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Endocrine 2 Flashcards

1
Q

List the steps in conversion of cholesterol to aldosterone.

A
  1. Cholesterol
  2. Pregnenolone
  3. Progesterone
  4. 11-deoxycorticosterone
  5. Corticosterone
  6. 18(OH) Corticosterone
  7. Aldosterone
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2
Q

What enzyme converts cholesterol to pregnenolone in all three layers of the adrenal cortex?

A

Cholesterol side chain cleavage, P450scc, Desmolase, Cyp11A1

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3
Q

What enzyme converts pregnenolone to progesterone in the G and F?

A

3-beta-HSD

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4
Q

What enzyme converts progesterone to 11-deoxycorticosterone?

A

21-hydroxylase, p450c21, Cyp21A2

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5
Q

What enzyme converts 11-deoxycorticosterone to corticosterone?

A

11-hydroxylase, P450c11, Cyp11B2

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6
Q

What enzyme converts corticosterone to 18(OH) corticosterone?

A

18-hydroxylase, p450aldo, aldosterone synthase, Cyp11B2

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7
Q

What enzyme converts 18(OH) corticosterone to aldosterone?

A

18-oxidase, p450aldo, aldosterone synthase, Cyp11B2

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8
Q

List the steps in conversion of cholesterol to cortisol.

A
  1. Cholesterol
  2. Pregnenolone
  3. Progesterone
  4. 17(OH) progesterone
  5. 11-deoxycortisol
  6. Cortisol
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9
Q

What enzyme converts progesterone to 17(OH) progesterone?

A

17-hydroxylase, P450c17, Cyp17

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10
Q

What enzyme converts 17(OH) progesterone to 11-deoxycortisol?

A

21-hydroxylase, P450c21, Cyp21A2

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11
Q

What enzyme converts 11-deoxycortisol to cortisol?

A

11-hydroxylase, P450c11, Cyp11B1

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12
Q

List the steps in conversion of cholesterol to DHEA.

A
  1. Cholesterol
  2. Pregnenolone
  3. 17(OH) pregnenolone
  4. DHEA
  5. DHEAS or Androstendione
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13
Q

What enzyme converts pregnenolone to 17(OH) pregnenolone?

A

17-hydroxylase, p450c17, Cyp17

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14
Q

What enzyme converts 17(OH) pregnenolone to DHEA?

A

17, 20-lyase; Cyp17

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15
Q

What enzyme converts DHEA to DHEAS?

A

Sulfotransferase

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16
Q

What enzyme converts DHEA to androstendione?

A

3-beta-HSD

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17
Q

Describe the levels of DHEA, glucocorticoids, and mineralocorticoids in 11-hydroxylase deficiency.

A
  1. High DHEA
  2. No glucocorticoids
  3. Low aldosterone, high MR activity
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18
Q

Describe the symptoms of 11-hydroxylase deficiency.

A
  1. Hypertension
  2. Hypokalemia
  3. Low renin, high ANP
  4. Masculinization
  5. High ACTH
  6. Salt and water retention
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19
Q

Describe the levels of DHEA, glucocorticoids, and mineralocorticoids in 17-hydroxylase deficiency.

A
  1. Low DHEA
  2. No glucocorticoids
  3. Low aldosterone, high MR activity
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20
Q

Describe the symptoms of 17-hydroxylase deficiency.

A
  1. Hypertension
  2. Hypokalemia
  3. Feminization/ambiguous genitalia
  4. High ACTH
  5. Salt and water retention
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21
Q

Describe the levels of DHEA, glucocorticoids, and mineralocorticoids in 21-hydroxylase deficiency.

A
  1. High DHEA
  2. No glucocorticoids
  3. No mineralocorticoids
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22
Q

Describe the symptoms of 21-hydroxylase deficiency.

A
  1. Hypotension
  2. Hyperkalemia
  3. High renin
  4. Masculinization/ambiguous genitalia
  5. High ACTH
  6. Sodium loss
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23
Q

Which 2 hormones are released from the ARC?

A
  1. Dopamine

2. GHRH

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24
Q

Which 4 hormones are release from the PVN?

A
  1. AVP
  2. CRH
  3. OXY
  4. TRH
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25
Q

Which hormone is released from the SON?

A
  1. AVP
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26
Q

Which hormone is released from the PeVN?

A
  1. Somatostatin
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27
Q

Which hormone is released from the POA?

A
  1. GnRH
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28
Q

What are the components of the HPL axis?

A

H: GHRH (ARC)
P: GH (somatotropes)
L: IGF-1 (liver)

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29
Q

What are the components of the HPA axis?

A

H: CRH (PVN)
P: ACTH (corticotropes)
A: Cortisol (zona fasciculata of adrenal cortex)

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30
Q

What are the components of the HPT axis?

A

H: TRH (PVN)
P: TSH (thyrotropes)
T: T3/T4 (follicles of thyroid gland)

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31
Q

What are the components of the HPG axis?

A

H: GnRH (POA)
P: LH/FSH (gonadotropes)
G: Androgens and Estrogens (testes/ovaries)

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32
Q

What are the receptors of CRH and which has a higher affinity for the hormone?

