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Pathohysiology > Endocrine > Flashcards

Endocrine Flashcards

1
Q

many hormones are synthesized in

A

several tissues

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2
Q

for most hormones, a tissues produces the hormone in _____(the gland) and other tissues secrete the hormone in ____ quantities

A

the gland produces large amounts of the hormone and other tissues secrete much smaller amounts of the hormone.

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3
Q

hormones are released in response to

A

an alteration in the cellular environment

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4
Q

hormones are released to maintain

A

a regulated level of certain substances or other hormones

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5
Q

what are hormones regulated by?

A

chemical, hormonal, or neural factors.

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6
Q

what are some water soluble hormones?

A

peptides

catecholamines

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7
Q

how do water soluble hormones circulate in the blood stream?

A

they generally circulate as free hormones

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8
Q

what are some water insoluble hormones?

A

steroid hormones

thyroid hormones

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9
Q

how do water insoluble hormones circulate in the blood stream?

A

they are carried in the blood bound to plasma proteins.

At low concentrations they are dissolved in the blood and travel as free hormones

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10
Q

water insoluble hormones reach an ____ between the protein bound hormone and the free hormone

A

equilibrium

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11
Q

the protein bound hormone cannot _____ and therefore serves as a circulating ___

A

cannot bind to receptors and therefore serves as a circulating reservoir for the hormones

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12
Q

which hormone is the active hormone? the free or the bound?

A

the free hormone is the active hormone

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13
Q

what affects the ratio of free to bound hormones?

A

changing the concentration of hormone binding proteins in the plasma.
drugs that compete for binding sites

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14
Q

what can change the concentration of hormone binding proteins in the plasma?

A

liver damamge
malnutrition
hormones such as estrogen

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15
Q

autocrine interactions

A

a cell releases hormones that affect itself and all identical cells

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16
Q

paracrine interaction

A

a cell releases hormones that affect cells around it in the same tissue

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17
Q

classic endocrine interactions

A

cells in one tissue produce hormones that affect cells in another tissue

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18
Q

what are the action of water soluble hormones?

A

signal transduction
second messenger
first messenger

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19
Q

what are examples of first messenger water sol hormones?

A

peptide hormones

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20
Q

what are examples of second messenger water sol hormones?

A

calcium

cAMP

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21
Q

what are possible causes of altered hormone levels?

A

usually a problem of the production or the reception of the hormone
failure of feedback systems

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22
Q

what alters hormone production?

A

dysfunction of an endocrine gland
ectopic hormone release
increased hormone degradation or inactivation

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23
Q

what might cause dysfunction of an endocrine gland?

A

secretory cells are unable to produce, obtain or convert hormone precursors or
the endocrine gland synthesizes or releases excessive amounts of hormone

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24
Q

how might there be altered hormone reception?

A

receptors associated disorders

inadequate synthesis of a second messenger

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25
Q

what are examples of receptor-associated disorders?

A

decrease in number of receptors
impaired receptor function
presence of antibodies against specific receptors
antibodies that mimic hormone action

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26
Q

the posterior pituitary consists of neurons with a cell body in the ___ and the axon ending in the _____

A

cell body in the hypothalamus and the axon ending in the posterior pituitary

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27
Q

SIADH

A

syndrome of inappropriate antidiuretic hormone secretion

hypersecretion of ADH

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28
Q

what do you need to be able to diagnose SIADH

A

normal adrenal and thyroid function must exist

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29
Q

what are clinical manifestations of SIADH?

A

enhanced renal water retention
hyponatremia and hypoosmolarity
high concentrated urine
increase sodium loss bc of an increase in blood volume

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30
Q

what are the actions of SIADH?

A

causes an increase in permeability of the renal collecting duct to water
at high concentrations causes constriction of arterial smooth muscle

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31
Q

what does ADH do?

A

inserts aquaporins into the wall of the collecting duct which leads to water reabsorption without ion reabsorption

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32
Q

what are some causes of SIADH?

A

ectopic production of ADH by cancer cells
surgery (related stress)
Drugs like: anesthetic agents, morphine, opiates, barbiturates)
cranial abnormalities ( head trauma, brain tumor, etc.)

