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Week 6 Flashcards

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1
Q

How does thyroid hormones affect GI motility?

A
  • increases
    • appetite adn food intake
    • rates of digestive juices
    • motility
  • Hyper: increases bowl movements
  • Hypo: constipation
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1
Q

How do the adrenal glands maintain homeostasis?

A
  • regulate body’s adaptive response to stress (cortisol)
  • regulate body water, sodium and potassium balance and metabolism (aldosterone)
  • control blood pressure
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1
Q

What is the vaginal fornix?

A
  • recess around cervix
  • has anterior, posterior and lateral parts
    • posterior is the deepest
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2
Q

What are the main functions of glucocorticoids?

A
  • ^ metabolism of proteins, carbs, and fats
    • ^ blood glucose
    • nearly all tissues have glucocorticoid receptors
  • important in resisting stress and inflammation
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3
Q

How does calcitriol work?

A
  • formed from 7-dehydrocholesterol
  • final activation occurs in kidneys
  • Bone: increase Ca2+ and Pi mobilization, stimulates osteoblasts and indirectly osteoclast
  • Kidneys: decrease both phosphate and Ca2+
  • Intestine: increase Ca2+ absorbtion by upregulating calbindin
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3
Q

How does Thyroid hormones effect carbohydrate metabolism?

A
  • increases the rapid uptake of glucose
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3
Q

What are the common causes of primary hyperthyroidism?

A
  • Graves disease
  • hyperfunctioning thyroid nodules
  • therapy induced hyperthyroidism
  • thyroiditis (inflammation)
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3
Q

What is congenital adrenal hyperplasia?

A
  • Cause:
    • autosomal receissive disorder leading to deficient production of cortisol and aldosterone
    • excessive production of sex steroids
  • 95% of cases due to 21-hydroxylase defiency
  • severe deficiency: life treatening vomiting and dehydration in first weeks of life. Ambigious genitalia of gentically female infants
  • moderate: prepubertal virilization
  • mild: infertility in women
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4
Q

How does TSH affect cellular metabolic activity?

A
  • increase
    • number, size, and activity of mito to increase ATP formation
    • Na+/K+ ATPase activity
    • synthesis of metabolic proteins
  • everything increases O2 consumption and BMR
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5
Q

Osteogenesis imperfecta

A
  • bone disorder
  • decreased osteoid
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5
Q

What are the properties of the thyroid hormone receptors?

A
  • TRs have much higher affinity for T3
  • TRs are nuclear receptors
    • ligand activated transcription factors
    • bind to enhance elements on DNA to produce new proteins
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5
Q

What are the structural properties of Vitamin D?

A
  • secosteroid
  • Open B ring
  • 27 carbons
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6
Q

What factors are involved in Thyroid hormone synthesis?

A
  • TSH
  • Thyroglobulin
  • Iodine
  • Membrane transporters
  • Enzymes
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6
Q

What is thyroid hormone metabolism of T3 and T4?

A
  • 40% of secreted T4 are converted to T3
  • T3 is mainly used by tissues
  • Main source of T3 is the deiodination of T4
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8
Q

How is calcium transported in the epithelial cell in the intestine?

A
  • Calcium passive transporter on the lumenal side
    • once in the cell, immediately bound to calbindin
    • Calbindin upregulated by Vit D
  • Ca2+ will disassociate and exit through Na antiporter
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8
Q

What are the 3 types of plasma proteins that thyroid hormones bind to?

A
  • Thyroxine bidning globulin (TBG) 70%
  • Transthyretin (prealbumin) 15%
  • Albumin 15%
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9
Q

What occurs during stage 4 of biosynthesis of thyroid hormones?

A
  • Endocytosis of thyroglobulin
  • Lysosomes fuse wiht pinocytotic vesicles
    • proteases mix with colloid to digest thyroglobulin
  • T3 and T4 released and diffuse into bloodstream and can bind to TBG
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10
Q

What intermediate do all steroid hormones go through?

