Endocrine Flashcards
(116 cards)
1
Q
paracrine
A
chemical signalling to nearby cells
2
Q
autocrine
A
chemical signaling of cells among the same type
3
Q
major endocrine glands (10)
A
- pineal gland
- parathyroid
- thyroid
- hypothalamus
- pituitary
- thymus
- kidney
- adrenal
- pancreas
- ovary/testes
4
Q
what type of feedback loop primarily regulates the endocrine system
how is regulation accomplished
A
negative
secretion of inhibiting or enhancing factors
5
Q
short feed back loop
A
a feedback loop where a trophic hormone from the pituitary inhibits production of stimulating factors from the hypothalamus
6
Q
long feedback look
A
a feedback loop where the end hormone produce by trophic stimulation will inhibit production at the hypothalamus and pituitary
7
Q
which is more relevant, long or short feedback loops?
why?
A
long, because they work on the hypothalamus and the pitutiary
8
Q
how are hormones sent through out the body
A
dissolved in blood or bound to carriers
9
Q
what type of hormones will dissolve in blood
what type of hormones will need a carrier
A
water soluable
lipid soluble
10
Q
target cell
A
the end-target of a hormone that produces a response within the cell
11
Q
two ways that hormone-receptor complexes elicit effects in target cells
A
2nd messanger
DNA transcription leading to protein production
12
Q
what links receptors of the same “family)
A
they have a similar structure
13
Q
what can happen if a homone is present in high enough concentrations
A
the hormone can interact with receptors of the same family
14
Q
four types of receptor hormone interactions
A
agonists (stimulate receptors)
antagonists (block receptors)
down regulation
change receptor affinity
15
Q
why is it imporant to know the amount of a hormone that is bound vs free
A
a bound hormone can’t do anything
16
Q
T/F horomes are secreted continuously
A
false they are usually in pulses
17
Q
three amino acid hormones
A
dopamine
thyroxine
catecholamines
18
Q
four small neurpeptide hormones
A
GnRH
TRH
vasopressin
somatostatin
19
Q
5 protein/glycoprotein hormones
A
FSH
LH
TSH
HCG
Insulin
PTH
20
Q
three types of steroid hormones
A
estrogens
androgens
progestins
21
Q
two types of vitamin derived hormones
A
retinoids (vitamin A)
vitamin D
22
Q
5 general categories of hormones
A
amino acid
neuropeptides
proteins/glycoproteins
Steroids
Vitamin deriviatives
23
Q
why can FSH, LH, TSH, and HCG cross react with each other
A
they have receptors in the same family
24
Q
three facts about peptide/protein/glycoprotein hormones
A
water soluble
interact with cell membrane
work through second messanger
25
three facts about steroid hormones
insoluble
requires transport molecules
causes DNA transcription and translation
26
explain why endocrine systems are homeostatic
they respond to outside challenges to maintain homeostasis
27
three environmental changes that can cause an endocrine response
nutritional
thermal
existential
28
what is the main task of the thyroid
to produce T3 ad T4
29
what is the full name of T3
T4
which is the main functional hormone of the thyroid
triodothyroinine
tetraiodothyroinine
T3
30
which thyroid hormone is most readily available
why is this effect in treatment
T4
because T4 is converted to T3 in tissues
31
where are T3 receptors found
in alll most all human tissue
32
5 locations in the body with especially high numbers of T3 receptors
brain
heart
muscle
kidneys
gonads
33
what will the response to T3 be
increased...
energy utilization
protein synthesis
sensitivity to other hormones
34
two regulators of thyroid function
thyrotropin-releasing hormone (TRH)
thyrotropin (TSH)
35
what is the function of TRH
stimulates the production of TSH and prolattin
36
what is the effect of thyrotropin (TSH)
increased T3 and T4
37
what wil happen if the thyroid gland is dysfunctional
what can also happen?
