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Endocrinology Part 1 Flashcards

1
Q

What are the sex steroids?

A

Progesterone, androgens, and estrogens

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2
Q

What is the main minaralocorticoid?

A

Aldosterone

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3
Q

What is the main glucocorticoid?

A

Cortisol

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4
Q

How are all steroid hormones made?

A

Cystolic cholesterol is converted to mitochondrial cholesterol by StAR which is then converted to pregnenolone by SCC.

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5
Q

How are steroids released from the cell?

A

Diffuse out of the cell (non-vesicular storage)

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6
Q

How are steroids transported? Metabolized/excreted?

A

Transport by binding proteins

Metabolized into an inactive form then excreted by either the liver or the kidney

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7
Q

What carrier protein does cortisol use?

A

Transcortin

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8
Q

What carrier protein do thyroid hormones use?

A

Thyroxine-binding Globulin (TBG)

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9
Q

What carrier protein do most steroid hormones use?

A

Albumin (it is non-specific)

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10
Q

What is the MOA of ketoconazole?

A

Inhibits SCC and CYP17

Decrease the synthesis of all steroids

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11
Q

What is ketoconazole used for?

A

Antifungal agent

Decrease tumor production of steroids

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12
Q

What is the MOA of finasteride?

A

Inhibits 5-alpha-reductase

Decrease the synthesis of dihyrdotestosterone (DHT)

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13
Q

What is finasteride used for?

A

Alopecia and BPH

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14
Q

What precautions should be taken with finasteride?

A

Do not touch if pregnant

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15
Q

What is the MOA of letrozole?

A

Inhibit aromatase

Decreases estrogens

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16
Q

What is letrozole used for?

A

Estrogen Receptor (+) Breast Cancer

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17
Q

What is the MOA of metyrapone?

A

Inhibit 11-beta-hyroxylase

Decrease cortisol

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18
Q

What is metyrapone used for?

A

Adrenal cortex excess production

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19
Q

How are hormones synthesized from peptides/proteins made?

A

Amino acids link to form a pre-prohormone –> prohormone –> hormone

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20
Q

How are peptide/protein hormones released?

A

Exocytosis from a vesicle

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21
Q

How are peptide/protein hormones transported? Metabolized/excreted?

A

Transported by some binding proteins but mostly water soluble and move in plasma

They are endocytosed and degraded by proteases

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22
Q

What are the major catecholamines?

A

Dopamine, norepinephrine, epinephrine

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23
Q

How are catecholamines synthesized?

A

Tyrosine –> L-DOPA –> dopamine –> norepinephrine –> PNMT converts it to epinephrine

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24
Q

How are catecholamines released? Transported? Metabolized/excreted?

A

Released by exocytosis from vesicles

Transported in plasma (water soluble) or bound to albumin

Uptake and breakdown by monamine oxidase (MAO) or catechol-o-methyltransferase (COMT)

