pineal to thyroid Flashcards by Precious Iris Impas II

pineal gland is — shaped, attached on —

pine coned shape attached on midbrain

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pineal gland

it converts serotonin to — which is important for —

MELATONIN

important for: sexual development, sleep/wake cycle

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hypothalamus is located at the base of the brain which is the source of what hormones?

hypothalamus controls pituitary gland by?

tropic hromones

neurosecretory and neurostimulation

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enumerate the functions of hypothalamus (7)

blood pressure
rate & force of heart beat
digestive tract motility
rate and depth of breathing
pleasure, fear, rage
body temp.
hunger, satiety, sleep cycle

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hypothalamus

enumerate the tropic hormones (6)

tropic hormones are insoluble to the body

thyrotropin-releasing hormone
gonadotropin-releasing hormone
growth hormone-releasing hormone
corticotropin-releasing hormone
somatostatin
dopamine

TRH, GnRH, GHRH, CRH, S, D

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hypothalamus

a tripeptide which goes to pituitary gland to TSH and the product is T3T4

Thyrotropin-releasing hormone (TRH)

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hypothalamus

GnRH has — amino acids
this is released at —

what is the product of gonadotropin-releasing hormone?

10 amino acids

released at onset of puberty for sexual development

products: ESTROGEN & TESTOSTERONE

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amino acids

GHRH:
CRH:
Somatostatin:

GHRH: 44
CRH: 41
Somatostatin: 2 active forms 14 and 28

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hypothalamus

product of CRH

acts – cells – anterior lobe of pituitary gland —-

Adenocorticotropic Hormone (ACTH)

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hypothalamus

a growth-inhibiting hormone which has 2 active forms and acts on anterior lobe of PG.

this hormone is also produced in —

SOMATOSTATIN

produced in pancreas & intestine

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hypothalamus

Somatostatin inhibits the hormone?

TSH and GH

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hypothalamus

dopamine is derived from — and inhibits release of — from anterior lobe of PG

derived from tyrosine and inhibits the release of prolactin

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pituitary gland (hypophysis) means to —

this gland is generally for — (enumerate)

to spit mucus

pituitary gland is for:
- growth
- metabolism
- milk production
- pregnancy

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pituitary gland

enumerate the cells and their associated hormones

Lactotrophs - PROLACTIN
somatotrophs - GH
thyrotrophs - TSH
corticotrophs - ACTH
gonadotrophs - FSH, LH

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pituitary gland

the extension of forebrain and the storage for — from neurosecreotry cells of hypothalamus

NEUROHYPOPHYSIS

storage for ADH & oxytocin

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pituitary gland

intermediate lobe of pars intermedialis is the thin layer of cells that produce what hormone?

melanocyte stimulating hormone

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pituitary gland

these produces large hormones and are more complex than hypothalamus

adenohypophysis

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pituitary gland

enumerate the hormones produced by adenohypophysis

somatotropin (GH)
gonadotropins (FSH, LH)
prolactin
thyrotropin (TSH)
corticotropin (ACTH)

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pituitary gland

this is associated with pituitary and parapituitary hypothalamic tumors

hypopituitarism

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pituitary gland

this has no pituitary function

panhypopituitaryism

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pituitary gland

this is associated with “shock of pregnant girl at time of delivery”

Sheehan’s syndrome
pituitary ischemia

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pituitary gland

enumerate the modifiers of adenohypophysis (6)

excercise, sleep
arginine
sex steroids
alpha-agonist drugs
beta-blockers
hypoglycemia

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pituitary gland - adenohypophysis

this has 191 amino acids, the most improtant for growth and the most abundant.

it is structurally related to PRL and HPL

growth hormone

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pituitary gland - adenohypophysis

growth hormone function

GH is for:
- onset of sleep (2-3 hrs peak)
- calcium retention of bones (mineralization, protein synthesis, lipolysis)
- internal organ development
- function of pancreas & gluconeogenesis

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# pituitary gland - adenohypophysis excess GH can lead to?

Acromegaly or Gigantism (Tumor in PG)

# pituitary gland - adenohypophysis the overall metabolic effect of this hormone is the conservation of glucose | inversely related to glucose

growth hormone

# pituitary gland - adenohypophysis gold standard/confirmatory test | complete rest at --- before collection

Insulin tolerance test | rest at **30 mins before collection**

# pituitary gland - adenohypophysis gonadotropins are inhibited by --- which is the 4th marker of down syndrome | if decrease = ?