A
  • Cytochrome p450 makes pregnenolone (C21 intermediate)
    • cleavage of 6 carbons from side chain of cholesterol
  • additional enzymes will make the steroid hormones
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11
Q

What occurs in Graves disease?

A
  • thyroid stimulating immunoglobulins TGIs (antibodies) form against TSH receptor in thyroid gland
  • Stimulates the receptor to release T3/4
  • Develop goiter
  • Low levels of TSH
  • Graves ophthamopathy
  • mexedema
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11
Q

What is the main function of adrenal medullary hormones?

A
  • makes rapid, short term adjustments to actual or threatened changes in external or internal environment
    • fight or flight
  • actions are supported by glucocorticoids
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12
Q

What are the structural properties of the seminal glands?

A
  • Between the fundus of bladder and rectum
    • covered with peritoneum superiorly but seperated from rectum by rectovesical pouch
  • contributes to formation of ejaculatory duct
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12
Q

What are the three parts to the uterine wall?

A
  • permetrium - serosa
  • mymetrium - sm, contains main branches of blood vessels
  • endometrium - inner mucous coat
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12
Q

What two muscles compress the vagina and act as sphincters?

A
  • external utrethral sphincter
  • bulbospongiosus
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13
Q

What is the normal blood concentration of aldosterone and cortisol? Where are they inactivated?

