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Endocrine 2 Flashcards

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1
Q

List the steps in conversion of cholesterol to aldosterone.

A
  1. Cholesterol
  2. Pregnenolone
  3. Progesterone
  4. 11-deoxycorticosterone
  5. Corticosterone
  6. 18(OH) Corticosterone
  7. Aldosterone
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2
Q

What enzyme converts cholesterol to pregnenolone in all three layers of the adrenal cortex?

A

Cholesterol side chain cleavage, P450scc, Desmolase, Cyp11A1

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3
Q

What enzyme converts pregnenolone to progesterone in the G and F?

A

3-beta-HSD

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4
Q

What enzyme converts progesterone to 11-deoxycorticosterone?

A

21-hydroxylase, p450c21, Cyp21A2

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5
Q

What enzyme converts 11-deoxycorticosterone to corticosterone?

A

11-hydroxylase, P450c11, Cyp11B2

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6
Q

What enzyme converts corticosterone to 18(OH) corticosterone?

A

18-hydroxylase, p450aldo, aldosterone synthase, Cyp11B2

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7
Q

What enzyme converts 18(OH) corticosterone to aldosterone?

A

18-oxidase, p450aldo, aldosterone synthase, Cyp11B2

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8
Q

List the steps in conversion of cholesterol to cortisol.

A
  1. Cholesterol
  2. Pregnenolone
  3. Progesterone
  4. 17(OH) progesterone
  5. 11-deoxycortisol
  6. Cortisol
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9
Q

What enzyme converts progesterone to 17(OH) progesterone?

A

17-hydroxylase, P450c17, Cyp17

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10
Q

What enzyme converts 17(OH) progesterone to 11-deoxycortisol?

A

21-hydroxylase, P450c21, Cyp21A2

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11
Q

What enzyme converts 11-deoxycortisol to cortisol?

A

11-hydroxylase, P450c11, Cyp11B1

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12
Q

List the steps in conversion of cholesterol to DHEA.

A
  1. Cholesterol
  2. Pregnenolone
  3. 17(OH) pregnenolone
  4. DHEA
  5. DHEAS or Androstendione
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13
Q

What enzyme converts pregnenolone to 17(OH) pregnenolone?

A

17-hydroxylase, p450c17, Cyp17

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14
Q

What enzyme converts 17(OH) pregnenolone to DHEA?

A

17, 20-lyase; Cyp17

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15
Q

What enzyme converts DHEA to DHEAS?

A

Sulfotransferase

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16
Q

What enzyme converts DHEA to androstendione?

A

3-beta-HSD

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17
Q

Describe the levels of DHEA, glucocorticoids, and mineralocorticoids in 11-hydroxylase deficiency.

A
  1. High DHEA
  2. No glucocorticoids
  3. Low aldosterone, high MR activity
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18
Q

Describe the symptoms of 11-hydroxylase deficiency.

A
  1. Hypertension
  2. Hypokalemia
  3. Low renin, high ANP
  4. Masculinization
  5. High ACTH
  6. Salt and water retention
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19
Q

Describe the levels of DHEA, glucocorticoids, and mineralocorticoids in 17-hydroxylase deficiency.

A
  1. Low DHEA
  2. No glucocorticoids
  3. Low aldosterone, high MR activity
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20
Q

Describe the symptoms of 17-hydroxylase deficiency.

A
  1. Hypertension
  2. Hypokalemia
  3. Feminization/ambiguous genitalia
  4. High ACTH
  5. Salt and water retention
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21
Q

Describe the levels of DHEA, glucocorticoids, and mineralocorticoids in 21-hydroxylase deficiency.

A
  1. High DHEA
  2. No glucocorticoids
  3. No mineralocorticoids
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22
Q

Describe the symptoms of 21-hydroxylase deficiency.

A
  1. Hypotension
  2. Hyperkalemia
  3. High renin
  4. Masculinization/ambiguous genitalia
  5. High ACTH
  6. Sodium loss
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23
Q

Which 2 hormones are released from the ARC?

A
  1. Dopamine

2. GHRH

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24
Q

Which 4 hormones are release from the PVN?

