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mic cabatu Physiology > Endocrine Physiology > Flashcards

Endocrine Physiology Flashcards

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1
Q

Produces new proteins from DNA

Lipid-soluble

A

Steroid Hormones

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2
Q

Modifies existing proteins

Water-soluble

A

Protein hormones

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3
Q

T3, T4, epinephrine, Norepinephrine

A

Derivative of Tyrosine

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4
Q

Convert hormonal signal into 2nd messenger

A

G proteins

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5
Q

For fat-soluble substances

A

Intracellular Receptors

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6
Q

Acts as transducers

A

G proteins

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7
Q

Is stimulated by Guanine Nucleotide Exchange Factors

A

GTP-activated

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8
Q

Is inhibited by GTPase-Accelerating Proteins, RGS proteins

A

GTP-activated

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9
Q

Activates Adenylate Cyclades converts ATP to cAMP -> activates Protein Kinase A

A

Alpha Subunit of G protein

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10
Q

May regulate ion channels directly

Broken down by cAMP phosphodiesterase

A

cAMP

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11
Q

Regulates effector proteins

A

PKA

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12
Q

Alpha t subunit activates cGMP phosphodiesterase -> decreases cGMP -> closes cGMP-dependent ion channels

A

G protein with alpha t (transducin)

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13
Q

Phospholipids C -> PIP2 -> PIP2 splits into InsP3 or IP3 (releases Calcium from ER) and DAG (activates Protein Kinase C)

A

G-protein with alpha q

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14
Q

Releases calcium from ER

A

IP3

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15
Q

activates Protein Kinase C

A

DAG

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16
Q

Guanylyl Cyclase converts GTP to cGMP -> activates Protein Kinase G -> Phosphorylates Proteins

A

Receptor Guanylyl Cyclases

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17
Q

Example of Receptor Guanylyl Cyclases

A

ANP

NO

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18
Q

Attaches to Type 1 subunit-> Phosphorylates Serine/Threonine residues on Type 2 subunit -> activates effectors

A

Receptor Serine/ Threonine Kinases

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19
Q

Example of Receptor Serine/ Threonine Kinases

A

TGF-Beta

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20
Q

Example of Receptor Tyrosine Kinase

A 
NGF
EGF
PDGF
IGF-1
insulin
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21
Q

No intrinsic tyrosine kinase activity

Associate with proteins that have tyrosine kinases of the Src family and Janus family (JAK)

