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Fundamentals Part 2 > Endocrinology > Flashcards

Flashcards in Endocrinology Deck (129):
1

What are some examples of the derivative tyrosine

epi, norepi, and thyroxine

2

An increase in functioning of target cell which send which type of feedback to the endocrine gland (positive/negative?)

negative

3

how would negative feedback alter the rate of releasing hormone

decrease

4

What is one example of the positive feedback resulting in increased hormone release

Dilation of cervix during labor, stimulates post. pituitary to secrete more oxycotin=more dilation

5

what receptor type is usually amplifying hormone signal

G-protein coupling (cAMP, cGMP, phospholipase C, Ca++, calmodulin)

6

What type of hormone acts by entering the cell and binding to an intracellular receptor.

Steroids

7

What is the result of a steroid binding with a intracellular receptor?

activates a gene, causing transcription, translation of proteins.

8

Which hormone-receptor system would elicit a faster response between cell surface or intracellular?

cell surface (such as G-protein)

9

Would epinephrine or prednisone cause a more immediate response

epi

10

What is the anterior pituitary also called

adenohypophysis

11

Where is the anterior pituitary or adenohypophysis derived from

embryonic cells from the oral cavity(Rathke's pouch)

12

Embryonic cells from Rathke's Pouch is responsible for producing:

the anterior pituitary

13

Neurohypophysis is another name for which component of the endocrine system

posterior pituitary gland

14

How is the posterior pituitary gland produced

formed by down growth of cell axons from the 3rd ventricle

15

Histamine that is released by mast cells diffuse into the ECF to the stomach and influence gastric parietal cells to secrete H+. This is an example of what type of signaling system

paracrine

16

Where are the neuron cell bodies that produce ADH & oxytocin

supra optic & paraventricular nuclei of the hypothalamus

17

How does the hypothalamus link to the anterior pituitary gland

through the hypothalamic-hypophysial portal blood vessels

18

Describe the portal system seen in the anterior pituitary gland

capillary beds connected via veins

19

Why would you pee a lot after drinking alcohol?

inhibits ADH release

20

Pain, nausea, hypoglycemia would cause what to ADH

stimulate release of ADH

21

What does ADH regulate:

osmolarity in the body

22

What cells do ADH act on increasing H2O reabsorption

principle cells in the distal renal tubules & collecting ducts

23

This hormone is responsible for uterine contraction, milk production, and ejection

oxytocin

24

This hormone can help reduce postpartum bleeding

ocytocin

25

HOw many hormones are produced by the Anterior pituitary gland

6 GH, TSH, LH, FSH, ACTH, Prolactin

26

Whats the difference between the anterior and posterior pituitary glands

portal vein system

27

How many cells are responsible for producing the hormones of the anterior pituitary? list them

5, somatotrophin(GH) thyrotrophes(TSH), gonadotrophes(FSH & LH) corticotrophs(ACTH) lactotrophs (prolactin)

28

HOw is prolactin inhibited from being released

dopamine

29

What is pregnancies effect on prolactin (specifically the high levels of estrogen/progesterone?

inhibits action of prolactin

30

What is galactorrhea

milk production unassociated with pregnancy/nursing.

31

what causes galactorrhea

hypothalamic-hypophysial portal tract interrupted (damage to pituitary, adenoma of the pituitary), or destruction of dopamine that inhibits the prolactin normal release.
-

32

How could we treat galactorrhea if it was a result of destructed dopamine

dopamine agonist (bromocriptine)

33

what is the 'pulsatile release' refer to in regards to the growth hormone

the largest burst occurs within the 1st hour of falling asleep

34

Why is T3 secreted from the thyroid gland have a "steady-state"

highly protein bound (not active when bound), with a long half life

35

acromegaly would result from a problem in which gland

pituitary

36

what is the mechanism of Grave's Disease

an autoimmune disorder results from antibodies that act against TSH receptors; result in an increased release of T3/T4

37

describe what you would see in someone who has myxedema

puffiness of skin, non-pitting edema, pleural, cardiac effusions

38

what pathology would myxedema be associated with?

Hypothyroidism

39

Would you expect the T3/T4 levels to be high, low, or the same with someone who is diagnosed with Grave's Disease

Raised

40

Cretinism causing a look of thick, pale skin with a floppy tongue is caused by what

lack of TSH within the thyroid

41

What is a classic presentation of iodine deficiency

Goiter (high TRH, high TSH, low T3/T4)

42

What are you to see with the TRH, TSH, and T3/T4 levels with a pituitary adenoma

Low TRH, high TSH, high T3/T4

43

What findings would be seen in Grave's Disease (TRH/TSH/T3/T4) levels

Low TRH, low TSH, high T3/T4

44

The adrenal medulla is responsible for the production of

catecholamine

45

What are the catecholamines produced in the adrenal medulla

epinephrine and norepinephrine

46

the adrenal cortex is responsible for

steroid hormones

47

The three cortical adrenal layers include:

zona reticularis, zona fasciculate and zona glomerulosa

48

What is zona resicularis responsible for

androgens

49

what is zona fasciculate do

glucorticoids (cortisol)

