Endocrino

Question 1

what are the 4 classes of hormones?

Answer 1

Amine (norepinephrine)
peptide (ocytocin)
proteins
steroids (one)

Question 2

what are the secretion patterns of hormones?

Answer 2

Circadian: cortisol peak a 6 am
Pulsatile: burst, break, burst, break
Substrate-dependent: secretion depends on something (insulin)

Question 3

lipid solubles hormones:

Answer 3

protein bound, longer half-life
Uber ride to destination

thyroxine (amine) & streroids
cortisol, aldosterone, ADEK

Question 4

water soluble:

Answer 4

free/unbound, easy travel, short half-life

proteins & amines
insulin, parathyroid, calcitonin, norepinephrine, FSH, LH

Question 5

What is positive feedback loop?

Answer 5

more you make, more you make (snowball effect)

stops when explodes and no more energy

Question 6

What is negative feedback ?

Answer 6

more you make –> less tyou make

Question 7

Only ___ hormones can have a physiological effect

Answer 7

free and unbound

Question 8

hormone receptors

Answer 8

no receptors, no message

Question 9

Where is the receptor for fat soluble hormone?

Answer 9

inside cell

Question 10

Where is the receptor for water soluble hormones?

Answer 10

cell membrane, because can’t diffuse in membrane

g-protein cascade –> 2nd messenger (CAMP) goes in cell

Question 11

What is the water soluble response?

Answer 11

1. non steroid hormone (1st messenger)
2. g-protein coupled receptor
3. ATP
4. cAMP (2nd messenger)

regulate protein activity

Question 12

What is the lipid-soluble response?

Answer 12

1. bound to carrier-protein to travel in bloodstream
2. steroid
3. nucleus

regulates protein synthesis

Question 13

What is ADH ?

Answer 13

regulated by osmoreceptors/baroreceptors, activates V2R at kidney tubular cells and increase water reabsorption

Question 14

cortisol and T2DM

Answer 14

cortisol –> obesity, increase lypolyse and blood glucose –> increase free fatty aids –> insulin release –> insuline insensitivity –> B-cells destruction –> DB2 –> increase free fatty acids –> increase lipogenesis and blood glucose –> obesity

Question 15

cortisol and female reproduction

Answer 15

stress –> CRH–> ACTH –> CORTISOL –> b-endorphins –> GnRH –> LH, FSH, Estradiol –> target tissue

Question 16

types of stress

Answer 16

conditioned response (pavlov)
anticipatory (exam)
reaction response ( adrenaline rush)

Question 17

chronic stress

Answer 17

Th1 to Th2 –> immunosuppression

Question 18

cortisol and immunity

Answer 18

inhibits Th1 –> immunosuppressant

Question 19

types of insufficient hormonal supply:

Answer 19

insufficient synthesis
feedback system failure
inactive hormones
delivery dysfunction

Question 20

types of inappropriate hormonal response:

Answer 20

cell receptor disorder

intracellular disorder

Question 21

what is SIADH

Answer 21

excessive ADH –> ++ H20 reabsorption –> increase ECF –> hyponatremia, hypoosmolarity

Question 22

sodium concentrations

Answer 22

normal : 145 mmol/l
thirst, fatigue, no edema : 140-130
120-130: severe GI distress
< 115 : confusion, seizures

Question 23

What is Diabetes insipidus (DI) ?

Answer 23

insufficient ADH –> increase diuresis –> polyuria, polydipsia(drinking) –> increase risk of dehydration, hypernatremia, hyperosmolarity

Question 24

Types of DI?

Answer 24

neurogenic
renal
dipsogenic

Question 25

hypopituitary:

Answer 25

hypothalamus dysfunction or lesion to pituitary Sx when panhypopituitary (all hormones decreased)

Question 26

hyperpituitarism --> increase prolactin --> ?

Answer 26

prolactonoma: - galaxrorrhea - abnormal menses - decrease estrogen - hirsutism - osteoporosis - small testies, erect dysfunction

Question 27

causes of hyperthyroidism :

Answer 27

1. graves disease 2. nodular goiter 3. adenoma 4. thyroid pill

Question 28

what is grave's disease?

Answer 28

TSI immunoglobulines that act like TSH --> increase t3t4 s/c swelling, erythematous skin, exophthalmos TSI intellect with ocular fibroblast receptors

Question 29

Causes of hypothyroidism:

Answer 29

1. Hashimoto's disease (autoimmune: TSI kill TH gland, less tissue, less synthesis) 2. surgery/rx tx 3. congenital 4. iodine deficiency

Question 30

what is cretinism?

Answer 30

Hypo TH at birth

Question 31

Types of hyper PTH?

Answer 31

1. Increase PTH and hypercalcemia : PT tumor 2. Increase PTH and hypocalcemia : chronic kidney disease 3. increase PTH and hypercalcemia (after an hypo) because system angry and takes all calcium from bones

Question 32

HypoPTH --> ?

Answer 32

hypocalcemia --> hyperphosphate --> less Vit D metabolize --> less Ca absorption

Question 33

What are the adrenocortical alterations?

Answer 33

- Cushing's disease - Hyperaldosteronism - Addison's disease - Pheochromocytomas

Question 34

What is Cushing's disease/syndrome

Answer 34

TOO much cortisol , no circadian rhythm disease: internal environment (tumor) -->CRH --> increase ACTH --> increase cortisol syndrome: exogenous cortisol (drugs) acne, moon face, weight gain, more body hair

Question 35

cortisol -->

Answer 35

catabolic --> dumps all glucose in blood --> don't need all --> stored as fat

Question 36

Consequences of hyper aldosterone

Answer 36

more NA reabsorption -->hyperNA --> more K excretion hypoK --> polyuria, metabolize alkalosis, weakness, paralysis hyperNA --> more plasma volume --> suppress renin-angio 1°: adrenal tumor 2°: extra-adrenal stimulus (more renin-angio 2)

Question 37

What is Addison's disease ?

Answer 37

not enough cortisol autoimmune destruction of adrenal cortex --> atrophy --> less cortisol

Question 38

What is pheochromocytoma?

Answer 38

adrenal medulla tumor --> more epinephrine

Question 39

What is T1DM?

Answer 39

cell mediated autoimmune destruction of beta-cells insulin dependent (absolutely no secretion of insulin) (no resistance to insulin) prone to ketoacidosis islet cells + insulin antibodies

Question 40

What is T2DM?

Answer 40

``` insulin resistance (less insulin or more secretion) ketoacidosis only under stress no antibodies ```

Question 41

How to diagnose DM?

Answer 41

- hemoglobine glyquée > 6.5 % (plasma glucose exposed to RBC) - fasting plasma glucose : > 7 mmol (126mg/dl) (100-125 more risk) - oral glucose tolerance testing : > 11. 1 (200) (75-99 more risk) - random glucose levels : 11. 1 (200)

Question 42

Metabolic syndrome criteria :

Answer 42

3 out of 5 : - increase waist circumference - plasma triglycérides > 150 - low HDL - pre HT - fasting gluc > 100

Question 43

What is nephropathy?

Answer 43

increase renal BF --> increase protein excretion --" macro/microalbuminuria --> glomerular damage --> decrease glomerular filtration rate --> end stage kidney disease

Question 44

How does neuropathy occur?

Answer 44

Schwann cell injury, myelin degeneration., impaired nerve condition, impaired axonal transport and repair - -> neuropathy - -> demyelination and degeneration