ENDOCRINE Flashcards
is significant to maintain a
stable internal environment, all metabolic processes, and
functions of different organs in the body (maintenance of
homeostasis)
Physiologic Regulatory System
Continue ongoing process which
allows body to function as its optimal level
homeostasis
2 PHYSIOLOGIC SYSTEM
endocrine and nervous
ENDOCRINE SYSTEM
Release of ___ into the blood stream
hormones
nervous SYSTEM
Release of ___ a cross synapse
neurotransmitter
endocrine or nervous system
Effect can be on many target
cells spread throughout the body
endocrine
endocrine or nervous system
Effect will be restricted to those
target cells actually innervated
nervous
endocrine or nervous system
Effect will take place over a
relatively long-time span ranging
from seconds to days
endocrine
endocrine or nervous system
Effect will be generated within
milliseconds
nervous system
types of glands in endocrine system
ENDOCRINE
EXOCRINE
this type of gland is * Ductless glands
* Release hormones
endocrine
this type of gland is attached to specific ducts and secretions directly toward the outer surface of the body/internal organs
exocrine
this type of gland directly release the analytes and do not go through the circulatory system
exocrine
this type of gland is responsible in releasing enzymes, mucous, sweat
exocrine
A network of ductless glands that secret hormones directly
into the blood (circulatory system) reaching its target
tissue/organs
endocrine system
It is considered to be the regulatory system of the body
endocrine system
It is regulated by means of control of hormone synthesis
rather than by degradation
endocrine system
An increased in the product also increases the activity of the system and production rate
positive feedback
hormones under positive feedback system
gonadal
thyroidal
adrenocortical hormones
An increased in the product decreases the activity of the
system and the production rate
negative feedback
negative feedback mechanism hormone examples
luteinizing hormone
MAJOR GLANDS OF ENDOCRINE SYSTEM
- Pituitary Gland
- Thyroid Gland
- Parathyroid Gland
- Adrenal Gland
- Pancreas
- Reproductive Glands (ovaries & testes)
- Thymus Gland
- Pineal Gland
Are chemical compounds secreted into the blood circulation
that affect target tissues generally at a site distant from
original production
HORMONE
Play an important role in the growth and development of an
organism, and equilibrium homeostasis
hormone
please give the difference between Type of NFM: long, short, and ultrashort
Long Feedback Mechanism (Long FM): When hormones from a target organ regulate the hypothalamus or pituitary gland.
Short Feedback Mechanism (Short FM): When pituitary hormones regulate the hypothalamus.
Ultra-Short Feedback Mechanism (Ultra-Short FM): When hormones regulate their own secretion at the same gland level.
secreted in endocrine cells and released into interstitial space between tissues
paracrine
binds to specific receptor in adjacent cell and affects its function
paracrine
secreted in endocrine cells and sometimes released into interstitial space
autocrine
binds to specific receptor on cell of origin resulting to self regulation of its function
autocrine
secreted in endocrine cells and remains in relation to plasma membrane;
juxtacrine
acts on immediately adjacent cell by direct cell-to-cell contact.
juxtacrine
– secreted in endocrine cells and released into lumen of gut;
exocrine
secreted in neurons and released into
extracellular space
neurocrine
secreted in neurons and released from
nerve endings;
neuroendocrine
secreted in the endocrine cells and functions INSIDE the origin of the synthesis
o Directly affects the function of the origin
intracrine
When two or more hormones work together to produce a particular result. May be complimentary or additive.
synergistic
a type of synergistic effect
▪ The more hormones involve the more effective it
is.
▪ It can stand with its own, but its better to have
another.
additive
a type of synergistic effect aside from additive
complimentary
When the action of a second hormone
enhances the responsiveness of a target organ to the
second hormone, or when it increases the activity of the
second hormone
permissive
Has initial particular hormone which activity
is increase or enhance once the second hormone is present
permissive
The actions of one hormone antagonize
the effects of another
antagonistic
Lactation during pregnancy is inhibited because the
high concentration of estrogen in the blood inhibits the
secretion and action of prolactin.
antagonist
stimulate growth & activity of other endocrine glands
tropic hormones
secreted by all endocrine glands & w/ non endocrine cells
as targets
effector hormones
from hypothalamus & GIT; suppress the secretion of a
particular hormon
inhibitory hormones
from hypothalamus; promote secretion of Ant. Pituitary
hormones
* promote the release of another co
releasing hormones
this classification of hormones is water-soluble and is not bound to a carrier protein
peptides and proteins
Synthesized and stored within the cell in the form of secretory granules and are cleaved as needed.
