Endocrinology Part 1 (Hypothalamus, Pituitary, and Pineal Gland) Flashcards
(253 cards)
1
Q
Controls flow of information between cells and tissues by releasing hormones
A
ENDOCRINE SYSTEM
2
Q
Substances secreted by endocrine gland that conveys information to its target cells
A
HORMONES
3
Q
All hormones will act on all cells
A
F (Not ALL hormones will act on all cells; requires
appropriate cell receptor)
4
Q
Chemical signals produced by specialized cells secreted into the bloodstream and carried to a target tissue (with specific receptor)
A
Hormones
5
Q
Generally, act at sites distant from their place of origin
Ex: some pituitary hormone acts on thyroid gland,
gonads, adrenal gland
A
Hormones
6
Q
Regulates cells and organs to maintain homeostasis
Ex:
ADH – regulates water homeostasis
Aldosterone – regulates Na homeostasis
A
Hormones
7
Q
hormone concentrations are regulated by?
A
feedback mechanisms/loop
8
Q
Actions of hormones
A
1) Regulatory substance
2) Controls body functions
8
Q
TYPES OF HORMONE ACTION
A
ENDOCRINE
PARACRINE
AUTOCRINE
JUXTACRINE
INTRACRINE
9
Q
Acts at a distant site from their place of origin
A
endocrine
10
Q
Acts on the neighboring cells
A
paracrine
11
Q
Acts on its self
Ex: hormone produced by hypothalamus will act on hypothalamus
A
autocrine
12
Q
Remain intact/bound to cell membrane; acts on
adjacent cells by cell-to-cell contact with cell
receptors
A
Juxtacrine
13
Q
how does juxtacrine acts on adjacent cells
A
cell-to-cell contact
14
Q
Acts inside the cells (non-producible/released)
A
intracrine
15
Q
CHEMICAL COMPOSITION/NATURE OF HORMONES
A
PEPTIDES & PROTEINS
STEROID
AMINO ACID DERIVATIVES (Amines)
FATTY ACID DERIVATIVES
16
Q
chemical composition of water soluble hormones
A
PEPTIDES & PROTEINS
17
Q
chemical composition of hormones that do not require carrier (transport proteins)
A
PEPTIDES & PROTEINS
18
Q
Nature of majority of the hormones
A
PEPTIDES & PROTEINS
19
Q
chemical composition of hormones that is synthesized and stored within cells
A
PEPTIDES & PROTEINS
20
Q
chemical composition of hormones that is stored inside the cell where they are produced
A
PEPTIDES & PROTEINS
21
Q
Example of hormone with peptide & protein nature
A
GH – produced by pituitary gland; cells that
produce GH will synthesize GH but they are
retained inside the cell; only released when the
body needs GH
22
Q
Steroid hormones regulates?
A
sexual dev’t and characteristics
23
Q
Precursor of steroid hormones
A
cholesterol (a sterol)
24
Example of steroid hormones
Sex hormones
- testosterone
- progesterone
- estrogen
- androgen
25
Have similarity with peptide & steroid in nature
Amino acid derivatives (amines)
26
Example of amino acid derivatives
Catecholamine, Thyroid hormone
27
Hormone with fatty acid derivative nature includes?
eicosanoids
28
Example of hormones with fatty acid derivative
prostaglandins (procoagulants – in relation with
homeostasis; thromboxane A2)
29
HORMONE TYPES ACCDG TO TRANSPORT
FREE
BOUND (to transport proteins)
30
Nature of free hormones
Peptides hormones (water soluble)
31
Exceptions in free hormones
Some are water soluble which do not require transport proteins. However, there are some that REQUIRES TRANSPORT PROTEINS:
* GH
* Insulin-like Growth Factor 1 (IGF-I)
* Insulin-like Growth Factor 2 (IGF-II)
* Vasopressin
* Oxytocin
32
Enumerate bound proteins
Steroid & Thyroid Hormones
* Albumin
* Corticosteroid-binding globulin (CBG)
* Sex hormone-binding globulin (SHBG)
* Thyroxine-binding globulin (TBG)
Amines (catecholamines)
* Serum proteins
* TBG
33
T/F
Both FREE and BOUND proteins have hormonal activity
F
*only FREE hormones have hormonal activity
*transport proteins must detach to bound hormones to exhibit hormonal activity
34
MAIN HORMONE PRODUCING GLANDS
HYPOTHALAMUS
PITUITARY
PINEAL
THYROID
PARATHYROID
ADRENAL
PANCREAS
OVARIES
TESTIS
35
Hypothalamus is responsible for these activities
1) Sleep
2) Thirst
3) Mood
4) Hunger
5) sex drive
36
Gland that secrete regulatory hormones (releasing, inhibitory)
hypothalamus
37
2 types of regulatory hormones produced by hypothalamus
* releasing hormones
* inhibitory hormones
38
Controls other glands by production of
stimulating hormone (tropic hormones)
Pituitary (master gland)
39
Pituitary gland produce hormones that triggers?
