Endocrinology Flashcards
(129 cards)
1
Q
secretion from neurons reach the blood stream and influence cells some distance away
A
neuroendocrine
2
Q
Hormone classifications (3)
A
- proteins and peptides
- steroids (cholesterol derived)
- aa tyrosine derived (epi, norepi, dopa, thyroxine)
3
Q
______ _______ usually controls secretion of hormones; less often by ________ _________ (oxytocin cervix dilation)
A
negative feedback,
positive feedback
4
Q
adrenal medulla is modified _______ ________
A
neural tissue
5
Q
amino acid based hormone classifications (4)
A
- simple aa, peptide & protein
- can’t enter cell
- 2nd messenger use
- most common
6
Q
Steroid hormone classifications (5)
A
- cholesterol derived
- can enter cells
- direct action
- gonadal and adrenocortical
- usually slower overall effect
7
Q
lab test for hormones
A
Challenging (small amounts)
-radioimmunoassay (bound/free ratio)
8
Q
Pituitary components
A
- anterior pituitary (adrenohypoghysis)
2. posterior pituitary (neurohypophysis)
9
Q
Posterior pituitary releases _________ and _______- both made in the ___________, particularly in the ____ _____ & ____________ nuclei. Released directly into circ.
A
ADH and Oxytocin,
hypothalamus,
supra optic ¶ventricular nuclei
10
Q
embriologic derivation:
anterior pituitary:
posterior pituitary:
A
- oral cavity pouch
- down growth of 3rd ventricle
11
Q
Hormones released by anterior pituitary(6)
GOAT FLAP
A
- Growth GH
- Ox
- adrenocorticotrophic ACTH
- Thyroid stimulating TSH (thyrotropin)
- Follicle Stimulating FSH
- Luteinizing LH
- ADH
- Prolactin
12
Q
Hypothalamus controls pituitary by_________ _______ ________, released into ________-________ portal blood vessels.
A
hypothalamic releasing hormones, (^ concentration vs. syst)
hypothalamic-hypophysial
13
Q
__________hypothalamus monitors body fluid _________ (CSF 3rd vent–directly adjacent). _____ secreted to adjust for _______ changes.
A
osmoreceptors,
osmolarity,
ADH,
osmolarity
14
Q
ADH acts on ______ _____ of the ____ renal tubules and _____ _____ to INCREASE H2O reabsorption
A
Principle cells,
DISTAL,
collecting ducts
15
Q
baroreceptors in the ____ _____, _____ ____, and carotid artery sense _______/ _____ and signal the hypothal via the _____ nerve to ^v ADH secretion
A
left atrium, aortic arch,
hypoveolemia/ hypervolemia,
vagus
16
Q
Diabetes insipidus DI can be:
A
- central DI
2. nephrogenic DI (osmolar gradient lost)
17
Q
ADH pathophys characterized by decrease in plasma osmolarity, decreased serum Na+ (too much total body water)
A
SIADH syndrom of inappropriate ADH secretion usually from (OAT CELL CARCINOMA of lung)
18
Q
Functions: uterine contration, milk “let down”, milk ejeciton
A
oxytocin
19
Q
oxytocin release stimulated by
A
- nipple stim
- sight, sound, smell infant
- cervical dilation (positive feedback)
20
Q
6 anterior pituitary hormones produced by 5 cell types: (5)
A
- trophes:
1. thyrotrophes
2. corticotrophes
3. lactotrophes
4. gonadotrophes
21
Q
Growth Hormone (GH) actions (4)
A
aka somatotropin
- ^ linear growth
- ^ protein synthesis
- ^ fat utilizaiton for energy
- ^ insulin resistance – DIABETOGENIC–wants body to use fats before glucose
22
Q
excess GH:
deficiency in GH:
A
- -Acromegaly(when growth plates already closed-over ^time) vs. gigantism (^ GH before plates closed)
- -pituitary dwarf (no linear growth)
23
Q
XRH
A
released by hypothalamus to stimulate pituitary
24
Q
GH secretion stimulated by: (4)
A
- fasting
- starving
- ^ aa in plasm
- exercise
25
- -GH opposed by
| - -GH mediated by
somatostatin
| somatomedin
26
pregnancy and suckling stimulate production and release of ______. Dopamine inhibits release. Hormone inhibits _____ , and promotes ______ development.
prolactin,
ovulation,
breasts
27
galactorrhea cause from. This along with _______ presenting symptoms of pituitary adenoma.