PEPTIDES & PROTEIN
Cannot cross the cell membrane due to their large
molecular size
peptides and proteins
Water soluble and not bound to carrier protein.
peptides and proteins
peptides and proteins
glycoprotein:
FSH, HCG, TSH, erythropoietin
polypeptides:
ACTH, ADH, PTH, GH, angiotensin, calcitonin, cholecystokinin, gastrin, glucagon, insulin, melanocyte-stimulating hormone, oxytocin, prolactin, somatostatin
are protein molecules with carbohydrates
molecules
Glycoprotein
Lipid molecules that have cholesterol as a common precursor
steroids
Water insoluble (hydrophobic) and circulate bound to a
carrier protein
steroid
steroids hormone are produced by ___ glands
adrenal glands, ovaries, testes, and placenta
steroids hormone example
aldosterone, cortisol, estradiol, progesterone, testosterone, and activated D3
Derived from an amino acid and they are intermediary between steroid and protein hormones
amines
example of AMINES
Melatonin, Serotonin, Thyroid hormones (T3 & T4), Epinephrine, Norepinephrine
Precursor is lipids specifically from Fatty acids
o with 20 carbon atom fatty acid (arachidonic fatty acid),
involved in cellular activity
eicosanoids
a type of hormonal rhythm that is endogenously generated with a period close to 24 hrs
circadian rhythm
a circadian rhythm that is synchronized with the day/night cycle
diurnal rhythm
difference between the circadian and diurnal rhyth,
circadian nagfofollow ng 24 hrs, basta 24hrs or around that time
diurnal - pwede rin 24hrs, pero light dependent, morning or night ganun
what is ultradian rhythm
biological rhythm (feeding cycles) with a much shorter period compared to a circadian rhythm
biological rhythm with a cycle that lasts longer than 24hrs (human menstrual cycle )
infradian rhythm
Portion of the brain located in the walls and floor of the
third ventricle.
hypothalamus
hypothalamus is Above the pituitary gland and is connected to the posterioir pituitary by the
INFUNDIBULUM
Serve as the link between the nervous system and
endocrine system.
hypothalamus
Anterior structure of hypothalamus
optic chiasma - role for sight
posterior structure of hypothalamus
mamillary body - for the development of nervous tissue
2 CATEGOGORIES of hypothalamus
o RELEASING HORMONES
o INHIBITING HORMONES
Inhibits
release of Growth hormone
growth Hormone Inhibitory Hormone
SOMATOSTATIN inhibits
growth hormone
– Inhibits release of
Prolactin
PIF (Prolactin Inhibiting Factor)
inhibitory
neurotransmitter
GABA (gamma-aminobutyric acid)
affected by the level of serotonin,
endorphins, acetylcholine
ACTH release
stress, inflammation low glucose
level (hypoglycemia) is an example of what stimulus
Physiologic stimulus
produced by adipose tissue → acts to reduce appetite and raise energy expenditure as body fat stores
rise
leptin
Named pineal as it looks like a pine cone Latin term is
pinea
Attached to midbrain (behind the 3rd cerebral ventricle of
the brain in the midline, in between the 2 cerebral
hemispheres at the back of hypothalamus)
pineal gland
pineal gland is Also known as
conarium or epiphysis cerebri
Produces melatonin that decreases pigmentation of the skin
(hormone derived from tryptophan that
plays a central role on the regulation of circadian rhythm)
pineal gland
synthesized within the pinealocytes from tryptophan
melatonin (N-acetyl-5-hydroxytrptamine)
a marker of the phase of internal circadian clock (regulates the circadian system and sleep patterns)
melatonin
used in therapy for sleep disorders
melatonin
this hormone has cell protection and neuroprotection properties
melatonin
plasma melatonin level in adults
60-70 pg/ml
concentration of melatonin in saliva is ___ times lower in plasma
3x
main function of pineal gland
receives information about the state of the light-dark-cycle from the environment and conveys this information to produce and secrete the hormone melatonin
possible cause of dysfunction of pineal gland
accidental and developmental conditions (pineal tumors, craniopharyngiomas and injuries to the gland)
health benefits from melatonin
anti-oxidant and anti-aging properties
potent free radical scavenger
more effective than glutathione in reducing oxidative stress (highly concentrated in the mitochondria)
Derived from both Latin and Greek which means “to spit
mucus”
PITUITARY GLAND (HYPOPHYSIS)
Hypophysis means
undergrowth
A pea shaped organ
PITUITARY GLAND (HYPOPHYSIS)
Also known as “Master Gland”
as it has the capability to
regulate other endocrine glands
PITUITARY GLAND (HYPOPHYSIS)
Located in a small cavity in the sphenoid bone of the skull
called sella turcica or Turkish saddle surrounded by dura
mater
PITUITARY GLAND (HYPOPHYSIS)
2 regions of pituitary gland (hypophysis)
anterior (adenohypophysis)
posterior (neurohypophysis)
- Aka. Adenohypophysis
ANTERIOR PITUITARY
The “true endocrine gland” as majority of endocrine hormones which regulates other endocrine glands are being released by
anterior pituitary
the hormones secreted by anterior pituitary gland is either ___(what classification of hormones)__ with ___(what pattern)____
peptide or glycoproteins with pulsatile pattern
the hormones secreted by this anterior lobe are either peptides or glycoproteins with pulsatile patterns
anterior pituitary (adenohypophosis)
types of cells in the adenohypophysis by immunochemical test
somatotrophs
lactotrophs or mammotrophs
thyrotrophs
gonadotrophs
corticotrophs
Somatotrophs releases
growth hormones
Lactotrophs releases
prolactin
Lactotrophs is also called as
mammotrophs
mammo as in mammal diba kasi mammal mga nagpapadede- eh prolactin is for lactation.