A

CRH-R1 (higher affinity for CRH)

CRH-R2 (higher affinity for urocortin)

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33
Q

What are the receptors of ACTH and which has a higher affinity for the hormone?

A

MC1R (lower affinity)

Mc2R (higher affinity)

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34
Q

What are the receptors of PTH and what is bound to each?

A

PTH1R: binds 1-34, 1-84, PTHrP
PTH2R: binds 1-34

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35
Q

Broadly, what is the result of the HPL axis?

A

Promotion of lean body mass, increased protein, decreased adiposity, increased plasma glucose

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36
Q

Broadly, what is the result of the HPA axis?

A

Steroidogenesis, cell growth, decrease muscle mass, bone formation, connective tissue, inflammation, increase arteriolar tone, fetus maturation, GFR/free water clearance

37
Q

Broadly, what is the result of the HPT axis?

A

Generation of futile metabolic cycles (metabolic homeostasis)

38
Q

Broadly, what is the result of the HPG axis?

A

Reproduction

39
Q

Which hormones must be released in a pulsatile manner?

A
  1. GHRH
  2. GH
  3. CRH
  4. GnRH
40
Q

What is the binding protein of AVP?

A

Neurophysin II

41
Q

What is the binding protein of OXY?

A

Neurophysin I

42
Q

What is the binding protein of GH?

43
Q

What is the binding protein of cortisol?

44
Q

What is the binding protein of T3/T4?

45
Q

What are the binding proteins of sex hormones?

46
Q

What hormone tonically activates dopamine?

47
Q

What hormone activates NE?

48
Q

What hormone activates EPI?

49
Q

What hormones activate GH?

A

Dopamine, NE/E, TH, ghrelin

50
Q

What hormone activates somatostatin?

51
Q

What hormones activate prolactin?

A

Estrogen, TRH, OXY

52
Q

What hormone activates CRH?

53
Q

What hormone activates Vitamin D?

54
Q

What hormones activate LH?

A

Fast GnRH pulses, kisspeptin, activin, estradiol

55
Q

What hormones activate FSH?

A

Slow GnRH pulses, kisspeptin, activin

56
Q

What hormone activates DHEA?

57
Q

What hormone activates testosterone?

58
Q

What hormones activate glucagon?

59
Q

What hormones activate EPO?

A

TH, NE, androgens

60
Q

What hormone inhibits AVP?

61
Q

What hormone inhibits GHRH?

A

Somatostatin

62
Q

What hormone inhibits somatostatin?

63
Q

What hormone tonically inhibits prolactin?

64
Q

What hormones tonically inhibits TSH?

A

Somatostatin, dopamine

65
Q

What hormone inhibits testosterone?

66
Q

What hormones inhibit insulin?

A

NE, E, ghrelin

67
Q

What hormone inhibits EPO?

68
Q

GH stimulation of IGF-1 in the liver is dependent upon what hormone?

69
Q

What activates CYP11B2 to synthesize aldosterone?

A

Angiotesin II

70
Q

How does PTH regulate calcium?

A

Increases bone resorption and plasma Ca2+

71
Q

How does Vitamin D regulate calcium?

A

Increases bone resorption, plasma Ca2+, and intestinal Ca2+ uptake

72
Q

How does calcitonin regulate calcium?

A

Decreases bone resorption and plasma Ca2+

73
Q

How does estrogen regulate calcium?

A

Increases 1-alpha-hydroxylase activity, stimulates OPG, leads to net decrease in bone loss

74
Q

How do GH and IGF-1 regulate calcium?

A

Stimulate bone synthesis and growth

75
Q

How do glucocorticoids regulate calcium?

A

Increase bone resorption, decrease bone synthesis, inhibit OPG

76
Q

What is the onset age in T1DM and T2DM?

A

1: Juvenile
2: Adult

77
Q

What is the major risk factor in T1DM and T2DM?

A

1: autoimmune
2: obesity

78
Q

What is the status of beta cells in T1DM and T2DM?

A

1: destroyed
2: partially functioning

79
Q

What are the insulin levels in T1DM and T2DM?

A

1: none-low
2: variable

80
Q

What is tolerance to glucose in T1DM and T2DM?

A

1: severely intolerance
2: variable

81
Q

What is the insulin dependence in T1DM and T2DM?

A

1: insulin dependent
2: variable

82
Q

What is the insulin resistance in T1DM and T2DM?

A

1: not resistant
2: insulin resistant

83
Q

Menarche (first menses) usually occurs at what age?

A

Between 11-14 y/o, avg. 12.5

84
Q

What is thelarche and when does it occur?

A

Breast budding; typically occurs before menstruation

85
Q

No puberty stages before age ___ is cause for evaluation.

86
Q

A difference in Tanner stages of more than ___ is cause for concern.

87
Q

What is the first puberty sign for females and males?

A

Breast bud development; testicle enlargement

88
Q

Define precocious puberty for females and males.

A

Females: puberty before 8
Males: puberty before 9

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