^ prolactin--headache
1. v dopamine
2. pituitary tumor
28
TSH--in response to ____
thyroid stimulating hormone (thyrotropin),
| thyroid releasing hormone (TRH)
29
TSH actions (2)
Thyroid stimulating hormone (thyrotropin)
1. regulates growth of thyroid
2. regulates secretion T3 & T4
Negative feedback to HYPO and PIT
30
ACTH from ___-_______. Released by _________-______ _____
adrenocorticotrophic hormone from pro-opiomelanocortin,
| corticotrophin-rleasing hormone
31
ACTH modulates ________ secretion from the zona __________ of adrenal _______
cortisol,
fasciculate,
cortex
32
FSH under control of ______.
Follicle stimulation hormone,
| Release controlled by GnRH (gonadotropin releasing hormone
33
FSh actions (2)
1. stim development of ovary follicles
| 2. stim spermatogenesis
34
LH under control by _____. Hormone stimulates development of _____ ______ in women. Stimulates ________ ______ for Leydig cells of ____ in men.
Luteinizing Hormone--GnRH,
corpus luteum,
testosterone secretion,
testis
35
T3 and T4 are highly _____ ______ in blood. So effects will be ______; long ____-_____. Less than __% free in serum, rest bound to ______-____ ______.
```
protein bound,
steady,
half-life,
1%,
thyroxine-binding globulin
```
36
steroid hormones secreted by follicles and corpus luteum of ovaries. Negative feedback to hypothalamus ^v release of ____ and ____
Estrogen and Progesterone,
| FSH & LH
37
T4 ==> T3 functions (slide 23)
| turns into
```
^ Na+ K+ ATPase
^ basal Metabolic rate
^ O2 consumption
^cardiac output
(think of hypo/hyperthyroidism symptoms)
```
38
__________hypothalamus monitors body fluid _________ (CSF 3rd vent--directly adjacent). _____ secreted to adjust for _______ changes.
osmoreceptors,
osmolarity,
ADH,
osmolarity
39
ADH acts on ______ _____ of the ____ renal tubules and _____ _____ to INCREASE H2O reabsorption
Principle cells,
DISTAL,
collecting ducts
40
baroreceptors in the ____ _____, _____ ____, and carotid artery sense _______/ _____ and signal the hypothal via the _____ nerve to ^v ADH secretion
left atrium, aortic arch,
hypoveolemia/ hypervolemia,
vagus
41
Diabetes insipidus DI can be:
1. central DI
| 2. nephrogenic DI (osmolar gradient lost)
42
ADH pathophys characterized by decrease in plasma osmolarity, decreased serum Na+ (too much total body water)
```
SIADH syndrom of inappropriate ADH secretion
usually from (OAT CELL CARCINOMA of lung)
```
43
Functions: uterine contration, milk "let down", milk ejeciton
oxytocin
44
oxytocin release stimulated by
1. nipple stim
2. sight, sound, smell infant
3. cervical dilation (positive feedback)
45
6 anterior pituitary hormones produced by 5 cell types: (5)
- trophes:
1. thyrotrophes
2. corticotrophes
3. lactotrophes
4. gonadotrophes
46
Growth Hormone (GH) actions (4)
aka somatotropin
1. ^ linear growth
2. ^ protein synthesis
3. ^ fat utilizaiton for energy
4. ^ insulin resistance -- DIABETOGENIC--wants body to use fats before glucose
47
excess GH:
| deficiency in GH:
- -Acromegaly(when growth plates already closed-over ^time) vs. gigantism (^ GH before plates closed)
- -pituitary dwarf (no linear growth)
48
XRH
released by hypothalamus to stimulate pituitary
49
GH secretion stimulated by: (4)
1. fasting
2. starving
3. ^ aa in plasm
4. exercise
50
- -GH opposed by
| - -GH mediated by
somatostatin
| somatomedin
51
pregnancy and suckling stimulate production and release of ______. Dopamine inhibits release. Hormone inhibits _____ , and promotes ______ development.
prolactin,
ovulation,
breasts
52
Zona Glomerulus affects the ______
Glomerulus of kidney (Aldosterone)
53
TSH--in response to ____
thyroid stimulating hormone (thyrotropin),
| thyroid releasing hormone (TRH)
54
TSH actions (2)
1. regulates growth of thyroid
2. regulates secretion T3 & T4
Negative feedback to HYPO and PIT
55
ACTH from ___-_______. Released by _________-______ _____
adrenocorticotrophic hormone from pro-opiomelanocortin,
| corticotrophin-rleasing hormone
56
ACTH modulates ________ secretion from the zona __________ of adrenal _______
cortisol,
fasciculate,
cortex
57
FSH under control of ______.
