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Pathophysiology Endocrine > Module #1: Intro to the Endocrine System > Flashcards

Module #1: Intro to the Endocrine System Flashcards

1
Q

What are the primary organs of the endocrine system?

A

Hypothalamus

Pituitary gland (hypophysis)

Thyroid gland

Parathyroid gland

Adrenal glands

Pancreras (islets cells) aka endocrine pancreas

Gonads

Placenta

Hormones/hormone-like substances produced in other organs (heart/kidney/GI tract)

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2
Q

What is the main purpose of the endocrine system?

A

coordinate and integrate cellular activity throughout the body to maintain homeostasis

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3
Q

How does the endocrine system coordinate/integrate cellular activites?

A

Chemical messengers (hormones); uses circulatory pathways

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4
Q

What are the 4 functions of the endocrine system?

A

Homeostasis (maintenance of the internal environment)

Control of storage and utilization of energy substrates

Regulation of growth, development, and reproduction

Regulate the body’s response to environmental stimuli

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5
Q

Compared to the nervous system, what are the actions of the endocrine system?

A

slower in response

but more prolonged response

“more diffuse”

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6
Q

What are the 3 main components of the endocrine system?

A

Endocrine glands

Target Organs

Hormones

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7
Q

What are endocrine glands?

A

ductless glands that secrete hormones into the blood stream

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8
Q

What are target organs?

A

organ that contains cells w/ receptors that have hormone specific receptors

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9
Q

What are hormones?

A

Chemical messengers released by one cell and exert a biological action on a target cell/tissue/organ

classical definition refers to those that are transported via bloodstream

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10
Q

Where do hormones bind and what do they do?

A

specific receptors of target tissues

mediate some function

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11
Q

Can a single hormone facilitate multiple effects?

A

Yes, can bind to different target tissues

different receptors mediate different responses

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12
Q

What are the different responses that can be mediated by epinephrine?

A

Alpha Receptors: BV of intestines = constriction

Beta receptors: BV of skeletal muscle = dilation; Liver = glycolysis

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13
Q

Can a single physiological function be regulated by the sum of multiple hormones?

A

Yes

BP influenced by ADH/aldosterone/epinephrine

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14
Q

What are the 4 types of hormone signaling?

A

Endocrine

Paracrine

Autocrine

Intracrine

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15
Q

In endocrine signaling where are the target tissues, and how do the hormones reach the target tissues?

A

Target tissues = distant from where hormone release

hormones travel through blood stream to reach target tissue

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16
Q

In paracrine signaling where are the target tissues and how do the hormones reach the target tissue?

A

target tissues = local or immediate near cells that release hormone

hormone released by one cell acts locally on nearby cell

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17
Q

What are some examples of paracrine signaling?

A

Nitric Oxide

Bradykinin

Neurotransmitters

Cytokines

Prostoglandins

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18
Q

What does Nitric Oxide do?

A

promotes BV vasodilation

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19
Q

What does bradykinin do?

A

promote BV vasodilation

part of inflammatory/immune cascade

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20
Q

What are 2 examples of paracrine neurotransmitters?

A

Epinephrine

Norepinephrine

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21
Q

What are cytokines and what do they do?

A

small proteins (act as signaling molecules)

involved in immunoregulation and growth function

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22
Q

What are some examples of cytokines?

A

interleukins = IL2, IL4, etc

TNF = tumor necrosis factor

IF = interferon

Growth Factors = bone morphic factor, TGF - transforming growth factors

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23
Q

What are prostoglandins and how are they produced?

A

fatty acids produced in most organs

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24
Q

What do prostoglandins do?

A

Numerous Functions:

Smooth muscle: contract/relax (depending on receptor)

inflammatory response throughout tissues of body

pain: hyperalgesia - sensitize neurons in spinal cord
kidney: mesangial cells (contract) after GFR
hypothalamus: thermoregulatory nuclei - produce fever

mediate platelet aggegation/disaggregation

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25
Q

What do prostoglandins do in the uterus?

A

uterine contraction:

menstrual cycle

labor

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26
Q

What do prostoglandins do in the lung?

A

bronchoconstriction

bronchodilation

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27
Q

What do prostoglandins do in the GI tract?