growth
40
T/F
Majority of pituitary hormone acts on another gland
T
41
Action of pituitary to stimulate thyroid gland to produce thyroid hormones
Release thyroid-stimulating hormone (TSH)
42
Gland that secretes melatonin (for sleep cycle)
Pineal gland
43
Gland that secretes hormones assoc. with calorie burning and heart rate
Thyroid gland
44
Secretes hormone that controls calcium and phosphate homeostasis
Parathyroid gland
45
Secretes sex drive hormones and stress hormones
Adrenal gland
46
Secretes insulin (for glucose homeostasis)
Pancreas
47
Gland that is both an exocrine and endocrine? what is the action?
Pancreas
* Exocrine – secretes enzymes
* Endocrine – secretes hormones
48
Hormones secreted by ovaries
* female sex hormones (progesterone & estrogen)
* testosterone
49
Hormones secreted by testes
testosterone
50
Amount of substance in a system regulates its own concentration
NEGATIVE FEEDBACK
51
Increased or decreased hormone levels will stimulate hormone inhibition or production, respectively
NEGATIVE FEEDBACK
52
Hormones released by an endocrine gland induces
more stimulating hormones to be released
POSITIVE FEEDBACK
53
The more hormone is secreted, the more action is stimulated
POSITIVE FEEDBACK LOOP
54
associated glands in ultrashort feedback loop
Hypothalamus and pituitary
55
associated glands in short feedback loop
Pituitary and target gland
56
associated glands in long feedback loop
Hypothalamus, pituitary, and target gland
57
Majority of endocrine functions are regulated through this gland
pituitary gland
58
Secretion of pituitary gland is regulated or controlled by?
hypothalamus
59
Hormone production involves 2 glands in CNS:
hypothalamus, pituitary
60
Glands other than hypothalamus & pituitary
Peripheral glands
61
Hormone secretion by peripheral glands is stimulated by these glands
hypothalamus & pituitary
62
Stimulating thyroid gland to produce its hormone is an example of what feedback loop
negative
63
Stimulating oxytocin production is an example of what feedback loop
positive
64
what is the term when hypothalamus, pituitary, and thyroid gland is involved in the process?
Hypothalamic pituitary thyroidal axis
65
Explain the events in hypothalamic pituitary thyroidal axis
1) Hypothalamus will secrete regulatory (releasing) hormones for thyroid → thyrotropin-releasing hormone (TRH).
2) TRH directly acts on pituitary gland to stimulate tropic hormone → thyroid-stimulating hormone (TSH) or thyrotropin.
3) TSH will stimulate thyroid gland to produce thyroid hormone.
4) Continuous process to increase thyroid hormone until it becomes in excess.
5) Thyroid gland will send signal to hypothalamus to stop production.
6) Hypothalamus will inhibit TRH release (following
processes will not continue).
✓ If in cases of low thyroid hormone: thyroid
gland will send signal to hypothalamus to start
production of TRH (further processes will follow)
✓ Equalized thyroid hormones will send another
feedback to stop.
