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Endocrine > Growth hormone, Oxytocin, ADH > Flashcards

Growth hormone, Oxytocin, ADH Flashcards

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1
Q

Another name for growth hormone is _

A

Another name for growth hormone is somatotropin

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2
Q

Growth hormone is a _ type hormone that plays a role in the regulation of bone growth

A

Growth hormone is a peptide hormone that plays a role in the regulation of bone growth
* It is hydrophilic and can freely travel in the serum

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3
Q

GH is produced by _ cells in the _ pituitary

A

GH is produced by somatotrophs in the anterior pituitary

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4
Q

The GH receptors on hepatocytes are linked to _ which phosphorylate the _ transcription factors; these TFs are then transported into the nucleus to induce gene transcription to make IGF-1

A

The GH receptors on hepatocytes are linked to JAKs which phosphorylate the STAT transcription factors; these TFs are then transported into the nucleus to induce gene transcription to make IGF-1

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5
Q

When concerned about a lack of growth we generally measure _ hormone

A

When concerned about a lack of growth we generally measure IGF-1
* IGF-1 is more stable than GH, which is released in a pulsatile manner

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6
Q

The epiphyseal plate is a plate of _ that is located at the end of a growing long bone

A

The epiphyseal plate is a plate of hyaline cartilage that is located at the end of a growing long bone
* This is where new growth takes place

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7
Q

By age _ (males) and _ (females) the epiphyseal plate closes

A

By age 20 (males) and 18 (females) the epiphyseal plate closes

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8
Q

GH and IGF-1 stimulate skeletal muscle growth by _ and _

A

GH and IGF-1 stimulate skeletal muscle growth by stimulating myocyte hypertrophy and increasing protein synthesis

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9
Q

GH and IGF-1 (increase/decrease) the serum glucose concentration

A

GH and IGF-1 increase the serum glucose concentration
* Increase hepatic gluconeogenesis
* Increase lipolysis
* Antagonize insulin

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10
Q

Two hormones secreted from the hypothalamus to regulate GH are _ and _

A

Two hormones secreted from the hypothalamus to regulate GH are GH-releasing hormone (GHRH) and GH-inhibiting hormone (GHIH)

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11
Q

Aging, obesity, and glucose will _ GHRH

A

Aging, obesity, and glucose will inhibit GHRH

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12
Q

Sleep, hypoglycemia, and stress will _ GHRH

A

Sleep, hypoglycemia, and stress will stimulate GHRH

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13
Q

Somatostatin will _ GH release from the anterior pituitary

A

Somatostatin will inhibit GH release from the anterior pituitary

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14
Q

During periods of starvation, fasting, and weight loss, GH is secreted to maintain blood sugar; this is triggered by the gastric hormone _

A

During periods of starvation, fasting, and weight loss, GH is secreted to maintain blood sugar; this is triggered by the gastric hormone ghrelin

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15
Q

Signs of acquired GH deficiency in adults may involve:

A

Signs of acquired GH deficiency in adults may involve:
* Decreased muscle mass
* Increased fat mass
* Decreased BMD
* Increased rate of fractures

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16
Q

_ syndrome is an autosomal recessive disorder that involves a mutation in the GH receptor; children present with growth failure, small head circumference, prominent foreheads, saddle nose, small genitalia

A

Laron syndrome is an autosomal recessive disorder that involves a mutation in the GH receptor; children present with growth failure, small head circumference, prominent foreheads, saddle nose, small genitalia
* They may also have hyperlipidemia, hypoglycemia

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17
Q

_ is an inherited deletion on chromosome 15 that causes childhood obesity and impaired growth

A

Prader-Willi syndrome is an inherited deletion on chromosome 15 that causes childhood obesity and impaired growth

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18
Q

In a true GH deficiency we expect IGF-1 to be _ and bone age to be _

A

In a true GH deficiency we expect IGF-1 to be low and bone age to be lower than expected

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19
Q

We can test for GH deficiency with a GH stimulation test; we adminster _ or IV _ to attempt to stimulate GH production

A

We can test for GH deficiency with a GH stimulation test; we adminster insulin or IV arginine to attempt to stimulate GH production
* Insulin decreases glucose levels –> should increase GH

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20
Q

Excess GH in childhood causes a condition called _

A

Excess GH in childhood causes a condition called gigantism
* Results in tall children

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21
Q

Excess GH in adulthood causes a condition known as _

A

Excess GH in adulthood causes a condition known as acromegaly
* This refers to GH excess that occurs after the fusion of the epiphyseal growth plates

