Ageing and endocrine manipulation

Question 1

elderly patients have a disproportionately higher prevalence of endocrine and metabolic dysfunction. which are they?

Answer 1

• hypopituitarism
• hypothyroidism
• osteoporosis
• Type 2 diabetes
• adrenal insufficiency
• hypogonadism
• endocrine malignancies

Question 2

which hormones are used in hormone replacement therapy

Answer 2

• insulin (type 1 and insulin-dependent type 2 diabetes)
• estrogen and estrogen/progesterone (reduce symptoms of menopause)
• growth hormone or IGF-1
• thyroid hormone: levothyroxine L-T4

Question 3

why do we refer to biexponential model of decline in follicular numbers

Answer 3

• follicular waves starting in utero eventually reduces oocyte pool to about 25 000 by the age of 37.5 years
• rate of follicular atresia increases until 51

Question 4

why do we prefer giving progesterone and estrogen as HRT for perimenopausal women rather than estrogen alone?

Answer 4

estrogen may help in controlling symptoms associated with menopause however, estrogen alone may increase the risk of endometrial and breast cancer
progesterone promotes conversion of estradiol to estrone in target cells where estrone has a lower affinity to estrogen receptors and thus may diminish cancer risk

Question 5

is it beneficial to use testosterone in HRT for men

Answer 5

testosterone has been used in HRT but whether it really improves quality of life and improvement is not very clear (bone mineral density/walking distance is the same for treated and placebo although there was a significant increase in lean mass and decrease in fat mass)

Question 6

to measure GH levels, we measure ____

Answer 6

IGF-1

Question 7

definition of doping

Answer 7

the use and abuse of performance enhancing substances in elite sport

Question 8

how does caffeine exert its effects as a stimulant

Answer 8

• increase in cAMP by inhibition of phosphodiesterase
• translocation of calcium for more neuromuscular availability
  => enhanced nervous (mood) and cardiovascular functions, beneficial for endurance events

Question 9

what are the legal limits of caffeine

Answer 9

15 microgram/mL -> 6-8 cups of coffee at one sitting

Question 10

what is the mechanism of action of beta-blockers, and why is it of interest

Answer 10

beta-blockers are considered relaxants, they block the beta receptor in cardiac muscle, reducing anxiety, jitters and slows the heart rate which could occur during heightened arousal where episode/norepinephrine are produced
=> commonly used in sports that require a steady hand

Question 11

injection of GH or IGF (direct manipulation) or stimulation of GH axis by GHRH, vasopressin (indirect manipulation) is banned by NCAA dn IOC. true or flase

Answer 11

true!

Question 12

what are the side effects of human growth hormone injection/stimulation

Answer 12

• acromegaly
• peripheral neuropathy
• coronary artery disease and cardiomyopathy
• diabetes, hypothyroidism and arthritis

Question 13

what is erythropoietin

Answer 13

EPO is a hormone released by the kidneys in response to low hematocrit (blood cell volume)

Question 14

what are the effects of erythropoietin

Answer 14

it stimulates RBC production from bone marrow and increase hematocrit

Question 15

why would erythropoietin be used as a doping agent?

Answer 15

endurance athletes use of it to increase oxygen carrying capacity by daily injection of EPO

Question 16

what is another technique that has the same effect as taking EPO

Answer 16

induced erythocythemia: re-transfusion of your own blood 1-7 days before event which increases Hb and increases the oxygen-carrying capacity

Question 17

what is the mechanism behind gene dopig

Answer 17

injection of plasmids expressing various genes including GH, IGF into muscle fibres -> increases levels in these and non-detectable