A

contriction

relaxation

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28
Q

Clinically what kind of drugs work via prostoglandins?

A

NSAIDs

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29
Q

In autocrine signaling where are the target tissues and how do the hormones reach the target tissue?

A

Target tissue = same cell

hormone released by cell that then acts on receptors located on same cell

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30
Q

In intracrine signaling where are the target tissues?

A

hormone produced in a cell acts WITHIN cell itself

theory of some steroid action and also some malignant pathways

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31
Q

How is hormone secretion regulated?

A

Negative Feedback

Positive Feedback

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32
Q

Describe Negative Feedback

A

most common feedback mechanism

hormone actions directly or indirectly inhibit further release of that hormone

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33
Q

Describe Positive Feedback

A

Rare feedback mechanism

hormone actions directly or indirectly stimulates further release of that hormone

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34
Q

How are hormones classified?

A

Derivative content classification

Solubility classification

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35
Q

What are some derivative content classifications?

A

Amino acid derivatives

Peptide/protein derivatives

Steroid derivatives

Fatty acid derivatives

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36
Q

What are 2 examples of amino acid derivatives?

A

catecholamines

thyroid hormones

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37
Q

What are some examples of peptide/protein derivatives?

A

Glycoproteins

releasing hormones formed from peptides

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38
Q

What are some examples of steroid derivatives?

A

Estrogens

Testosterone

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39
Q

What are some fatty acid derivatives?

A

eicosanoids –> prostaglandins

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40
Q

What are the 2 solubility classifications of hormones?

A

Lipid soluble = lipophilic

Water soluble = hydrophilic

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41
Q

Which types of hormone derivatives are lipophilic?

A

Steroid hormones

Thyroid hormones

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42
Q

What is the precursor for all steroid hormones?

A

cholesterol

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43
Q

Describe how lipophilic hormones are circulated

A

circulate bound to plasma proteins

don’t break down easily –> have longer half life (hours to days)

hormone/plasma protein carrier disassociate @ target tissues

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44
Q

Which types of hormone derivatives are hydrophilic?

A

most hormones = water soluble

GH

TSH

PTH

etc

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45
Q

Describe how hydrophilic hormones are circulated?

A

circulate “freely” in plasma

easily broken down –> short half life (1-30 minutes)

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46
Q

Where are hormone receptors located?

A

on cell membrane

w/ in cell itself

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47
Q

Are there a fixed number of receptors?

A

No; continuous turnover

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48
Q

What are the 2 types of receptor turnover?

A

Up regulation

Down regulation

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49
Q

Under what circumstances are receptors up regulated?

A

low concentrations of a hormone will INCREASE the number of receptors on target tissue

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50
Q

What will receptor up regulation result in?

A

lead to increased sensitivity to the hormone

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51
Q

Under what circumstances are receptors down regulated?

A

high concentrations of hormone will DECREASE number of receptors on target tissue

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52
Q

What will receptor down regulation result in?

A

lead to decreased sensitivity to the hormone

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53
Q

What is signal transduction?

A

process by which extracellular signals (hormones) are communicated into a cell

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54
Q

What are the 2 types of signal transduction messengers?

A

Primary messengers

Secondary messengers

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55
Q

Describe what happens in primary messenger signal transduction

A

hormone ITSELF enters cell and mediates cell function

most target tissue receptors are located w/ in the cell itself

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56
Q

Which type of messengers are lipophilic hormones?

A

primary messenger

lipophilic hormones easily diffuse across cell membrane to communicate to receptors w/ in cells

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57
Q

Describe what happens in secondary messenger signal transduction

A

secondary messenger “links” primary messanger (hormone) and inside of cell

  1. hormone attaches to target tissue receptors located on cell membrane
  2. secondary messenger/mechanism communicates to interior structures of cell to produce desired physiological action
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58
Q

What types of hormones require secondary messengers?

A

hydrophilic (water soluble) hormones

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59
Q

Why do hydrophilic hormones need a secondary messenger?

A

can’t diffuse across membrane –> “needs” mechanism to communicate w/ interior structures of cell –> physiological action

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60
Q

What are some examples of secondary messengers?

