endo Flashcards
layers of adrenal Cx
GFR, the deeper you go the sweeter it gets
what is the most common adrenal medulla tumor in adults?
pheo
what is the most common adrenal medulla tumor in kids?
neuroblastoma
ant pit
adenohypophysis FLAT-PiG FSH LH ACTH TSH Prolactin GH
which ant pit hormones are acidophils
GH and prolactin
which ant pit hormones are basophils?
B-FLAT basophils FSH LH ACTH TSH
what is ant pit derived from
Rathke pouch - oral ectoderm
intermediate lobe of pit
grouped w/ant
secreted MSH
post pit
neurohypophysis
vasopressein/ADH (from supraoptic)
oxytocin (from paraventricular)
what is post pit derived from?
neuroectoderm
endocrine pancreas cells
alpha- glucagon (peripheral)
beta- insulin (central)
delat- somatostatin
insulin sysnthesis
preproinsulin synth in RER
cleavage -> proinsulin
cleavage -> exo of both insulin and C-peptide
insulin R
tyrosine kinase -> increased PI3 and RAS/MAP for TFs
insulin effects
increased glucose into mm and adipose increase glyocogen synth increased TG synth increased Na retention increaed protein synth increased cellular uptake of K and aa decreased glucagon does not cross placenta
GLUT-4
adipose and striated mm
insulin dependent
exercise increases expression
GLUT-1
RBCs, brain, cornea
insulin independent
GLUT-2
beta cells liver kidney small intestines bidirectional insulin independent
GLUT-3
brain
insulin independent
GLUT-5
spermatocytes
GI
fructose
insulin independent
what inhibits glucagon
insulin
hyperglycemia
somatostatin
CRH overview
increases ACTH, MSH, and beta-endorphin
decreased in chronic exogenous steroid use
Dopamine overview
decreases prolactin
dopamine antagonists can cause galactorhea
GHRN overview
increased GH
analog (Tesaorelin) used to Tx HIV-associated lipodystrophy
GnRH overview
increased FSH, LH
regulated by porlactin
tonic GnRH supresses HPA
pulsatile causes puberty and fertility
Prolactin overview
decreased GnRH
pit prolactinoma -> amenorrhea, osteoporosis, hypogonadism, galactorhea
somatostatin overview
decreased GH, TSH
analogs used to Tx acromegaly
TRH overview
increased TSH, prolactin
prolactin fnx
secreted from ant pit
stimulates milk production
inhibitis ovulation and permatogenesis by inhibiting GnRH
excessive amounts decrease libido
regulation of prolactin
tonically inhibited by dopamine from hypothalamus
prolactin inhibits itself by increases dopamine
TRH increases prolactin
dopamine agonists
bromocriptine
inhibits prolactin secretion
dopamine antagonists
antiphyschotics and Estrogens
stimulate prolactin secretion
GH aka
somatotropin
GH fnx
ant pit
stimulates linear growth and mm mass via IGF-1 (somatomedin C)
increased insulin resistance
regulation of GH
pulses in response to GHRH
secretion increased during exercise and sleep
inhibited by glucose and somatostatin
ghrelin
stimulates hunger (orexigenic effect) and GH release
produced by stomach
increased w/sleep loss and Prader-Willi syndrome
leptin
satiety hormone
produced by adipose
mutation -> congenital obesity
sleep deprivation -> increased leptin
ADH fnx
synth by hypothalamus supraoptic nuclei released by post pit regulates serum osmolarity via V2Rs regulated BP via V1Rs increased aquaporin Ch insertion in renal collecting duct
Desmopressin
ADH analog Tx of central DI
17alpha hydroxylase deficiency
increases mineralcorticoids decreased cortisol decreased sex hormones increased BP decreased K decreased androdtenedione
male presentation of 17alpha hydroxylase deficiency
pseudo-hermaphroditism
female presentation of 17alpha hydroxylase deficiency
lack secondary sex characteristics
21- hydroxylase deficiency
MC decreased mineralcorticoids decreased cortisol increased sex hormones decreased BP increased K increased renin increased 17-hydroxyprogesterone
21- hydroxylase deficiency presentation
infants w/salt wasting
childhood precocrious puberty
XX- virulization
no virulization of prego mom
11 beta hydroxylase deficiency
decreased aldosterone increased 11-deoxycorticosterone decreased cortisol increaed sex hormones increased BP decreased K decreased renin XX virulization
11 beta hydroxylase deficiency presentation
XX virulization
no virulization of prego mom
cortisol source
from adrenal zona fasiculata
bound to corticosteroid binding globulin
cortisol fnx
BIG FIB
increased BP
increased Insulin resistance
increased Gluconeogenesis, lipolysis, and proteolysis
decreased Fibroblasts
decreased inflammatory and Immune responses
decreased bone formation
cortisol and increased BP
upregulated alpha-1 Rs
at high concentrations can bind mineralcorticoids Rs
cortisol and fibroblasts
striaw
cortisol and immune system
inhibits production of leukotrienes and PGs
inhibits WBC adhesion
blocks H2 release from mast cells
reduces eos
blocks IL-2
exogenous corticosteroids can reactivate TB and candidiasis via IL-2 blockade
cortisol and bone
inhibits osteoblasts
cortisol regulation
CRH -> ACTH -> cortisol
excess cortisol -> decreased CRH, ACTH, and cortisol secretion
PTH regulation
decreased Ca -> increased PTH
decreased Phos -> increased PTH
decreased Mg -> increased PTH
very decreased Mg -> decreased PTH
common cause of decreased Mg
diarrhea
aminoglycosides
diuretics
alcohol abuse
which hormones act via cAMP
FLAT ChAMP FSH LH ACTH TSH CRH hCG ADH (V2) MSH PTH calcintonin GHRH glucagon
which hormones act via cGMP?
ANP
BNP
NO
which hormones act via IP3
GOAT HAG GnRH Oxytocin ADH (V1) TRH H1R Angiotensin II Gastin
which hormones act via intracellular Rs
VETTT CAP vit D E T T3/4 Cortisol Aldosterone Progesterone
which hormones act via intrinsic tyrosine kinase
insulin IGF-1 FGF PFG PDGF EGF
which hormones act via R-associated TK?
PIGGlET Prolactin Immunomodulators GH G-CSF Erythropoietin Thrombopoietin
T3/4 source
contain I
follicles of thyroid
T3 formed in target tissues
T3/4 fnx
4B's Brain maturation Bone growth Beta adrenergic effects BMR increased
what decreases TGB
hepatic failure, steroids
what increases TGB?
prego
OCP
E
regulation of TH
TRH -> TSH -> stimulates follicles -> T4
neg feedback by free T3/T4 to ant pit decreased sensitivity to TRH
wolff-chaikoff effect
excess I -> temporarily inhibits thyroid peroxidase -> decreased T3/4
peroxidase
oxidation and organification of I
coupling of MIT and DIT
PTU
inhibits both peroxidase and 5’ deiodinase
methimazole
inhibits peroxidase only