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22
Q

Clinical features of acromegaly:

A

Clinical features of acromegaly:
* Enlarged hands and feet
* Enlarged head circumference
* Enlarged vocal cords (hoarse voice)
* Snoring from airway obstruction
* Joint pain, muscle fatigue
* Coarse facial features
* Enlarged jaw (widely spaced teeth)

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23
Q

GH excess can result in constant elevation of blood glucose levels and can lead to _ and _

A

GH excess can result in constant elevation of blood glucose levels and can lead to secondary diabetes mellitus and accelerated atherosclerosis

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24
Q

Complications of agromegaly:

A

Complications of agromegaly:
* Diabetes
* Atherosclerosis
* Hypertension
* Sleep apnea
* Hypogonadism
* Carpal tunnel
* Colon cancer

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25
What is a GH suppression test?
**GH suppression test** can be given when IGF-1 is elevated and GH excess is suspected; we administer **glucose** which normally inhibits GH
26
_ is a somatostatin analog that can be used to decrease GH release
**Octreotide** is a somatostatin analog that can be used to decrease GH release * Oct-treo-tide
27
_ is a GH receptor antagonist that can be used to treat excess GH
**Pegvisomant** is a GH receptor antagonist that can be used to treat excess GH * Peg-viso-mant
28
_ is a dopamine analog which can be used to suppress GH release (second-line option)
**Cabergoline** is a dopamine analog which can be used to suppress GH release (second-line option) * Caber-goline
29
Oxytocin is a _ type hormone
Oxytocin is a **neuropeptide** hormone * It is water soluble and travels freely in the bloodstream
30
Oxytocin is mostly made in the _ of the hypothalamus
Oxytocin is mostly made in the **paraventricular nucleus** of the hypothalamus * Made in smaller amounts in the peripheral tissues like the ovaries, placenta, pancreas, etc
31
Oxytocin is synthesized as an inactive precursor protein which must be cleaved by enzymes; _ is one of these enzymes that is dependent on _
Oxytocin is synthesized as an inactive precursor protein which must be cleaved by enzymes; **PAM** is one of these enzymes that is dependent on **vitamin C**
32
Oxytocin secretion is stimulated by _ trigger from the hypothalamus
Oxytocin secretion is stimulated by an **action potential delivered from the hypothalamus**
33
Oxytocin binds its receptor (in the breast and brain) --> activates _ --> initates a signaling cascade and altered gene expression
Oxytocin binds its receptor (in the breast and brain) --> activates **MAP kinase** --> initates a signaling cascade and altered gene expression
34
Oxytocin promotes _ of smooth muscle during childbirth
Oxytocin promotes **contraction** of smooth muscle during childbirth * Pushes fetus towards the cervix
35
Rising levels of _ during the third trimester of pregnancy increases oxytocin receptor expression in the uterus
Rising levels of **estradiol** during the third trimester of pregnancy increases oxytocin receptor expression in the uterus
36
Cervical dilation during labor activates _ which stimulates (positive/negative) feedback
Cervical dilation during labor activates **stretch receptors** which stimulates **positive feedforward** signaling to increase oxytocin * Oxytocin release even continues after baby is born to reduce bleeding and return uterus to normal size
37
Pitocin is a synthetic form of _ that is given to initate labor and cause stronger contractions during delivery
Pitocin is a synthetic form of **oxytocin** that is given to initate labor and cause stronger contractions during delivery
38
Milk _ is caused by prolactin while milk _ is caused by oxytocin
Milk **production** is caused by prolactin while milk **letdown** is caused by oxytocin
39
Oxytocin (increases/decreases) CRH
Oxytocin **decreases** CRH release from the hypothalamus * This decreases ACTH, decreases cortisol release, reduces stress
40
The main stimuli for oxytocin release are _ and _ (both positive feedback mechanisms)
The main stimuli for oxytocin release are **suckling by the infant** and **dilation of the uterine cervix** (both positive feedback mechanisms)
41
Vasopressin is produced in the hypothalamus by _ and _ nuclei
Vasopressin is produced in the hypothalamus by **paraventricular** and **supraoptic nuclei**
42
Vasopressin's principal functions are _ and _
Vasopressin's principal functions are **vasoconstriction of arterial smooth muscle** and **increasing water absorption in the kidney**
43
Vasopressin binds to _ receptors in the vasculature, liver, and brain to stimulate smooth muscle contraction
Vasopressin binds to **V1A receptors** in the vasculature, liver, and brain to stimulate smooth muscle contraction