A
  • aldosterone: 6 ng/dl (secretory rate 0.15 mg/day)
  • cortisol: 12 microg/dl (secretory rate 15 mg/day)
  • inactivated mainly in the liver and conjugates excreted mainly in urine
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13
At what level is the rectosigmoidal junction?
S3
14
How is cytochrome P450 important to steroid hormones?
* Used extensively in steroid hormone biosynthesis * heme containing membrane bound protein found in the sER of liver and lungs can also be mito * broad substrate specificity * works with cytochrome P450 reductasen(CPR) * e- flow from NADPH to FADH2-CPR to heme in p450 * C27 to C21
15
Osteomalacia/Rickets Calcium? Phosphate? PTH? Alkaline phosphate?
* Calcium: down * Phosphate: down * PTH: up * Alkaline phosphatase: up
15
What is pheochromocytoma? Symptoms? Diagnosis?
* cause: chromaffin cell tumor * over secretion of catecholamines * symptoms * elevated HR * systemic hyertension * anxiety * pallow and sweating * hyperglycemia * diagnosed * high levels of catecholmines and metabolites in blood in blood and urine
15
What is benign hypertropy of prostate (BHP)?
* common after middle age in every male * median lobe becomes enlarged * projects into bladder and obstructs prostratic urethra * Symptoms * nocturia * dysuria * urgency * treatment: trans-urethral resection of prostate
16
What occurs during stage 1 of biosynthesis of thyroid hormones?
* Iodide trapping - influenced by TSH * movement of iodides from blood into thyroid cells and follicles * NaI symporters (NIS) * actively pump iodide into cytosol * Pendrin * counter transporter of iodide into colliod lumen for Cl-
16
What is the blood supply to the male bladder?
* Internal iliac artery * obturator artery * inferior gluteal artery * inferior vesical artery * prostatic venous plexus * superior vesical artery
17
What is the long term regulation of Ca2+ plasma levels?
* PTH * Calcitrol (active Vit D) * Calcitonin (CT)
18
How does the Calcium sensing receptor and Vit D help to regulate PTH release?
* in chief cells * If there is high plasma Ca2+ levels it inhibits PTH release * Vit D directly downregulates PTH synthesis * opposite increases PTH release
19
Where do most steroids bind to their receptor in cell?
* Steroid hormone diffuses straight into nucleus * binds to receptor in nucleus * results in activated dimer * dimer binds to HRE
20
What is congential hypothyroidism (cretinism)?
* extreme hypothyroidism during fetal life and infancy either from * lack of thyroid gland * iodine insufficiency * symptoms appear a few weeks after birth: sluggish movements, retarded physical and metal development * mental growth remains if not treated
22
How do osteoblasts work?
* synthesize bone * cells are signal nuclei but function as a group of connected cells to form a calcium and phosphate mineral base after the matrix has been laid down * Release RANK ligand that binds to RANK receptor on stem cells and osteoclast precursors to stimulate the activation of oxteoclasts
23
What are the secretory products of adrenal medulla?
* epi: norepi 4 to 1 * adrenal medula sole source of epinephrine * chromafin cells are modified postganglionic neurons * not esstential for survival as long as sympathetic nervous system is intact
25
Chronic Renal Failure Calcium? Phosphate? PTH? Alkaline phosphate? Treatment?
* Calcium: down * Phosphate: up * PTH: up * Alkaline phosphatase * Treatment * restore and maintain clacium levels * Vit D supplements * restrict phosphate
26
How does Deiodinase Type II work?
* Brain, pituitary, thyroid, skeletal and cardiac muscle * T4 to T3 * rT3 to T2 * major source for local production of T3 in tissues
26
How does thyroid hormone affect the CNS?
* maturation of CNS during perinatal period is completely dependent on thyroid hormones * cerebral and cellubular growth, myelinization, vascularization, axonal and dendritic density, cell migration and differentiation are all affected * generally excitatory effects * hyper: nervousness and psychoneurotic tendencies * hypo: lack of energy. slowness of speech, dulled mental capacity
27
What are the measurements of the male and female pelvis?
* male: \< 70º * female \>80º
29
What are the half lives of T3 and T4
* T3 has a shorter half life than T4 * T4 is 15 days * Binding proteins has a higher affinity for T4 is 10x higher than T3 * binding thyroid hormones of plasma proteins ensures a circulating reserve and delays their clearance