A

cAMP (adenosine monophosphate)

Ca2+

cGMP (guanosine monophosphate)

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61
Q

What is the hypothalamic- Pituitary Axis (HPA)?

A

critical signaling pathway for the endocrine system

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62
Q

How is the Hypothalamic-Pituitary Axis (HPA) divided?

A

Anterior pituitary

Posterior pituitary

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63
Q

How does the hypothalamus communicate with the anterior pituitary?

A

hypothalamus releases “pituitary releasing hormones”

hormones descend through the hypophyseal portal system

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64
Q

What does the hypophyseal portal system do?

A

allow capillaries in hypothalamus to communicate w/ pituitary capillaries BEFORE entering venous system

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65
Q

What do the hypothalamic hormones do to the anterior pituitary?

A

Most stimulate release of pituitary hormones

some inhibit release of pituitary hormones

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66
Q

How does the hypothalamus communicate with the posterior pituitary?

A

hypothalamic nuclei synthesize pituitary hormones

hormones descend to pituitary via DIRECT neural connection (so through nerves) to posterior pituitary –> axons of hypothalamic neuron transport hormone

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67
Q

What are the 2 major posterior pituitary hormones?

A

ADH

Oxytocin

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68
Q

What is the major function of the hypothalamus?

A

links CNS to endocrine system

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69
Q

Where is the hypothalamus located?

A

diencephalon of CNS

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70
Q

What is the hypothalamus

A

collection of nuclei that “control” release of hormones from pituitary gland

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71
Q

What are the hormones released from hypothalamus that control anterior pituitary gland?

A

TRH = thyrotropin releasing hormone

GnRH = gonadotropin releasing hormone

Somatostatin = aka SRIF (somatoropin release-inhibiting factor)

GHRH = growth hormone releasing hormone

CRH = corticotropin releasing hormone

Substance - P

Dopamine = old terminology = PIF (prolactin inhibiting factor)

PRF = prolactin releasing factor

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72
Q

What does TRH (thyrotropin releasing hormone) do?

A

stimulates release of TSH (thyroid stimulating hormone) from anterior pituitary

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73
Q

What does GnRH (gonadotropin releasing hormone) do?

A

stimulates release of LH (leutenizing hormone) and FSH (follicle stimulating hormone) from anterior pituitary

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74
Q

What does somatostatin do?

A

INHIBITS release of GH (somatotropin) and TSH (thyroid stimulating hormone) from anterior pituitary

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75
Q

What does GHRH (growth hormone releasing hormone) do?

A

stimulates release of GH (growth hormone) from the anterior pituitary

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76
Q

What does CRH (corticotropin releasing hormone) do?

A

stimulates release of ACTH (adrenocorticotropic hormone) and Beta-endorphin from anterior pituitary

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77
Q

What does substance - P do?

A

inhibits synthesis/release of ACTH (adrenocorticotropic hormone) from anterior pituitary

stimulates release of GH (growth hormone), FSH (follicle stimulating hormone), LH (leutinizing hormone) and prolactin from anterior pituitary

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78
Q

What does dopamine do?

A

inhibits synthesis/release of prolactin from anterior pituitary

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79
Q

What does PRF (prolactin releasing factor) do?

A

stimulates release of prolactin from anterior pituitary

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80
Q

What are the 2 hormones synthesized in nuclei of hypothalamus and descend to posterior pituitary?

A

ADH (antidiuretic hormone)

Oxytocin

81
Q

What is another name for the pituitary gland?

A

Hypophysis

82
Q

How is the pituitary gland divided?

A

Anterior pituitary = adenohypophysis

Posterior pituitary = neurohypophysis

83
Q

What is the “master gland” of the endocrine system?

A

Pituitary gland

84
Q

What are the 3 regions of the anterior pituitary?

A

Pars distalis

Pars tuberalis

Pars intermedia

85
Q

What is the function of the pituitary gland?

A

regulates activity of most endocrine glands in the body

86
Q

What is the posterior pituitary made of?

A

neural tissue

87
Q

What are the 3 regions of the posterior pituitary?

A

Median eminence

Infundibular stem aka pituitary stem

Infundibular process aka pars nervosa, neural lobe, posterior lobe

88
Q

Where is the median eminence located?

