endo high yield Flashcards
post pituitary hormones
oxytocin
ADH/vasopressin
pituitary gland sits inside what and where is it located
sella tursica (in center of skull, center of sphenoid bone)
adenohypophesis
ant pituitary
neurohypophesis
post pituitary
ant pituitary hormones
GH TSH ACTH FSH LH PRL
hypothalamus hormones
GnRH GHRH CRH GHIH/somatostatin Dopamine
where does unfiltered arterial blood flow in; why?
hypothalamus; no BBB
types of hormone kinetic mechanisms
steroid/thyroid mechanism
second messenger systems
hypopituitarism causes
ant pituitary path
lesions in hyopthalamus or adenohypophysis
nonsecretory chromophobe adenomas
sheehan’s syndrome, empty sella syndrome
diabetes insipidus etiology/sx
no ADH from post pit
cannot concentrate urine
thirst wakes from sleep
hyperpituitarism
ant pit; adenoma secreting one hormone
prolactinoma somatotroic adenomas (excess GH) corticotroph tumors (ACTH; cushing) gonadotropic adenomas thyrotrophic adenomas
thyroid composition
tyrosine + iodine
what is exported in thyroid hormone synthesis
T3
T4
what is imported in thyroid hormone synthesis
iodine
tyrosine
T3 type of receptor
cell membrane
nuclear
active thyroid hormone
T3
enzyme that converts T4 > T3
5’ deoiodinase
hypothyroid/myxedema causes
hashimotos
iodine def
hashimotos thyroiditis etiology
autoimmune
most euthyroid then hypothyroid
transient hyperthyroid possible
hyperthyroid/thyrotoxicosis causes
graves disease
graves disease etiology, sx
women > men
exopthalmos
goiter
dequervains subacute granulomatous thyroiditis etiology
self limited, painful inflammation of thyroid
autoimmune/viral
women>men, 10-40
begins with hyperthyroid, then hypothyroid, then euthyroid
reidels thyroiditis
rock hard, woody thyroid
mimics carcinoma
older women
fibrotic proliferation, may cause hypothyroidism or dyspnea
goiters simple vs multinodular
simple: iodine def or too many goitrogens (Ca and luroine in water, brassicae, polluted water)
multinodar: very large, often mistaken for cancer
thyroid adenomas
90-99% of nodules are benign adenomas
may cause pressure sx
post menopausal women
malignant thyroid tumors
most papillary carcinoma
estrogen receptors, well differentiated
low mortality, solitary noduels more likely to be cancer
men < 40 more likely cancer
calcitonin produced where
parafollicular cells of thyroid
calcitonin actions
lowers blood Ca, preserves bone Ca
acts on bone
-inhibits resorption by osteoclasts
acts on kidney
(conc in cortex)
inc Ca, Na, K excretion
Dec Mg excretion
PTH vs calcitonin actions on Ca, Na, K, Mg in blood, bone, kidney
PTH: ca inc blood, dec bone, dec ca excretion in kidney (via vit D)
Cal: ca dec blood, inc bone, inc excretion of Ca/Na/K and dec exretion of Mg in kidney
outer layer adrenal cortex
name, hormones/actions
zona glomerulosa (mineral corticoids; aldosterone)
Na retention, H/K excretion
middle layer adrenal cortex
name, hormones/actions
zona fasiculata (glucocorticoids; cortisol)
stress response, glucose inc, immunity
layers of adrenal gland
inner neurological medulla (SNS; epi/nore) outer cortex (corticoids)
inner layer adrenal cortex
name, hormones/actions
zona reticularis (glucocorticoids; sex steroids)
primary hyperparathyroidism causes
adenoma of parathyroid
elevated Ca
stones bones moans
secondary hyperparathyroidism causes
hyperplasia due to hypocalcemia or hyperphosphatemia, renal failure, vit D def
serum ca low (reactive)
hypoparathyroidism
low serum ca
high serum phosphate
chovsteks sign, trousseaus sign
CATS go numb
pheochromocytoma
tumor in adrenal medulla
secretes catecholamines
HTN, arrythmias
gyperglycemia, hypermetabolism
neuroblastoma
childhood tumor of adrenal medulla most sporadically (some hereditary) often born w it large abdominal mass often affects other neuro tissues course variable, some fatal
addisons
hypoadrenalism (ADD some cortisol)
most often autoimmune
sometimes TB or idiopathic atrophy, medulla unaffected
