Chem Unit 4 Flashcards
1
Q
What is the definition of hormone?
A
A regulatory substance produced and transported in the body to stimulate specific cells or tissues.
2
Q
What is the definition of Endocrine?
A
An enzyme or hormone that acts inside the body.
3
Q
What is the definition of Exocrine?
A
An enzyme or hormone that acts outside of the body.
4
Q
What is the definition of Tropic Hormone?
A
Hormone which causes the cell to secrete another hormone.
5
Q
What is the definition of Trophic Hormone?
A
Hormone which causes a direct effect on the cell.
6
Q
What is a hormone with Diurnal variation?
A
The concentration of hormone varies throughout the day.
7
Q
What is a hormone bound to that makes it inacitve?
A
A protein
8
Q
What are steroid hormones derived from?
A
Cholesterol
9
Q
What hormones are hydrophobic?
A
Steroid hormones
10
Q
Where do steroid hormones bind to elicit a response?
A
Nucleus of the cell
11
Q
How do Polypeptide hormones elicit a response?
A
They bind to a membrane-bound receptor and then use a second messenger system.
12
Q
What hormones are hydrophilic
A
Polypeptide and Amino Acid hormones
13
Q
Thyroxine is what type of hormone?
A
Amino Acid
14
Q
Cortisol is what type of hormone?
A
Steroid
15
Q
PTH is what type of hormone?
A
Polypeptide
16
Q
Epinephrine is what type of hormone?
A
Amino Acid
17
Q
Estrogen is what type of hormone?
A
Steroid
18
Q
Serotonin is what type of hormone?
A
Amino Acid
19
Q
What are the 2 ways hormones are regulated?
A
Positive or Negative feedback loop
20
Q
What does the positive feedback loop do?
A
Tells the body to accentuate the process, which, in turn, creates more of the message.
21
Q
What are 2 most common processes that use the positive feedback loop?
A
Childbirth
Clotting
22
Q
What are the steps in negative feedback loop?
A
Homeostasis
Abnormal variable
Detected by a sensor
Activates an effector
Homeostasis is regained
23
Q
What produces Thyroglobulin?
A
Follicular cells in the thyroid
24
Q
What happens to Thyroglobulin in the colloid matrix?
A
Iodinated and conjugated into T3 and T4
25
What is the predominant form of thyroid hormone secreted by follicular cells?
T4
26
What are test results for Primary Hypothyroidism?
TSH: High
T4: Low
T3: Low
27
What are test results for Secondary Hypothyroidism?
TSH: Low
T4: Low
T3: Low
28
Primary Hypothyroidism is a problem with what?
Thyroid
29
Secondary Hypothyroidism is a problem with what?
Pituitary gland
30
Hashimoto is what Thyroid Pathology?
Primary Hypothyroidism
31
What are the test results for Primary Hyperthyroidism?
TSH: Low
T4: High
T3: High
32
What are the test results for Secondary Hyperthyroidism?
TSH: High
T4: High
T3: High
33
Graves Disease is what Thyroid pathology?
Thyroid
34
Pituitary adenoma can cause?
Secondary Hyper and Hypo Thyroidism
35
Thyroid hormone is primary bound to what?
Transthyretin
TBG
Albumin
36
What does the thyroid gland primarily produce?
T4
37
How is T3 produced
Deiodination in the peripheral tissues
38
Metabolically active T3 and T4 are what?
Free fraction (not protein bound)
39
What happens in Graves Disease?
Thyroid Stimulating Immunoglobulins which bind and activate the TSH Receptor ----> Increases T4 secretion
40
What causes Hashimoto Thyroiditis
Thyroglobulin and TPO antibodies
41
What can cause Non-thyroidal Illness
Stress on the body
Trauma
Surgery
Malignancy
42
What is the result from Non-thyroidal Illness
Decrease in TSH secretion and subsequently low T3 and T4 without any antibodies
43
When do we see Non-Thryroidal Illness (NTI)
Chronic disease states where the body is either repairing itself or fighting something
44
Symptoms of Hyperthyroidism
Anxiety/Nervousness
Tremors
Sweating
Heat Intolerance
Hyperactivity
Palpitations
45
Symptoms of Hypothyroidism
Lethargy/Stupor
Weight gain
Dry Skin
Cold Intolerance
Hair loss
Bradycardia
46
What controls Cortisol?