66
substance released by hypothalamus to stimulate thyroid gland secretion of thyroid hormones
thyrotropin-releasing hormone (TRH)
67
function of TRH
directly acts on pituitary gland to stimulate tropic
hormone → thyroid-stimulating hormone (TSH) or
thyrotropin
68
function of TSH
stimulate thyroid gland to produce thyroid hormone
69
signal is sent by a peripheral gland (target gland) to this gland to stop production of hormones in cases of excess production? what is the action?
hypothalamus
inhibit TRH release (or other releasing hormones required)
70
Acts on uterus during labor involving uterine contraction (Ferguson reflex)
oxytocin
71
uterine contraction is aka
Ferguson reflex
72
mechanism of oxytocin
The more oxytocin, the more contraction
The more the contraction, the more it stimulates oxytocin production
Until it reaches parturition (giving birth)
73
2 MODULATION OF HORMONE LEVEL
HYPOTHALAMIC-PITUITARY-END ORGAN (PERIPHERAL GLAND) SYSTEM
FREE-STANDING ENDOCRINE GLAND SYSTEM
74
Regulation is CNS input
HYPOTHALAMIC-PITUITARY-END ORGAN (PERIPHERAL GLAND) SYSTEM
75
Regulation is Varied input
FREE-STANDING ENDOCRINE GLAND SYSTEM
76
Enumerate activities under HYPOTHALAMIC-PITUITARY-END ORGAN (PERIPHERAL GLAND) SYSTEM
* Regulation: CNS input (signal sent by peripheral gland to the hypothalamus)
* Hypothalamus (Releasing hormone)
* Pituitary (Tropic/Stimulating hormone)
* Peripheral Glands (Hormone)
* Target cell (Effect) with appropriate cell receptor
77
Enumerate activities under FREE-STANDING ENDOCRINE GLAND SYSTEM
* Regulation: Varied Input (depends on target cell or substance that is regulated by the hormone)
* Free-Standing Endocrine Gland (Hormone)
* Target cell (Effect) with appropriate cell receptor
78
Modulation wherein hormone concentration depends on the substance that it regulates
FREE-STANDING ENDOCRINE GLAND SYSTEM
79
example hormones of FREE-STANDING ENDOCRINE GLAND SYSTEM
Parathyroid hormone – Ca and PO4 homeostasis
Insulin – glucose homeostasis during ↑ GLU
80
Mount a response to a hormone
TARGET ORGAN
81
Express appropriate cognate hormone receptor/
appropriate cell receptor
TARGET ORGAN
82
3 TYPES OF HORMONE RECEPTORS
Cell Surface Receptors
Intracellular Receptors
Multiple Receptors
83
Cell Surface Receptors
Insulin
GH
PRL
Leptin
Catecholamine
84
hunger hormone secreted by
adipocytes/fat cells; mechanism
Leptin
Fat individuals – frequent
hunger promotion due to ↑
Adipocytes (↑ Leptin)
85
Intracellular Receptors
Steroids
Thyroid hormones
86
Multiple Receptors
Estrogen
Progestins
87
location of hypothalamus
walls and floor of 3rd ventricle (above pituitary gland)
88
hypothalamus is connected to posterior pituitary gland by this structure
pituitary stalk (infundibulum)
89
Majority of the hormone produced by this gland has direct effect on pituitary gland
hypothalamus
90
Hypothalamus is part of this feedback mechanism
NEGATIVE feedback loop
91
Releasing hormones produced by hypothalamus
1. Thyrotropin-releasing hormone (TRH)
2. Growth hormone-releasing hormone (GHRH)
3. Gonadotropin-releasing hormone (GnRH)
4. Corticotropin-releasing hormone (CRH)
5. Prolactin-releasing factor (PRF)
92
Inhibiting hormones produced by hypothalamus
1. Prolactin-inhibiting factor (PIF)
2. Vasopressin (inhibit urine output)
3. Oxytocin
4. Somatostatin
93
Pituitary gland is aka
hypophysis (meaning: below the hypothalamus)
94
pituitary literally means
“spit mucus”
(believed in the past that the mucus secreted is necessary for growth)
95
Pituitary gland is previously referred to as
master gland
(they believed that no pituitary, no growth)
96
Pituitary gland is presently referred to as