Inhibin A | decrease = **sterility**

# pituitary gland - adenohypophysis gonadotropins acts on thecal cells of ovarial follicles to produce --- (3)

- androgens - estrogens - progesterone | IF DECREASE = **STERILITY**

# pituitary gland - adenohypophysis enumerate the uses of gonadotropins

evaluate: - infertility (w/ other hormones) - functioning gonads - early/late puberty - menstrual problems - menopause

# pituitary gland - adenohypophysis (gonadotropin) a specific hormone for **menstrual cycle and ovulation** of girls | for boys, it stimulate **production of testosterone** by leydig cells

Luteinizing hormone

# pituitary gland - adenohypophysis (gonadotropin) Follicle stimulating hormone (FSH) functions in girls and boys

girls: **mens and eggs by ovaries** boys: **sperm production (constant amount)**

# pituitary gland - adenohypophysis prolactin is also called as a --- hormone. this is produced by lactotrophs, with single chain and can be stimulated by --- or --- | prolactin is a direct effector.

**STRESS HORMONE** stimulated by **TRH/estrogen**

# pituitary gland - adenohypophysis prolactin is for --- and highest in what time?

production of **breast milk** highest in: **4-8 am and 8-10 pm**

# pituitary gland - adenohypophysis a glycoprotein that travels to thyroid gland then adds iodine = T3, T4

**thyrotropin (TSH)** 2 monocovalently subunits: - a: **92 amino acid sequence** same with LH, FSH, HCG - B: **118 amino acids** and specific info to the binding receptors of hormonal activities

# pituitary gland - adenohypophysis ACTH is a single chain polypeptide which is the function is to activate --- | if decrease ACTH: ? if increase ACTH: ?

CORTISOL | decrease: **atrophy** | increase: **Addisons disease & Ectopic tumors**

# pituitary gland - adenohypophysis ACTH peaks at --- and low at --- | specimen should?

peaks: **6-8 am** low: **6-11 pm** | **NO CONTACT WITH GLASS**

T or F: neurohypophysis produces and releases hormones

FALSE **release only** does NOT produce

hormones released by neurohypophysis

oxytocin and antidiuretic hormone

# neurohypophysis oxytocin & ADH are nonapeptides which is produced by ---

**supra optic cells & paraventicular cells** of the hypothalamus

# pituitary gland - neurohypophysis oxytocin with corner protein associated is for --- (enumerate)

CONTRACTION of: - uterus - muscle during delivery and lactation and has **emotional effects** | oxytocin has **no known disease**

# pituitary gland - neurohypophysis contraction of uterus is also known as ---

fergussion reflex

# pituitary gland - neurohypophysis oxytocin are produced due to ---

- birth canal (stimulate) - touch receptor of breast (milk flow)

# pituitary gland - neurohypophysis this hormone is associated with a "cry of a hungry baby"

oxytocin

# pituitary gland - neurohypophysis oxytocin have effects on --- (4)

- pituitary - renal - cardiac - immune function

# pituitary gland - neurohypophysis ADH is also known as --- which conserve body water and constrict in BV. it act on --- and --- of kidneys to maintain water balance.

**arginine vasopressin** act on DCT and CD of kidneys

# pituitary gland - neurohypophysis ADH is stimulated by --- | enumerate the 8

- Low BP - hypovolemia - fright - pain - nicotine - narcotics - barbiturates - increase plasma osmolality

# pituitary gland - neurohypophysis ADH is inhibited by ---

- carbonated drinks - alcohol - dilantin - a-agonists

# pituitary gland - neurohypophysis max of ADH ADH is coupled with --- and induce aquaporin-2 insertion in the tubular luminal membrane.

**>295 mosm/kg** coupled with **adenylate cyclase**

# pituitary gland - neurohypophysis diabetes insipidus (>2L/day urine) this is increase/decrease in what hormone?

**decrease ADH** ## Footnote **neurogenic** - ADH def./hypothalamus **nephrogenic** - kidney receptors impaired

# pituitary gland - neurohypophysis increase ADH without stimuli due to **brain injury, trauma, tumors, lung cancer** | increase water retention, hypo-osmolality, hyponatremia

Syndrome of inappropriate antidiuretic hormone secretion (SIADH)

thyroid gland is a --- shaped with 2 lobes separated by --- (15-25g) | LARGEST ENDOCRINE GLAND!!

