Endocrine

Question 1

Thyroid Stimulating Hormone

Answer 1

Tyrotrope cell

Stimalation of Thyroid hormones and growth

Question 2

Follicle Stimulating Hormone

Answer 2

Gonadotrope cell
ovarian follicle growth in female
Spermatogenesis in male

Question 3

Luitenizing Hormone

Answer 3

Ovulation in female
Testosterone in male
Gonadotrope cell

Question 4

Human Grown Hormone (HGH, Somatotropin

Answer 4

Somatotrope cell
Body growth
Inhibit insulin

Question 5

Prolactin

Answer 5

Lactotrope
Milk secretion
Maternal behavior
Inhibition of ovulation

Question 6

Adrenocorticotrophic hormone ( ACTH)

Answer 6

Cortiocotrope
Adrenal cortex secretion
Growth
Steroid production

Question 7

Beta Lipotropin

Answer 7

Corticotrope

Precursor of endorphin

Question 8

Oxytocin - Posterior

Answer 8

Paraventricular nuclei
Ejection of milk
Uterine contraction

Question 9

Arginine Vassopressin-posterior

Answer 9

Supraoptic Nuclei
Water retention
Plasma Osmolarity

Question 10

Most abundant anterior pituitary hormone

Answer 10

Growth Hormone.

Question 11

HGH specific effect is

Answer 11

Stimulation of Linear bone growth through the epiphyseal cartilage plate of long bone

Question 12

Acromegaly vs Gigantism

Answer 12

Acromegaly: Excess GH after epiphyseal closes— bone thicker not longer
Gigantism : Excess GH before epiphyseal plate closes . Long bones

Question 13

Growth Hormone Metabolic effects

Answer 13

Anabolic: Increase synthesis of protein
Ketogenic: increased mobilization of fatty acid
Diabetogenic: inhibits insulin secretion
Na+ and H2O retention

Question 14

What stimulates GH?

Answer 14

Hypoglycemia
Fasting
Estrogen 
GH- releasing Hormone 
Sleep
Decreased Free Fatty Acid 
Increased Amino Acid
Stress 
Alpha - adrenergic 
Dopamine

Question 15

What inhibits growth hormone

Answer 15

Insulin like growth factor 1
Cortisol- large doses of corticosteroids
Obesity
Pregnancy
Hyperglycemia
Free Fatty acid increase
Growth- Hormone inhibiting hormone ( Somatostatin)

Question 16

What inhibits release of prolactin

Answer 16

Dopamine

Question 17

What increases prolactin

Answer 17

Preop anxiety

Question 18

2 things decrease the secretion of TSH

Answer 18

Corticosteroid

SNS stimulation

Question 19

How is TSH released?

Answer 19

Proteolysis of thyroglobulin in follicles of thyroid cells

Question 20

How is T3 produced? Triiodothyronine.

Answer 20

Direct metabolism of tyrosine yields T3 ( it is 5 times more active than T4)
Conversion of T4 in the peripheral tissues

Question 21

How is T4 produced ? Thyroxine

Answer 21

Prohormone synthesized by Thyroxine , is 80% of the thyroid hormone in circulation . It serves as prohormone to T3

Question 22

1/2 life T3- T4

Answer 22

T3: 1.5 days
T4: 7 days

Question 23

Thyroid and O2 consumption

Answer 23

Thyroid hormone increased O2 requirement in all tissue except brain = Minimal changes in MAC requirement for patient with hyper or hypothyroidism
Excess= tissue O2 consumption increased by 100%
Absent= tissue O2 consumption decrease by 40%

Question 24

Thyroid secretes

Answer 24

T3
T4
Calcitonin

Question 25

Earliest sign of thyroid hormone abnormality

Answer 25

Cardiac changes

Question 26

Thyroid hormone most effect through

Answer 26

Control of protein synthesis.activated DNA transcription in the cell nuclei = new proteins and enzymes

Question 27

Cardiac cholinergic receptor numbers and thyroid

Answer 27

They are decreased = not enough inhibitory cholinergics in heart = high HR compared to increase in CO

Question 28

Thyroid hormone modulates what adrenergic receptors

Answer 28

Al;pha and Beta

Question 29

How does thyroid increase CO?

