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Medical Pathophysiology > Week 2 - Endocrine system > Flashcards

Week 2 - Endocrine system Flashcards

1
Q

how do hormones travel?

A

1 Can be dissolved in the blood plasma (water soluble)
2 can travel in the blood bound to plasma proteins
3 Then they diffuse across capillary walls to reach target cells

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2
Q

What is a hormone?

A

A molecule produced by an endocrine gland that act on target organs.

They regulate physiology and behaviour

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3
Q

What can hormones be classified into?

A

Proteins
Polypeptides
Lipids

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4
Q

How do hormones work?

A

The hormone binds to the target cells which has receptors

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5
Q

Where are the hormone binding events?

A

Ion channels
Receptor binding - GPCR/second messengers
Activation/inhibition of gene expression

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6
Q

What are the different types of cell communication?

A

Neural - neurotransmitters etc

Endocrine - hormones release into the bloodstream, travel to target tissues and regulate distant organs

Paracrine - the secretions act on and regulate nearby cells

Exocrine - secretions released into body cavity via a duct e.g. saliva into the mouth

Autocrine - the secretions/chemical messenger act on the same cell that produced the secretions

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7
Q

how do hormones travel?

A

1 Can be dissolved in the blood plasma (water soluble)
2 can travel in the blood bound to plasma proteins
3 Then they diffuse across capillary walls to reach target cells

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8
Q

what is the concentration of a hormone in blood plasma dependent on?

A

the rate of secretion and the rate of removal

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9
Q

how are hormones removed?

A

excreted from kidneys
metabolised in blood or target cells

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10
Q

what is antagonism?

A

where the hormone reduces the number of receptors available for a second hormone

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11
Q

what is permissiveness?

A

where the hormone increases the number of receptors available for the second hormone

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12
Q

what is the anterior pituitary?

A

the master gland

controls the functions of other endocrine glands

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13
Q

what are the different cells in the pancreas?

A

Alpha cells: produce glucagon
Beta cells: produce insulin
Delta cells: somatostatin

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14
Q

Describe the exocrine function of the pancreas?

A

Secretes digestive enzymes such as lipases, proteases and amylase into the small intestine via the pancreatic duct

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15
Q

Describe the endocrine function of the pancreas?

A

The pancreas releases hormones via specialised cells to control blood glucose levels

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16
Q

what is glucagon?

A

produced via alpha cells
Increases blood glucose levels
converts glycogen to glucose

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17
Q

what is insulin?

A

produced via beta cells
decreases blood glucose levels
coverts glucose to glycogen

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18
Q

describe diabetes mellitus

A

when you have high blood sugar level (hyperglycaemia)

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19
Q

what are the types of diabetes?

A

Type 1- where the pancreas fails to produce insulin via beta cells

Type 2- where organs stop responding to insulin

Gestational- comes on during pregnancy

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20
Q

Treatment for type 1 diabetes?

A

you need to keep blood glucose levels down so you can give insulin injections

‘Artificial Pancreas’- automated insulin delivery

Beta cell transplant

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21
Q

Treatment for type 2 diabetes?

A

you need to get the cells to respond to insulin again

Lifestyle changes

Metformin medication

Insulin/non insulin therapy

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22
Q

where are the sites in the body where the drugs for type 2 diabetes act?

A

skeletal muscle
liver
brain
pancreas
small intestine
adipose tissue

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23
Q

what is the HbA1c test?

A

used to monitor blood glucose levels

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24
Q

symptoms of hyperglycaemia (high blood sugar)