TRH and TSH will be produced in high amounts
prolactin can also be produced
38
two main types of hyperthyroidism
graves disease
toxic nodular goiter
39
what are the laboratory tests that will confirm hyperthyroid
very low or absent TSH
very high T4
sometimes autoimmune tests are positive
40
what nervous system are many of the symptoms of hyperthyroidism related to
sympathetic nervous system
1. restlessness
2. insomnia
3. tremor
4. weight loss
5. heat intolerance
41
three disease that can be triggered by hyperthyroid
acute chest pain (MI)
CHF
Arrhythmia
42
why would you check for hyperthyroidism in new onset a fib
because hyperthyroid can trigger arrhytmias
43
what is the most common type of hyperthyroidism (60-80%)
graves disease
44
what causes graves disease
auto-antibodies that bind and active TSH receptors
45
what is the gender ratio of patients with graves disease
female 8:1
46
exophthalmos
cause
protrusion of the eyes found in 20-40% of Graves patients
caused by lymphcytic infilitration of the eyes
47
what is the cause of goiters
is there a gender bias
what may be a contributing factor
unknown
no, 1:1
low iodine may contribute
48
in what hyperthyroid condition does exopthalmos not occur
goiter
49
what is the treatment plan of hyperthyroid
control symptoms
prevent thyrid storm
plan long term control
50
thyroid storm
acute high levels of T3 and T4 that can cause hypotension and fever
51
two long term control options for hyperthyroid
thyroid excision or destruction
continued antithyroid drugs
52
what do beta blockers do in treating hyperthyroid
four results of treatment
block sympathetic pathways
rapid reduction in anxiety, restlessness, tremor, palpitations
53
what are two methods of lowering T3 and T4 in hyperthyroidism
prevent hormone release
stop T3 and T4 production
54
what drug can stop the relase of T3 and T4
potassium iodine
55
what drugs stop the production of T3 and T4
when are they most effective
thioamides
when combined with beta blockers and potassium iodine
56
what is the preferred method of treatment to definatively cure hyperthyroid
what makes it good
ablation wth radioactive iodine
because it spares the parathyroid
57
why can radioactive iodine be used to ablate the thyroid
because the thyroid is the only place where iodine is stored in the bdoy
58
what lab tests confirm hypothyroid
Low T4
very high TSh
59
five hypothyroid symptoms
1. cold intolerance
2. hair loss
3. weight gain
4. weakness
5. dry skin
60
primary hyperthyroid
the 99% of hypothyroidism that is caused by failure of the thyroid galdn
61
secondary hyperthyroid
failure of the pituitary to release TSH
62
four causes of hypothyroid
post thyroidectomy/ablation
hashimotos thyroiditis
Drug induced
dietary iodine deficiency
63
what is the most common cause of hypothyroid
hashimotos thyroiditis
64
what drug will cause hypothyroid
amiodirone
65
how common is hashimotos
is there a gender bias
1-4/1000
females 1:4
66
what happens in hashimotos
the thyroid is infiltrated with T and B cells
67
what is the first line treatment for hypothyroid
daily thyroxine
68
two parts of the adrenal gland
medulla
cortex
69
what is the function of the adrenal medulla
secretes epi/norepinephrine
70
what is the function of the adrenal cortex
secretes glucocorticoids, androgens, mineralocorticoids
71
describe the negative feedback loop that regulates adrenal function
pituitary secretes ACTH
adrenal cortex secretes cortisol
cortsol inhibits ACTH secretion
72
cushing syndrome
a cluster of symptoms caused by excess cortisol
73
three causes of Cushings
iatrogenic
secondary adrenal hyperplasia
primary adrenal hyperplasia
74
what is a common iatrogenic cause of cushings
prednisone
75
what causes cushings disease
what is the distinction between this and secondary adrenal hyperplasia
an ACTH secreting tumor on the pituitary
there isn;t one
76
where are other ACTH secreting cells located beside the pituitary
small cell lung cancers
77
primary adrenal hyperplasia causes
idiopathic
neoplasm
congenital
78
five effects of cortisol
increases glucose production
raises blood pressure
raises blood sugar
lowers lymphcyte and monocyte levesl
79
what two effects of cortisol are considerd to improve resistance to stress
increased glucose availibility
increased blood pressure
80
5 adverse effects of cortisol
weight gain
striae
moon facies
HTN
peptic ulcers
81
T/F most chronic conditions are no effected by cortisol
false, many (such as DM and HTN) can be exacerbated by cortisol
82
how does cortisol exacebate HTN?