A
  1. AVP
  2. CRH
  3. OXY
  4. TRH
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25
Which hormone is released from the SON?
1. AVP
26
Which hormone is released from the PeVN?
1. Somatostatin
27
Which hormone is released from the POA?
1. GnRH
28
What are the components of the HPL axis?
H: GHRH (ARC) P: GH (somatotropes) L: IGF-1 (liver)
29
What are the components of the HPA axis?
H: CRH (PVN) P: ACTH (corticotropes) A: Cortisol (zona fasciculata of adrenal cortex)
30
What are the components of the HPT axis?
H: TRH (PVN) P: TSH (thyrotropes) T: T3/T4 (follicles of thyroid gland)
31
What are the components of the HPG axis?
H: GnRH (POA) P: LH/FSH (gonadotropes) G: Androgens and Estrogens (testes/ovaries)
32
What are the receptors of CRH and which has a higher affinity for the hormone?
CRH-R1 (higher affinity for CRH) | CRH-R2 (higher affinity for urocortin)
33
What are the receptors of ACTH and which has a higher affinity for the hormone?
MC1R (lower affinity) | Mc2R (higher affinity)
34
What are the receptors of PTH and what is bound to each?
PTH1R: binds 1-34, 1-84, PTHrP PTH2R: binds 1-34
35
Broadly, what is the result of the HPL axis?
Promotion of lean body mass, increased protein, decreased adiposity, increased plasma glucose
36
Broadly, what is the result of the HPA axis?
Steroidogenesis, cell growth, decrease muscle mass, bone formation, connective tissue, inflammation, increase arteriolar tone, fetus maturation, GFR/free water clearance
37
Broadly, what is the result of the HPT axis?
Generation of futile metabolic cycles (metabolic homeostasis)
38
Broadly, what is the result of the HPG axis?
Reproduction
39
Which hormones must be released in a pulsatile manner?
1. GHRH 2. GH 3. CRH 4. GnRH
40
What is the binding protein of AVP?
Neurophysin II
41
What is the binding protein of OXY?
Neurophysin I
42
What is the binding protein of GH?
GHBP
43
What is the binding protein of cortisol?
CBG
44
What is the binding protein of T3/T4?
TBG, TTR
45
What are the binding proteins of sex hormones?
SHBG, ABG
46
What hormone tonically activates dopamine?
TH
47
What hormone activates NE?
ACTH
48
What hormone activates EPI?
Cortisol
49
What hormones activate GH?
Dopamine, NE/E, TH, ghrelin
50
What hormone activates somatostatin?
IGF-1
51
What hormones activate prolactin?
Estrogen, TRH, OXY
52
What hormone activates CRH?
AVP
53
What hormone activates Vitamin D?
PTH
54
What hormones activate LH?
Fast GnRH pulses, kisspeptin, activin, estradiol
55
What hormones activate FSH?
Slow GnRH pulses, kisspeptin, activin
56
What hormone activates DHEA?
ACTH
57
What hormone activates testosterone?
Inhibin
58
What hormones activate glucagon?
NE, E
59
What hormones activate EPO?
TH, NE, androgens
60
What hormone inhibits AVP?
Cortisol
61
What hormone inhibits GHRH?
Somatostatin
62
What hormone inhibits somatostatin?
Insulin
63
What hormone tonically inhibits prolactin?
Dopamine
64
What hormones tonically inhibits TSH?
Somatostatin, dopamine
65
What hormone inhibits testosterone?
Activin
66
What hormones inhibit insulin?
NE, E, ghrelin
67
What hormone inhibits EPO?
Estrogens
68
GH stimulation of IGF-1 in the liver is dependent upon what hormone?
Insulin
69
What activates CYP11B2 to synthesize aldosterone?
Angiotesin II
70
How does PTH regulate calcium?
Increases bone resorption and plasma Ca2+
71
How does Vitamin D regulate calcium?
Increases bone resorption, plasma Ca2+, and intestinal Ca2+ uptake
72
How does calcitonin regulate calcium?
Decreases bone resorption and plasma Ca2+
73
How does estrogen regulate calcium?
Increases 1-alpha-hydroxylase activity, stimulates OPG, leads to net decrease in bone loss
74
How do GH and IGF-1 regulate calcium?
Stimulate bone synthesis and growth
75
How do glucocorticoids regulate calcium?
Increase bone resorption, decrease bone synthesis, inhibit OPG
76
What is the onset age in T1DM and T2DM?
1: Juvenile 2: Adult
77
What is the major risk factor in T1DM and T2DM?
1: autoimmune 2: obesity
78
What is the status of beta cells in T1DM and T2DM?
1: destroyed 2: partially functioning
79
What are the insulin levels in T1DM and T2DM?
1: none-low 2: variable
80
What is tolerance to glucose in T1DM and T2DM?
1: severely intolerance 2: variable
81
What is the insulin dependence in T1DM and T2DM?
1: insulin dependent 2: variable
82
What is the insulin resistance in T1DM and T2DM?
1: not resistant 2: insulin resistant
83
Menarche (first menses) usually occurs at what age?
Between 11-14 y/o, avg. 12.5
84
What is thelarche and when does it occur?
Breast budding; typically occurs before menstruation
85
No puberty stages before age ___ is cause for evaluation.
13
86
A difference in Tanner stages of more than ___ is cause for concern.
2
87
What is the first puberty sign for females and males?
Breast bud development; testicle enlargement
88
Define precocious puberty for females and males.
Females: puberty before 8 Males: puberty before 9

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