transponders
97
Reason why pituitary gland is characterized as transponders
Translate neural/CNS input (signal sent by
peripheral gland) from hypothalamus into a
hormonal product
98
location of pituitary gland
base of the skull in the pocket of the
sphenoid bone (sella turcica/Turkish saddle)
99
depression of sphenoid bone is aka
sella turcica/Turkish saddle
100
Largest portion of pituitary gland
Anterior pituitary gland (Adenohypophysis)
101
Function of anterior pituitary gland (adenohypophysis)
Secretes and produce hormones
102
aka Posterior pituitary gland
Neurohypophysis
103
aka Anterior pituitary gland
Adenohypophysis
104
aka Intermediate lobe
Pars intermedialis
105
function of posterior pituitary gland
Only secretes
ADH and oxytocin storage
106
Poorly developed; no function
Mistaken as nodules or benign cyst
Intermediate lobe (Pars intermedialis)
107
Hormones produced in anterior pituitary gland
GH
PRL
LH, FSH
TSH
ACTH
108
Specialized cells for GH production
Somatotrophs
109
Specialized cells for PRL production
Lactotrophs
110
Specialized cells for LH, FSH production
Gonadotrophs
111
Specialized cells for TSH production
Thyrotrophs
112
Specialized cells for ACTH production
Corticotrophs
113
2 types of hormones secreted by anterior pituitary gland
Direct effector hormones
Tropic/stimulating hormones
114
types of hormones secreted by anterior pituitary gland that act on peripheral tissues
Direct effector hormones
115
Example of direct effector hormones
GH, prolactin
116
types of hormones secreted by anterior pituitary gland that acts on another endocrine gland
Tropic/stimulating hormones
117
Examples of Tropic/stimulating hormones
LH, FSH, TSH, ACTH
118
aka GH
SOMATOTROPIN
119
hormones that are structurally similar with each other
GH
Prolactin
Human placental lactogen
120
Most abundant hormone secreted by pituitary gland
GH
121
GH directly acts on this organ? what is produced?
liver
stimulate liver to produce growth factors
122
essential for LINEAR/LONGITUDINAL GROWTH
growth factors
123
A peptide hormone but an exception as it requires
transport protein (IGFBP-3)
GH
124
GH production is heavily modulated by other factors such as
Ghrelin
125
An enteric hormone, potent stimulator of GH receptors
Ghrelin
126
Ghrelin is responsible for?
1. Nutrient sensing
2. Appetite
3. Glucose Regulation
127
1/3 of the total pituitary weight (most abundant cell in anterior pituitary gland)
Somatotrophs
128
release of GH is STIMULATED by this substance produced by hypothalamus
GHRH
129
release of GH is INHIBITED by this substance produced by hypothalamus
Somatostatin
130
manner of GH secretion? what is the interval? what is the most reproducible peak?
pulses
Ave. pulse interval: 2-3 hrs
Most reproducible peak: Onset of sleep
131
Method for GH measurement
Chemiluminescence Immunoassay
132
GH Reference Value
<7 ng/ml (fasting state)
133
GH secretion is STIMULATED by these modifiers
* Sleep (deep sleep) *major contributor
* Exercise
* Physiologic stress
* Amino acids (arginine)
* Hypoglycemia
* Sex steroids (estradiol)
* a-agonists (norepinephrine)
* b-blockers (propranolol)
134
GH secretion is INHIBITED by these modifiers
* glucose loading
* emotional/psychogenic stress
* nutritional deficiencies
* insulin deficiency
* thyroxine (T4) deficiency
* b-agonist (epinephrine)
* a-blockers (phentolamine)
135
In hypoglycemia, GH secretion is increased/decrease? reason?
increased GH
to increase GLU
136
In exercise, GH secretion is increased/decreased? reason?
increased GH
since it utilizes energy, requires GH to increase GLU
137
In glucose loading, GH secretion is increased/decreased? reason?