50

what is zona glomerulosa do

mineralocorticoids (aldosterone)

51

what the difference in release of mileralocorticoids (aldosterone) when compared to androgens & glucorticoids (cortisol)

it is controlled by the RAAS system whereas the latter two are produced AND released by ACTH

52

What is one thing to be aware of when reading lab results on hormone levels (hint what does it measure)

they measure immunologic amounts NOT biological activity hence the #'s may be normal, but that doesn't necessarily mean they are functional

53

In terms of concentration- how do the hypothalamic releasing hormones compare with the hormones released into the systemic circulation?

They are much more highly concentrated

54

how would alcohol and or ANP affect ADH

inhibit the release

55

What controls the pituitary to release ADH

osmoreceptors in the hypothalamus, barorecptors in the aortic arch, L atrium, and carotid artery sense hypovolemia/hypervolemia also signaling the hypothalamus via vegas nerve

56

where are the baroreceptors located that are responsible for sensing hypo/hyper volemia

aortic arch, L atrium, and carotid artery

57

how do baroreceptors signal the hypothalamus neuronally to increase/decrease ADH secretion

via the vegas nerve

58

HOw would you describe nephrogenic DI (diabetes insipidus)

loss of osmolar gradient so the loop of Henle can't concentrate the urine

59

how would you describe Central DI

no ADH is released from the brain

60

Oat cell carcinoma of the lung is a condition closely associated with SIADH.... how could you explain these similarities

Low Na+ serum

61

this hormones actions are mediated through somatomedins

Growth Hormone

62

what acts as a type of negative feedback for growth hormone

somatostatins

63

what are 4 actions that growth hormone causes

increases linear growth in bones
increases protein synthesis
promotes utilization of fats as energy and this leads to a type of diabetogenic (increase in insulin resistance)

64

How would starvation, fasting, and exercise affect the rate of Growth Hormone secretion

it would increase (may utilize fat stores for energy)

65

Which hormone is responsible for lactogenesis

prolactin

66

this hormone is responsible for breast development at puberty & pregnancy

prolactin

67

This hormone inhibits ovulation by inhibiting gonadotrophin-releasing hormone

prolactin

68

Secondary to spermatogenesis, infertility in males can be caused by excess of this hormone

prolactin

69

If a patient were to present to you with a headache and galactorrhea, we can assume?

pituitary adenoma

70

A failure to lactate or "empty sella syndrome" would cause us to believe what condition

prolactin deficient

71

what is empty sella syndrome

the pituitary has shrunk so the bony saddle appears partially empty

72

This hormone stimulates development of follicles in the ovary and spermatogenesis

follicle stimulating hormone

73

this hormone stimulates development of corpus luteum in the ovaries & testosterone secretion from the Leydig cells of testis

Luteinizing hormone

74

luteinizing & FSH are both under control of

gonadotrophin releasing hormone

75

Whats the more active form between T3/T4

T3

76

the thyroid hormone is contained primarily:

thyroglobulin

77

this hormone is comprised of a large number of follicles that are filled with colloid material

thyroid

78

This hormone is actually apart of a family including MSH, Beta-endorphin and alpha/beta lipotropin

ACTH

79

ACTH produces & stimulates to secrete these two hormones? from these zona's? in the adrenal cortex

cortisol from zona fasciculate & androgens from the zona reticularis

80

What stimulates the secretion of the ACTH from the anterior pituitary

the corticotrophin releasing hormone (CRH) from the hypothalamus

81

glucocorticoids/androgens are secreted pulsatile and diurnal, how do you best explain this?

Peak release is in early morning. Diurnal=daily

82

this test is a method evaluating the functioning of the pituitary-adrenal axis

dexamethasone suppression test (DST) a blood test to measure cortisol levels in the adrenal gland, often diagnose Cushing syndrome

83

This hormone stimulates gleuconeogenesis & glycogen storage

cortisol

84

This hormone is an antiinfammatory inhibiting prostaglandins, leukotrienes/histamines/serotonin

glucocorticoids (cortisol)

85

this hormone suppresses the immune response & inhibits bone formation

cortisol

86

this hormone maintains vascular response to catecholamines & increases GFR

cortisol

87

What mechanism of aldosterone's function would cause metabolic alkadosis

increased secretion of H+

88

An abnormal function in the DHEA (dehydro-epiandrosterone) in a female would cause what charecteristic

masculinization

89

Addison's disease is associated with which gland

adrenal cortex

90

What is the difference between primary and secondary adrenal insufficiency

primary is failure of the gland itself whereas secondary is failure to stimulate the gland

91

How could we have primary destruction of the adrenal gland

autoimmune disease, metastatic lung cancer

92

Hyperpigmentation of the nails/hands and gumlines would be associated with this disease

Addison's

93

In a secondary cause of insufficient adrenal hormones, a pituitary hormone would lack this which would also be a sign to rule out primary

no hyperpigmentation

94

these symtpoms would be seen in both primary and secondary causes of adrenal insufficiency (Addison's desease)

hypoglycemia, anorexia, and weakness.