gets?oki lab yu, topnotcher RMT 2026 cutieee
Gonadotrophs releases
Luteinizing hormone (LH)
follicle stimulating hormone (FSH)
gonads kasi diba sex organs ang gonads, so basically hormone for sex
corticotrophs releases
POMC or proopiomelanocortin
and will cleave Adrenocorticotropic Hormone, endorphin, and lipotropin
thyrotrophs secrete what hormones
TSH - thyroid stimulating hormone
adenohypophysis Composed of three cell types
o Chromophobe (50%)
o Acidophilic (40%)
o Basophilic (10%)
acts on the nervous system and reduce feelings of pains
endorphins
released on a distant tissue or organ affecting the release of another hormone
tropic
Most abundant of all pituitary hormones
GROWTH HORMONE (SOMATOTROPIN)
difference of somatotropin to somatostatin
somatotropin - growth hormone
somatostatin - growth hormone inhibitor
somatoTROPIN - as in TROPA, besfren yan so increase growth hormone. Hindi siya mag iinhibit kasi tropa sila wink
Growth hormone or somatotropin is regulated bu
GH-RH and somatostatin
(growth hormone-releasing hormone)
describe the secretion of growth hormone
erratic and occurs in short burst
it is Markedly elevated during sleep (deep sleep)
GROWTH HORMONE (SOMATOTROPIN)
what is the overall METABOLIC effect of growth hormone
metabolize fat stores while conserving glucose
relationship of growth hormone to insulin
has anti insulin effect because its metabolic effect uses fat stores and CONSERVE glucose
it promotes bone growth with anti insulin effect on muscles
growth muscles
major stimulus of growth hormone
deep sleep
major inhibitor of growth hormone
somatostatin
increased level of growth hormone are seen in what condistion
ACROMEGALY, chronic malnutrition, renal disease, cirrhosis, sepsis, and DM
decreased growth hormone are seen in what condistion
Growth hormone deficiency, obesity, and hypothyroidism
common method for GH determination
chemiluminescent immunoassay
Reference values (fasting) of growth hormone
<10ng/mL
growth hormone in normal individuals are below 1ng/ml, which means, if the patient has decreased growth velocity, the growth hormone level is
very low or non detectable
1ng/ml na nga lang mababawasan pa edi wala na talagang makikita kapag low GH
most common cause of GH deficiency in children
idiopathic GHD
the most common etiology in adult onset GH deficiency
pituitary adenoma
GH deficiency in children = ___
GH deficiency in adult = ____
GH deficiency in children = idiopathic GHD
GH deficiency in adult = pituitary adenoma
a condition due to overproduction of growth hormone, more than 50 ng/ml
tapos ang normal lang is <1ng/ml, sa condition nito super bongga na 50 ng/ml ba naman, sino ka dyarn
acromegaly
clinical manifestation of acromegaly
diffused enlargement of soft tissues and organs throughout the body,
prognathism,
frontal bossing
and spade like hands
specimen requirement for growth hormone determination
preferably fasting serym
fasting 8-12 hrs
screening test for GH deficiency
physical activity test
gold standard confirming test for GH deficiency
insulin tolerance test
since GH is always elevated after any form of exercise, how can we conclude in screening test that there’s a deficiency in Growth hormone
ofcors if di tumaas si GH after exercise, next step is to confirm using confirmatory test
second confirmatory test for GH deficiency
arginine stimulation test
third confirmatory test for GH deficiency
glucagon stimulation test
this test determines the integrity of hypothalamus-pituitary axis, specifically the GH secretion
insulin tolerance test
interpretation of insulin tolerance test
failure of GH to rise > ___ ng/ml in adults and >___ ng.ml in children is a confirmed GHD
> 5 ng/ml in adults
10 ng/ml in children
confirmation of GHD in children is made if there is no increase after how many pharmacologic stimuli
2 stimuli
confirmatory test of acromegaly
OGTT
acromegaly is confirmed if the GH fails to decline <1 ng/ml
explain how do it works
High blood glucose triggers hypothalamic somatostatin release, which inhibits GH secretion.