A

Tyrosine-associated Kinase Receptors

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22
Q

Example of Tyrosine-associated Kinase Receptors

A

EPO

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23
Q

Synthesize in the hypothalamus

A

CRH

Vasopressin/Oxytocin

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24
Q

cAMP - 2ND MESSENGER

A 
DH (V2 receptors)
Angiotensin II (Epithelial cells)
Catecholamines (B1 & B2 Receptors)
ACTH
LH, FSH, TSH
HCG
MSH
CRH
Calcitonin
PTH
Secretin
Somatostatin
Glucagon
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25
IP3/ DAG - Phospholipase C
``` ADH (V1 receptor) Angiotensin II (vascular. Smooth muscles) catecholamines (A1 receptors) GnRH TRH GHRH Oxytocin ```
26
Steroid Hormone
``` Aldosterone Cortisol Testosterone Progesterone Estrogen Vitamin D Thyroid Hormone ```
27
Tyrosine Kinase
``` LeptinIGF-1 Insulin EPO GH Prolactin ```
28
Guanylate Cyclase Mecanism (cGMP)
ANP EDRF nitric oxide
29
Transport of steroid hormone
Bound to proteins
30
Active form of steroid hormones
Free, unbound form
31
Main site of inactivation of hormones
Liver
32
Mechanism for removal of hormones
Liver | Kidneys
33
Number of Hormone Receptors - Constant or Variable?
Variable
34
Minimum amount of hormone to produce effect
1 pictograms per ml
35
Onset of Hormone Effects
seconds to months
36
Additive effects of synergistic effects
Epinephrine | NE
37
Complementary Effects of Synergistic Effects
FSH | Testosterone on spermatogenesis
38
Permissive effects
Cortisol has permissive effects on Epi & NE with regards to blood vessels T3 - on Epi with regards to lipolysis
39
Antagonistic effects
Estrogen blocking prolactin effects on the breast during pregnancy
40
More common | Hormone has biological actions that, directly or indirectly, inhibit further secretion of the hormone
Negative Feedback (Self-Limiting)
41
Rare, exploding | Hormone has biological actions that, directly or indirectly, stimulate further secretion of the hormone
Positive Feedback (Self-Augmenting)
42
Supraoptic Nucleus
Vasopressin
43
Paraventricular Nucleus
Oxytocin
44
Give an example of Negative Feedback that does not utilize HPA
Insulin
45
Give 3 examples of Positive feedback involving hormones
Estrogen-induced LH and FSH Surge Oxytocin during labor oxytocin during lactation
46
Decrease in receptor number or receptor affinity
Down-regulation of Receptors
47
Example of Down-regulation of Receptors
In uterus, progesterone | T3 down regulates TRH receptors
48
Increase in receptor number or receptor affinity
Up-regulation of Receptors
49
Example of Up-regulation of Receptors
Prolactin increases the number of its receptors in the breast Growth hormone increases the number of its receptors in skeletal muscle and liver In the ovary, estrogen up-regulates it's own receptor and that of LH
50
Lies in the Sella Turcica
Pituitary Gland
51
Connected to the Median Eminence of the Hypothalamus via pituitary/hypo physical stalk
Pituitary gland
52
Transmit hypothalamic hormones to the pituitary without passing through the systemic circulation
Hypothalamic-Hypophysial Portal Blood vessels
53
Adenohypophysis
Anterior Pituitary
54
Neurohypophysis
Posterior Pituitary
55
Derived from oral ectoderm (rathke's Pocuh)
Anterior Pituitary
56
Basophils cells of Ant. Pituitary
``` FSH LH ACTH TSH MSH ```
57
Acidophilus Cells of Ant. Pituitary
GH | Prolactin
58
Derived from neural ectoderm (neural outgrowth of Hypothalamus)
Posterior Pituitary
59
Pituicytes of Post. Pituitary
Vasopressin | Oxytocin
60
Which of the following is a consequence when the anterior lobe of the pituitary gland is resected?
Inability to stimulate production of thyroid hormone
61
4 hormones that increase Blood Glucose Level
Epinephrine GH (acromegaly, gigantism) lead to DM Cortisol Glucagon
62
If pituitary stalk is damaged, all anterior pituitary hormones would decreased, EXCEPT