A

frequent hunger/thirst, fatigue, dry mouth, increased volume of urination

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25
what are microvascular and macrovascular complications of diabetes?
Microvascular: retinopathy Nephropathy neuropathy Macrovascular: heart disease cerebrovascular disease peripheral artery disease
26
what is diabetic retinopathy?
a complication that you get from diabetes it's where the blood vessels in the retina increase in size, bulge and eventually burst causing a haemorrhage
27
what is diabetic nephropathy?
a complication that you get from diabetes that causes damage to the kidney where the blood vessel bursts so proteins enter into the urine
28
why is hypertension (high blood pressure) dangerous when you have diabetes
because it worsens complications and increases risk of heart attack and stroke
29
how to control blood pressure when you have diabetes?
lifestyle changes treatment with ACE inhibitor and Angiotensin 2 receptor blocker
30
what is considered as high blood pressure?
systollic over 130 mmHg diastolic over 80 mmHg on 2 different days
31
what is dyslipidaemia?
imbalance of lipids
32
how do you manage lipids in diabetes
via an annual screening for diabetic patients via blood tests
33
what are statins? (DRUGS)
they lower lipids by inhibiting hmg-coa to reduce cholesterol in the liver
34
what is the hypothalamic pituitary adrenal axis?
the interaction between the hypothalamus, the adrenal glands and the pituitary gland It responds to stress and results in the production of cortisol, nor/adrenaline
35
what is the adrenocorticotrophic hormone (ACTH)
the hormone that responds to stress secreted from anterior pituitary acts on adrenal glands causing them to release cortisol Produced from the POMC gene
36
what are POMC products?
the products that are produced from the POMC gene Enzymes cleave the POMC gene into smaller products/peptides
37
some examples of POMC products/peptides
Alpha-MSH - it effects and alters skin pigmentation via GPCRs Beta-endorphin - has pain relief effects via opioid receptors
38
what are the diseases related to adrenocorticotrophic hormone (ACTH)
Cushing's syndrome Addison's Syndrome Secondary Adrenal Insufficiency
39
what is Cushing's syndrome?
excess cortisol production by excess ACTH release REMEMBER THAT ATCH RESULTS IN THE PRODUCTION OF CORTISOL FROM THE ADRENAL GLANDS
40
what is Addison's syndrome?
also known as PRIMARY adrenal insufficiency it's the lack of ATCH secretion REMEMBER THAT ATCH RESULTS IN THE PRODUCTION OF CORTISOL FROM THE ADRENAL GLANDS
41
What is secondary adrenal insufficiency
when the pituitary gland doesn't produce enough ATCH
42
what are the different tests to diagnose ATCH diseases
measure your cortisol levels from 9am to midnight Synacthen tests - to diagnose Addisons disease - this is where you are injected with a synthetic ACTH to measure the amount of cortisol produced Dexamethasone Suppression test (DMT) - to diagnose Cushing's syndrome - this is a steroid that carries out negative feedback to the pituitary gland to suppress the secretion of ATCH
43
What is the difference between Cushings syndrome and Cushings disease?
Cushings syndrome refers to general excessive levels of cortisol Cushings Disease refers to excessive levels of cortisol caused by a pituitary tumour secreting ACTH
44
Symptoms of Cushing's syndrome?
hypertension purple striae excessive bruising hirsutism truncal obesity back pain
45
what are the causes of Cushing's syndrome?
Normal: excess cortisol made by excess ACTH production (NEGATIVE FEEDBACK LOOP) Cushing's Disease: Adrenal Tumours: Ectopic ACTH secretion:
46
Describe the negative feedback loop for ACTH and cortisol?
When there is an excess amount of ACTH, there is an excess production of cortisol, so the negative feedback loop tries to counteract this by getting the levels back to normal
47
How do you diagnose Cushing's disease?
MRI Cortisol saliva test Checking blood ACTH levels
48
How to treat Cushing's disease?
Surgery to remove pituitary tumour Medication to inhibit the adrenal glands from producing cortisol Radiation therapy to control pituitary tumour growth
49
What are the regions of the adrenal glands?
Adrenal cortex Adrenal medulla
50
What are the zones of the adrenal glands?
Zona glomerulosa Zona reticularis Zona Fasciculata
51