**butterfly shaped** separated by **Isthmus**

thyroid gland straddles the trachea and start to produce hormone at --- | enumerate the functions of thyroid gland

11 week gestation | function: **produce thyroid hormones, iodine storage**

# thyroid gland cells that controls metabolism

follicular epithelium **T3, T4**

# thyroid gland cells that is associated with calcitonin

parafollicular cells

# thyroid gland normal thyroid iodide to plasma iodide ratio | this is needed for hormone synthesis

25-40:1 | **iodine**

# thyroid gland iodine intake: <50 ug/day | this indicates?

hormone secretion deficiency

# thyroid gland iodine intake: 150 ug/day (1 mg/week) | this indicates?

normal function

# thyroid gland organized by thyroid cells and it absorbs iodine (ring shape)

follicles

# thyroid gland reservoir of materials for hormone production (rich in glycoprotein thyroglobulin) surrounded by follicle | a **viscous** substance

colloid | colloid is within the follicle.

# thyroid gland major component of colloid which is synthesized and secreted by follicles | additional info: with tyrosyl groups (**rich in tyrosine**)

thyroglobulin | thyroglobulin is located inside a colloid.

# thyroid gland presence of this in the blood indicate tumor (malignant/benign) | reflected **thyroid mass, injury & TSH receptor stimulation**

thyroglobulin

# thyroid gland thyroglobulin is increase in?

- graves disease - thyroiditis - nodular goiter

# thyroid gland resources will be used for creation of T3 and T4, this refers to ---

thyroglobulin

# thyroid gland enumerate the 6 in biosynthesis | biosynthesis is controlled by TSH.

- iodide trapping/uptake (by Na-iodide symporter) - oxidation - iodination of tyrosyl residius by TPO - coupling/condensation reaction - thyroglobulin is then moved to the colloid for storage - exocytosis of collod droplets

# thyroid gland this biosynthesis happens at basal membrane of follicular cells. Iodide diffuse into the lumen | lumen iodide to follicular iodide ratio

iodide trapping/uptake | lumen iodide to follicular iodide ratio: **5:1**

# thyroid gland conversion of iodide to elemental iodide by thyroid peroxidase enzyme. this refers to what biosynthesis?

oxidation

# thyroid gland iodothyronine formed at optical barrier, follicular cells

monoiodothyronine & diiodothyronine

# thyroid gland DIT + DIT by TPO

# thyroid gland MIT + DIT

# thyroid gland T4 BINDING PROTEINS plasma protein: __ % free: ___%

plasma protein: **99.95%** free: **0.05%**

# thyroid gland * **thyroid binding globulin** is ___% of T4 * thyroid binding pre albumin is __% of T4 * **thyroid binding albumin** is ___% of T4 | TBG is measured by?

TBG: **75%** TBPA: **15-20%** TBA: **9%** | measured by **immunoassay**

# thyroid gland T3 BINDING PROTEINS (%) ___ : free ___ : TBG ___ : TBPA ___ : TBA

free: **0.5%** TBG: **99.5%** TBPA: **very low** TBA: **none**

# thyroid gland enumerate the hormone loop (step by step)

1. decrease metabolism 2. detected by hypothalamus (TRH) 3. stimulate anterior pituitary 4. target organ (thyroid) 5. T3/T4 6. target organ 7. adrenal medulla 8. epinephrine & norepinephrine 9. increase metabolism

# thyroid gland enumerate the physiologic actions (8)

1. basal metabolic rate 2. tissue growth 3. CNS development 4. ANS 5. CV & respiratory systems 6. GIT 7. Skin 8. lactogenesis

# thyroid gland this is for deiodination and has 2 types

iodothyronine 5' -deiodinase

# thyroid gland most abundant type of iodothyronine 5' -deiodinase. this is for T3 circulation and found in ---

**type 1** found in liver and kidney

# thyroid gland type 2 iodothyronine 5' -deiodinase is found in?

- brain - maintain T3 levels in CN3

# thyroid gland main serum carrier of T3 & T4

thyroxine-binding globulin (TBG)

# thyroid gland T4:T3 ratio in blood

20:1

# thyroid gland T or F: most of the plasma are T3 derived but the major is T4 which is from direct TG secretion

TRUE

# thyroid gland T4 aacounts 80% of plasma T3, this refers to ---

extrathyrodial deiodination | **liver/kidney**: deiodinate T4 | **peripheral tissue**: T4 -> T3

# thyroid gland 3rd major circulating thyroid hormone which is the removal or 1 iodine from inner ring of T4

reverse T3 (rT3) | function: **more on testing since it is inactivated**

# thyroid gland used to assess borderline or conflicting lab results and this is elevated in patients with **erythroid sick syndrome** | also **high in newborns**

rT3 | difference between T3 is that **T3 is active | rT3 inactive**

# thyroid gland T or F: T3 is not useful in diagnosing hypothyroidism because levels are not reduced until it becomes severe.