A

base of the hypothalamus

89
Q

What is the infundibular stem (pituitary stem) and what does it contain?

A

neural connection (conduit) between hypothalamus

contains neural axons that originate in hypothalamus

90
Q

What is the infundibular process?

A

site where hypothalamic axons terminate

site of hormone release

91
Q

Describe how hormones are synthesized and released from the hypothalamic nuclei

A

Neural cell bodies synthesize hormones

Hormones transported down neural axon to posterior pituitary

Terminal neural axon releases hormones from the posterior pituitary gland

92
Q

What does oxytocin do in females?

A

stimulates milk ejection

stimulates uterine contraction (synthetic versions of oxytocin given to induce labor)

93
Q

What does oxytocin do in males?

A

suggested to have role in sperm motility

suggested to be elevated in plasma during sexual activities (females too)

94
Q

What are the target tissues of oxytocin?

A

mammary glands (lactation)

uterus during pregnancy

95
Q

What are some stimuli of oxytocin release?

A

distention of cervix @ end of pregnancy

Breast stimulation (during labor/sucking reflex on lactating breast)

Positive emotional responses (seeing/hearing newborn)

96
Q

What kind of feedback mechanism does oxytocin have?

A

Positive feedback mechanism

oxytocin release stimulates more release

97
Q

What are some inhibition signals of oxytocin release?

A

External stimulus stops (breastfeeding)

Negative emotional factors –> stress, fear, noise, pain

98
Q

What are some clinical uses of oxytocin?

A

Synthetically used to induce labor –> Pitocin, Misoprostol

Not common to have excess oxytocin disease

Oxytocin deficiency will impair nursing

99
Q

What is the function of ADH (antidiuretic hormone)

A

Control osmolality/osmolarity of plasma –> blood volume

ADH will INCREASE blood volume –> decreasing osmolarity and increasing blood pressure

100
Q

What are the target tissues of ADH?

A

Collecting ducts in kidney (DCT and collecting duct)

Vascular smooth muscle

101
Q

What is the effect of ADH on the collecting ducts in kidney?

A

increases water reabsorption by increasing permeability of collecting duct

102
Q

What is the effect of ADH on vascular smooth muscle?

A

promotes blood vessel contraction to assist in elevating BP

103
Q

What are the stimuli for ADH release?

A

Increased plasma osmolarity

decreased blood volume

angiotensin II (indirectly)

Stress/trauma/exercise/heat

drugs: nicotine, morphine

104
Q

How does increased plasma osmolarity stimulate ADH release?

A

osmoreceptors in hypothalamus detect increases of plasma osmolarity

= primary control of ADH release

105
Q

How much change in osmolality is required to stimulate release of ADH?

A

1%

106
Q

How does decreased blood volume stimulate ADH release from the posterior pituitary?

A

mechanoreceptors (baroreceptors) in the atria, aortic arch and carotid sinus detect blood volume changes

**not as effective as osmoreceptors in hypothalamus

107
Q

How much of a drop in blood pressure is needed to stimulate the release of ADH?

A

10%

108
Q

How does angiotension II promote ADH release from the posterior pituitary?

A

renin-angiotensin system synergistically trying to increase blood volume and pressure

Angiotension II:

increase sensitivity of osmoreceptors in hypothalamus

stimulate thirst centers in hypothalamus

109
Q

What other stimuli effect ADH release?

A

Stress

Trauma

Exercise

Heat

Various drugs –> nicotine, morphine

110
Q

What inhibits ADH release?

A

Decreased plasma osmolality

Increased blood volume/pressure

Alcohol/Caffeine

111
Q

Which receptors detect plasma osmolality?

A

osmoreceptors

112
Q

What receptors detect blood volume/pressure?

A

mechanoreceptors in atria, aortic arch and carotid sinus

113
Q

What happens with ADH in pts w/ diabetes insipidus?

A

too little or ineffective ADH

114
Q

Describe central diabetes insipitus

A

most common form of diabetes insipitus

decreased release of ADH from posterior pituitary

115
Q

Describe nephrogenic diabetes insipitus

A

less common

kidneys aren’t able to respond to ADH

116
Q

What are the signs and symptoms of diabetes insipitus?