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25
What is the common metabolite from catecholamine metabolism?How is it used diagnostically?
Vanillylmandelic acid (VMA) If the patient has a catecholamine secreting tumor VMA will be found in high amounts in urine
26
What are two hormones are amino acid derivatives?
Thyroid hormones and melatonin
27
What are thyroid hormones made up of?
2 tyrosines plus iodides
28
What does melatonin come from?
Tryptophan
29
What are the major eicosanoids?
Prostaglandins, thromboxanes, and leukotrienes
30
How are eicosanoids made?
Pathway 1: PLA2 breaksdown phospholipids to arachidonic acid which is broken down by COX or LOX into eicosanoids Pathway 2: DAG lipase breaksdown DAG to arachidonic acid which is broken down by COX and LOX into eicosanoids
31
How are eicosanoids released? Where do the act? Metabolized/excreted?
Diffuse out of the cell (non-vesicular storage) Act locally (no transport) Metabolized by enzymatic breakdown
32
What is the MOA of NSAIDs?
Inhibit COX Decrease synthesis of PG and TX May increase LT synthesis
33
What are NSAIDs used for?
Anti-inflammatory/immune agents Decrease clot formation
34
What is the MOA of cortisol?
Inhibit COX and PLA2 Decrease PG synthesis
35
What is cortisol used for?
Anti-inflammatory/immune agent | ex. athletes get cortisone shots when they have major inflammatory injuries
36
What is the MOA of zilueton?
Inhibit LOX Decrease LT synthesis
37
What is zilueton used for?
Asthma, rhinitis, and nasal congestion
38
What are two characteristics of negative feedback?
1. Holds the system at the set point | 2. Has an odd number of inversions
39
What are two characteristics of positive feedback?
1. Disrupts homeostasis | 2. Has zero or an even number of inversions
40
What hormones are released from the posterior pituitary?
Antidiuretic hormone (aka arginine vasopressin) Oxytocin
41
Hormones released from the posterior pituitary are made in the cell bodies of what neurons? Where are they stored?
Magnocellular neurons Stored in vesicles at axon terminals
42
What does ADH do and at what receptors?
V1 (Gq) = vasoconstriction V2 (Gs) = renal water reabsorption, urea reabsorption
43
What does the release of ADH trigger?
Thirst Factor VIII release von Willebrand factor release
44
What stimulates the release of ADH?
Increase in Posm Decrease in BP/blood volume Ang II Medications Surgery/anesthesia
45
What inhibits the release of ADH?
Ethanol
46
What is central diabetes insipidus?
Low ADH due to synthesis or release problems
47
What is nephrogenic diabetes insipidus?
Low ADH due to receptor problems (V2, Aq2) Low ADH due to lithium or demclocycline
48
What is seen clinically in diabetes insipidus?
Cell dehydration (hypernatremia, high Posm) Low Uosm Polyuria Thirst
49
How can both types of diabetes insipidus be treated?
Both types treat with water
50
What is SIADH?
Syndrome of Inappropriate ADH (aka high ADH activity)
51
What can cause SIADH?
ADH producing tumors (usually lung) CNS damage Pulmonary disease (TB, pneumonia) Surgery Medications
52
What is seen clinically with SIADH?
Cerebral edema (hyponatremia, low Posm) High Padh High Uosm
53
How is SIADH treated?
Treat the cause (aka tumor) Hypertonic saline Fluid restriction Furosemide (decrease concentrated urine) Demeclocycline (inhibit ADH pathway) Tolvaptan (V2 receptor antagonist)
54
What does oxytocin do and at what receptors?
OT receptor (Gq) = smooth muscle contraction of the milk ducts and uterus myometrium (during birth)
55
What stimulates the release of oxytocin?
Nursing and cervical stretch
56
What is the MOA of pitocin?
Synthetic oxytocin
57
What is pitocin used for?
Induce/maintain labor Post-partum hemorrhage
58
What are tocolytics used for?
To decrease uterus contractions associated with premature labor
59
What are the four main tocolytics and at what receptor to the act?
Ritodrine = Beta2 agonist Nifedipine = LTCC blocker Mg2+ Sulfate = LTCC blocker and decreases MLCK activity Atosiban = OT receptor blocker
60
What is the MOA of ergot alkaloids?
Increase smooth muscle contraction by stimulating the 5-HT1b/1d receptors
61
What are ergot alkaloids used for?
Migraines Post-partum hemorrhage
62
What is a precaution taken with ergot alkaloids?
Don't take during pregnancy because it will decrease blood flow to the fetus
63
How can central diabetes insipidus be treated?
Central = give desmopressin (synthetic ADH)
64
How can nephrogenic diabetes insipidus be treated?
give HCTZ (induces water reabsorption due to diuretic breaking)
65
How can lithium induced nephrogenic diabetes insipidus be treated?
give amiloride (blocks Li2+ entry through ENaC)
66
How can demeclocycline induced nephrogenic diabetes insipidus be treated?
change antibiotics
67
What meds can cause SIADH
Antidepressants Antipsychotics Opiates Vinca alkaloids

ERM (27 decks)

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