TRUE

# thyroid gland TH is metabolized by?

1. deiodination 2. deamination 3. cojugation (by glucoronic acid) | conjugated -> bile duct -> intestine -> excreted

# thyroid gland a thyroid hormone with most hormonal activity. this is measured by **competitive assay** | 75-80% is from tissue deiodination of T4 (outer ring)

Trioodothyronine | **3, 5, 3 Trilodothyronine**

# thyroid gland Trioodothyronine is for diagnosing --- | increase T3 is first seen in ____

for diagnosing **T3 thyrotoxicosis** | first seen in **hyperthyrodism**

# thyroid gland a hormone indicator of recovery and recurrence of hyperthyroidism (low in cord blood) | what is the physiologically active form of this hormone?

Trioodothyronine (T3) | **FT3** - physiologically active and is readily available

# thyroid gland principal secretory product and the major fraction of **organic iodine** | prohormone of T3

Tetraiodothyronine (T4) | **3, 5, 3', 5' tetraiodothyronine | thyroxine**

# thyroid gland indicator of thyroid secretory rate physiologically active form of T4? | increase T4 indicates?

Serum T4 active form: **FT4** | increase T4 = **no TSH**

# thyroid gland enumerate the methods used for thyroglobulin tests

- ELISA - RIA - IRMA - Immunochemiluminescent assay

# thyroid gland increase thyroglobulin tests indicates?

thyroid cancer nodular goiter, hyperthyroidism

# thyroid gland decrease thyroglobulin test indicates?

goitorous hypothyroidism and thyrotoxicosis factitia

# associated diseases - inc T3 & T4 - dec TAG level enumerate the signs and symptoms

**hyperthyroidism** - heat intolerance (incr sweating) - emotionally labile - tachycardia - unexplained weight loss - tremors, restlessness, hyperkinesis, anxiety, irritability - diarrhea and increase appetite

# associated diseases **primary hyperthyrodism** enumerate the inc and dec

**increase**: T3, T4, FT4, rT3 **decrease**: TSH **normal TBG**

# associated diseases **secondary hyperthyroidism** enumerate the inc and dec

**increase** T3, T4, TSH "pituitary problems"

# associated diseases - hyper most common and autoimmune diffuse toxic goiter due to circulating antibodies to TSH receptor test? | with **exophthalmos & pritibial myxedema**

**Grave's disease** | test: **TSH receptor antibody test**

# associated diseases thyroid is woody/stony hard mass

Riedel's thyroiditis

# associated diseases enumerate the diseases in hyperthyroidism

- Grave's disease - Reidel's thyroiditis - subclinical hyperthyroidism - subacute granulomatous/subacute non-suppurative thyroiditis / De Quervain's

# associated diseases painful thyroiditis TPO antibody is absent | **increase thyroglobulin and ESR**

subacute granulomatous/subacute non-suppurative thyroiditis / De Quervain's

# associated diseases low TSH, normal FT3 & FT4 and without symptoms

subclinical hyperthyrodism

# associated disease after fertility

increase FT4 and T3 low TSH

# associated disease decrease T3, T4 increase TAG | enumerate the sign and symptoms

**HYPOTHYROIDISM** - cold intolerance - bradycardia, fatigue - dryness of skin - unexplained weight gain, dyspnea, hair loss - mental dullness, muscle weakness, constipation - yellow discoloration of skin - decrease Na+ incrase CK

# associated disease associated with severe hypothyroidism

- pleural and peritoneal effusions - irregular mens - periorbital edema - myopathy - anemia

# associated disease **inc** TSH **dec** T3 T4 rT3 FT4 **normal** TBG

primary hypothyroidism | normal or increase: **aTPO, ATG, TBII** normal to decrease: **Tg**

# associated disease **dec** T3 T4 FT4 TSH

secondary hypothyroidism

# associated disease **normal** T3 T4 FT4 **slightly inc** TSH | no signs and symptoms

subclinical hypothyroid...

enumerate the associated diseases in hypothyroidism

- hashimoto's disease - myxedema - congenital hypothyroidism

# associated disease common cause of primary hypothyroidism | with goiter, thyroid is replaced by nest of lymphoid tissue

Hashimoto's disease **Chronic autoimmune thyroiditis** | also known as **chronic lymphocytic thyroiditis**

# associated disease test for hashimoto's disease and its results

**TPO antibody test** increase TSH | TPO Ab = **tissue destructive disease**

# associated disease peculiar nonpitting swelling of skin - "puffy face" (moon face) - weight gain, slow speech - thin eyebrows, dry yellow skin

myxedema | **myxedema coma** is due to severe hypothyroidism

# associated disease development/functional defect of gland **retarded child**

congenital hypothyroidism **"cretinism"**

pineal to thyroid Flashcards

(113 cards)