95

This one symptom would help determine as to whether Addison's disease is caused by a primary or secondary failure

hyperpigmentation

96

If you had insufficient cortisol secretion with no sign of hyperpigmentation, we could assume the problem is

a pituitary tumor

97

What are the hallmark signs of Cushing Syndrome

Round Face, Buffalo Bump, abdominal striae, hyperpigmentation, HTN, Hyperglycemia

98

What are some causes of Cushing Syndrome

excess cortisol caused by pituitary adenoma, adrenal adenoma, and iatrogenic

99

What is the most common cause of Cushing Syndrome in developed countries?

iatrogenic causes

100

In Empty Sella Syndrme ( a secondary hypothyroidism) what are the TRH, TSH and T3/T4 levels

High TRH, Low TSH, Low T3/T4

101

If there are low levels of T3/T4, caused by a problem in the hypothalamus. How would you see the TRH & TSH levels

low TRH low TSH

102

Estrogen and Progesterone are a negative feedback for what hormones?

they act on hypothalamus to inhibit FSH & LH

103

HOw does the FSH & LH act to increase estrogen and progesterone?

it acts on ovaries to make it

104

Insulin dependent diabetes mellitus refers to which type

Type I

105

What is the mechanism of Type I DM

Beta cells are destroyed so u have inadequate insulin secretion

106

Polyuria, polydipsia and polyphagia are hallmark signs of this problem

high glucose levels in Type I DM

107

what is ketoacidosis

increased use of fatty acids/amino acid for energy particularly in Type I DM

108

Insulin is produced by which type of cells

beta cells

109

How can you explain hyperkalemia in a type I diabetic

since insulin promotes the uptake of K+ into the cell, Type I diabetics don't make adequate insulin and hence more K+ is left outside the cells

110

What would u assume is the problem if a patient presets with fruity smelling breath

They are experiencing ketoacidosis and may have Type I diabetes

111

What are three things that can increase Insulin secretion

GIP (gastric inhibitory peptide) GLP-1 (glucagon like peptide) and sulfonylureas

112

Why would Metformin help treat Type II diabetics (think what their pathophys is)

improves tissues usage of insulin.... counteracts the "insulin resistance

113

Which type of diabetes is described as insulin resistance

Type II (make enough insulin, but cells don't utilize it)

114

If you were to treat a hyperkalemic patient with a normal blood glucose level, which pairing of treatment could u use

insulin with glucose

115

What opposes insulin and is referred to as the Hormone of Starvation

Glucagon

116

What 3 things does Glucagon act on

gluceoneogenesis, Glycogenolysis, increased lipolysis

117

Somatostatin

acts as a "stop" for growth hormone release produced by hypothalamus; stimulated by ingestion of food

118

What are the hallmark signs of hypocalcemia

hyperreflexia, muscle cramping, spontaneous twitching, tingling & numbness, Chvostek sign, and Trosseau sign

119

hallmark signs of hypercalcemia

polyuria, polydipsia, hyporeflexia, constipation, lethargy, coma, and death

120

What is the Chvostek sign

twitching of facial muscle caused by tapping o facial nerve

121

What is the Trosseau sign

carpopedal spasm with inflation of BP cuff

122

How can Chronic Renal failure be caused/linked to problems with parathyroid hormone?

It is a secondary form of hyperparathyroidism

123

How can you have a vitamin D deficiency even if you are getting enough from the sun or your diet? (how is it processed)

Vitamin D is inactive until it is first synthesized by the liver and modified by the kidney. The kidney can make it active (1,25-dihydroxycholecalciferol) or inactive based on body needs

124

What is the hallmark Vitamin D deficient condition

Rickets in children

125

What can you use to treat a mild form of hyperparathyroidism? It also can help treat renal failure

Calcitonin

126

How does Calcitonin work to treat hyperparathyroidism?

opposes action of PTH, lowering serum Ca++ levels and stimulates deposition of bone when serum Ca++ high.

127

What causes Conn's Syndrome

primary hyperaldosteronism

128

What are some symptoms of Conn's Syndrome

increase in ECF volume HTN, hypokalemia, metabolic alkalosis

129

What is spironolactone's mechanism if given to treat Conn's Syndrome

an aldosterone antagonist