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Clin Med II > Endo General > Flashcards

Endo General Flashcards

(133 cards)

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1
Q

What are steroids derived from

A

cholesterol

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2
Q

What are amines/AA derived from?

A

tyrosine

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3
Q

peptide hormone receptor location at target cell

A

plasma mem

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4
Q

steroid hormone receptor location at target cell

A

intracellular

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5
Q

peptide hormone speed of action

A

fast onset

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6
Q

steroid hormone speed of action

A

slow onset

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7
Q

Corticotropin-releasing hormone (CRH) is released from what gland?

fn?

A

hypothalamus

Fn: Stimulates adrenocorticotropic hormone (ACTH)

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8
Q

ACTH is released from what gland?

fn?

A

Anterior pituitary

Fn: Stimulates synthesis and secretion of cortisol, aldosterone, and androgens

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9
Q

Antidiuretic hormone (ADH) (also called arginine vasopressin, or AVP) is released from what gland?

fn?

A

Posterior pituitary

Fn: Increases water retention at kidney, vasoconstricts arterioles

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10
Q

Oxytocin is released from what gland?

fn?

A

Posterior pituitary

fn: Stimulates uterine contractions during labor, milk ejection in lactation

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11
Q

Aldosterone is released from what gland?

fn?

A

Adrenal cortex

Fn: Decreases urinary Na+ excretion, Increases urinary K+ and H+ excretion

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12
Q

Cortisol is released from what gland?

fn?

A

Adrenal cortex

Fn: Released in response to stress, Multiple metabolic actions

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13
Q

Insulin (β cell) is released from what gland?

fn?

A

Pancreas

Fn: Promotes storage of glucose as glycogen in liver and muscle
Promotes uptake of glucose and storage as triglyceride in adipose tissue and liver

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14
Q

Hormones circulate at (low/high) levels and bind to receptors with (low/high) affinity

A

Hormones circulate at LOW levels and bind to receptors with HIGH affinity

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15
Q

Hormone generally (can/cannot) cross cell membrane via diffusion

A

Hormone generally CANNOT cross cell membrane via diffusion

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16
Q

↑ receptor number when hormone level is low

A

Upregulation

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17
Q

when hormone level is high and/or continuous

A

Downregulation or desensitization

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18
Q

The plasma free hormone concentration is affected by:

A
  1. The rate of hormone secretion
  2. The rate of hormone elimination
  3. The extent of hormone binding to plasma proteins
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19
Q

What are the Trophic hormones?

A 
GH: Growth Hormone
ACTH: Adrenocorticotropic Hormone
LH: Luteinizing Hormone
FSH: Follicle Stimulating Hormone
TSH: Thyroid Stimulating Hormone
PRL: Prolactin
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20
Q

What hormone stimulates release of pancreatic enzymes and where is it released from?

A

Cholecystokinin (CCK) from Small Intestine

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21
Q

Where is GH produced & released?

A

anterior pituitary

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22
Q

What are the most abundant cells in the anterior pituitary?

A

somatotrophs

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23
Q

What is the MC pituitary cell to become malignant

A

somatotrophs

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24
Q

What do malignant somatotrophs produce?