Prolactin
63
In terms of number, what are the top 2 cells in the anterior pituitary?
Somatotropin (40%) | Corticotropes (20%)
64
What are the 3 families of hormones in the anterior pituitary
TSH, LH, FSH ( same alpha unit, unique beta unit) MSH, ACTH ( derived from POMC) GH, Prolactin
65
Both catabolic and anabolic
Growth hormone
66
Released in pulsatilla fashion (every 2 hours) | Nocturnal Peak: 1 hours after stage 3 or 4 sleep
Growth hormone
67
Growth hormone
Somatotropin
68
Stops growth hormone
Somatostatin
69
IGF
Somatomedin
70
Mcc of dwarfism | Defect in FGF receptor 3
Achondroplasia
71
Increased GH | With skeletal deformities
Gigantism
72
Actions of Prolactin
Lactogenesis Lactation amenorrhea Breast development
73
What is one possible side effects of anti-psychotic drugs that involve Prolactin?
Amenorrhea-Galactorrhea
74
Prolactin is stimulated by the following
``` Pregnancy(ESTROGEN) breast ending Sleep Stress TRH Dopamine antagonist ```
75
Prolactin is inhibited by
Dopamine, Bromocriptine Somatostatin Prolactin (negative feedback)
76
Aka as ADH or AVP
Vasopressin
77
Secreted by Supraoptic Nuclei of the hypothalamus
Vasopressin
78
Responds to ECF changes detected by osmoreceptors in the Organum Vasculosum
Vasopressin
79
Most potent stimulus of Vasopressin
Increased plasma osmolality
80
Vasoconstrictor
V1 blood vessels
81
Water permeability
V2 kidneys
82
Central DI
URine volume: high Urine osmolarity: low ADH levels:low Treatment: DDAVP (ADH analog)
83
Peripheral DI
URine volume: high Urine osmolarity: low ADH levels: high Treatment: thiazides diuretics
84
SIADH
URine volume: low Urine osmolarity: high ADH levels: high Treatment:Demeclocycline (ADH antagonist)
85
In SIADH, the brain reduces intracellular osmolytes to prevent cell swelling. What happens if you rapidly correct the Hyponatremia?
Osmotic Demyelination Syndrome (esp. In the pons)
86
From Paraventricular nuclei of the hypothalamus
Oxytocin
87
Synthesized by the follicular epithelial cells of the thyroid
Thyroid Hormone
88
T4
``` 93% More half life (6 days) More affinity for binding plasma protein Less (10% of the receptors) binding to nuclear receptor Onset of action: 4x slower (2 days) ```
89
T3
``` 7% synthesized Less half life (1 day) Less affinity More (90%) binding receptor) 4x faster (12 hours) onset of action ```
90
Thyroxine Binding Globulin (TBG
70%
91
Transthyretin or Thyroxine Binding Prealbumin (TBPA)
20%
92
Thyroxine Binding Albumin
10%
93
Free Thyroxine
0.03%
94
MIT + DIT
= T3
95
DIT + DIT
= T4
96
Iodine trapping
I2
97
Organic action
MIT & DIT
98
Coupling
MIT + DIT = T3 | DIT + DIT = T4
99
Storage
Thyroglobulin
100
Secretion
TSH binding & TSH Receptor
101
Bone maturation | Bone formation
Thyroid hormone Growth hormone IGF 1
102
Regulation of thyroid hormone secretion is mediated by
TRH & TSH levels
103
Hyperthyroidism symptoms
``` Increased basal metabolic rate Weight loss Negative nitrogen balance Increased cardiac output Dyspnea (shortness of breath) Tremor, muscle weakness Exophthalmos - deposition of GAGs and fat Goiter Tibial edema ```
104
Hyperthyroidism causes
Graves' disease Thyroid neoplasm Excess TSH secretion Exogenous T3 or T4
105
Hyperthyroidism TSH levels
Decreased (feedback inhibition of T3 on the anterior lobe) | Increased (if defect is in anterior pituitary)
106
Hyperthyroidism treatment
Propylthiouracil Thyroidectomy I132 Beta adrenergic blocking agents
107
Hypothyroidism symptoms
``` Decreased basal metabolic rate Weight gain Positive nitrogen balance Decreased heat production Cold sensitivity Decreased cardiac output Hypoventilation Lethargy, mental slowness Drooping eyelids Myxedema Growth retardation Mental retardation ```
108
Hypothyroidism causes
``` Thyroiditis Surgery for hyperthyroidism I deficiency cretinism Decreased TRH or TSH ```
109
Hypothyroidism TSH levels