A

polyuria (excessive urine volume)

polydipsia (excessive thirst)

117
Q

What is a medication that is given to treat diabetes insidious (central diabetes)

A

desmopressin

118
Q

What happens in pts w/ syndrome of inappropriate ADH secretion (SIADH)

A

too much ADH

elevated ADH secretion –> excessive water reabsorption in kidney

119
Q

What is hypervolemia caused by?

A

excessive ADH release –> water reabsorption in DCT/collecting duct

120
Q

What does hypervolemia lead to?

A

hypoatremia (decreased Na+ in blood)

natriuresis (excessive Na+ secretion)

121
Q

Why does hypervolemia lead to hypoatremia?

A

increased extracellular fluid –> inhibits RAAS (renin/angio/aldosterone system)

122
Q

Describe what causes natriuresis (excessive Na+ excretion) (3 things)

A

expansion of exracellular fluid volume reduces Na+ resorption in kidney

baroreceptors in atria/aorta to release ANp –> reduces Na+ resrption (decreased Na+ resorption in proixmal convoluted tubule)

decreased aldosterone release –> reduces Na+ resorption in kidney

123
Q

Name some of the etiologies of SIADH (syndrome of inappropriate ADH secretion)

A

tumors

head injuries

meningitis

bronchiogenic tumors (produce vasopressin)

diabetes mellatus

side effect of some drugs

124
Q

Name the drugs that can cause SIADH (syndrome of inappropriate ADH secretion)

A

chlorpropamide

cyclophosphamide

carbamazepine

selective serotonin reuptake inhibitors (SSRIs; type of antidepressant)

125
Q

What is another name for the anterior pituitary?

A

adenohypophysis

126
Q

What are the 3 parts of the anterior pituitary?

A

Pars distalis

Pars tubularis

Pars intermedia

127
Q

What does the pars distalis do?

A

produce and secrete anterior pituitary hormones

128
Q

What is the pars tubularis?

A

thin layer of cells that wrap around anterior/lateral infundibular stem (pituitary stalk)

129
Q

What is the pars intermedia?

A

small layer of cells located between pars distal is and pars nervousa

130
Q

How is the release of anterior pituitary hormones regulated?

A

hypothalamic-hypophyseal portal system

131
Q

Describe how the hypothalamic-hypophyseal portal system works

A

releasing/inhibiting hormones are released from hypothalamus

circulation from hypothalamic capillaries travels to hypophysis via hypophyseal portal system

circulating hormones stimulate the anterior pituitary to inhibit or release specific hormones

132
Q

What are the 6 hormones synthesized and released by the anterior pituitary?

A

prolactin

GH (growth hormone)

TSH (thyroid stimulating hormone)

GnRH (gonadotropin releasing hormones)

ACTH (adrenocorticotrophic hormone)

MSH (melanocyte stimulating hormone)

133
Q

There are 2 GnRH (gonadotropin releasing hormones), what are they?

A

LH (luteinizing hormone)

FSH (follical stimulating hormone)

134
Q

What does prolactin do?

A

breast development during puberty and pregnancy

stimulate milk production after birth (lactogenesis)

inhibit ovulation

135
Q

What is the target tissue of prolactin hormone?

A

mammary glands during puberty, pregnancy, and while lactating newborns

136
Q

What stimulates prolactin release from the anterior pituitary gland?

A

Puberty (breast development)

Pregnancy (breast/duct growth)

Lactation (milk production)

Miscellaneous factors that stimulate release

137
Q

What specifically during puberty stimulates the release of prolactin?

A

combined presence of growth hormone, estrogen, progesterone, thyroid releasing hormone

**these guys also inhibit dopamine (which is a prolactin inhibiting factor)

138
Q

What specifically during pregnancy stimulates prolactin release from the anterior pituitary?

A

combined presence of elevated estrogen and progesterone

139
Q

What specifically during lactation (milk production) stimulates prolactin release from the anterior pituitary?

A

breast feeding

140
Q

What are the other miscellaneous factors that stimulate release of prolactin from the anterior pituitary?