inhibited GH
no need to increase GLU
138
Actions of GH
1) amphibolic
2) effective transition from fed state → fasting state
3) insulin antagonists
4) promotes hepatic gluconeogenesis
5) stimulates lipolysis
139
explain GH as an amphibolic hormone
directly influences both anabolic (req. energy) and
catabolic (prod. energy, still req. energy) processes
140
Actions of GH which increases glucose
1. insulin antagonists
2. promotes hepatic gluconeogenesis
3. stimulates lipolysis
141
associated with GH, these are GF secreted by liver
structurally similar to insulin
Somatomedins
142
aka Somatomedins
Insulin-like Growth Factors (IGF)
143
major GF induced by GH
Somatomedin C (IGF-1)
144
Biologic amplifier of GH levels (most potent)
Somatomedin C (IGF-1)
145
Transport protein of somatomedin C (IGF-1)
Insulin-like Growth Factor Binding Protein-3 (IGFBP-3)
146
↑ GH is seen in
1. Acromegaly
2. Gigantism
3. Chronic malnutrition
4. Renal disease
5. Cirrhosis
6. Sepsis
147
↓ GH is seen in
1. Idiopathic GH deficiency (among children)
2. Pituitary Adenoma (among adults)
148
↑GH + closed epiphyseal plate
diffused overgrowth/lateral
Acromegaly
149
↑GH + open epiphyseal plate
linear/longitudinal growth
Gigantism
150
Pathologic or autonomous GH excess – unregulated GH regardless of GHRH presence or absence
Acromegaly
151
Progressive enlargement of hands, feet, facial bones, mandible bones of the skull
Acromegaly
152
Manifestations of acromegaly
* Diffused growth
* Glucose intolerance/overt diabetes (↑ GH = ↑ Glu)
* Excessive sweating
* Heat intolerance
* Advanced cases: significant gaps between teeth
153
GH level in acromegaly
>50 ng/ml
154
TESTS for Acromegaly
SCREENING: Somatomedin C (IGF-1) measurement
CONFIRMATORY: OGTT
155
Patient preparation for OGTT (test for acromegaly)? What is the effect?
overnight fasting
Normally: decreased Glu = increased GH
156
Glucose Load administered for OGTT (test for acromegaly)? What is the effect?
100g oral GL
Normally: increased Glu = decreased GH (or undetectable)
Acromegaly = still INCREASED GH
157
Blood collection interval for OGTT (test for acromegaly)
thrice (0 hr, 1hr, 2hr)
*all have increased GH in acromegaly
158
another case that has ↑ IGF-1 aside from acromegaly; autonomous IGF-1 production
Hepatoma (liver cancer)
159
TESTS for GH deficiency
Insulin-induced Hypoglycemia
Combination infusions of GHRH and L-arginine
L-arginine + oral Levodopa (L-DOPA) infusion
160
previous gold standard for GH deficiency testing? what is the normal and abnormal results?
Insulin-induced Hypoglycemia
Normally, in hypoglycemia: ↑ GH (to ↑ Glu)
GH deficiency: ↓ GH (regardless of ↑/↓ Glu)
161
Reference interval for GH deficiency tests
3-5 ng/ml (less likely to have GHD)
162
Value for GH deficiency test that signifies GHD
<3 ng/ml
163
aka PROLACTIN
Stress hormone
164
has vital function in reproduction, lactation initiation and maintenance
prolactin
165
release of prolactin is STIMULATED by these substances produced by hypothalamus
TRH
Estrogen
166
release of prolactin is INHIBITED by this substance
Dopamine (Prolactin Inhibitory Factor)
167
what is unique in regulation of prolactin
tonic inhibition
(NO direct signaling to hypothalamus to stop
production; instead, it produce dopamine)
168
Increased PRL is seen in
Medications
Tumors (prolactinoma)
Trauma
Inflammation
Hypogonadism
169
Result of increased PRL in postpartum lactating women, no ovulation or menstruation (↓ FSH & LH - necessary for ovulation)
hypogonadism
170
Reference value of PRL in male and female
Male: 1-20 ng/ml
Female: 1-25 ng/ml
171
Highest PRL level is during
Sleep (4pm – 8am)
--> Other ref.: 8pm to 10pm
172
Method for PRL measurement
Immunometric assay
173
Autonomous secretion of prolactin due to pituitary tumor
Prolactinoma
174
Most common type of functional pituitary tumor
Prolactinoma
175
PRL level in prolactinoma
>150 ng/ml
176
If PRL level is >200 ng/ml, it causes?