weakness, faitgue, wt loss, diarrhea, vomiting
hyperpigmentation (high ACTH/K, low Na, Cl)
cushings
hyperadrenalism (CUSHION of cortisol)
iatrogenic, pituitary adenoma
moon face, buffalo hump, purple straie
conn syndrome
solitary aldosterone secreting adenoma in adrenal cortex
causes hyperaldosteronism (low renin and K, high Na and aldosterone)
high blood vol, tachycardia, arrythmia
“parent steroid”
pregnenolone
where does pregnenolone come from
cholesterol
estrogens are reduced from
testosterones and androstenediones
aldosterone is stimulated by
ACTH
hyperkalemia
angiontensin 2
alpha cells of pancreas secrete
glucagon
beta cells of pancreas secrete
insulin
delta cells of pancreas secrete
somatostatin
what are ducts lined with (tissue/cell type)
cuboidal epithelium
ductless glands are called
endocrine glands
insulin function
announces sugar t/o body
insulin is always around glucose
triggers biochem pathways that spare fat
insulin lack effects on catabolism and anabolism + their major risks
inc catabolism (inc glycogenolysis, gluconeogenesis, lipolysis) > DKA
dec anabolism (hyperglycemia) > water + salt depletion
diabetic ketoacidosis (DKA)
life threatening acidosis caused by lack of insulin (usually in type I)
insulin lack > cellular catabolism > inc ketone (3-hydroxybutyrate)
cells burn fats because they dont have sugar (sugar high in blood, low in cells); ketones toxic to liver
DKA causes
undiagnosed diabetes lack/interruption of insulin therapy stress of comorbidity (MI, CHF) infxn (release of glucocorticoids) emotional disturbance (also raises stress hormones)
DKA clinical presentation
GI (abd pain, vomiting) thist, polyuria, oliguria hypotensive, tachycardic hyperventilation, "ketone breath" drowsiness
type I vs type II DM
type I -
STOP B cells from producing insulin; insulin lack, good receptors
autoimmunity to islet cells, KA, retinopathy, nephropathy
insulin DEPENDENT
type II -
too much insulin/not enough receptor activity
genetic, obesity, insulin excess > def, no KA
insulin RESISTENT
both have high blood sugar
zollinger ellison syndrome etiology/sx
tumor in pancreas, secretes gastrin
peptic ulcers, gastric hypersecretion, malabsorption, diarrhea
60% malignant
insulinoma etiology/sx
beta cell tumor, produces hypoglycemia
confusion, stupor, LOC
relieved by eating
thymic hyperplasia etiology
lymphoid follices in thymus
often in myasthenia gravis, chornic inflammatory + immune states, SLE, graves, RA
digeorge syndrome etiology
aplasia/hypoplasia of thymus with parathyroid development failure
total absence/severe lack of cell mediated immunity and often hypoparathyroidism
may have developmental defects in heart and great vessels
DIT + DIT
T4 (thyroxine)
DIT + MIT
T3 (triiodothyronine)
oxytocin composition + origin
peptide from PVN of hypothalamus (stored in post pit)
oxytocin stimulation
uterine cervix stretching, breast suckling
oxytocin inhibition
lack of neural stimuli
oxytocin actions
uterus: stim contractions, initiates labor
breast: initiates milk ejection
ADH/vasopressin composition + origin
peptide from SO nucleus of hypothalamus
ADH/vasopressin stimulation
inc blood solute conc, dec BV, pain/drugs/low BP
ADH/vasopressin inhibition
adequate hydration, alcohol
ADH/vasopressin actions
kidneys: stim tubule cells to reabsorb H2O from forming urine back into blood
hyper-secretion ADH/vasopressin
SiADH
hyposection ADH
DI
GH composition + origin
protein from somatotropic cells of ant pituitary
GH stim
GHRH release; which is due to low glood GH, deep sleep, hypglycemia, inc blood AA, dec FAs, exercise
GH inhibition
GH feedback inhibition, IGFs, hyperglycemia, hyperlipidemia, obesity, emotional deprivation (inc GHIH, dec GHRH)
GH action
liver, muscle, bone, cartilage
anabolic; stim somatic growth, mobilizes fat, spares glucose
hyper-secretion GH
gigantism, acromegaly
hypo-secretion GH
pit. dwarfism
TSH composition + origin
glycoprotein from thyrotropic cells of ant pit
TSH stim
TRH, cold temp (infants)