What are the adrenal sex steroids?
Testosterone (androgen) Oestrogen
52
What are glucocorticoids?
A type of steroid hormone. They contribute to the breaking of glycogen and the forming of glucose. They stop the secretion of ACTH (negative feedback loop) an example is cortisol
53
What are mineralocorticoids?
They are a steroid hormone. They promote reabsorption of Sodium in the kidneys and promote excretion of potassium. Promotes electrolyte balance of sodium and potassium across cell membranes throughout the body an example is aldosterone, which is secreted from the adrenal glands
54
What is Addison's disease?
Adrenal hyPOfunction (the adrenal glands can't function properly) The adrenal glands produce low levels of cortisol
55
Common causes of Addison's disease?
Autoimmune adrenalitis Tuberculosis Adrenalectomy
56
Common features of Addison's disease?
Weight loss nausea lethargy pigmentation
57
How do you diagnose Addison's disease?
Check for hyperpigmentation Blood tests to check ATCH and cortisol levels synacthen test
58
How can you treat Addison's disease?
Corticosteroid supplement Mineralocorticoid replacement
59
What is Conn's syndrome?
Where the adrenal glands produce excess aldosterone
60
Where is the thyroid gland?
located below the larynx above the thyroid cartilage
61
What does the thyroid gland do?
Produces thyroxine -T4 Produces tri-iodothyronine - T3, which are crucial for metabolic control Produces calcitonin - decreases calcium levels in the blood by inhibiting breakdown of bone
62
What is TSH (thyroid stimulating hormone)
a hormone produced via the pituitary gland which stimulates the thyroid gland to produce T3 and T4. It's a negative feedback loop
63
What is hyPOthyroidism?
It is when your thyroid gland is underactive, leads to slowing of metabolic processes
64
What are the types of hyPOthyroidism?
Hashimoto's thyroiditis - autoimmune which usualy cause primary hypothyroidism Primary hypothyroidism - caused by the gland itself Secondary hypothyroidism - pituitary disease Tertiary hypothyroidism - hypothalamic disease
65
Explain what Hashimoto's thyroiditis is and what it is caused by?
It's where the thyroid gland gradually gets destroyed, it causes hyPOthyroidism. It can be caused by an autoimmune reaction to: thyroglobulin thyroid peroxidase TSH receptor To test for hASHIMOTO'S thyroiditis test for autoantibodies against the above
66
How do you diagnose Hashimoto's thyroiditis?
Carry out a blood test and check for TSH, T4 levels and anti thyroid antibodies
67
Symptoms of hyPOthyroidism?
fatigue dry skin muscle cramps dyspnea etc
68
How do you diagnose hyPOthyroidism?
Do a screening of serum TSH If your TSH (thyroid stimulating hormone from the pituitary gland) is high, you may have primary hyPOthyroidism If your TSH, T4, T3 levels are all low you may have a pituitary tumour so you may have secondary or tertiary hyPOthyroidism To test for Hashimoto's thyroiditis, test for autoantibodies against thyroglobulin, thyroid peroxidase, TSH receptor
69
What is the treatment for hyPOthyroidism?
Hormone replacement of the hormones T3 and T4 Keep checking TSH levels 4-8 weeks after hormone replacement
70
Who are the special circumstances for with hyPOthyroidism?
Pregnant women People with Downs Syndrome People with type 1 diabetes This is because there is a higher incidence in these groups
71
What is hyPERthyroidism?
When you have an overactive thyroid gland. It can cause Graves disease
72
What are some symptoms of hyPERthyroidism?
Weight loss excessive sweating hyperactivity LESS common: nausea exacerbation of angina
73
what is a goiter\?
A swollen thyroid gland caused by hyPERtyroidism
74
How do you diagnose hyPERthyroidism?
Diffuse the goiter and if the patient HAS hyPERtyroidism, the TSH levels are suppressed and the T4 levels are elevated
75
Treatment for hyPERthyroidism?
Radioactive synthesis - however this can cause hyPOtyroidism in the future Carry out surgery on large goiters Propylthiouracil - to block the synthesis of thyroid hormones (T3, T4) to stop the thyroid gland from being too overactive Propanolol - used to treat and reduce symptoms such as anxiety, trembling etc
76
What is thyroiditis?
It's caused by a viral infection Presents as a tender thyroid

Medical Pathophysiology (11 decks)

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