibit organification

Wolff-Chaikoff Effect

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32
Q

DIT + DIT

A 
makes thyroxine (T4)
T4 is more prevalent but T3 is more active
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33
Q

MIT+DIT

A 
makes triiodothyronine (T3)
T3 downregulates TRH receptors
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34
Q

Thyroid deiodinase

A

deiodinates leftover MIT and DIT, if deficient in this enzyme, it will mimic iodine deficiency

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35
Q

Liver Failure and Thyroid Hormone

A

Liver failure causes a decrease in TBG leading to decrease in total thyroid hormone levels, but normal levels of free thryoid

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36
Q

Pregnancy and Thyroid Hormone

A

TBG levels increase leading to an increase in total thyroid hormone levels, normal levels of free hormone

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37
Q

5’-iodinase

A

converts T4 into T3 or rT3 (rT3 is inactive)

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38
Q

Grave’s Disease

A

thyroid stimulating antibodies
low conc of TSH
hyperthyroidism

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39
Q

Actions of Thyroid Hormone

A

promote bone formation
matures CNS in perinatal period
up-regulates B1 in the heart, increase CO
increases syn of Na/K-ATPase
glycogenolysis, gluconeogenesis, glucose oxidation, lipolysis, catabolic protein

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40
Q

listlessness, slowed speech, somnolence, impaired memory, and decreased mental capacity

A

hypothyroidism

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41
Q

Cretinism

A

Congenital Hypothyroidism

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42
Q

Myxedema

A

Hypothyroidism

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43
Q

Exophthalamos

A

Hyperthyroidism

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44
Q

Zona glomerulosa

A

makes aldosterone

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45
Q

Zona fasciculata

A

makes glucocorticoids (cortisol)

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46
Q

Zona Reticularis

A

makes androgens like dehydroepiandrosterone and androstenedione

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47
Q

21-Carbon steroids

A

progesterone, deoxycorticosterone, aldosterone, and cortisol

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48
Q

Hydroxylation of C21 of progesterone

A

makes deoxycorticosterone (a mineralocorticoid)

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49
Q

Hydroxylation of C17 of progesterone

A

makes cortisol (a glucocorticoid)

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50
Q

19 Carbon Steroids

A

have androgenic activity and are precursors to estrogen

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51
Q

18 Carbon Steroids

A

have estrogenic activity

Oxidation of A ring (aromatization) priduce estrogen occurs in ovaries and placenta

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52
Q

Cortisol levels for people who sleep at night

A

highest just before waking (~8am) and lowest in the evening (~12am)

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53
Q

precursor to ACTH

A

POMC which is synthesized when CRH binds corticotrophs in anterior pituitary

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54
Q

Cholesterol desmolase

A

stimulated by ACTH to increase steroid synthesis

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55
Q

Dexamethasone Suppression test

A

based on the ability of dexamethasone to inhibit ACTH secretion

  • normal people: ACTH will be suppressed
  • ACTH-sercreting tumors: high-dose dexa suppresses it
  • adrenal cortical tumors: no dex can inhibit cortisol secretion
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56
Q

Aldosterone

A

under tonic control by ACTH and separately regulated by RAS

used to increase blood volume by reabsorpting Na and secrete K and H

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57
Q

Glucocorticoids in response to stress

A

stimulates gluconeogenesis, they increase protein catabolism, decrease glucose utilization and insulin sensitivity in adipose, increase lipolysis

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58
Q

Glucocorticoids anti-inflammatory effects

A

Induce syn of lipocortin and inhibitor of phospholipase A2
inhibit production of IL-2 and prolif of T cells
inhibit release of histamine and serotonin

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59
Q

Glucocorticoids and the suppression of the immune system

A

inhibit the production of IL-2 and T cells

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60
Q

Glucocorticoids and vascular responsiveness to catecholamines

A

cortisol up-regulates alpha-1 receptors on arterioles, increasing their sensitivity to the vasoconstrictor effect of NE