Follicle stimulation hormone,
| Release controlled by GnRH (gonadotropin releasing hormone
58
FSh actions (2)
1. stim development of ovary follicles
| 2. stim spermatogenesis
59
LH under control by _____. Hormone stimulates development of _____ ______ in women. Stimulates ________ ______ for Leydig cells of ____ in men.
Luteinizing Hormone--GnRH,
corpus luteum (temporary structure in women's follical during luteal phase, releases ^ progesterone/estrodial),
testosterone secretion,
testis
60
T3 and T4 are highly _____ ______ in blood. So effects will be ______; long ____-_____
protein bound,
steady,
half-life
61
steroid hormones secreted by follicles and corpus luteum of ovaries. Negative feedback to hypothalamus ^v release of ____ and ____
Estrogen and Progesterone,
| FSH & LH
62
T4 ==> T3 functions (slide 23)
| turns into
```
^ Na+ K+ ATPase
^ basal Metabolic rate
^ O2 consumption
^cardiac output
(think of hypo/hyperthyroidism symptoms)
```
63
Hormone affects every organ system in body, mediate cellular metabolic rate.
Thyroid Hormones:
1. T3-triodothyronine -- ^active than T4
2. T4 -thyroxin--target tissue converts to T3
64
Thyroid gland composed of ^# of _____ filled with _____ _____, made up of thyroglobulin containing ______ ______
follicles,
colloid material,
thyroid hormone
65
_______ _____ of thyroid concentrates ______ in gland (30X greater than in blood).
iodide pump,
| iodide,
66
Thyroid hormone affects ____, increasing _______. Effects last several days. Effects:
```
DNA,
transcription
1. ^ thermogenesis, sweating
2. ^ rate /depth of respiration
3. ^cardiac output
4. etc. ^ metabolic excitation
```
67
hyperthyroidism aka
Graves' Disease--autoimmunce process destroying negative feedback receptors
read abt symptoms
68
Hypothyroidism symptoms:
v metabolic rate resulting in:
1. cold intolerance
2. weight gain
3. lethargy
4. hyxedema (puffiness of skin)
69
deficient dietary iodine resulting in decreased T3/T4 secretion there for high TSH levels --> stimulate thyroid growth =
thyroid goiter
70
Adrenal gland CORTICAL Zones and products mnemonic (steroid hormones)
Go Find Rex, Make Good Sex
1. Zona Glomerulosa = Mineralocorticoids (aldosterone)
2. Zona Fasciculata = Glucocorticoids (cortisol)
3. Zona Reticularis = Androgens
71
Adrenal Medulla makes ___________: _______ & ________
catecholamines:
| epinephrine & norepinephrine
72
ACTH stimulated by ____ from hypothalamus. ACTH stimulates the SYNTHETIC pathways to make the _______ _____ derived from ________.
CRH (corticotrophin releasing hormone),
adrenocortical hormones,
cholesterol
73
secretion of ______ from Zona glomerulosa stimulated by ____--also stimulated by ______ __
aldosterone,
Renin,
angiotensin II
74
PRODUCTION and SECRETION from Zona fasciculate and Zona reticularis under direct control of _____.
ACTH
75
*T3 and T4 need _______ for synthesis
IODINE (for test should know at which level problem is (hyp, pit, thyroid, diet) in relation to symptoms and lab test values)
76
Glucocorticoid(cortisol) /androgen secretion from adrenal glad controlled by _____ ______ of _______ to pituitary. Release peaks in early _______.
negative feedback,
cortisol,
morning
77
Zona Glomerulus affects the ______
Glomerulus of kidney (Aldosterone)
78
* Cortisol (glucocorticoid) is the _____ hormone. Peaks in ____. Functions: (5)
Study actions deeply!
