Endocrine > Intro to Endocrine > Flashcards

Intro to Endocrine Flashcards

(58 cards)

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1
Q

Characteristics of hormones

A

specific rates and rhythms of secretion
operate in feedback systems to maintain homeostasis
affect cells only with appropriate receptor and then act on cell to initiate activity.
excreted either directly by the kidneys or metabolized by liver to aide excretion (made water soluble)

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2
Q

protein/polypeptide hormones

A

most hormones in body
water soluble, circulate in free forms, short half life
synthesized in the ER of originator cell (travels to golgi and repackaged into vesicles)
attach to receptor on target cell surface (initiating a secondary messenger system)

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3
Q

steroid hormones

A

lipids-derived from cholesterol
primarily circulate bound to carrier or binding proteins
travels to receptor inside the target cell-primary messenger (located cytoplasm or nucleus, affects transcription and translation of protein)

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4
Q

amine hormones

A

derivatives of single amino acid

fast and slow acting

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5
Q

thyroid hormones

A

slow-acting
steady state
acts at the nuclear level

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6
Q

catacholamines

A

fast acting
short half life
bind to cell surface
emergent response

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7
Q

determination of hormone effect

A

number of hormone molecules
number of hormone receptors
binding affinity between hormone and receptor

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8
Q

up-regulation of hormones

A

low concentrations of hormone increase the number of receptors per target cell

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9
Q

down-regulation of hormones

A

high concentrations of hormone decrease the number of receptors per target cell

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10
Q

hypothalamic-pituitary axis

A

hypothalamus-coordinating center: regulates body temp, appetite, sleep and circadian rhythm
pituitary gland-releases hormones that affect most endocrine systems in the body: thyroid gland, adrenal gland, gonads, influencing growth, milk production, and water balance

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11
Q

stimulation/provocation tests

A

used to assess hypoactive hormone function-when basal level is normal or indeterminate

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12
Q

suppression tests

A

use to assess hyperactive hormone funtion

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13
Q

Hormone assays

A

Elisa or RIA commonly used to assess serum levels of hormones. Must be aware of pattern of hormone secretion. 24 hour urine sampling useful for those that vary throughout day. saliva tests

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14
Q

most common benign pituitary adenoma?

A

prolactinoma

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15
Q

signs and symptoms of pituitary tumor

A

hormone hypersecretion- related to enlarging adenomas. eventually leading to hyposecretion of other hormones

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16
Q

diagnosis of pituitary tumors

A

typically serum hormone level, MRI with contrast to confirm

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17
Q

growth hormone

A

effects on bone and muscle growth-primarily mediated through IGF-1 produced by liver. Metabolic effects: protein synthesis, liver gluconeogenesis, lipolysis. Pulsatile release. Controlled by somatostatin and growth hormone releasing hormone

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18
Q

how HGH works

A

fasting can increase GH and can raise blood sugar

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19
Q

most common cause of hypersecretion of GH

A

GH secreting pituitary adenoma-insidious onset. Children: gigantism Adults: acromegally

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20
Q

acromegally

A

feet and hand enlargement, coarsening of facial features, metabolic & endocrine: menstrual irregularities, impaired glucose tolerance, CVD

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21
Q

lab testing for hypersecretion of GH

A

serum IGF-1: single best screening test- sensitive. random serum GH not useful. Oral glucose tolerance test: PO admin of 100 mg of glucose and assess serum GH in 120 minutes. normal: increase or no change in GH

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22
Q

treatments of GH hypersecretion

A

surgery, medications: somatostatin analogs, GH receptor antagonist

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23
Q

deficiency of GH

A

childhood: growth retardation, short stature, fasting hypoglycemia
adulthood: increased abdominal adiposity, reduced muscle strength and exercise capacity, reduced muscle mass, glucose intolerance and insulin resistance, lipid profile abnormalities, other sxs of panhypopituitarism

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24
Q

prolactin

Study These Flashcards
A

polypeptide, produced in lactotrophs of AP

function: induce milk production during pregnancy and lactation, suppression of ovulation, role in immune function