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61
Q

Addison’s Disease

A

Primary Adrenocortical Insufficiency
increased ACTH, hypoglycemia, hyperpigmentation, decreased pubic and axillary hair
Wt loss, Weak, N/V

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62
Q

Secondary Adrenocortical Insufficiency

A

Caused by primary deficiency of ACTH
only cortisol levels are low
fatigue, muscle weakness, wt loss

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63
Q

Cushing Syndrome

A

Primary adrenal hyperplasia.
produces elevated glucocorticoid levels
HTN, Wt gain, truncal obesity, moon facies, buffalo hump, virilization in women

64
Q

Cushing Disease

A

ACTH-secreting pituitary microadenoma
- pituitary form of cushing syndrome
Hyperglycemia; Muscle wasting; Central obesity; Round face, supraclavicular fat, buffalo hump; Osteoporosis; Striae; Virilization and menstrual disorders in women; Hypertension

65
Q

Cushing Dx treatment

A

Ketoconazole - an inhibitor of steroid hormone synthesis

or Metyrapone

66
Q

Conn’s Syndrome

A

Hyperaldosterone caused by aldosterone secreting tumor

Hypertension; Hypokalemia; Metabolic Alkalosis; Decreased Renin

67
Q

Tx of Conn’s

A

Spironolactone (aldosterone antagonist)

68
Q

17α-Hydroxylase deficiency

A

↓ adrenal androgens and glucocorticoids; ↑ mineralcorticoids; ↑ ACTH
Lack of pubic and axillary hair in women; hypoglycemia; metabolic alkalosis, hypokalemia, hypertension

69
Q

21β-Hydroxylase deficiency

A

↓ glucocorticoids and mineralcorticoid(cortisol and aldosterone); ↑ adrenal androgens
Virilization of women; Early acceleration of linear growth; Early appearance of pubic and axillary hair

70
Q

Links beta cells and alpha cells in the pancreas

A

Gap Junctions

71
Q

Decrease blood glucose stimulates this

A

Glucagon

72
Q

Actions of Glucagon

A

increase glycogenolysis, gluconeogenesis, lipolysis and urea production
decreases phosphofructoskinase activity

73
Q

Central Islet

A

beta cells, insulin

74
Q

outer rim of islet

A

alpha cells, glucagon

75
Q

intermixed in islet

A

delta cells that secrete somatostatin and gastrin

76
Q

second messenger for glucagon

A

cAMP, acts of liver and adipose tissue

77
Q

What to measure in diabetics to see if they’re making insulin

A

C-peptide

78
Q

Major factor that stimulate insulin

A

blood glucose (which binds Glut 2 on beta cells)

79
Q

Sulfonylurea drugs

A

tolbutamide and glyburide, stimulate insulin secretion by closing K channels

80
Q

Insulin receptor

A

tetramer with 2 alpha and 2 beta subunits.

Beta subunits span the cell membrane and have TK activity

81
Q

Factors that decrease insulin secretion

A

decreased blood glucose, somatostatin, NE and epinephrine

82
Q

Factors that increase insulin secretion

A

increased blood glucose, AA like arginine, lysine, leucine, increased FA, glucagon, GIP and ACh

83
Q

of insulin receptors in obesity and starvation

A

insulin downregulates itself so they will increase in number in starvation and decrease in number in obesity

84
Q

Insulin and Potassium

A

insulin decreases K in blood and increases its uptake into cells

85
Q

Diabetes Mellitus

A

Insulin Deficiency: Hyperglycemia, Hypotension, Metabolic Acidosis, Hyperkalemia

86
Q

Positive Calcium Balance

A

growing children, intestinal Ca absorption exceeds urinary excretion, and excess is deposited in growing bones

87
Q

Negative Calcium Balance

A

in women during pregnancy or lactation. intestinal calcium absorption is < calcium excretion

88
Q

PTH is secreted from where?