```
stress,
morning,
Functions:
1. catabolism--glycogen storage
2. antiinflammatory-- (v response to hist, sero, protag)
3. suppresses immune response
4. ^ GFR
5. inhibits bone formation
```
79
Aldosterone functions:(3)
1. ^ Na+ reabsorption--ECF vol expansion
2. ^ renal K+ secretion
3. ^ renal H+ secretion--metabolic alkalosis
80
Adrenal Androgens & function: (video) (4)
1. dehydro-epiandrosterone DHE and androstenedione
2. DHE minor role in males
3. DHE major androgen in females
4. may cause "masculinization" in females
81
Leptin made by _______ ______. Adjusts ______ _____ & _______ ______
adipose tissue/ fat cels,
hunger sensation,
Energy expenditure
82
Failure of adrenal gland (causes: autoimmune, cancer) -- disease and symptoms
```
(PRIMARY) Addison's disease (adrenal insufficiency)
symp:
1. hypoglycemia
2. anorexia
3. weakness
4. HYPERPIGMENTATION
```
83
Failure to stimulate adrenal gland (causes: iatrogenic, pit tumor, hypo disorder): disease, symptoms, and RX
(SECONDARY) Addison's disease--adrenal insufficiency
Symp:
1. same as primary minus hyperpigmentation
RX: replace steroids
84
Excess glucocorticoids aka--caused by?
Cushing's syndrome:
1. iatrogenic
2. pituitary adenoma w/ ^ ACTH release
3. Adrenal adenoma
85
* Cushing's syndrome symp + RX
```
Symp: 1.hyperglycemia
2. HTN
3. muscle wasting
4. moon face
5. buffalo hump
6. abdominal striae
RX depends on cause:
1. adrenalectomy
2. pit surgery
```
86
makes MSH melanocyte stimulating hormone
pituitary gland--overproduction can cause hyperpigmentation
87
Primary hyperaldosteronism aka--tumor--RX
Conn's syndrome--Spironolactone (aldo antagonist)/ surg
88
Main extracellular buffer (alkaline)
Bicarb CO3---released by pancreas into small intestines
| CO2 + H2O --> H2CO3 (carb acid) --> CO3- + H2
89
Pancreas hormones and cell mnemonic GIS
AG (starvation)
BI (plenty)
DS (inhibitory)
90
Hormone that regulates insulin and glucagon--
| also known at Growth Hormone Inhibitory Hormone
Somatostatin
91
empty sella syndrome
pituitary sits in sella tersica--
92
iodine needed for synthesis of ____ & _____. Thus low levels in diet will lead to higher release of _____ from pituitary. And ______ will result.
T3& T4,
TSH,
goiter
93
to check integrity of pituitary-adrenal axis (based on negative feedback loop)
Dexamethasone suppression test (pituitary will react to dex same way as cortisol--then check cortisol next morning) If you give dex and cortisol down next day = normal. If you give dex and cortisol high next day = adrenal producing cortisol on its own=disfunction
94
negative feedback for FSH and LH controlled by
levels of progesterone/ estrodile in blood -- intermediary in contrast to T3/T4 feedback for thyroid/pit/hypo system
95
opposes aldosterone--need to be wary of ________ due to interplay of Na+ and K+ by aldo in kidney (to keep me electrically neutral)
spironolactone,
| hyperkalemia (K+ not be excreted by aldo)
96
Symptoms of Conn Syndrome (3) + treatment
1. hypertension
2. hypokalemia
3. metabolic alkalosis
1. RX w/ spironolatone (aldo antagonist)
97
Hormone of abundance + actions (4)
Insulin,
1. decrease blood glucose
2. decrese blood lipid levels
3. decrease blood aa concentration
4. ^ K+ uptake by cells
98
Preproinsulin -->
proinsulin --> insulin
99
Diabetes type I aka; cause
Insulin dependent diabetes mellitus IDDM--inadequate insulin secretion secondary to DESTRUCTION of BETA cells
100
Type I diabetes characterized by (7)
1. hyperglycemia
2. polyuria
3. ketoacidosis (because using fat/aa for energy)
4. polydipsea
5. polyphagia (cellular starvation)
6. hyperkalemia (insulin promotes K+ cell uptake)
7. diabetic ketoacidosis, coma
101
Type II diabetes mellitus aka + cause
Non-insulin dependent diabetes lmellitus NIDDM,
--adequate insulin secretion--cells "insulin resistant"
(not prone to ketosis because insulin working somewhat)
102
Type II diabetes mellitus characterized by (2)
1. abnormal glucose levels
| 2. metabolic derangements of Type I
103
Diabetic coma caused by
hyperosmolarity cause neurons not to work right
104
Hormone of starvation (____), stimulated by _______ blood glucose. Increases blood glucose concentraiton by: (3)
```
glucagon,
decreased,
1. glycogenolysis (break down glycogen)
2. gluconeogenesis
3. increased lipolysis
```
105
________ produced and released from hypothalamus stimulated by food ingestion. Modulates response of _____/____ to food ingestion--affects rest of body in _______ manner.
