LMP301 Lecture 7: Endocrine Disease Flashcards Preview

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Flashcards in LMP301 Lecture 7: Endocrine Disease Deck (78)
1

List the principle endocrine glands

1. Hypothalamus
2. Pituitary
3. Thyroid gland
4. Parathyroid gland
5. Adrenal gland
6. Pancreas
7. Ovaries
8. Testes

2

What types of hormones does the hypothalamus release?

- Releasing hormones
- Inhibiting hormones

3

What are the releasing hormones released by the hypothalamus?

- GHRH (growth hormone)
- TRH (thyrotrophin)
- CRH (corticotrophin)
- GnRH (gonadotrophin)

4

What are the inhibiting hormones released by the hypothalamus?

- Somatostatin
- Dopamine

5

Hypothalamus usually sends signals to...

Pituitary gland

6

Pituitary gland is divided into...

- Anterior Pituitary
- Posterior pituitary

7

What hormones are released by the a. pituitary?

- GH (growth)
- TSH (thyroid-stimulating)
- ACTH (adrenocorticotrophic)
- LH (luteinizing)
- FSH (Follicle-stimulating)
- PRL (Prolactin.)

8

What hormones are released by the p. pituitary?

- Antidiuretic hormone (ADH/vasopressin)
- Oxytocin

9

Hormones secreted by thyroid gland

- T4
- T3
- Calcitonin

10

T3

thyroxine

11

T4

Triiodothyronine

12

Hormones secreted by adrenal cortex

Steroids:
- Mineralocorticoids (aldosterone)
- Glucocorticoids (cortisol)
- Adrenal androgens

13

Thyroid gland controls...

metabolism

14

Hormones secreted by parathyroid gland

PTH (parathyroid hormone)

15

Parathyroid gland controls...

Ca++ levels in the body

16

The adrenal gland is divided into

- Adrenal cortex
- Adrenal medulla

17

Hormones secreted by adrenal medulla

Catecholamines: E and NE

18

Catecholamines are...

neurohormones

19

Hormones secreted by ovaries

- Estrogens
- Progesterone

20

Hormones secreted by the testes

Testosterone

21

Hormones secreted by pancreas

- Glucagon (alpha cells)
- Insulin (Beta cells)
- Somatostatin (delta cells)

22

how are hormones classified?

- Endocrine
- Paracrine
- Autocrine
- Neuroendocrine, NT

23

What are endocrine hormones?

Long distance
- sent through blood and carried to target cells

24

What are paracrine hormones?

Short distance
- act on nearby cells

25

Example of paracrine hormone?

Glucagon act on B-cells of the pancreas

26

Example of endocrine hormone?

ACTH from pituitary act on adrenal cortex

27

What are autocrine hormones?

Local
- hormone act on cell that secreted it

28

Example of autocrine hormone

1,25(OH)2vitD from prostate & pancreas

29

What are NT/NE hormones?

Hormones secreted from neural axon terminals

30

Examples of NT/NE hormones

E
NE

31

Ways in which the endocrine system is controlled:

1. Feedback (positive and negative)
2. Receptor

32

___ interaction between hormone and their receptor

Reversible

33

2 types of receptors

1. Cell surface receptors
2. Intracellular receptors

34

Cell surface receptors

Used by large, liquid insoluble hormones
- Rapid response
- cascade
- intracellular signalling pathway

35

Intracellular receptors

Used by smaller, liquid soluble hormones
- Gene regulation
- in cytosol or nucleus
- activates TF
- slow response

36

Relationship between hypothalamus and p. pituitary

Hormones produced by hypothalamus can be stored in the p. pituitary until signal for release

37

Relationship between hypothalamus and a. pituitary

Hypothalamus sends signal (releasing hormones), and the corresponding hormones are produced at the a. pituitary

38

Effect of GnRH on a. pituitary

stimulate LH/FSH production

39

Effect of CRH on a. pituitary

stimulate ACTH production

40

Effect of GHRH on a. pituitary

stimulate GH production

41

Effect of somatostatin on a. pituitary

Inhibit GH and TSH production

42

Effect of TRH on a. pituitary

Stimulate TSH and prolactin production

43

Effect of domapine on a. pituitary

inhibit prolactin production

44

What is prolactin mostly affected by?

If dopamine inhibiting signal is there. TRH does not have a major effect (unless abundance of TRH)

45

Target organ of LH/FSH

gonads

46

Target organ of ACTH

adrenal cortex

47

Target organ of GH

liver, other tissues

48

Target organ of TSH

thyroid

49

Target organ of prolactin

breasts, other tissues

50

LH/FSH stimulates production of...

- Androgens
- Estrogens

51

ACTH stimulates production of...

Cortisol

52

GH stimulates production of...

IGF-1

53

TSH stimulates production of...

T4, T3

54

Hormone concentration in blood ____ due to normal reasons, such as...

Changes
- episodic secretion patterns
- stress
- circadian rhythm

55

How do we investigate endocrine diseases?

use dynamic tests (provocative tests)

56

dynamic tests

Test hormone response and feedback following a stimulating / inhibiting signal

57

What dynamic test is used for Cushing's syndrome?

Dexamethasone suppression tests

58

What dynamic test is used for Addison's disease?

Synacthen test (using synthetic ACTH)

59

What dynamic test is used for diabetes & acromegaly?

Oral glucose tolerance test

60

"Spade-like" hands is a symptom of...

Acromegaly

61

Define: acromegaly

increased GH in adults

62

Most likely cause of acromegaly?

pituitary adenoma (tumour)

63

Clinical features of acromegaly?

- rough facial features
- soft tissue thickens
- spade-like hands
- protruding jaw (prognathism)
- sweating
- impaired glucose tolerance / diabetes

64

Why do people with acromegaly tend to have impaired glucose tolerance?

- GH opposes effects of insulin
- IGF-1 initially acts like insulin and lowers glucose, but overtime, the insulin receptors become insensitive due to continual large outputs of IGF

65

Major effects of GH (somatotrophin)

- Reduce glucose metabolism (less insulin receptors)
- Increase lypolysis (use FA for energy)
- Increase AA transport into muscles, liver, adipose cells
- Increase proteins synthesis (transcription & translation in the liver)
- Increase IGF

66

Factors that enhance effects of GH

- sleep
- AA
- Exercise
- Stress
- Low glucos

67

Factors that supresse effects of GH

- High glucose

68

GH can be directly measured by...

Immunoassay

69

2 dynamic tests given to diagnose problems with GH

- Use insulin to induce hypoglycemia -> will GH be secreted in response to low glucose? (GH deficiency)
- Glucose tolerance test -> will high glucose stop GH secretion? (acromegaly)

70

How to measure IGF-1 (somatomedin C)?

Immunoassay

71

IGF-1 is an indicator of...
Why is it so good?

GH
Very stable in the blood stream; easy to detect because very concentrated in the blood

72

IGF-1 is what type of hormone?

Endocrine, autocrine, paracrine

73

The body has more insulin or IGF-1?

IGF-1

74

_____ in response to a GTT is the diagnostic test for acromegaly

Lack of GH suppression

75

GTT

glucose tolerance test

76

Treatment of acromegaly

- surgery
- drugs
- radiotherapy

77

What kind of drugs can treat acromegaly?

- GH agonists
- GHRH angonists (not as effective)

78

Hypothalamus - a. pituitary - liver axis for GH control

GHRH (+) and somatostatin (-) released from hypothalamus

GH released from a. pituitary

IGF-1 released from liver