anovulation, cessation of ovulation
177
Manifestation of prolactinoma
Elderly: hypogonadism, osteoporosis
Premenopausal women: amenorrhea,
infertility, galactorrhea, breast discharge
Men/Postmenopausal women: Pituitary
mass, Reduced libido, Erectile dysfunction
178
normal prolactin but lactating; common
among women who had several pregnancies
Idiopathic Galactorrhea
179
medications that can cause hyperprolactinemia? give the examples
Dopamine antagonists
1. Phenothiazines
2. Butyrophenones
3. Metoclopramide
4. Reserpine
5. Tricyclic antidepressants
6. Alpha-methyldopa
180
Enumerate Tropic/Stimulating Pituitary Hormones
Gonadotropins (FSH/LH)
Thyroid-Stimulating Hormone (TSH)/Thyrotropin
Adrenocorticotropic hormone (ACTH)
181
Markers in diagnosing fertility and menstrual cycle disorder
Gonadotropins (FSH/LH)
182
function of FSH and LH in male
FSH – spermatogenesis
LH – helps Leydig cells to prod. testosterone
183
function of LH in female
ovulation
184
Diagnosis clue of premature menopause
↑ FSH
185
↑ FSH, LH indicates?
Post-menopause (↓ estrogen)
186
Estrogen regulation is under this loop? give the process?
NEGATIVE feedback loop
* ↓ estrogen signals hypothalamus to ↑ estrogen
* Hypothalamus will ↑ GnRH
* GnRH will directly act on pituitary gland
* Pituitary gland will secrete FSH & LH
* FSH & LH will act on gonads to produce estrogen
187
Problem in post-menopausal women
Estrogen can no longer be produced due to ruptured gland in ovaries.
Even ↑ FSH, LH: there will be no estrogen production
188
Regulates thyroid hormone production
Thyroid-Stimulating Hormone (TSH)/Thyrotropin
189
Main stimulus for uptake of iodide by thyroid gland
Thyroid-Stimulating Hormone (TSH)/Thyrotropin
190
required by thyroid gland for production (TSH aids in uptake of iodine into the follicular cells of thyroid gland)
iodine
191
Acts to increase the number and size of follicular cells of thyroid gland
Thyroid-Stimulating Hormone (TSH)/Thyrotropin
192
Produced in response to ↓ plasma cortisol
Adrenocorticotropic hormone (ACTH)
193
Regulator of adrenal androgen synthesis
Adrenocorticotropic hormone (ACTH)
194
hormone that requires EDTA plastic tube for collection
Adrenocorticotropic hormone (ACTH)
195
Specimen for ACTH
EDTA (plastic tube)
*glass tubes – not used; ACTH adheres to the wall of glass (false ↓ ACTH)
196
Best time to collect specimen for ACTH
8-10 am (ACTH exhibits diurnal variation)
↑ conc. – 6-8 am
↓ conc. – 6-11 pm
197
Conditions associated with HYPOPITUITARISM
Panhypopituitarism
Monotropic Hormone Deficiency
Sheehan’s Syndrome
Kallmann Syndrome
198
Complete pituitary function loss (all hormones secreted by pituitary gland is decreased/no function)
Panhypopituitarism
199
Loss of 1 single pituitary hormone
Monotropic Hormone Deficiency
200
Postpartum ischemic necrosis of pituitary following a complicated delivery; Failure to lactate
Sheehan’s Syndrome
201
aka Kallmann Syndrome
Idiopathic hypopituitarism (there is loss of pituitary functions)
202
Never produce but secretes hormones from hypothalamus
POSTERIOR PITUITARY GLAND
203
Storage region for vasopressin and oxytocin (both produced from the supraoptic and paraventricular nuclei of hypothalamus)
POSTERIOR PITUITARY GLAND
204
Synthesized by paraventricular nuclei of hypothalamus
OXYTOCIN
205
Critical role of oxytocin
lactation
206
Major role of oxytocin
labor & parturition → positive feedback loop
o Uterine contraction (Ferguson reflex)
207
how is oxytocin released
neural stimulation of touch receptors (birth canal, uterus and breasts)
208
has structure similar with oxytocin
VASOPRESSIN /ADH/Arginine vasopressin
209
Regulates water homeostasis (water reabsorption in collecting duct)
VASOPRESSIN /ADH/Arginine vasopressin
210
urine output in increased ADH? example?