so kapag mataas ang blood glucose level, dpaat ang normal response is inhibit lahat ng related kay GH, dapat bababa ito to normal level. Ang kaso, kapag may acromegaly, hindi to bababa and keep lang na mataas
screening test for acromegaly
somatomedin C or insulin like growth factor 1
this determines if a person is producing a normal amount of GH
somatomedin C or insulin-like growth factor
this hormone functions in growth and maturity of ovarian follicles and estrogen secretions
follicle-stimulating hormone
FSH aids in ____ for males
spermatogenesis
primary effect is to
stimulate food intake.
ghrelin
Also known as “hunger hormone”
ghrelin
somatomedin C is mostly produced by what organ in GH stimulation
liver
luteinizing hormone helps in ___ male
to produce testosterone in males
Luteinizing hotmone helps in ___ for female
necessary for ovulation and the final follicular growth
FSH or LH
maturation of ovarian follicle and sperm
FSH
FSH or LH
production of testosterone and for ovulation in female
LH
elevation of ___ is a clue in the diagnosis of premature menopause
FSH
increase in FSH and LH after menopause is due to lack of ___
estrogen
hypogonadotropic hypogonadism is also known as
2nd hypogonadism
2nd hypogonadism will cause __ to fsh and lh production
decrease production
inadequate spermatogenesis means there is a deficiency in what hormone
BOTH FSH and LH
polycystic ovarian disease means there is ___ (describe the level of fsh and lh )
normal or sometimes low level of FSH
high level of LH
Lower FSH levels impair follicular maturation, leading to many small, immature follicles that fail to ovulate (hence, the term “polycystic ovaries”).
In PCOS, there’s Fast GnRH pulses → Favor LH secretion (important for ovulation and androgen production)
LH favor makes more androgens specifically si testosterone
testosteron interrupts ovulation, so kahit mataas si LH di magoovulate.
Di na nga nagmature ung egg/follicle, di pa nagovulate so naging cysts
around 50 y/o, male testosterone secretion rate and concentration drops,
however, in female, particularly the FSH, it will increase
explain why
With low estrogen and progesterone during menopausal, the hypothalamus increases GnRH secretion.
because estrogen and progesterone acts in negative feedback to gonadotropin hormones, without them, no inhibition in its production can takes place
is the common cause of secondary amenorrhea
hypogonadotropic hypogonadism
the gold standard test in identifying central precocious puberty and cases with clinical signs and symptoms of early puberty
GnRH stimulation test
its purpose is to determine the cause of the onset of pubertal signs before the age of 8 years in girls
gonadotropin-releasing hormone stimulation test
standard dose of GnRH IV bolus for GnRH stimulation test
100 ug GnRH
also known as thyrotropin
thyroid stimulating hormone
the main stimulus of the uptake of iodide by the thyroid gland
thyroid stimulating hormone
it acts to increase the number and size of thyroid follicular cells
TSH
it stimulates thyroid hormone synthesis
TSH
describe the peptide and bond formation of ACTH
single chain peptide without disulfide bonds
it is produced in response to low serum cortisol
adrenocorticotrophic hormone
regulator of adrenal androgen synthesis
adrenocorticotrophic hormone
highest level of adrenocorticotrophic hormone
6-8:00 am
lowest level of adrenocorticotrophic hormone
6-11:00 PM
sample antocoagulant for ACTH sample collection
pre-chilled polysterene (plastic) EDTA tubes to prevent degradation of ACTH
increased adrenocorticotrophic hormone ‘s associated conditions
cushing’s disease - high acth –> stimulates adrenal gland resulting to production of cortisol
addison’s disease - low cortisol –> high ACTH due to lack of cortisol’s negative feedback
ectopic tumors
after protein-rich meals
it is a pituitary lactogenic hormone, a stress hormone, and a direct effector hormone
prolactin (PRL)
biological rhythm and pattern of prolactin
circadian rhythm and pulsatile like growth hormone
prolactin’s actions is inhibited by what hormone that is produced by the hypothalamus as well
dopamine
this hormone functions in the initiation and maintenance of lactation
prolactin