Increased (by negative feedback if primary defect is in thyroid gland) Decreased ( if defect is in hypothalamus or anterior pituitary)
110
Hypothyroidism treatment
Thyroid hormone replacement therapy
111
RDA of Iodine per day
150 nanograms
112
High levels of Iodine inhibiting organize action and iodine thyroid hormone synthesis
Wolf-Chaikoff Effect
113
Bone age < Chronological Age
Hypothyroidism
114
Liver and Kidney Failure: TBG levels
Decreased TBG
115
Estrogen or Pregnancy: TBG levels
Increased TBG
116
Enzyme that converts T4 to T3
5' iodinase
117
T4 can also be converted to
RT3 (inactive)
118
Aldosterone (mineralocorticoid)
Zone Glomerulosa
119
Cortisol, corticosterone (Glucocorticoids)
Zone Fasciculata
120
De-hydro-Epi-androsterone (DHEA) and Androstenedione (weak androgens)
Zone Reticularis
121
Epinephrine - 80% | NE - 20%
Adrenal medulla
122
Right adrenal kidney
Pyramidal
123
Left renal kidney
Crescent shape
124
Inhibits 11beta-hydroxylase
Metyrapone
125
Inhibits Desmolase
Ketoconazole
126
Adrenal androgens in males
Insignificant
127
Adrenal androgens in females
Significant
128
Need ACTH for 1st step, but otherwise controlled by RAAS
Aldosterone
129
Diabetogenic Hormones
Cortisol GH Glucagon Epinephrine
130
Increases Na reabsorption in the kidneys, sweat glands, salivary glands and colon Increase K secretion in the kidneys and colon Increases H secretion in the kidneys
Aldosterone
131
Oscillates with circadian rhythm
Cortisol
132
Carbohydrate Effects of Cortisol
Stimulate gluconeogenesis Increases protein catabolism in muscles Decreases glucose utilization and insulin sensitivity of adipose tissue
133
Protein effects in Cortisol
Reduces cellular proteins (except liver) Increases blood amino acids Increases liver and plasma proteins
134
Fat effects of Cortisol
Increases lipolysis | Moon face and buffalo hump
135
Anti-inflammatory effects of Cortisol
Induces synthesis of lipocortin which inhibits Phospholipase A2 needed for PG and LT synthesis Stabilizes lysosomal membranes Decreases migration and phagocytosis of WBC Suppression of T-lymphocytes Reduces IL-1, IL2 Increases resolution of inflammation Blocks inflammatory response to allergies Decreases eosinophils and lymphocytes Inhibits histamine and serotonin Increases RBCs
136
Dexamethasone Test Cushing syndrome
Cortisol level not suppressed either by low or high dose
137
Dexamethasone Test Cushing Disease
ACTH and cortisol suppressed by high dose but not low dose
138
Addison's disease
Primary adrenocortical insufficiency
139
Addison's disease
``` Hypoglycemia Anorexia, weight loss, vomiting, nausea Weakness Hypotension Hyperkalemia Metabolic acidosis Decreased pubic and auxiliary hair in females Hyper pigmentation ```
140
Addison's disease ACTH levels
Increased (negative feedback effect of decreased cortisol)
141
Addison's disease treatment
Replacement of glucocorticoids and mineralocorticoids
142
Cushing syndrome
Ex. Primary adrenal hyperplasia
143
Cushing syndrome
``` Hyperglycemia Muscle wasting Central obesity Round face, supraclavicular fat, buffalo hump Osteoporosis Striae Virilization and menstrual disorders in females Hypertension ```
144
Cushing syndrome ACTH levels
Decreased (negative feedback effect of increased cortisol)
145
Cushing syndrome treatment
Ketoconazole | metyrapone
146
MCC of exogenous dose of steroid
Cushing syndrome
147
Cushing disease
Excess ACTH
148
Cushing disease
``` Hyperglycemia Muscle wasting Central obesity Round face, supraclavicular fat, buffalo hump Osteoporosis Striae Virilization and menstrual disorders in females Hypertension ```
149
Cushing disease ACTH levels
Increased
150
Cushing disease treament
Surgical removal of ACTH-secreting tumor
151
Conn Syndrome
Aldosterone-secreting tumor
152
conn syndrome
Hypertension (inc ECF vol) Hypokalemia (inc K secretion) Metabolic acidosis ( inc H secretion) Decreased renin levels ( inc ECF levels)
153
Conn syndrome treatment