DM
HTN: increase salt intake
DM: increase blood sugar
83
tests and exams to confirm cushings
elevated cortisol
cortisol suppression test
Low ACTH levels
imaging
84
what pattern is lost with cushing syndrome
the diurnal pattern which causes higher cortisol in the morning and lower at night
85
three possible treatment plans for cushings
stop glucocorticoids
surgery
antiglucocorticoid medication
86
what diagnoses for cushings have a good prognosis?
poor?
good: cushings disease and iatrogenic cushings
bad: adrenal carcinoma and small cell lung cancer
87
define diabete mellitus
a disorder characterized by chronic hyperglycemia due to relative or absolute deficiency of insulin, or resistance to insulin
88
what cells in the pancreatic islets that secrete insulin
glucagon
beta cells
alpha cells
89
which are more prominent, alpha or beta cells?
alpha (75% to 20%)
90
what is insulin
what compound is it derived from
how does this happen
a small protein
conversion of proinsulin into insulin
removal of connecting C peptide
91
what is the fucntion of C peptide after it is removed from proinsulin
what would high levels of c peptide indicate?
low?
nothing
high levels = type 2 DM
low = type 1 DM
92
two actions of insulin
inhibit catabolism
promotes anabolism
93
how does insulin promote anabolism
increase glycogen production and storage
promotes triglyceride synthesis in fat cells
incrases protein synthesis in muscle
94
how does insulin inhibit catabolism
inhibits glycogen break down
inhibits amino acid and fatty acid break down
95
describe tie etiology of Type I DM
an autoimmune disorder that causes rapid loss of beta cells
96
what triggers beta cell loss in type I DM
can be a virus or toxin such as mumps or coxsackie, as well as a genetic predispostion
97
describe the etiology of type II DM
a very slow loss of beta cells causd by genetic or obestity
98
three Ps of diabetes
polyuria
polydipsia
polyphagia
99
two other symptoms of diabetes that aren't the 3 Ps
weight loss despite increased appetite
fatigue
100
fatal complication of diabetes
diabetic ketoacidosis
101
what typpe of diabetics are most likely to have DKA
type one
102
five chronic complications of DM
CAD
PVD
nephropathy
neuropathy
retinopathy
103
what causes DKA
hyperglycemia \>300mg/dl causes keto acids to accumulate
104
five symptoms of DKA
tachycardia
dehydration
SOB
lethargy
coma
105
four conditions that are most commonly caused by DM
chronic renal failure
neuropathic pain
blindness
gangrene caused limb amputation
106
what was the mean survival of a diabetic patient before 1922
after
what changed?
5 year \<5%
increaed to 30-40 years
insulin was discovered
107
when will most diabetic have complications
after 20 years
108
what is the treatment for type I DM
type II
type I = insulin
type II = insulin plus other stuff
109
five non-insulin treatments of DM
reduce insulin resistance
stimulate secretion fo endogeneous insulin
reduce glucagoon
reduce glucose absorption
enhance urinary secretion
110
T/F complete control of glucose is bad
true, it decreases longevity
111
what does tight management of DM entail
diet
frequent blood assays
medication 3-4 times daily
flexible dosing
112
what is the hallmark of type II DM
insulin resistance
113
two stratgies to reduce insulin resistance
weight loss
medication (biguanides and thiaxolidinediones)
114
what is the most common medication for type II DM
metformin (glucophage)
115
medication used to decrease glucagon secretion
glucagon like peptide 1
116
where does glucagon like peptide naturally come from
what does it do
L cells in the intestine
opposes insulin