44
ADH binds to _ receptors in the principal cells of the collecting ducts to increase water reabsorption
ADH binds to **V2A receptors** in the principal cells of the collecting ducts to increase water reabsorption * Increases the number of aquaporins
45
ADH binding to the V1B receptors on the anterior pituitary gland causes _
ADH binding to the V1B receptors on the anterior pituitary gland causes **ACTH release --> cortisol synthesis** * Cortisol will also support the blood pressure
46
ADH binding V1A receptors will cause the release of _
ADH binding V1A receptors will cause the release of **von Willebrand factor** * This stimulates platelet aggregation and blood clotting
47
Release of ADH is stimulated by _ or _
Release of ADH is stimulated by **increased serum osmolality** or **extracellular volume** * Increased osmolality is sensed by *osmoreceptors in the hypothalamus* * Decreased effective circulating volume is sensed by *baroreceptors in heart, vessels, lungs, liver, brain*
48
(True/False) Ang II also stimulates ADH release
True; Ang II also stimulates ADH release
49
The two main hormones that inhibit ADH effects are _ and _
The two main hormones that inhibit ADH effects are **cortisol** and **ANP** * Cortisol blocks ADH release; ANP blocks ADH effect on the collecting duct
50
Acromegaly will cause (increased linear bone growth/ disproportionate growth)
Acromegaly will cause **disproportionate growth** * Recall that acromegaly occurs after the fusion of epiphyseal plates * Involves frontal bossing, jaw enlargement, large hands and feet
51
The most common cause of death in patients with gigantism is _
The most common cause of death in patients with gigantism is **heart failure**
52
Acromegaly is associated with _ syndrome due to the compression of the median nerve
Acromegaly is associated with **carpal tunnel syndrome** due to the compression of the median nerve
53
Acquired GH deficiency may occur secondary to:
Acquired GH deficiency may occur secondary to: * Brain tumor * Surgery * TBI * Radiation to pituitary
54
GH deficiency is associated with a short stature with (proportional/disporportional) measurements
GH deficiency is associated with a short stature with **proportional** measurements
55
The most potent regulator of ADH secretion is _
The most potent regulator of ADH secretion is **serum osmolality** * Other regulators include blood volume, blood pressure, angiotensin II, cortisol, ANP
56
(High/Low) cortisol levels stimulate ADH release
**Low cortisol** stimulates ADH release
57
Two regulators of oxytocin release are _ and _
Two regulators of oxytocin release are **suckling at the breast** and **uterine stretching**
58
A patient with central DI will have: _ serum sodium _ serum osmolality _ urine osmolality
A patient with central DI will have: **High** serum sodium **High** serum osmolality **Low** urine osmolality
59
A patient with SIADH will have: _ serum sodium _ serum osmolality _ urine osmolality
A patient with SIADH will have: **Low** serum sodium **Low** serum osmolality **High** urine osmolality
60
SIADH can cause _ volemic hyponatremia
SIADH can cause **euvolemic** hyponatremia
61
First line treatment for DI is _
First line treatment for DI is **fluid administration** * In more severe cases, IV hydration may be needed * Synthetic ADH can be used
62
Synthetic ADH like _ can be given in cases of DI
Synthetic ADH like **desmopressin** can be given in cases of DI
63
The first line therapy for SIADH is _
The first line therapy for SIADH is **fluid restriction** * ADH antagonists can also be given
64
_ can be given to restore sodium in patients with SIADH
**Hypertonic saline** can be given to restore sodium in patients with SIADH
65
The most common cause of excess GH is _
The most common cause of excess GH is **benign pituitary adenoma**
66
Benign pituitary adenomas are associated with which risk factors?
Benign pituitary adenomas are associated with: * **MEN-1** (multiple endocrine neoplasia) * **McCune Albright** syndrome * **Familial isolated pituitary adenomas** * **GNAS** related (oncogene)
67
Pituitary adenomas are associated with which MEN syndrome?
MEN-1
68
Pseudoacromegaly is a condition in which an individual has features of acromegaly but shows no change in GH or IGF-1 axis; what can cause this?
Causes of pseudoacromegaly: * Medication-induced insulin resistance * Minoxidil * Phenytoin * Hypothyroid
69
Why might medication induced insulin resistance cause pseudoacromegaly?
Insulin and GH normally oppose each other; without insulin, **GH is left uninhibited**
70
Three medication options for GH excess include _ , _ , _
Three medication options for GH excess include **octreotide, pegvisomant, cabergoline**

Endocrine (8 decks)

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