TSH inhibition
feedback inhibition thyroid hormones, GHIH, PIH
TSH action
thyroid; stim release of thyroid hormones
TSH hyper-secretion
hyperthyroid
TSH hyposecretion
hypothyroid
ACTH composition + origin
peptide from corticotropic cells of ant pit
ACTH stim
CRH (fever, hypoglycemia, stressors)
ACTH inhib
glucocorticoid feedback inhibit
ACTH action
adrenal cortex; promotes release of glucocorticoids and androgens
hyper-secretion ACTH
cushings dz
FSH composition + origin
glycoprotein from gonadotropic cells of ant pit
FSH stim
GnRH
FSH inhib
feedback inhibition estrogen/testosterone
FSH actions
ovaries and testes: stim ovarian follicle matruation, production of estrogens, sperm cell production
FSH hyposecretion
failure of sexual maturation
LH composition + origin
glycoprotein from gonadotropic cells of ant pit
LH stim
GnRH
LH inhib
feedback inhibiton estroens, progesterones, testosterones
LH action
ovaires and testes: triggers ovulation, stim ovarian production of estrogens + progestone, promotes testosterone production
LH hyposecretion
failure of sexual maturation
PRL composition + origin
protein from prolactin cells of ant pit
PRL stim
dec PIH (dopamine), estrogens, BC, breast feeding
PRL inhib
PIH (dopamine)
PRL action
breast secretory tissue: promotes lactation
hyper-secretion PRL
galactorrhea, cessation menses, impotence in males
hypo-secretion PRL
poor milk production in nursing
Function insulin
Binds insulin receptors to induce glucose uptake into insulin dependent tissues
Hyposecretion insulin
DM 1+2
LADA
Hypersecretion insulin
Insulinoma
Regulation insulin
Glucose enters B cells > inc ATP > K channels close/depolarization > VGCa open, Ca rushes to stimulate insulin exocytosis
Synthesis insulin
Preproinsulin>proinsulin> exocytosis of insulin and C peptide
Glucagon functions
Glycogenolysis, gluconeogenesis, lipolysis, ketone production
Glucagon hypersecretion
Glucagonoma
Glucagon regulation
Secreted due to hypoglycemia
Inhibited by insulin / hyperglycemia / SS
Somatostatin function
Dec GH and TSH
Ghrelin is secreted where + has what function
Stomach, stim hunger
Gastrin is secreted where and has what function
enhancing gastric mucosal growth, gastric motility, and secretion of hydrochloric acid (HCl) into the stomach. It is present in G cells of the gastric antrum and duodenum
CKK is secreted where and has what function
Small intestine -
Leptin is secreted where and has what function
Satiety hormone
function cortisol
Inc appetite, BP, insulin resistance, gluconeogenesis, lipolysis, proteolysis
Dec fibroblast activity, inflammation, immune response, bone formation, blocks IL2 production
DHEA origin
Adrenal cortex - Zona reticularis
Epinephrine origin
Adrenal medulla, chromaffin cells
Norepinephrine origin
Adrenal medulla
Chromaffin cells
Amide hormones are derived from what/examples
Tyrosine
Epi, norepi, thyroid hormones
Peptide hormones ex
Insulin
PTH
Hypothalamic, pituitary hormones
Steroid hormones derived from/ex
Cholesterol
Pregnenolone, cortisol, DHEA/testosterone, estrogens, progesterone, Vit D
Amide receptors
On surface of membrane, A 1-2, B 1-3
Peptide hormone receptors
Protein receptors, on surface of cell membrane, C protein receptors, cAMP second messenger
Steroid hormone receptors
Intracellular
Cholesterol endocrine function
Cholesterol desmolase > pregnenolone > 17OHpregnenolone > DHEA
17a hydroxylase endocrine function
Converts pregnenolone > DHEA and progesterone > androstenedione
Aromatase endocrine function
Converts androstenedione > estrone and testosterone > estradiol
5 reductase endocrine function
Converts testosterone > DHT
21 hydroxylase + 11b hydroxylase endocrine function
Converts progesterone > 11 deoxycorticosteone > corticosterone (to eventually be made into aldosterone)
Function of Vit D
Inc absorption Ca and Ph, enhances mineralization of bone
Inc PTH > dec Ca and Ph > inc 125OHD
Liver and kidney forms of Vit D
25OHD liver 125OHD kidney