``` Aldosterone antagonist (spironolactone) Surgery ```
154
21 beta-hydroxylase deficiency
Virility ton in females Early acceleration of linear growth Early appearance of public and axillary hair Symptoms of deficiency of glucocorticoids and mineralocorticoids
155
21 beta-hydroxylase deficiency ACTH levels
Increased (negative feedback effect of decreased cortisol)
156
21 beta-hydroxylase deficiency treatment
Replacement of glucocorticoids and mineralocorticoids
157
17alpha-hydroxylase deficiency
Lack of pubic and axillary hair in females Symptoms of deficiency of glucocorticoids Symptoms of excess mineralocorticoids Hypoglycemia
158
17alpha-hydroxylase deficiency ACTH levels
Increased (negative feedback effect of decreased cortisol)
159
17alpha-hydroxylase deficiency treatment
``` Replacement of glucocorticoids Aldosterone antagonist (spironolactone) ```
160
Which of the following statements are true of Cushing's syndrome except? A. Pituitary tumors are the most common cause of Cushing's disease B. ACTH secreting Tumors can be suppressed by high dose Dexamethasone C. Exogenous steroids are the most common cause of Cushing's syndrome D. NOTA
NOTA
161
What is the predominant mechanism of hypotension in Addison's disease?
Decreased responsiveness of Arterioles to catecholamines
162
Which of the following are expected effects/manifestation of a patient with conn's syndrome?
Decreased plasma renin level
163
``` All of the following substances are decreased in 21 beta-hydroxyl asedeficiency except? A. Deoxycorticosterone B. Aldosterone C. Androgens D. Cortisol ```
C. Androgens
164
Glucagon is Synthesizedand secreted by
Alpha cells
165
Glucagon functions
Mirror image of insulin Hormone of starvation Promotes storage of metabolic fuels, mobilization and utilization Synthesized as pre-glucagon
166
Glucagon actions
Increase and maintain blood glucose concentration
167
Major factor stimulating the secretion of decrease blood glucose level
Glucagon
168
Glucagon secretes what AA?
Arginine and Alanine
169
Glucagon
CCK - fasting and increase exercise
170
2nd messenger of Glucagon
CAMP
171
Delta cells
Somatostatin
172
Secretion inhibited by insulin via intraislet paracrine mechanism Inhibit secretion of insulin and glucagon Modulate or limit the response of insulin and glucagon to ingesting of food
Somatostatin
173
21 - beta - hydroxylase
``` Aldosterone: dec COrtisol: dec Androgens: inc ACTH: inc Blood pressure: dec Accumulating substance: 17-hydroxyprogesterone ```
174
11 - beta- hydroxylase
``` Aldosterone: dec COrtisol: dec Androgens: inc ACTH: inc Blood pressure: inc Accumulating substance: 11-deoxy-corticosterone ```
175
17-alpha-hydroxylase
``` Aldosterone: inc COrtisol: dec Androgens: dec ACTH: inc Blood pressure: inc Accumulating substance: pregnenolone ```
176
Secretes insulin and Aylin
Beta cells (60%)
177
Secretes glucagon
Alpha cells (25%)
178
Secretes Somatostatin
Delta Cells (10%)
179
Secrete Pancreatic Polypeptide
F cell / PP Cell (5%)
180
Actions of Insulin
``` Increases: glucose uptake into the cells Glycogen edits Amino acid uptake into the cells. (For protein synthesis) Lipogenesis and uptake fat deposition Potassium uptake into the cells ```
181
Actions of Insulin
Decreases: Gluconeogenesis Glycogenolysis Lipolysis
182
Actions of glucagon
Increase blood glucose (inc glycogenolysis, gluconeogenesis) Inc Blood fatty acid and ketoacids Inc Urea production Inc Insulin
183
Actions of Somatostatin
Inhibits both glucagon and insulin to modulate their effects Inhibits all GI hormones Stimulated by all types of nutrients Decreases motility of stomach, duodenum and gallbladder Decreases both absorption and secretion in the GIT
184
Side effect of Metformin
Lactic Acidosis
185
Type 1 crisis
DKA
186
Type 1 treatment
Insulin
187
Type 2 crises
HHHS
188
Type 2 treatment
``` Weight loss Thiazolidinediones Metformin Sulfonylureas Insulin ```