30
What are the three parts of the broad ligament?
* mesosalpinx - uterine tube * mesovarium - ovary * mesometrium - mesentry for the uterus itself
31
Where does unbound cortisol and aldosterone bind in the cell?
* binds to receptor in cytoplasm * cause the release of heat shock protein * creates activated dimer * dimer translocates into nucleus * binds to HRE on DNA
32
What are the bones in the bony pelvis?
* Ilium * Iliac crest 1 * Anterior superior iliac spine 2 * Greater siactic notch 3 * Ischium * Ischial spine 4 * Ischial tuberosity 5 * Lesser siatic notch * Pubis * pubic tubercle 7
33
What are the rapid changes used to change Ca2+ plasma levels?
* Protein bound Ca2+ * Exchange with bone
34
How is phosphorus absorbed in the kidneys?
* proximal tubule * 80% in transcellular * inhibited by PTH * Na cotransporter * distal tubule * 10% transcellular * Na cotransporter * 10% excreted
35
When Norepi or Epi bind to alpha-1, what G protein do they use?
* Gq to IP3/DAG/^ [Ca2+] * vasoconstriction
35
What is the blood supply to the prostate gland?
* inferior vesical * middle rectal * internal pudenal * prostatic venous plexus * continuous iwth vesical venous plexus
36
How is calcium stored in the body?
* Bones and teeth 99% * Extracellular fluid 0.1% where most of it is free * Intracellular fluid 0.9% most bound with a protein
38
What is the negative feedback of TSH?
* Thyroid hormones inhibit * TRH synthesis * gene expression for TSH and TRH receptor * TSH release
39
What are the two regions of the pelvis?
* Superior/greater (false) pelvis * Inferior/lesser (true) pelvis
40
What is secreted by the prostate gland?
* 20% of semen volume * Slightly acidic * zinc - stability of chromatin * citric acid - protection * acid phosphatase * prostate specifc antigen - liquefies semen * pro(fibrinolysin) - liquiefies coagulated semen
41
What are the symptoms of Cushing's syndrome?
* glucocorticorid excess * ^ hyperglycemia * ^ fat mobilization from lower body and redistribution to thorax and abdomen (buffalo torso) * moon face ( round and puffy) * weaknes, osteoporosis, striae on skin * androgen excess: acne, excess growth of facial hair in females
42
What is the cause of Conn's syndrome and what are the symptoms?
* Causes * small tumor on the zona glomerulosa that secretes large amounts of aldosterone * hyperplastic adrenal cortices secrete aldosterone rather than cortisol * Symptoms * hypokalemia * hypertension * low plasma renin
43
Why doesnt cortisol excert more effects on the kidneys becuase it can bind to minealocorticoid receptors with high affinity?
* renal epithelial cells contain 11beta-HSD2 * converts cortisol to cortisone * Cortisone doenst bind with such high affinity so cortisol doesnt exert significant amounts of mineralcorticoid effects
45
What does PTH stimulate?
* essential for life * Bone: directly stimulates osteoblasts which release cytokines to stimulate osteoclasts * bone resorption = increased [Ca2+] * Kidney: increase phosphate excretion and Ca2+ reabsorbtion * Intestine: Indirectly stimulates Vit D activation which increases absorption of Ca2+ from diet
46
What are the four parts of the uterine tube?
* infundibulum * ampulla * isthmus * uterine part
47
Where is the suspensory ligament of ovary?
* superolateral aspect of the ovary * contains ovarian vessels, lymphatics, and nerves * crosses the pelvic brim
48
What is pseudohyperaldosteronism?
* genetic deficiency of 11beta-HSD2 so cortisol can have substantial mineralcorticoid effects * ingestion of large amounts licorice can block 11beta-HSD2 activity
48
How does cortisol have anti-inflammatory effects?
* released during body stressful situations * rapid mobilization of AA and fats for energy and synthesis of compounds required for maintenance and prouduction of new cells * transrepression * inhibition of proinflammatory gene * transactivation * stimulation of anti-inflammatory gene
49
What are the properties of the nuclear steriod hormone receptor?
* contain * poorly conserved trans-activation domain * highly conserved DNA binding domain * ligand binding domain * once the hormone binds they have will bind to hormone response elements (HRE) on DNA * bind to DNA as homodimers * increase or decrease transcription
50