prolactin together with __ and __, they promotes breast tissue development
estrogen and progesterone
a hormone used in a supplemental test in erectile dysfunction
prolactin
unique characteristic of prolactin among the anterior pituitary hormones is the __
tonic inhibition
major circulating form of prolactin is
non glycosylated monomer
the 2 hormones that posterior pituitary is capable of releasing
oxytocin and vasoppresin
hormones produced by neuropophysis are controlled by
Central nervous system
it is a nonapeptide and very similar in composition to ADH o
oxytocin
it stimulates contraction of the gravid uterus at term “fergusson reflex “
oxytocin
it is a nonapeptide and very similar in composition to ADH
oxytocin
it is released in response to neural stimulation of receptors in the birth canal and uterus, and of touch receptors in the breast
oxytocin
it plays a role in hemostasis at the placental site following delivery
oxytocin
it stimulates muscle contraction during delivery and lactation - with bursts ___ secretion occuring with anticipation of nursing or on hearing a baby cry
oxytocin
what is the purpose of synthetic preparation of oxytocin to woman
to increase weak uterine contractions during parturition and to aid in lactation
is the function of oxytocin in males well known?
nope, oxytocin’s male function remains unknown
formerly known as the anti-diuretic hormone
arginine vasopressin
a nonapeptide that acts on the distal convoluted and collecting tubules of the kidneys
arginine vasopressin
decreases the production of urine by promoting reabsorption of water by the renal tubules thereby maintains water homeostasis
AVP
it regulates the total concentration of blood through water balance
arginine vasopressin
effect of arginine vasopressin to blood pressure
it increases blood pressure
kapag mababa ang volume ng blood/mababa ang blood pressure, magre-release ng AVP para pataasin ito
anti ihi
effect of AVP to permeability of the collecting tubules
it make sit permeable to absorb water
major function of AVP
maintains osmotic homeostasis by regulating water balance
what are the inhibitors of ADH release
ethanol, cortisol, lithium, demeclocycline
deficiency of AVP which results in severe polyuria
diabetes insipidus
hallmark of DI
hypotonic urine
urine osmolality of a patient with DI
<300 mOsm/kg
2 major types of diabetes insipidus
true diabetes
nephrogenic diabetes insipidus
this type of diabetes insipidus is characterized by either a complete or absence of or low plasma AVP with effective AVP receptors
true diabetes
this type of diabetes insipidus is seen as having normal plasma or elevated AVP but abnormally functioning AVP receptors
nephrogenic diabetes insipidus
known as the compulsive water drinking disorder without a stimulues
primary polydipsia
this condition is may be due to a faulty thirst hypothalamic mechanism
primary polydipsia
it results from the degradataion of the AVO by placental cysteine aminopeptidase or PCAP during pregnancy
gestational diabetes insipidus
gold standard in the diagnostic test in diabetes insipidus
water deprivation test/ dehydration test
osmolality which it shows sign of DI
serum osmolality > 295 mOsm/kg
dapat kasi lalabnaw na yan eh, 8 hrs no fluid na eh. Dpat si body ico-control na niya ung osmolality, dapat lower osmolality or malabnaw na
osmolality which it shows highly suggestive of DI
serum osmolality >305 mOsm/kg
urine osmolality where it will excludes DI
urine osmolality 800-1200 mOsm/kg
super concentrated na niyan, excluded na yan. Kasi if may DI dapat malabnaw ang wiwi <300 mOsm/kg
plasma osmolality of about 285 mOsm/kg usually acts as a trigger for __
thirst
this test differentiates neurogenic DI from nephrogenic DI
desmopressin
neurogenic DI - kulang sa AVP
nephrogenic DI - normal AVP pero di nagre-respond si kidney, possible baka sira
this test differentiate neurogenic DI from primary polydipsia
3% HSI with copeptin
this test differentiate neurogenic DI and primary polydipsia from nephrogenic DI
avp and copeptin
this condition is seen with continuous production of ADH in the absence of stimuli
SIADH - syndrome of inappropriate ADH secretion
diagnostic feature of a sample with SIADH
euvolemic hypoosmolar hyponatremia associated with hyperosmolar urine