Hypothalamic-Pituitary-Adrenal Axis
47
What are the Cortisol pathologies?
Addison Disease
Cushing Syndrome
48
What disease state has ACTH present but the adrenal glands don't secrete enough Cortisol
Addison Disease
49
What is the Primary Adrenal Insufficiency
Addison Disease
50
What disease state hyper secretes cortisol but ACTH is low
Cushing Syndrome
51
Cholesterol is the precursor to?
Testosterone
Aldosterone
Cortisol
52
How is Cushing Disease different than Cushing Syndrome?
Disease has a pituitary tumor that produces ACTH while syndrome refers to the symptoms caused by an increase in Cortisol.
53
Hypercortisolism symptoms
Buffalo hump
hypertension
poor wound healing
Striae (reddish-looking stretch marks)
54
What is Conn Syndrome
Primary Hyperaldosteronism
55
What causes Conn Syndrome
Primary adrenal tumor hypersecreting unregulated aldosterone.
*causes salt and fluid retention in the kidneys ---> hypertension
56
What is Pheochromocytoma
Tissue that over produces catecholamines which increases the levels of dopamine, epinephrine, and norepinephrine
57
Where is Pheochromocytoma found
Neurochromaffin cells of the adrenal medulla
**low rate of malignancy
58
What is Neuroblastoma
tissue that over produces catecholamines
59
How is Neuroblastoma different than Pheochromocytoma
It is a malignant neoplasm that is found in the neural crest tissue anywhere in the body
60
How many hormones are deficient in hypopituitarism
Only one
61
How many hormones are deficient in panhypopituitarism
All pituitary hormones are low
62
Trophic hormones from the Anterior Pituitary gland
Gh
Prolactin
63
Tropic hormones from the Anterior Pituitary gland
TSH
ACTH
LH
FSH
64
Hormones released from the Posterior Pituitary gland
Oxytocin
ADH
65
What is Diabetes Insipidus
ADH deficiency causes an increased loss of free water resulting in an extremely high plasma osmolarity.
66
What is Nephrogenic Diabetes Insipidus
Adequate ADH present, but the kidney does not respond
67
What is Central Diabetes Insipidus
Complete lack of ADH production
68
What hormones are secreted in stress
Cortisol
Catecholamines
Vasopressin
Prolactin
69
What detects all Thyroid Hormone, Bound and unbound
TT3
TT4
70
What only detects unbound Thyroid Hormone
FT3
FT4
71
What detects the protein that primarily binds to Thyroid Hormone
TBG
72
What is the cortisol test for?
Evaluate the total cortisol in the blood, bound and unbound
73
What is the Free cortisol test for?
Evaluates only the unbound fraction of cortisol in the blood
74
What is the DHEA-S test for?
Evaluates the natural byproduct of adrenal testosterone production
75
What is the ACTH test for?
Evaluates the concentration of the corticotropic hormone ACTH
76
What is the Dexamethasone Suppression test used for?
Evaluate the negative feedback loop to ensure there is no unregulated secretion of cortisol.
77
What is the Metyrapone test for?
Metyrapone blocks the conversion of 11-deoxycortisol to cortisol by inhibiting 11-Beta-hydroxylase.
*results in elevated 11-beta-hydroxylase and decreased cortisol levels overnight.
78
What is Vanillylmandelic acid (VMA) test used for?
To diagnose pheochromocytoma
79
What is the Catecholamines test used for?
Dopamine, Epinephrine, and norepinephrine are used to diagnose phoechromocytoma
80
What are the 2 markers used to diagnose carcinoid tumors
5-hydroxy-indole-acetic acid (5-HIAA)
Chromogranin A (CgA)
81
What is 5-HIAA derived from?
Serotonin
82
What does the LH spike correlate with?
Ovulation and a spike of estrogen
83
After menopause, what does the hypothalamus release to replace estrogen and progesterone?
GnRH
84
What does GnRH do?
tells anterior pituitary to secrete FSH and LH
85
What is competitive Ab binding assay
labeled Ag competes with a patient Ag for Ab binding sites
86
What is Direct ELISA
1 Ab
1st Ab bound to solid phase and 1 epitope of the Ag of interest. Ab is labeled. DIRECTLY assessing the Ag
87
What is Indirect ELISA
2 Ab
1st Ab is what we are interested in.