What are the peritoneal relections of the female pelvis?
* Down from anterior abdominal wall to the level of the pubic bone * superior surface of bladder * isthmus, fundus and body of uterus * extends over the fornix of vagina * makes the rectouterine pouch before going up to the rectum * covers anterior and lateral sides of super rectum * lateral sides of middle rectum * becomes sigmoid mesocolon at S3
52
Osteogenesis
* Bone disorder * decreased mineralization
52
What is Hasimotos disease?
* autoantibodies against thyroglobulin, TPO, TSH receptor * autoimmune thyroiditis and progressive deterioration and finally fibrous of gland so no thyroid hormone is produced * Low T3/4 but high TSH
54
What is calcium used in the body for?
* Nerve excitability * Transmiter release * Muscle Contraction * Enzyme cofactor * Bone
55
What does the vesical venous plexus do and what does it surround?
* Envelops * fundus of bladder * prostate * seminal glands * ductus deferens * inferior ureter * receives blood from deep dorsal vein of penis (drains erectile tissue) * mostly drains bladder through inferior vesical veins to internal iliac veins
56
Vitamin D intoxication Calcium? Phosphate? PTH? 24 hr urine calcium?
* Calcium: up * Phosphate: up * PTH: down * 24 hr urine calcium: up up up
57
How is calcium absorbed in the intestine?
* active absorption in duodenum and jejunum * passive absorption in the ileum
58
What is important clinical note about the ureter in the female?
* ureter passes under uterine artery * water under the bridge
59
What is the major end product of norepi and epi metabolism?
* Vanillylmandelic acid * inactivated products are conjugated with glucuronic acid and sulfates
60
How is phosphorus used in the body?
* phosphoproteins * buffering pH * DNA, RNA * Bone
61
What are the genomic effects of aldosterone?
* Purpose is to uptake Na+ and secondarily water * binds to receptor complex in the cytoplasm * ^ gene transcription of * enzymes (Na/K ATPase) * membrane transport proteins * effects are not immeidate, takes 45-60 mins for protein synthesis
62
What is the secretions from the bulbourethral gland?
* * galactose * mucus * pre-ejactulate * phosphate and bicarbonate
64
When TSH binds to thyroid cells, what genes are upregulated?
* Iodide pump * Thyroglobulin * Enzymes involved in T3 and T4 synthesis * NO synthase to increase blood flow * local growth factors to increase size and number of thyroid cells
65
Where is the round ligament of uterus?
* anteroinferior to uterotubal junction * will go through the deep inguinal ring * terminates at the labia majoris
66
What are the three stages epithelial thyroid cells size ?
* Synthesis of thyroglobulin - tall with microvilli * Resting - short and flat * Breakdown of thyroglobulin - scapploed edges
67
C19 is
* Androgens * Testosterone * DHEA (dihydroestosterone)
69
How does Deiodinase Type 1 work?
* Liver, Kidney, Thyroid * Catalyzes both outer and inner ring deionation * T4 to T3 * T4 to rT3 * T3 to T2 (inactive)
71
How does osteoprotegetrin work?
* Stops the RANK ligand from activating osteoclast precursors
72
What is the secretion made by the seminal glands?
* 60% of secretions * Alkaline fluild containing * fructose - nutrition * prostaglandins - motility and protection * fibrinogen - clotting, keeps semen inside female productive tract
73
What are the degrees of uterine prolapse?
* 1st - cervix still inside vagina * 2nd - cervix appears outside vulva * 3rd - complete prolapse
74
What are the structural properties of the uterine tube?
* 10 cm long, usually site of fertilization * lie in mesosalphix * fimbriae ideally arch anterior and superior to ovaries
76
How is phosphorus tansported in the small intestine?
* Sodium/phosphorus co-transporter * Unsure how phosphorus gets out * Sodium concentration maintained by Na+/K+ antiporter on basolateral side
77
How does Diodinase Type III work?
* Brain, placenta, fetal tissues * placental protection of fetus to reduce flow of T3 to fetus * Adult Brain: protective mechanism against high thyroid hormone concentrations * has only inner ring deiodination activity * T3 to rT3
78
What is the blood supply to the rectum?
* rectal arteries * Superior - IMA * Middle - Anterior division of Internal iliac * Inferior - Internal pudendal artery * connection between the portal and caval system
79