A

sleep

dopamine antagonists

141
Q

What inhibits prolactin release from the anterior pituitary?

A

dopamine (a constant tonic release) from hypothalamus

elevated levels of prolactin stimulates hypothalamus to increase release of dopamine

dopamine agonists (bromocriptine)

142
Q

What is another name for growth hormone?

A

somatotropin

143
Q

How is growth hormone (GH) release and when is the peak of release?

A

released in pulsing/cyclic pattern

peaks during adolescence

144
Q

What is the function of GH (and IGF-1)?

A

stimulates all tissue growth and maturation (anabolic function)

145
Q

How does GH (and IGF-1) function to stimulate tissue growth/maturation?

A

work synergistically

promote growth of tissues

regulates metabolism to facilitate growth

146
Q

Where does growth hormone and IGF-1 not function?

A

central nervous system

147
Q

Besides growth and maturation what are some other functions of growth hormone?

A

aging

sleeping

reproductive hormone function

148
Q

Which tissues does growth hormone have a direct effect, and how does it have a direct effect?

A

Binds directly to growth hormone receptors

Liver

Muscle

Adipose Tissue

149
Q

Describe how growth hormones produce an indirect effect

A

GH stimulates the liver –> produces/secretes IGF-1

150
Q

When do IGF-1 levels peak?

A

peak @ puberty –> decline gradually w/ age

151
Q

What are the target tissues of IGF-1?

A

Bone

Cartilage

Visceral Organs

152
Q

What does IGF-1 stand for?

A

Insulin Like Growth Factor 1

153
Q

What are the actions of growth hormone in the liver?

A

IGF synthesis

Protein synthesis

154
Q

What are the actions of growth factor in adipose tissue?

A

increase lypolysis

decrease glucose uptake

155
Q

What are the actions of growth factor in muscles?

A

increase amino acid uptake/protein synthesis

Decrease glucose uptake

156
Q

Generally, what is the action of IGF-1 throughout the body

A

mediate cell growth in most tissues

157
Q

What are the actions of IGF-1 in cartilage?

A

Stimulate cartilage matrix growth/balance

increase synthesis of matrix (chondroitin sulfate/collagen)

Amino acid uptake/protein synthesis –> DNA/RNA synthesis

** critical for linear bone growth during development

158
Q

What are the actions of IGF-1 in muscles, bones, and organs?

A

Amino acid uptake/protein synthesis –> DNA/RNA synthesis

Increase cell size/number

Bone = facilitate osteoblast/osteoclastic activity

159
Q

What does IGF-2 do?

A

inhibitory (antagonistic) effect on tissue growth

160
Q

What are the metabolic actions of growth hormone/ IGF-1?

A

GH (directly) and IGF-1 (indirectly) regulate fat, carbohydrate and protein metabolism to facilitate growth

161
Q

Specificially what does GH/IGF-1 do to protein metabolism?

A

stimulate amino acid uptake/synthesis and protein anabolism in tissues

162
Q

Specifically what does GH/IGF-1 do to carbohydrate metabolism?

A

assist in maintaining blood glucose levels

impair glucose uptake

stimulate liver glycogenolysis

163
Q

Specifically what does GH/IGF-1 do to fat metabolism?

A

increase lipolysis

decrease glucose uptake into fat cells

164
Q

How is IGF-1 involved in feedback?

A

inhibits growth hormone release from pituitary

stimulates somatostatin (growth hormone inhibiting factor) release from hypothalamus

165
Q

What are the factors that stimulate growth hormone release from the anterior pituitary gland?

A

GHRH = growth hormone releasing hormone from hypothalamus

Elevated sex hormones –> puberty

Dietary Protein –> increase ingestion of amino acids (provide building blocks for growth)

Hypoglycemia –> inhibits somatostatin (GH inhibitor from hypothalamus)

Stage 4 (deep) sleep (esp. in kids)

Exercise –> stress response to exercise

166
Q

What are the factors that inhibit GH release from the anterior pituitary?

A

Somatostatin –> hypothalamic hormone

Glucocorticoids

Hyperglycemia

167
Q

What is the name of the syndrome that causes excessive corticosteroid production, and what does it cause?