A

GH & PRL

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25
What occurs due to growth of a pituitary adenoma?
compresses infundibulum decreasing hypothalamic hormonal stimulation of anterior pituitary hormone release but also decreasing anterior pituitary hormones due to inability to suppress
26
How do GHRH neurons regulate GH production?
Positive feed-forward regulation GHRH is released into hypo-physeal portal system and transported to somatotrophs causing GH release to secondary capillary plexus and to the body of the anterior pituitary
27
How is GH regulated by hypothalamic somatostain neurons?
Negative feed-forward regulation Somatostain is released into hypophyseal portal system goes to somatotrophs and inhibits GH release
28
Fn of GH
``` Linear growth (soft tissue, visceral organ, muscle & bone) in growing ages Maintains lean body mass in adulthood ```
29
What is fetal growth mediated by?
IGF1 and IGF-2
30
How does GH work?
utilizes fat as main energy source maximizes protein deposition for lean body mass marks glucose for use by the brain
31
What contains the greatest number of GH receptors?
liver and cartilage
32
What is the effect on insulin when GH acts on fat and causes lipolysis and increased FA release?
antagonistic to insulin
33
GH action on AA
maximize AA and protein for lean body mass production
34
What is GH action on glucose metabolism?
antagonistic (so blood glucose levels increase)
35
What happens when there is excessive chronic GH release?
there is sustained increase in plasma glucose causing an increase in insulin and eventually insulin resistance and diabetogenesis
36
What causes GH excess?
pituitary adenoma extrapituitary GH excess excess GHRH
37
What hormones are secreted from the adrenal cortex?
corticosteroids mineralocorticoids androgens
38
What hormones are secreted from the adrenal medulla?
epinephrine | NE
39
What regulates glucocorticoid synthesis?
episodic secretion and circadian rhythm of ACTH stress responsiveness of HPA axis FB inhibition by cortisol on ACTH sectretion
40
When are ACTH burst most frequent?
in the AM
41
What are the physiological actions of glucocorticoids?
maintain blood glucose levels during fasting (increase during stress) by increasing liver synthesis of glucose and glycogen deposition calcium homeostasis by slowing bone growth and inducing bone demineralization
42
``` What is the effect of glucocorticoids on: CV system Skeletal muscls CNS Immune system ```
CV: HEN with prolonged levels Skeletal muscle: wasting with prolonged high levels CNS: either excess fo insufficiency will cause alterations in mood, behavior and excitability Immune: secreted in response to stress
43
What prevents glucocorticoids from interacting with the mineralocorticoid receptor?
11β-HSD2 will turn cortisol into cortisone so only the aldosterone can interact witht the MR
44
MR binds to cortisol with (high/low) affinity. MR target tissues express 11-betaHSD2 which (inactivates/activates) cortisol.
HIGH INACTIVATES
45
What is the most active androgen?
testosterone
46
What is the consequence of 21-Hydroxylase deficiency?
Decreased cortisol and aldosterone Hypoglycemia because of low cortisol Loss of sodium because of mineralocorticoid deficiency Virilization because of excess androgen production
47
What is the consequence of 11β-Hydroxylase deficiency?
Excess mineralocorticoid activity Hypoglycemia because of low cortisol Salt and water retention
48
What is the consequence of 11β-HSD2 deficiency?
Decrease in glucocorticoid inactivation in mineralocorticoid- sensitive cells leading to excess mineralocorticoid activity
49
ACTH dependent causes of cushings
ACTH secreting tumors | CRH secreting tumors
50
ACTH independent causes of cushings
glucocorticoid secreting tumors
51
Causes of addison's disease
primary adrenal insufficiency due to destruction of adrenal cortex both mineralocorticoid and glucocorticoid deficiency
52
What is effect of Mifepristone at high doses on Glucocorticoid Function?
blocks the glucocorticoid receptor, blocks feedback regulation of HPA, increases ACTH and cortisol but blocks the action of cortisol at the receptor
53
What is effect of Spironolactone and Eplenerone at on Mineralocorticoid Function?
Inhibits binding of aldosterone to the MR
54
What is secreted from zona glomerulosa layer of adrenal cortex?
Mineralocorticoids Aldosterone, deoxycorticosterone
55
What is secreted from zona fasiculata layer of adrenal cortex?
Glucocorticoids Cortisol, corticosterone
56
What is secreted from zona reticularis layer of adrenal cortex?
Sex Steroids Androgen
57
What is the precursor for adrenal steroidogenesis?
cholesterol
58
What is the principal hormone that stimulates adrenal glucocorticoid synthesis and secretion and where is it syntehsized?
ACTH synthesized in the anterior pituitary
59
What controls POMC secretion which leads to the production of ACTH?
CRH Argininevasopressin Endogenouscircadianrhythm
60
What causes hyperpigmentation in primary AI?
increased production of POMC which produces melanocyte stimulating hormone in addition to ACTH
61
What does TH do?
Maintains level of metabolism in tissues optimal for normal function
62
What happens if fetus/neonate has thyroid hypofn?
results in mental retardation and dwarfism
63
What happens if adult has thyroid hypofn?
mental and physical slowing, poor resistance to cold; adult hyperthyroidism-body wasting, nervousness, tachycardia, tremor, excess heat production
64
Effect of TH on heart
Increased number of beta-adrenergic receptors
65
Effect of TH on adipose tissue
Stimulated lipolysis
66
Effect of TH on muscle
Increased protein breakdown
67
Effect of TH on bone
Promote normal growth and skeletal development
68
Effect of TH on nervous system
Promote normal brain development
69
Effect of TH on gut
Increased rate of carbohydrate absorption