INDIRECTLY assesses Ag
88
How does Sandwich Assay work
1. primary Ab bind to target substrate and a solid phase
2. wash
3. Labeled 2nd Ab
4. detection of signal in sample
89
What is the posterior pituitary gland made up of
Neural tissue
*extension of neurons from hypothalamus
90
What are the gonadotropins?
FSH
LH
91
What happens during the follicular phase?
-FSH stimulates growth of several follicles
-Dominant follicle secretes estrogen
-Estrogen inhibits growth of other follicles (&FSH)
-Estrogen stimulates development of endometrium
92
What happens during ovulation
-A surge in LH causes egg to release
- rupturing of follicle creates corpus luteum
93
What happens in Luteal phase
-Corpus luteum secretes progesterone
-progesterone stimulates development of endometrium
-estrogen and progesterone inhibit FSH and LH
-Corpus luteum degrades which drops progesterone
-Without progesterone endometrium is sloughed away
94
What happens in tertiary hypothyroidism
Problem is in the hypothalamus so TRH is not being secreted resulting in low TSH, T3, T4
95
In Grave's disease what is the result for TSH Receptor Ab?
Hallmark Posititve
96
In Grave's disease what is the result for TPO Ab?
Usually positive
97
In Grave's disease what is the result for Tg Ab?
usually negative
98
In Hashimoto's disease what is the result for TSH Receptor Ab
usually negative
99
In Hashimoto's disease what is the result for TPO Ab
hallmark Positive
100
In Hashimoto's disease what is the result for TG Ab
usually positive
101
What does an enzyme bind to and changes it
A substrate
102
What is the definition of an enzyme
A protein that decreases the activation energy of a reaction
103
What is the definition of a catalyst
any substance that increases the reaction rate without being permanently changed
104
what is an apoenzyme
an inactive enzyme without its cofactor
105
what is an active site
the specific location on an enzyme where the reaction takes place
106
What is a substrate
the substance that is used up in the reaction
107
what is a product
the substance that is formed in the reaction
108
What is an inhibitor
a substance that prevents tor inhibits a reaction taking place
109
what is kinetic assay
the change of absorbance is measured on a spectrophotometer to assess the reaction rate
110
What is endpoint assay
the change in absorbance is measured at the end of the reaction
111
What is international unit
a unit of activity or potency for many substances defined individually in terms of the activity of a standard solution
112
What is Vmax
the maximum velocity of an enzymatic reaction
113
what is Km
the concentration of substrate which allows the enzyme to achieve half Vmax
114
What is activation energy
the energy required to get the reaction started.
115
What is first order reaction
the reaction rate is dependent upon substrate and enzyme concentration
116
what is zero order reaction
the reaction rate is constant and dependent upon only the enzyme concentration
117
What are cofactors
inorganic and organic compounds that are required for full enzyme function
118
What is Coenzyme
Organic cofactors that commonly have a structure similar to vitamins
119
What is Prosthetic groups
coenzymes covalently bound to an enzyme
120
What is holoenzyme
is the apoenzyme and coenzyme in one catalytically active unit
121
what is metalloenzyme
enzymes that have a metallic ion in them
122
What is a 1:1 relationship between substrate an velocity
First Order Kinetics
123
What is the Michaelis constant
the substrate concentration at which the reaction rate is half of Vmax
124
What is the reaction equation.