A

Cushing’s syndrome

inhibits the release of growth hormone from the anterior pituitary

168
Q

Name some glucocorticoid drugs that can inhibit the release of GH from the anterior pituitary, what is a potential consequence of using these drugs?

A

Prednisone

Prednisilone

Dexamethasone

Can inhibit growth in kids

169
Q

What will elevated levels of growth hormone do (in regards to feedback)?

A

inhibits the release of GH from the anterior pituitary

170
Q

What will elevated levels of IGF-1 do (in regards to feedback)?

A

inhibit GH release from the anterior pituitary

stimulate somatostatin (GH inhibiting factor) release from the hypothalamus

171
Q

What will excessive androgen levels do?

A

inhibit release of GH from the anterior pituitary

172
Q

What are the 3 phases of growth?

A

Phase I = prenatal to first year of growth

Phase II = juvenile growth (1 - puberty)

Phase III = Puberty

173
Q

What influences phase I growth?

A

not well understod

174
Q

What influences phase II growth?

A

growth hormone

thyroid hormones

insulin

175
Q

What influences phase III growth?

A

added influence of sex steroid hormones (testosterone/estrogen) –> thought to increase GH levels

176
Q

What are the hormones that influence growth?

A

Growth Hormone

Thyroid Hormones

Gonadal Steroid Hormones

Insulin

Cortisol

177
Q

How does growth hormone influence growth?

A

metabolic changes to favor growth/maturation

direct/indirectly stimulate cell growth (synergistic w/ IGF-1)

178
Q

How do the thyroid hormones influence growth?

A

maintenance function/stimulate GH

necessary for CNS development

necessary for normal function of IGF-1

179
Q

How do gonadal steroid hormones influence growth?

A

stimulate growth spurt @ puberty

necessary for normal GH secretion

180
Q

How does insulin influence growth?

A

Stimulate fetal and postnatal growth

181
Q

How does cortisol influence growth?

A

inhibits GH release –> INHIBITS growth

decreases efforts of growth factors on epiphysis (growth plates) of bone

182
Q

What is a consequence of insufficient GH?

A

dwarfism

183
Q

In dwarfism, WHEN do you see GH dysfunction?

A

BEFORE growth plates close

impaired GH secretion or GH receptors

184
Q

What is the consequence of excessive GH?

A

Gigantism

Acromegaly

185
Q

In gigantism, when do you see GH dysfunction?

A

see increase of GH BEFORE epiphyseal plates close

186
Q

In acromegaly, when do you see GH dysfunction?

A

see increase of GH AFTER epiphyseal plates close

187
Q

Which parts of the body are usually effected in acromegaly?

A

chin

hands

feet

188
Q

What type of bone growth do you have in acromegaly?

A

enlargement of structures due to periosteal bone growth

189
Q

What might you see in Excessive GH disorders (gigantism/acromegaly)?

A

Adenomas = benign glandular tumors

190
Q

What are the clinical findings of long-term excessive growth hormone?

A

arthropathy

neuropathy

cardiomyopathy/hypertension

respiratory disease

carbohydrate intolerance/diabetes

increased risk of malignancy

DECREASED lifespan

191
Q

What does TSH (thyroid stimulating hormone) do?

A

stimulate syntehsis/release of thyroid hormones (t3 and T4)

192
Q

What are the 2 gonadotropin hormones?

A

LH = luteinizing hormone

FSH = follicle stimulating hormone

193
Q

What does luteinizing hormone do in females?

A

simulate ovulation

formation of corpus luteum

synthesis of progesterone in the ovaries

194
Q

What does luteinizing hormone do in males?

A

stimulates synthesis and secretion of testosterone

195
Q

What does follicle stimulating hormone do in females?

A

stimulates the growth of ovarian follicles

stimulates estrogen secretion

196
Q

What does follicle stimulating hormone do in males?

A

stimulates sperm maturation in testicles

197
Q

What does ACTH (adrenocorticotropic hormone) do?

A

stimulates synthesis and secretion of adrenal cortical hormones

198
Q

What does MSH (melanocyte stimulating hormone) do?

A

stimulates melanin synthesis/release from melaonocytes in the skin –> increases pigmentation

Pathophysiology Endocrine (3 decks)

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