189
Effect of insulin on the brain
None
190
Insulin: 2nd messenger
Tyrosine Kinase
191
Glucagon: 2nd messenger
cAMP
192
Marker for endogenous insulin
C peptide
193
When proinsulin becomes insulin, what part is cleaved off?
C peptide
194
GLUT transport is found in Beta Cells
Glut 2
195
Oral vs IV Glucose: great insulin secretion
Oral glucose
196
Is more powerful stimulant for insulin secretion because it stimulates the GIP (gastric inhibitory peptide)
Oral Glucose
197
Type 1
Inadequate secretion: Inc blood glucose conc Inc blood fatty acid and ketoacids conc Inc blood AA conc
198
Type 2
Down-regulation of insulin receptor on target tissues | Insulin resistance
199
``` All of the following insulin secretion EXCPET? A. Hyperglycemia B. Glucagon C. Cholecystokinin D. Alpha adrenergic stimulation E. Gastric inhibitory peptide ```
D. Alpha adrenergic stimulation
200
ECF + Chondroitin Sulfate + Hyaluronic Acid Gelatinous medium
Ground Substance of Organic Matrix
201
95% of organic matrix for Tensile Strength
Collagen Fibers
202
secrete collagen & Ground Substance where calcium precipitates
Osteoblast
203
Bone Remodelling
Osteoblast
204
Bone Resorption
Osteoclast
205
secrete Lysosomal enzymes, citric acid and lactic acid
osteoclast
206
calcium intake > calcium excretion
Positive Calcium Balance
207
calcium intake < Calcium excretion
Negative Calcium Balance
208
hyperreflexia, spontaneous twitching, muscle cramps, and tingling and numbness
Hypocalcemia
209
constipation, polyuria, polydipsia and neurologic signs of hyporeflexia, lethargy, coma, and death
hypercalcemia
210
signs of hypocalcemia
chvostek & Trousseau sign
211
what is the location of PTH receptors
osteoblast
212
would thyroidectomy cause hypercalcemia due to absent calcitonin?
no, since calcitonin does NOT participate in minute-to-minute calcium regulation
213
what is the secreted by osteoblast to inhibit osteoclastic activity in hyperparathyroidism?
Alkaline Phosphate
214
Vitamin D comes from?
Cholesterol
215
1st activation of vitamin D synthesis
Liver
216
2nd activation of Vitamin D synthesis
Kidney
217
secreted by chief cells of the parathyroid gland
PTH
218
stimulated by hypocalcemia
PTH
219
also stimulated by hypomagnesemia, except hypomagnesemia caused by alcoholism
PTH
220
secreted by Parafollicular Cells (C Cells) of the thyroid gland
Calcitonin
221
PTH in the kidney
increases calcium reabsorption (DT) decreases phosphate reabsorption (PCT) increases active vit D
222
PTH in intestine
none
223
PTH in bone
increased calcium decreased phospate
224
vit D in intestine
increases calcium & phosphate absorption
225
vit D in Kidney
increases calcium & phosphate reabsorption increases urinary calcium
226
vit D in bone
at normal levels: calcium and phosphate deposition at high toxic levels: calcium & phosphate resorption
227
PTH net effect on serum levels
increased calcium | decreased phosphate
228
Vit D net effect on serum levels
increased calcium | increased phosphate
229
what is the treatment for Humoral Hypercalcemia of Malignancy?
Furosemide ( inhibits renal Ca reabsorption) | Etodronate ( inhibits bone resorption)
230
presents with short stature, short neck, obesity, subcutaneous calcification, and shortened fourth metatarsals and metacarpals?
Albright Hereditary Osteodystrophy (Pseudohypoparathyroidsm Type Ia)
231
vitamin D resistance is seen in which condition?
chronic Renal Failure
232
Which of the following is an action of parathyroid hormone (PTH) on the renal tubule? a. stimulation of adenylate cyclase b. inhibition of distal tubule K secretion c. inhibition of distal tubule ca reabsorption d, stimulation of proximal tubular phosphate reabsorption e, inhibition of production of 1,25-dihydroxycholecalciferol
a. stimulation of adenylate cyclase

mic cabatu Physiology (12 decks)

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