A

Chief cells in parathyroid glands

89
Q

Secretion stimulus for PTH

A

decreased serum calcium

90
Q

Secretion stimulus for Vit D

A

decreased serum calcium, increased PTH, decreased serum phosphate

91
Q

Secretion Stimulus for Calcitonin

A

increased serum calcium

92
Q

Action of PTH on Bone

A

increases resorption to increase serum calcium

same as vit D

93
Q

Action of Calcitonin on Bone

A

decreases bone resorption

94
Q

Action of PTH on Kidney

A

decreases phosphate reabsorption but increasing urinary cAMP

increase calcium reabsorption in DT

95
Q

Action of Vit D on Kidney

A

increases phosphate reabsorption

increase calcium reabsorption

96
Q

Action of PTH on intestine

A

increases calcium reabsorption

increase calcium absorption by activating vit D

97
Q

Action of Vit D on Intestine

A

increases Calcium absorption bu calbindin D-28K) and phosphate absorption

98
Q

PTH on serum calcium and phosphate

A

increase in calcium, decrease in phosphate

99
Q

Vit D on serum calcium and phsophate

A

increase both phosphate and calcium

100
Q

calcitonin on serum calcium

A

decreases serum calcium, puts it back into the bones

101
Q

Parathyroid adenoma

A

Most common cause of primary hyperPTH
hypercalcemia, hypoPhos, phosphaturic effect of PTH (increase urine secretion of Phos), increase calcium excretion by increase filtered load of Calcium, increase urinary cAMP, increase bone resorption

102
Q

Humoral hyperCa of Malignancy

A

PTH-related peptide from malignant tumor, increase bone resorption, hyperCa, hypoPhos, decreased serum PTH due to increase serum Calcium

103
Q

Most common cause of Hypoparathyroidism

A

Thyroid surgery

104
Q

HypoPTH

A

hypocalcemia (tetany)

hyperPhos

105
Q

Albright’s Hereditary Osteodystrophy

A

PseudohypoPTH type Ia
defective Gs protein in kidney and bone causing end organ resistance to PTH
hypocalcemia and hyperphosphatemia can’t be corrected with exogenous PTH
PTH elevated

106
Q

Chronic Renal Failure

A

decreased GFR, increase serum phosphate, decrease calcium
decreased production of 1,25-dihydroxycholecalciferol
secondary hyperPTH

107
Q

Renal osteodystrophy

A

S/E of chronic renal failure, increased bone resorption and osteomalacia

108
Q

Vit D deficiency in kids

A

Rickets

109
Q

Vit D deficiency in adults

A

Osteomalacia

110
Q

Active form of Vit D

A

1,25-dihydroxycholecalciferol which made in kidney from 1alpha-hydroxylase

111
Q

1alpha-hydroxylase activity is increased when

A

decreased serum calcium, increased PTH, decreased serum phosphate

112
Q

Secreted by Parafollicular cells of the thyroid

A

Calcitonin, inhibits bone resorption, used to treat hyperCa

113
Q

genetic sex

A

XX is female

XY is male

114
Q

Gonadal sex

A

testes in males

ovaries in females

115
Q

Phenotypic Sex

A

characteristics of internal genital tract and the external genitalia

116
Q

testes secrete

A

Antimullerian hormone and testosterone

117
Q

Sertoli Cells

A

secrete antimullerian hormone
FSH acts on this to maintain spermatogenesis
Produces inhibin

118
Q

Leydig cells

A

stim cholesterol desmolase

LH acts on this to promote testosterone synthesis

119
Q

Mullerian Ducts

A

Female internal genital tract

120
Q

5alpha-reductase

A

In prostate, converts testosterone to its active form dihydrotestosterone

121
Q

Finasteride

A

5alpha-reductase inhibitor used to tx benign prostatic hyperplasia

122
Q

Arcute nuclei of hypothalamus

A

secrete GnRH

123
Q

Inhibin

A

produced by Sertoli Cells to inhibit the secretion of FSH

124
Q

Cause pubertal growth spurt and cessation of it (epiphyseal closure)