V =
Vmax [S] /
[S] + Km
125
What is happening in zero order reactions
All active sites are occupied so the speed of the reaction can not increase any further with more substrate
126
Where does LD-1 have an effect
Heart
RBCs
Kidney
127
Where does LD-2 have an effect
Lungs
RBCs
128
Where does LD-3 have an effect
Spleen
Lung
many tissues
129
Where does LD-4 have an effect
Liver
Skeleton
130
Where does LD-5 have an effect
Liver
Skeleton
131
What is the Order of the 5 LD isoenzymes
LD2>LD1>LD3>LD4>LD5
132
What does lactate dehydrogenase do
Catalyzes the conversion of L-lactate to pyruvate and NADH
133
What are the 2 methodologies for LD
Wacker
Wroblewski and LaDue
134
If LD1>LD2 what does that indicate
MI
Shock
Myocarditis
CHF
135
When does LD peak
48-72 hours
136
How long does LD stay elevated
7-14 days
137
What does LD5>LD4 indicate
Liver disease
138
How does hemolysis effect LD
Causes a gigantic spike
139
What does freezing do to LD
All activity is lost
140
What is the reference range for CK
Male: 52-236
Female: 38-176
141
What is the stability of CK
Light sensitive
RT for 4 hours
48 hours fridge
1 month frozen
142
Where is CK found
Brain
Heart
muscles
143
When does CK-MB peak
24 hours
144
CK-MM is elevated in what conditions
Duchenne muscular dystrophy
seizures
trauma
extreme exercise
145
When is CK-BB elevated
Brain injury
146
What are the CK isoenzyme methodologies
Immunoinhibition
Mass assay
147
If CK-MB is >6% of the total CK what does that indicate
Myocardial Infarction
148
How do we measure AST
Karmen Method
149
Where is AST primarily found
Cytoplasm of cells
150
Where is AST present
RBC
Heart
Liver
Skeletal muscle
Kidney
151
What enzyme is the most sensitive to alcoholic injury
AST
152
What does AST stand for
Asparate Aminotransferase
153
What is the reference range for AST
5-30
154
What does ALT stand for
Alanine Aminotransferase
155
How do we measure ALT
Wroblewski and LaDue method
156
What is used in ALT methodology to indicate the reaction
Lactate Dehydrogenase
157
Where is ALT primarily found
Cytoplasm of cells
158
What is ALT most specific for
Liver
159
What is the reference range for ALT
6-37
160
What is the DeRitis Ratio
AST/ALT ratio
161
DeRitis Ratio >2 means
Alcoholic liver disease
162
DeRitis Ratio <1 means
Other hepatitides
163
What enzyme is used to differentiate hepatobilliary tract disorders
GGT
164
Where is GGT primarily found
Biliary tract
Liver
Kidney
Pancreas
Large and Small intestine
165
What does GGT stand for
Gamma Glutamyl Transferase
166
What tissue has the highest concentration of ACP
Prostate
167
ACP has a very high intracellular concentration in what?
RBCs
168
What is used in forensic rape testing
ACP
169
What will inhibit Prostate ACP
Tartrate
170
Most ACP in serum is from what?
Osteoclasts
171
What does amylase do
catalyzes the hydrolysis of starches
172
What are the 2 types of amylase in humans
Salivary
Pancreatic
173
What is amylase increased in?
Pancreatitis
Alcoholism
Parotitis
174
What is a very sensitive marker for pancreatitis
Amylase
175
What activates pancreatic amylase in gastric acid
chloride
176
What is the role of Lipase
Hydrolyzes glycerol esters
177
What stabilizes droplets of fat while they are being digested by pancreatic lipase
Bile salts
178
What is lipase a specific marker for?
Pancreatitis
179
What cells produce lipase
Pancreatic acinar cells
180
When does lipase peak
after 24 hours then stays elevated for 8-14 days
181
What are the lipase methodologies
Turbimetric assay
Enzymatic assay
182
What is the stability for lipase
RT for 1 week
Fridge 3 weeks
Frozen for years
183
Where is Cholinesterase primarily located
RBC
Lungs
Spleen
CNS
184
What deficiency can cause a patient under anesthesia to stay paralyzed for longer than intended
CHE (Cholinesterase)
185
What is the reference range for CHE
Men 40-78
Women 33-76
186
How is CHE measured
5-MNBA at 410 nm
187
Test that measure hepatocyte integrity
AST
ALT
188
Tests that measure hepatocyte function
PT/PTT
Serum Albumin
189
Tests that access biliary tract
GGT
ALP
5-'NT
190
What is the methodology for Alkaline Phosphatase
Bowers and McComb Reaction
191
Reference range for ALP
44-147
191
Where is ALP found
Bone
Biliary tract
placenta
192
What is the optimal Ph for ALP
9-10
193
What enzyme is associated with gallstones
ALP
194
If ALP is refrigerated what happens to it
activity is decreased
195
ACP + ALP =
hepatobiliary disorder
196
When is 5-'NT useful
When ALP is elevated to determine the source of elevation
197
What is ALP associated with
Lung
Colon
Ovarian
Breast
Uterine cancers
lymphomas
198
What is ACP associated with?
Prostate cancer
199
Enzymes useful in diagnosis of pancreatitis
Amylase
Lipase
200
Fecal chymotrypsin is a diagnostic tool for what?
Exocrine pancreatic insufficiency
201
As Chymotrypsin levels increase, what decreases
Pancreatic enzymes
202
Enzymes that are skewed by hemolysis
ACP
AST
LD