somatostatin,
glucose/glucagon,
inhibitory
106
drug for Type II diabetes that ^ tissue usage of insulin
metformin
107
Ca ++ concentrations:
Protein bound: 40% (unfilterable)
Ion complexed: 10% (ultafilterable)
Active ionized form: 50% (ultrafilterable + active)
108
*hyocalcemia causes: (6)
1. hyperreflexia
2. muscle cramping
3. spontaneous twitching
4. tingling/ numbness
5. chvostek sign (facial twitch when CN 7 tapped)
6. Trosseau sign (carpopedal spasm--w/ BP cuff inflation)
109
*Hypercalcemia causes: (5)
1. polyuria
2. polydipsia
3. hyporeflexia
4. consipation
5. lethargy, coma, death
110
Ca++ and H+ both bind to _________, so ^v H+ (pH change) in blood can can alter ____ binding, and ^v levels in blood, (____________/__________) symptoms
albumin,
Ca++,
(Hypo/hypercalcemia)
111
*GIP/GLP-1
Gastric inhibitory peptide
Glucagon-like peptide (glucagon analog)
INCREASE insulin secretion,
OPPOSE actions of glucagon
(for type II diabetes)
112
serum _______ stimulates release of insulin--if Beta cells get worn out by overuse, a ____ __ ________ will start to look like a ____ __ ________
glucose,
Type II diabetic
Type I diabetic
113
Increased ________ concentration increases complexed Ca++, decreasing free ______ concentrations
phosphate,
| Ca++
114
Decreased _______ concentration increases _______ Ca++, increasing free Ca++ concentrations
phosphate,
| complexed
115
Somatostatin made in:
| aka growth hormone inhibiting hormone GHIH
1. hypothalamus
2. liver
3. GI tract
Stimulated by food ingestion
116
Secretion of _______ ______ stimulated by decreased serum Ca++ concentration
parathyroid hormone
117
Parathyroid hormone effects:(3)
1. Bone (^ resorption-->^ Ca++ & phosphate in ECF)
2. kidney (^ Ca++ reabsorption; v phosphate reabsorption)
3. small intestine (^ Ca++ absorption via VITAMIN D)
118
PRIMARY Hyperparathyroidism, as from ______ ______, may cause (3) ______, _______ ______, and ________
parathyroid ADENOMA,
1. hypercalcemia,
2. kidney stone (Ca++/Phosphate)
3. hypophosphatemia
119
SECONDARY hyperparathyroidism, as from excessive ___ ______ secondary hypocalcemia as from: (3) _______, _______, _________
PTH secretion,
1. Vit D deficiency
2. Renal failure
3. PTH secretion tumor
120
PTH wants to increase:
Ca++ concentration in serum
121
Hypoparathyroidism usually from: clincaly we'll see
treatment of thyroid gland resulting in destruction of parathyroid glands.
-hypocalcemia/hyperphosphatemia
122
2nd major regulatory hormone for Ca++ & phosphate
Vitamin D aka cholecalciferol
123
_____ modifies vitamin-D to make inactive form then ______ further modifies into _______ or ______ form
liver,
kidney,
active/inactive
124
Actions of active vitamin-D derivative (4)
1. ^ mineralization of new bone
2. * ^ Ca++ / phosphate absorption by SMALL INTESTINES
3. Kidney--^ reabsorption of Ca++ & phosphate
4. Bone--stim bone "REMODELING"
125
ppl with chronic renal failure will have _______ due to inability to excrete _________, thus ____ will be taken out of bones. SECONDARY HYPERPARATHYROIDISM
osteoporosis,
phosphate,
Ca+
126
Vitamin D deficiency will cause:
______ in children:
______ in adults:
- Rickets (can't mineralize bones)
| - osteomalacia, osteoporosis (from renal failure--no active D)
127
_______ opposes PTH by lowering serum free ____. Made in thyroid--stims Ca++ into bones.
calcitonin,
| Ca++
128
^v Ca++ chart on pg 17 of outline
*
129
bones made of--thus vitamin D wants to save ______
calciumphosphate --bound,
| both