A

Testosterone

125
Q

Paracrine effect of Spermatogenesis in Sertoli cells

A

Testosterone

126
Q

Deepens Voice

A

Testosterone

127
Q

Causes differentiation of penis, scrotum, and prostate

A

Dihydrotestosterone

128
Q

Male hair pattern and male pattern baldness

A

Dihydrotestosterone

129
Q

Growth of Prostate and sebaceous gland activity

A

Dihydrotestosterone

130
Q

Androgen Insensitivity Disorder

A

testicular feminizing syndrome
deficiency of androgen receptors but increased testosterone
femal external genitalia and no internal geital tract

131
Q

Childhood LH and FSH

A

low but FSH>LH

cause you eat more goldfish in childhood

132
Q

Puberty and Reproductive Years LH and FSH

A

hormone levels are increased and LH > FSH

133
Q

Senescence LH and FSH

A

hormone levels are the highest FSH > LH

134
Q

Theca Cells

A

produce testosterone in females (stim at 1st step by LH)
and then diffuses to granulosa cells
LH from theca cells change cholesterol into pregnenolone

135
Q

Granulosa cells

A

contain aromatase and convert testosterone to 17beta-estradiol (stim by FSH)

136
Q

Causes the development of female secondary sex characteristics at puberty

A

estrogen

Progesterone participates in the development of breasts

137
Q

Causes proliferation and development of ovarian granulosa cells

A

Estrogen

138
Q

Lowers uterine threshold to contractile stimuli during pregnancy

A

Estrogen

139
Q

Has negative feedback effects on FSH and LH secretion during luteal phase

A

Progesterone

140
Q

Maintains Pregnancy

A

Estrogen and progesterone

141
Q

Raises uterine threshold to contractile stimuli during pregnancy

A

Progesterone

142
Q

Maintains secretory activity of the uterus during luteal phase

A

Progesterone

143
Q

Follicular Phase

A

days 0-14
primordial follicle becomes graafian w/ atresia of neighboring follicles
estradiol levels increase and proliferate the uterus
FSH and LH are suppressed, progesterone is low

144
Q

Ovulation

A

Day 14 if on a 28day cycle
burst of estradiol has + feedback effect on secretion of FSH and LH (LH surge)
cervical mucus increases in quantity, less viscous

145
Q

Luteal Phase

A

Days 14-28
corpus luteum develops and synthesizes estrogen and progesterone
basal body temps increase due to progesterone
vascular and secretory activity of endometrium increase

146
Q

Lack of fertilization

A

no fertilization in luteal phase will cause corpus lueum to regress and estradiol and progesterone levels decrease abruptly

147
Q

Menses

A

days 0-4

endometrium is sloughed due to abrupt withdrawal of estradiol and progesterone

148
Q

Pregnancy

A

steadily increasing levels of estrogen and progesterone to maintain the endometrium
inhibit FSH and LH and stimulae breast development

149
Q

fertilization

A

corpus luteum is rescued from regression by hCG which is produced by the placenta

150
Q

1st Trimester

A 
corpus luteum (stim by hCG) is responsible for productino of estradiol and progesterone
peak levels of hCG at week 9 gestation
151
Q

2nd and 3rd Trimester

A

progesterone from placenta

estrogens from fetal adrenal gland and placenta

152
Q

Major Placental estrogen

A

Estriol

153
Q

Human Placental Lactogen

A

produced throughout pregnancy, actions similar to GH and prolactin

154
Q

Parturition

A

Progesterone increases threshold for uterine contraction

near term, estrogen/progesterone ratio increases making uterus more sensitive to contractile stimuli

155
Q

Effects of Prolactin

A

inhibits GnRH secretion, therefore inhibits LH and FSH

antagonizes actions of LH and FSH

156
Q

Who is ready to drink?

A

ME!

BRS Physio (7 decks)

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