What are the non-genomic effects of TSH binding to a cell?
* increases cAMP * increases proteolysis of thyroglobulin to increase T3 and T4 * increases iodide pump activity to increase iodide trapping
80
What is the major effect of Vitamin D?
* activated in the kidneys, travels to the intestine * stimulates Ca2+ and phosphate from intestinal lumen * increases transcription of Ca pump molecules and calbindins
80
How are glucocorticoids released?
* CRH, ACTH, and cortisol secretion are high in the early morning and then steadily decrease throughout the day * release is pulsatile
80
What are the parts of the male urethra?
* Preprostatic part * prostatic part * membranous part * spongy part
81
What is secondary hyperthyroidism?
* TSH secreting pituitary adenomas resulting in high TSH, T3/4
82
How are catecholamines released?
* ACh released from preganglionic sympathetic * ACh binds to nicotinic receptors * Na+ influx into cell * Depolarization * ^ [Ca2+] * exocytosis of neurosecretory granules
83
What is the blood supply to the uterus?
* mostly from uterine arteries * anatomoses from the ovarian artery from above * will supply placenta * uterine veins go with arteries and form venous plexus * drains into internal iliac veins
84
How is calcium reabsorbed in the kidneys?
* Proximal tubule * 70% mainly paracellular * ascending tubule, distal and collecting tubule * transcellular * influenced by PTH
85
When norepi or epi bind to alpha-2 what g protein use?
* Gi inhibits cAMP * decreases Norepi release
85
What are the 4 lobes of the prostate?
* Anterior lobe * Posterior lobe * Lateral (or right and left) - on both sides of the urethra * Median lobe
86
What is the transverse cervical (cardinal) ligaments?
* extends from supravaginal part of cervix to lateral walls of pelvis * primary support of cervix
87
What is the broad ligament?
* double layer of peritoneum * extends from sides of uterus to lateral walls of abdomen to floor of pelvis * keeps uterus in position
89
What are the main actions of androgens in the body?
* Normally only weak effects in humans * may contribute to early dvelopement of male sex organs * Females: growth of pubic and axillary hair in females * Males: in testes adrenal androgens converted to testosterone
90
What are the possible causes of hypothyroidism?
* Hasimotos disease * Endemic collid goiter * Congential hypothyroidism (cretinism) * Inherited defects of hormone synthesis * Treatments of hyperthyroidsm * Thyroid surgery and radiation therapy
91
C18 is
* Estradiol * Aromatic A ring points up (receptor recognition)
92
What is the arterial supply in the female bladder?
* superior vesical arteries * anterosuperior bladder * vaginal arteries * fundus and neck * obturator
93
What are the affects of cortisol on protein metabolism?
* decreases protein stores in all body cells (except liver) * decreases protein synthesis * ^ protein catabolism * ^ liver and plasma proteins * ^ liver enzymes for protein synthesis that will be used for protein catabolism * ^ blood AA * ^ available AA for the liver to turn into glucose
94
95
What is the blood supply to the ureter?
* it receives branches from * renal arteries * aorta * gonadal vessels * common iliac artery * super and inferior vesical arteries * note: vaginal artery instead of inferior vesical artery in females * venous drainage mostly parallels
96
When norepi and epi bind to Beta 1 and 2 what G protein?
* Gs increase cAMP * increases contractility, conduction, velocity * sm vasodilation
97
What occurs during stage 5 of biosynthesis of thyroid hormones?
* 75% of iodinated tyrosine in thyroglobulin never becomes T3 or T4 * digested MIT and DIT are freed into cytosol of the thyroid cell * Iodine is cleaved from MIT and DIT by **deiodinase enzyme** and recycled
98
Osteoporosis
* Bone disorder * decreased osteoid and mineral
100
What drugs stimulate osteoblasts?
* Denosumab (increases RANK ligand) * Teriparatide (mimics PTH)
102
What is the biosynthesis and storage of catecholamines?
* Catecholamines are synthesized in chromaffin cells * synthesized from tyrosine * Stored in electron dense chromaffin granules at very high concentrations * Granules contain ATP and ADP and severl neuropeptides
103
What are the causes of uterine prolapse?