decreased urine output
SIADH
211
urine output in decreased ADH? example?
increased urine output
Diabetes insipidus
212
Stimulates FVII and vWF
VASOPRESSIN /ADH/Arginine vasopressin
213
Synthesized by magnicellular neurons of supraoptic
VASOPRESSIN /ADH/Arginine vasopressin
214
Reference value of ADH
0.5-2 pg/uL
215
2 types of Diabetes Insipidus
Nephrogenic DI
Neurogenic DI / True DI / Hypothalamic DI / Central DI / Cranial DI
216
Polyuria (due to kidney resistance to ADH; no
receptors), normal ADH, and milder symptoms
Nephrogenic DI
217
Polyuria, ↓ ADH
Neurogenic DI / True DI / Hypothalamic DI / Central DI / Cranial DI
218
Same symptoms for 2 Types of DI
1. ADH deficiency (except nephrogenic)
2. Severe polyuria (↑ urine output; hyperosmotic blood)
3. Polydipsia (↑ thirst promotion)
4. Occasional polyphagia
219
Hyperosmosis promotes:
ADH secretion
Thirst
220
TEST for DI
Overnight Water Deprivation Test
221
Definitive test for Diabetes Insipidus
Overnight Water Deprivation Test
222
Px Preparation in overnight water deprivation test? what will be the effect in ADH?
8-12 hrs fasting w/o water intake
o normal: hyperosmolality, promotes ↑ ADH
o DI: hyperosmolality, still ↓ ADH
223
Overnight Water Deprivation Test value for diabetes insipidus
≤300 mOsm/kg
224
aka PINEAL GLAND
CONARIUM/EPIPHYSIS CEREBRI
225
Pineal gland is attached to this structure
midbrain
226
Function of pineal gland
secretes melatonin
227
Melatonin is for
a) Sleep cycle
b) ↓ skin pigmentation
228
control the secretion of melatonin produced by pineal gland
nerve stimuli
229
melatonin secretion is stimulated and inhibited during
stimulated: darkness (Circadian rhythm at night)
Inhibited: light (daytime or ↑ screen time)
230
Pituitary gland is called as master gland due to this reason
It controls other glands
231
releasing hormone produced by hypothalamus will act directly on?
pituitary gland
232
markedly increased GH level is seen during
deep sleep
233
end product of anabolic and catabolic processes
energy
234
T/F
Manifestation of Prolactinoma depends on age group and onset of menopause
T
235
amino acid can stimulate/decrease GH secretion? what is the example?
stimulate
Ex: arginine
236
sex steroids can stimulate/inhibit GH secretion? what is the example?
stimulate
Ex: estradiol
237
a-agonist can stimulate/inhibit GH secretion? what is the example?
stimulate
Ex: norepinephrine
238
b-blockers can stimulate/inhibit GH secretion? what is the example?
stimulate
Ex: propanolol
239
b-agonist can stimulate/inhibit GH secretion? what is the example?
inhibit
Ex: epinephrine
240
a-blockers can stimulate/inhibit GH secretion? what is the example?
inhibit
Ex: phentolamine
241
GH secretion during:
physiologic stress?
emotional/psychogenic stress?
physiologic stress: stimulates GH
emotional/psychogenic stress: inhibits GH
242
highest conc of ACTH is seen during
6-8am
243
lowest conc of ACTH is seen during
6-11pm
244
corresponding amino acid of leucine in structure of oxytocin to vasopressin
arginine
245
corresponding amino acid of isoleucine in structure of oxytocin to vasopressin
phenylalanine
246
synthetic ADH for treatment
desmopressin
247
receptor of ADH responsible for water permeability? what is the channel?
V2 receptors
aquaporin-2
248
receptor of ADH responsible for vasoconstriction
V1 receptor
249
immediate detectable lost hormones
tropic hormones (ACTH, TSH, LH, FSH)
250
Delayed unnoticeable lost hormones
direct effectors (GH and prolactin)
251
It is where 80-90% of the blood supply and hypothalamic factors pass and received by anterior pituitary gland
hypothalamic–hypophyseal portal system
252
Level of prolactin that can cause anovulation
>200 ng/ml
