Endo Flashcards
Posterior pituitary
ADH (vasopressin)and oxytocin produced in hypothalamus and stored in posterior pituiritary
ADH action
Decrease urine output by increaseing water reabsorption at collecting ducts
Vascular constriction-increased vascular resistance and increase BP
Oxytocin
Uterine contraction MILK EJECTION not production from sucking not milk production
Anterior pituitary
Store and release hormones and produce hormones
FSH
Pulsation GnRH stimulate
Women-grow mature follicles
Men-sertoli cell to mature sperm
Inhibit by inhibit
LH
Stim by pulsation release of GnRH from hypothalamus
Women-theca lutein cells for estrogen and progesterone production stimulate ovulation and maintain CL
Men-testosterone production, get negative feedback
ACTCH
CRH stimulate
Act on adrenal cortex to make cortisol
Inhibited by cortisol
TSH
Stim by TRH
Act on thyroid gland to make a Reduce thyroid hormone
Inhibit by somatostatin and T3 and T4
GH
Stim by GHRH
Promote growth cell reproduction and generation
Inhibit by somatostatin
Prolactin
TRH stimulate
Breast development
Inhibit ovulation
Stimulate milk production and secretion
Only pituitary hormone promptly controlled by its inhibitor WHIHC IS DOPAMINE
Cortex outer
Mesoderm
Medulla
NCC(ectoderm)
Make
Chromatin cells
Adrenal cortex layers
Glomerulosa
Fasciculata
Reticularis
Glomerulosa
SALT
Mineralocortocoid aldosterone
Na retention
Fasciculata
Sugar
Cortisol-glucocorticoid regulate glucose metabolism
Reticularis
Sex
Androgens
Steroid hormone
Diffuse through plasma membrane
Bind intracellular receptors
—DNA binding transcription factors
Chromatin
Produce catecholamines (E (Adrenalin)and NE
Adrenal medulla most common tumor NOT MEDULLA
Pheochromocytoma
Most common adrenal tumor
In medulla and adenoma, but if in cortex most common is pheochromocytoma)
Pheochromocytoma
Most common tumor of the adrenal medulla in adults
Chromaffin cell tumor that produces catecholamines
Episodes of HA, sweat, HTN, tachycardia
Medulla kid most common tumor
Adrenal neuroblastoma-DONT GET episodes of HTN that you see in adults, causes sustained HTN
Fetal adrenal gland
Important for lung maturation
Need cortisol for type II pneumocytes
Congenital adrenal hyperplasia
AR
21 a hydroxylase defiency
Or
11b hydroxylase
Too much androgens less others
21 a hydroxylase
Can’t make aldosterone or cortisol
Too much progesterone and 17 OH progesterone so go to androstenedione and testosterone
Pituitary make more ACTH to stimulate the adrenal garland, but will exacerbate the problem
Salt wasting hypotension from lack of aldosterone
11B hydrozylase defiency
Can’t make aldosterone or cortisol
ACTH up
See DOC, deoxycorticosterone, so don’t get hypotension, HAVE HTN from sodium retention
Why called congenital adrenal hyperplasia
Too little cortisol overall, pituitary try to stimulate by secreting ACTH whihc stimulates growth of the adrenal cortex
Hyperplasia or growth of adrenal gland
Diabetes drugs
Biguanide-metformin
Sulfonylurea-glimepiride, glipizide, glyburide
Thiazolidinediones
GLP-1 agonists-exenatide, liraglutide, ambiguities, dulaglutide
DPP-4 inhibitors-sitagliptin, alogliptin, saxagliptin, linagliptin
SGLT-2 inhibitors-dapagliflozin, empagliflozin, canagliflozin
Metformin MOA
Biguanide
Decrease gluconeogenesis int he liver
Improves insulin sensitivity
Side effects metformin
GI upset, lactic acidosis
Sulfonylureas MOA
Increase insulin
Side effect sulfonylureas
Hypoglycemia, weight gain
Thiazolinideniones MOA
Increase sensitivity to insulin
Decrease gluconeogenesis I
Bind PPAR gamma receptors in adipose, liver, skeletal (regulat FA storage and glucose metabolism, to improve insulin sensitivity in peripheral tissue)
Side effect thiazolidendiones
Fluid retention
Weight gain
MOA GLP-1 agonists
Increase glucose dependent insulin release
Decrease glucagon release
Promote delayed gastric emptying
Side effects GLP-1 agonist
Nausea
Injection
DPP-4 inhibitors
Increase glucose dependent insulin release
Less potent in GLP1 but use in older
Side effect DPP4 inhibitos
Low side effects use old
SGLT-2 inhibitor
Sodium glucose 2 inhibitors
More glucose lost in urine, less blood glucose
Lose weight
Rely on normal kidney function to work
Side effects SGLT-2 inhibitos
Recurrent UTI from mycotic infections with SGLT-2 inhibitors bc of increased glucose in urine
Dehydration
Diabetic ketoacidosis