* weakness of pelvic floor muscles and/or ligaments * more common with multiple vaginal births * other causes * normal aging * lack of estrogen after menopause * anything thats puts pressure on pelvic msucles * retroversion
104
What mineralocorticoid has the most activity?
* aldosterone * very potent 90% of all mineralcorticoid activity * coritsol has slight mineralocorticoid activity and is not as potent as aldosterone but has 2000x higher plasma concetration
106
How much calcium is excreted from the urine?
* 150 mg/day
108
How does thyroid hormones effect the heart?
* Increases SV * because of up metabolism and O2 consumption * increased contractility * increases HR * T3 increases expression of beta adrenergic receptors
109
What is the cause of adrenogenital syndrome and what are the symptoms?
* Cause * adrenocortical tumor secreting excessive quantities of androgens * Symptoms * Females - masculinization of hair, voice, growth of clitoris, masculine appearance in skin and muscle * Males - repid development of sexual organs in prepubertal males * Diagnosis * levels of 17-ketosteroids in urine
111
What abnormalities could lead to colloid goiter?
* deficient * iodide trapping mechanism * TPO * coupling of iodinated tyrosines * deiodinase enzyme
112
What are the parts of the uterus?
* Body * fundus most superior part * isthmus is where is uterus becomes narrow before forming the cervix * Cervix * supravaginal (btwn isthmus and vagina) * vaginal (part protrudes into vagina) * external ox is mostly fibrous
114
How are adrenal medullary hormones transported?
* most circulate in blood bound to albumin * T1/2 of circulating catecholamines is very short (10 sec to 1.7 mins)
115
What is cushing's syndrome? What are the possible causes?
* signs and symptoms related to prolonged exposure to inappropriately high levels of cortisol * causes * Hypersecretion of CRH or ACTH - Cushing's disease * adrenal cortex adenomas * ectopic secretion of ACTH
117
What are the effects of excess aldosterone?
* loss of K+ from ECF into urine = hypokalemia * muscle weakness and cramping * ^ tubular H+ secretion = metabolic alkalosis
119
What drugs block osteoclasts?
* Bisphosphates * calcitonin * Estrogen
120
What is the role of the parathyroid hormone (PTH)?
* role is to regulate the concentration of Ca2+ in the extracellular fluid * PTH is stimulated when [Ca2+] is low * stored in the parathyroid gland
121
Besides the kidneys, where else does aldosterone target?
* sweat glands * conserves body salts in hot environments * Salivary glands * conserves salt when excesive quantities of saliva are lost * intestinal epithelial glands * prevents loss of Na in stool
122
How does Thyroid hormone affect lipid metabolism?
* lipids are quickly mobilized from fat tissue adn decreases fat stores * Decreases plasma cholesterol by increasing LDL receptors on liver
123
What is prostatic carcinoma?
* most common cancer among men * usually in posterior lobe * prostatic venous plexus anatomoses with vertebral venous plexus * symptoms * blood in urine * back pain * numbness
124
What is the normal position of the uterus?
* normally * anteverted (90º with respect to vagina) * anteflexed 170º with respect to cervix
125
What is the metabolism of adrenal medullary hormones?
* 3 possible fates * Reuptake by extraneuronal sites * Degradation at target cells by COMT or MAO * Direct filtration into urine
126
What supports the bladder?
* puboprostatic (male) pubovesical (female) ligaments * pubic bones * perineal membrane and associated muscles * levator ani
127
What are the anti-inflammatory effects of high levels of cortisol?
* stabilizes lysosomal membranes - keeps proteolytic enzymes inside lysosomes * decrease permeability of capillaries * decrease migration of WBC * prevents phagocytosis of damaged cells to decrease formation of prostaglandins adn leukotrienes * suppresses immune system - decreases production of T lymphocytes * decrease fever
128
How is phosphorus stored in the body?
* Bones and teeth 86% * Extracellular 0.08% * Intracellular 14%
129
Primary Hyperparathyroidism Calcium? Phosphate? PTH? 24 hour urine calcium?
in most cases people have a benign tumor called adenoma * Calcium: up * phosphate: down * PTH: up * 24 hr urine calcium: up Treatment - remove tumor
129
Why is there an increased vitamin requirement for thyroid hormones?
* thyroid hormone increases the amount of enzymes which require a number of vitamins * can have a vitamin defiency with hyperthyrtoidism