70
Effect of TH on lipoprotein
Formation of LDL receptors
71
What cells secrete thyroid hormones, which are critical to development, growth and metabolism?
Follicle cells
72
What cells secrete calcitonin, which regulates circulating levels of calcium
Parafollicular cells
73
What is minimum daily intake of iodine recommended for normal adult thyroid fn?
150 ug/d
74
Deiodination is dependent on what?
P450
75
What is conserved with a decline in T3?
calories and protein
76
What happens to the thyroid if you remove the pituitary?
gland atrophies
77
What happens to the thyroid if you administer TSH?
thyroid fn is stimulated | if prolonged will become a goiter
78
What is Wolff-Chaikoff effect?
large doses of iodine inhibit organification and metabolic activity of the thyroid gland is decreased
79
What is NIS?
sodium iodide symporter
80
What happens to TH receptors during starvation?
decreased number of receptors
81
Thyrotoxicosis
thyroid hormone excess
82
Hyperthyroidism
excessive thyroid function
83
What is the MC thyroid abnormality?
goiter
84
Causes of goiter
Iodide deficiency Hashimoto’s (aka chronic lymphocytic thyroiditis or autoimmune thyroiditis) Grave’s disease
85
When do sx of hypoglycemia develop in healthy individuals?
<55 mg/dl
86
Name the only endogenous steroid inhibiting ACTH
Cortisol (synthetics also suppress)
87
What do Extraadrenal ganglia produce?
NE
88
What does adrenal medulla produce?
epi
89
Innermost concept of self as | male, female, a blend of both or neither
Gender Identity
90
External appearance of one's gender expressed through behavior, clothing etc.
Gender Expression
91
Who you like, desire, are attracted to
Sexual Orientation
92
What cells make up the majority of the islets of langerhans?
Beta cells (which secrete insulin)
93
What do alpha cells in islets of langerhans secrete?
glucagon
94
What do beta cells in islets of langerhans secrete?
insulin
95
What do delta cells in islets of langerhans secrete?
somatostatin
96
What do F(PP) cells in islets of langerhans secrete?
pancreatic polypeptide
97
Fn of insulin
energy conservation-directs fuel metabolism to CHO use DECREASES blood glucose concentration
98
Fn of glucagon
energy use INCREASES BG concentration
99
What is insulin's halflife?
5 min
100
What stimulates insulin release?
glucose, GLP1 and GIP parasym stimulation Beta 2 adrenergic receptor agonists
101
Biphasic effect of sympathetic stil
inhibition via alpha 2 and stimulation via beta2 Overall effect is INHIBITORY
102
What occurs as a result of insulin signaling?
cell growth, differentiation, survival, protein synthesis, glycogen syntehsis, metabolic pathways
103
What occurs in muscle and fat tht lowers blood glucose?
insulin promotes relocalization of GLUT4 transporter to cell mem
104
GLUT 2 Fn
Regulation of insulin release
105
GLUT 4 Fn
Insulin-mediated glucose uptake found primarily in adipose tissues and striated muscle (skeletal and cardiac)
106
What occurs as a result of chronic activation of insulin receptor?
causes receptor internalization & down- regulation of response
107
Glycolysis
breakdown of glucose
108
Gluconeogenesis
generation of glucose
109
Glycogenolysis
breakdown of glycogen into glucose
110
Glycogenesis
formation of glycogen
111
What does somatostatin do?
inhibits everything
112
Effect of glucagon on: glucose FA ketoacids
Increases them all
113
What hormones increase BG besides glucagon?
catecholamines- fast when SEVERELY hypoglycemic or stress glucocorticoids- slow when stress, prolonged fasting or hypoglycemia GH- slow when fsating, sleep or stress
114
epi, NE and dopamine
catecholamines
115
Effect of catecholamines on: insulin secretion glycogenolysis gluconeogenesis
Inhibits insulin secretion Stimulates glycogenolysis Stimulates gluconeogenesis
116
Effect of glucocorticoids on: insulin secretion glycogenolysis gluconeogenesis
Reduces insulin sensitivity Does NOT stimulate glycogenolysis Stimulates gluconeogenesis
117
Effect of GH on: insulin secretion gluconeogenesis
Reduces insulin sensitivity (decreases glucose uptake) Stimulates gluconeogenesis
118
What stimulates somatostatin release and what is its effect?
stimulated by glucose; amino acids; fatty acids Inhibitory effect on virtually all gastrointestinal and pancreatic exocrine and endocrine functions.
119
Why is somatostatin's effect on insulin and glucose limited?
it is produced in delta cells which are in the periphery of islet and the blood flows from the center first then to the periphery
120
What is the effect of pancreatic polypeptide?
antagonizes CCK and inhibits gallbladder contraction and decreases GI motility
121
Why does insulin resistance occur as fat increases?
fat cells synthesize and release hormone signals (adipokines) that antagonize insulins effects on target cells
122
What adipose signal can aid in insulins effects?
Leptin
123
Fn of leptin
Acts in brain to lower appetite
124
What is the effect of exercise on glucose and insulin?
↑ glucose entry into skeletal muscle insulin-independent ↑ in the number of GLUT-4 transporters Can precipitate hypoglycemia in diabetics
125
What does a 1% change in HbA1c do to plasma glucose
29 mg/dl change in average plasma glucose
126
What is a strong predictor of cardiovascular disease in patients with type 2 diabetes?
Microalbuminuria
127
Effect of PTH
increase bone reabsorption, inc ca and Cl and decrease PO4 and HCO3-
128
Effect of calcitriol (1,25-OH)2 vit D
increase Ca, PO4 abs
129
What is recommended daily vit D intake?
Children, adults, pregnancy, lactation- 600 IU >70- 800 IU
130
What is optimal vit D levels?
20-60 ng/ml
131
What is the active form Vit D?
1,25 (OH) vitamin D
132
What cells produce T4 and T3?
Follicular cells
133
Colloid represents
stored thyroid hormone

Clin Med II (19 decks)

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