25
hyperprolactinemia
women-more common, amenorrhea, galactorrhea, and or in infertility. Due to estrogen deficiency: osteopenia, vagnial dryness, and hot flashes. Men: loss of libido and ED MC caused by: prolactinomas, medications: block the effects of dopamine interferes with the synthesis and delivery of dopamine
26
clinical manifestations of hyperprolactinemia
inability to lactate after delivery isolated prolactin deficiency is rare, most patients with acquired prolactin deficiency have evidence of other pituitary hormone deficiencies
27
thyroid-stimulating hormone (TSH)
glycoprotein hormone synthesized in the thyrotroph cells in anterior pituitary target: thyroid gland mechansim: production and secretion of thyroid hormones (T3 and T4). increases iodine uptake
28
thyroid gland
two lobes-either side of the trachea | produces thyroid hormones from follicular cells (T3 and T4)
29
thyroid hormone functions
CV effects: increase heart rate GI effects: increase motility in gut Increases basal metabolic rate
30
Assessing thyroid function
TSH-initial screening. ultrasensitive assay for function Total serum T3 and T4 both bound and unbound free serum T3 and T4 (unbound) anti-thryoid antibodies thyroid scan with radioactive iodine uptake thryoid ultrasound with or without FNA of nodule
31
adrenocorticotropic hormone (ACTH)
``` peptide hormone (short half life) target: adrenal cortex-cortisol Pulsatile secretion (circadian control) ```
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adrenals
synthesize, secrete, and store catacholamines: epinephrine, norepinephrine, dopamine, stress response Glucocorticoids: cortisol Mineralcorticoids: aldosterone androgens and estrogens
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evaluation of ACTH secretion
plasma cortisol: best refelcts HPA function ex: low morning cortisol suggests adrenal insufficiency Plasma ACTH: helps determine if primary or secondary adrenal insufficiency. primary increased pumping out to get it to work. secondary decrease coming more upstream ACTH provacation/stimulation test: insulin-tolerance test: normal function indicated with a peak cortisol level of 18 mcg/mL Dexamethasone suppression test: normal suppression of corisol level in the morning
34
adrenals
hypofunction: addisons disease, low ACTH hyperfunction: cushing's disease, androgens, aldosterone, catacholamines (pheochromocytoma)
35
cushings syndrome
constellation of clinical features from excess glucocorticoids (cortisol) of any etiology.
36
etiology of cushings syndrome
pituitary tumor secreting ACTH secretion of ACTH by non-pituitary tumor ACTH independent tumore of the adrenal gland iatrogenic
37
cushings disease
refers to cushings syndrome caused by a pituitary adenoma secreting ACTH
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signs and symptoms of cushings syndrome
obesity, diabetes mellitus, diastolic hypertension, hirsutism, striae, buffalo hump, central adiposity, hyperpigmentation with ectopic ACTH production
39
tests for cushings syndrome
initial tests: 24 hour urinary free cortisol excretion increased 3 times above normal, dexamethasone overnight test (plasma cortisol >50 nmol/L at 8-9 AM after 1 mg dex at 11 pm midnight plasma cortisol > 130mnol/mL imaging studies: MRI pituitary to look for pituitary adenoma. CT adrenal glands to look for adrenal tumors
40
adrenal insufficiency (hypofunctioning)
primary adrenal insufficiency is most commonly autoimmune may be part of autoimmune polyglandular syndrome (APS) other causes are destruction of adrenal glands by infection, hemorrhage, or infiltration
41
signs and symptoms of primary adrenal insufficiency
``` fatigue weight loss anorexia myalgias and arthralgias fever anemia, lymphocytosis, eosinophilia hypoglycemia hypotension (postural) hyponatremia ```
42
test for suspected adrenal insufficiency
Short ACTH stimulation test: measure plasma cortisol 30 to 60 minutes after giving 250 micrograms cosyntropin IMor IV. Cortisol post cosyntropin <500 mmol/L suggests adrenal insufficiency other tests: antiadrenal antibodies, evaluate for infections, eg adrenal TB. MRI of pituitary to rule out pituitary adenoma. screen for autoimmune polyglandular syndrome.
43
Antidiuretic hormone (ADH)
faciliatates water reabsorption at kidney, concentrates urine, vasoconstriction increases blood pressure. (posterior pituitary)
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Oxytocin
(posterior pituitary) uterine smooth muscle contraction
45
Deficiency of ADH
central vs. nephrogenic: central: posterior pituitary fails to secrete ADH nephrogenic: kidney fails to respond to ADH
46
testing for ADH deficiency
compare plasma osmolarity and NA to urine osmolarity. used to determine primary polydispia vs. diabetes insipidus
47
water deprivation test
normal: decrease in urine output, increase in urine concentration
48
diabetes insipidus
continue high urine output continue low urine osmolarity administration of vasopressin to differentiate central vs. nephro. vasopressin urine concentration increase central. vasopressin no effect on kidney in nephrogenic
49
Diabetes insipidus symptoms
polyuria, polydipsia, and nocturia
50
excess of ADH
syndrome of inappropriate ADH (SIADH) leads to water retention and concentrated urine lab findings: hyponatremia, serum hypoosmolality, high urine osmolality (above 100 mosmol/kg)
51
Parathyroid glands
maintains tight control of serum calcium levels, and in turn phosphorus ion. mechanism PTH increases calium levels and decreases phosphorus calcitonin: produced by the thyroid gland, counteracts PTH
52
homeostasis blood calcium level
if calcium level rises above set point-->thyroid gland releases calcitonin-->blood calcium level falls --> if calcium level falls below set point --> parathyroid glands release PTH --> blood calcium levels rise
53
disorders of parathyroid glands
hyperparathyroidism: primary parathyroid tumor adenoma-common cause hypercalcemia, decalcification of bones, and kidney stones. Secondary: chronic kidney disease. hypoparathyroidism: surgery pseudoparathyroidism
54
pancreas
endocrine function: Insulin- increase secretion with high blood glucose levels. Glucagon- low glucose levels and sympathetic NS stimulation
55
islets of langerhans
alpha cells secrete glucagon. beta cells secrete insulin. delta cells secrete somatostatin
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pineal gland
monitors circadian rhythm and sleep/wake cycle produces melatonin melatonin induces drowsiness and core body tempature available over the counter as a sleep aid and may be used in jet lag
57
common endocrince disorders symptoms
obesity, over weight, DM2, thryoid disease, parathyroid disorders, adrenal disorders, growth pattern disturbances
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common symptoms of endocrine dysfunction
``` body size/shape (short, tall, weight loss/gain) metabolic effects (fatigue, weakness, appetite/thirst, urinary changes) local effects (swelling, HA, visual changes, exopthalmos) reproduction/sexual (libido, impotence, fetility, puberty, breast changes) Skin (hair, pigment, moisture, sweating) ```
Endocrine
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