131
What is the route of sperm?
* made in testis goes into epididymis and ductus deferens to be stored * during emissionsperm up ductus deferens to ampulla * join with secretions from seminal gland in ejaculatory duct * more secretions from prostate and bulbourethral glands * sperm ejactuated by urethra
132
Pseudohypoparathyroidism Calcium? Phosphate? PTH? Alkaline phosphate?
* Calcium: down * Phosphate: up * PTH: up * Alkaline phosphatase: no change
133
What is the non-genomic effect of aldosterone?
* activation of second messenger system * ^ H+ secretion and bicarbonate retention * faster
135
How does cortisol effect carbohydrate metabolism?
* stimulates gluconeogenesis * ^ enzymes required to breakdown AA into glucose * decreases glucose utilization by cells * ^ storage of glucose as glycogen in liver cells * elevates blood glucose concentration * stimulates insulin
136
How does thyroid hormone affect the skeletal system?
* thyroid hormone is required fro attainment of normal stature and bone maturation * necessary for normal growth in children
137
How are adrenocortical hormones transported?
* Bound to plasma proteins and free form * binds to corticosteroid binding globulin (CBG) and albumin * 90-95% of cortisol is bound T1/2 = 60-90 min * 60% of aldosterone is bound T1/2 20 min
138
What is peritonitis?
* an inflammation of the peritoneum * may result from build up of fluid or infection * left untreated, sepsis
139
What are the measurements of the pelvis?
140
C21 is
* Progesterone * Aldosterone * Cortisol
141
What occurs during stage 2 of biosynthesis of thyroid hormones?
* Formation and secretion of thyroglobulin * ER and golgi synthesize and secrete thyroglobulin into follicular colloid * each thyroglobulin molecule is glycosylated and has 140 tyrosine AA, some combine with iodine * thyroid hormone forms within the thyroglobulin molecule
143
Osteopetrosis
* bone disorder * increased osteoid and mineral
144
What is the pathway activated by the hormone to activate steroid hormone synthesis?
* hormone \> adenylate cyclase \> cAMP \> PKA \> ^cholesterol easterase to cholesterol \> transported to the mito through StAR protein * in mito * side chain cleavd off cholesterol \> pregnenotone \> synthetic pathway in cytosol \> sent back into mito for modification \> steriod hormone diffuses out of cell
145
Hypoparathyroidism Calcium? Phosphate? PTH? Alkaline phosphate?
* Calcium: down * Phosphate: up * PTH: down * Alkaline phosphatase: no change
146
Where is the Pouch of Douglas and what can happen to it? How is it treated?
* lies behind posterior fornix of vagina * susceptible to injury (illegal abortion) or collection of fluids * **culdocentesis** extraction of fluid from pouch of douglas via posterior fornix of vagina
147
How to osteoclasts work?
* resorbs bone tissue * critical for maintenance, repair, and remodeling of bones * form from macrophage precursors * stimulated by the RANK ligand secreted by osteoblasts
148
What are the effects of cortisol on fat metabolism?
* promotes mobilization of FA from adipose tissue * ^ FFA to be used for energy * enhances beta oxidation of FA in cells * important factor for long term conservation of body glucose and glycogen
149
What ducts open into the urethra?
* prostatic ducts * seminal colliculus * prostatic utricle * opening of ejaculatory duct * opening of bulbourethral duct
150
What occurs during stage 3 during biosynthesis of thyroid hormones?
* Oxidation of iodide and coupling of iodine with tyroglobulin * thyroperoxidase (TPO) * oxidizes iodine * adding iodine to tyrosine * coupling of iodothyrosine residues * thyroglobulin in colloid acts as a storage form of thyroid hormones
151
What anterior pituitary hormones regulate steroid hormone production? What second messenger do they use?
* FSH - cAMP * LH - cAMP * TSH - cAMP * ACTH * Cortisol - cAMP, phosphoinositol * Aldosterone - phosphoinositol
152
What are the structural differences of the male pelvis?
* iliac wings less flattened * smaller tranverse diameter of pelvic inlet * Ischial tuberosities are inverted * taller pubic symphysis * narrower pubic arch * heart shaped inlet (female - oval) * more curved sacrum * narrower interpubic disc

Block 3 (8 decks)

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