Answer 29

Accelaration of metabolism = tissues (not veins) vasodilate= more blood available in the vessels = increased CO but : SBP does not go up bc peripheral vasodilation offset that ( less SVR)

Question 30

PTH inversely related to

Answer 30

ionized calcium concentration

Question 31

PTH and calcium

Answer 31

Stimulates release of calcium from bone ( Osteoclasts) ( Bone ) Converts Vit D to active 1,25,Dihydroxicholecalciferol to increase absorb of ca in GI (GI) Prevents reabsorption of phosphate in renal to increase ca and decrease Phosphate( renal tubule)

Question 32

Cholesterol is precursor of ...

Answer 32

Corticosteroids

Question 33

What can cause Diabetes . Table 38-2

Answer 33

Type 1+ absolute deficiency destroyed pancreatic B cells Type2- Insulin resistance and deficiency Exogenous pancreas disease: hemochromatosis, cystic fibrosis, pancreatitis, pancreatectomy Gestational Drug induced: Thiazides, glucocorticoid, thyroid hormone, Beta adrenergic Endocrinopathy: acromegaly, Cushing syndrome Defect of pancreatic B cells Defect of insulin action- resistance Infection : congenital rubella, CMV Uncommon immune mediated diabetes : Stiff man syndrome , anti-insulin receptor antibody

Question 34

Hyperglycemia cause

Answer 34

Impaired vasodilation | Chronic pro inflammatory, prothrombogenic, proartherogenic , = vascular

Question 35

IV insulin 1/2 time

Answer 35

5- 10 minutes

Question 36

Insulin metabolized by

Answer 36

Kidney and Liver by proteolytic enzyme

Question 37

Insulin goes to liver how?

Answer 37

50% goes to liver via the portal vein

Question 38

Which affects insulin clearance rate more ?

Answer 38

Renal more than liver

Question 39

Type 2 Diabetes

Answer 39

Oral before Insulin | Pancreatic beta cell dysfunction or auto antibody have developed

Question 40

Primary Failure of Sulfonylurea

Answer 40

20% of patients started on it do not have adequate hypoglycemic to max dose .,

Question 41

Secondary Failure of Sufonulurea

Answer 41

Initially responded but then failed to respond

Question 42

Effects of ETOH and salicylates on BG

Answer 42

Decreases = with sulfonylureas hypoglycemia worse !!!

Question 43

What meds patient sulfonylureas

Answer 43

Warfarin and Sulfonamide

Question 44

Risk factors for sulfonylurea hypoglycemia

Answer 44

Poor nutrition >60 y.o. Warfarin and sulfa abx- potentiate sulfonylurea Salicylate and ETOH - decrease BG Impaired renal function - can’t eliminate

Question 45

Excretion of Glyburide

Answer 45

50% in feces

Question 46

The 2 sulfonylurea most likely to cause low BG

Answer 46

Glyburide - long 1/2 time 4.6- 12 hrs- 18/24hrs duration | Chlorpropamide - longest 1/2 time- 30/36 hrs - 36 hrs duration

Question 47

Which sulfonylurea favorable for renal pts?

Answer 47

Glypizide - feces and only small unchanged in kidney | Torbutamide- only small unchanged in kidney

Question 48

How does sulfonylurea affect ischemic preconditioning ?

Answer 48

By closing K-ATP channels. Increase CV mortality with sulfonylurea

Question 49

Sulfonylurea and placenta

Answer 49

Crosses= fetal hypoglycemia

Question 50

Sulfonylurea with lowest elimination 1/2 life

Answer 50

Acetoheximibe : 1.3 to 6 hrs

Question 51

Which sulfonylurea can you give with liver dysfunction

Answer 51

Acetoheximibe, bs lower 1/2 life, less prolonged elimination in liver patients = less chances of hypoglycemia