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33
Q

what are treatments for SIADH?

A

water restriction
remove tumor is present
ADH receptor blocker

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34
Q

Diabetes insipidus

A

insufficiency of ADH
polyuria and polydipsia
partial or total inability to concentrate the urine

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35
Q

neurogenic diabetes insipidus

A

damage to the brain or posterior pituitary. Generally caused by trauma of the head, cranial surgery, cranial tumor, or idiopathic
insufficient ADH

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36
Q

nephrogenic diabetes insipidous

A

lack of ADH receptors in the kidney or lack of function of the receptors to modify permeability
insufficient ADH response

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37
Q

psychogenic diabetes insipidus

A

drinking too much water

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38
Q

how do you treat psychogenic DI?

A

water restriction

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39
Q

how do you treat nephrogenic DI?

A

drink large amounts of water and have a diet rich in sodium chloride

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40
Q

How do you treat neurogenic DI?

A

ADH replacement (generally nasally)

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41
Q

how does oxytocin affect the cervix during birth?

A

stretch of the cervix

42
Q

what are the psychological triggers of oxytocin release?

A

mother hearing baby crying
mother thinking about baby
stress

43
Q

oxytocin is called the “love hormone” because of it’s role in

A

intimacy

44
Q

tactile stimulation of the breast (nursing) mediates release of

A

oxytocin

45
Q

What are the consequences of hyposecretion of oxytocin?

A

Possible lack of milk ejection and prolonged labor

possible lack of compassion, bonding, etc/

46
Q

what are the consequences of hypersecretion of oxytocin?

A

galactorrhea

47
Q

What are the hormones of the anterior pituitary?

A 
andrenocorticotropic hormone (ACTH)
leutinizing hormone (LH)
follicle stimulating hormone (FSH) 
Growth hormone (GH)
prolactin (PRL)
thyroid stimulating hormone (TSH)
48
Q

because the pituitary is highly vascularized, it is vulnerable to

A

ischemia and infarction

49
Q

pituitary infarction is a result of

A

hemorrhaging

50
Q

pituitary infarction can lead to

A

hypopituitarism

51
Q

sheehan syndrome

A

blood loss from severe hemorrhage during delivery can damage mother’s pituitary

52
Q

hyperpituitarism is commonly due to

A

a benign, slow-growing pituitary adenoma

53
Q

what are the consequences of hyperpituitarism?

A

headache (if tumor is large)
visual defect (if tumor is large)
Oculomotor palsies

54
Q

what ocularmotor palsies may result from hyperpituitarisms?

A

an inability to properly dilate or constrict the pupil in one or more eyes
inability to properly follow objects with the eyes
inability to open eyelid properly

55
Q

what are two consequences of hypersecretion of the growth hormone(GH)?

A

gigantism

acromegaly

56
Q

gigantism

A

hypersecretion of GH in children and adolescents

57
Q

acromegaly

A

hypersecretion of GH during adulthood

58
Q

what are some factors that stimulate GH release?

A

GRH
Ghrelin from stomach and hypothalamus
estrogen
testosterone

59
Q

what are some factors that inhibit GH release?

A

somatostatin

IGF

60
Q

how does somatostatin inhibit GH release?

A

GH stimulates the hypothalamus to secrete somatostatin and decrease secretion of GRH

61
Q

how does IGF inhibit GH production?

A

IGF inhibits GH release and increases somatostatin and inhibits GRH release from the hypothalamus

62
Q

GH stimulates ___ production by the liver and other tissues

A

IGF

63
Q

GH and IGF stimulate growth of ___ at the epiphyseal plate

A

long bones

64
Q

GH and IGF increase _____ incorporation into proteins

A

Amino Acid

65
Q

GH and IGF inhibit ___ breakdown

A

Protein Breakdown

66
Q

GH and IGF increases

A

lipolysis

67
Q

GH inhibits hepatic ____ and promotes ______

A

inhibits glucose uptake and promotes gluconeogenesis

68
Q

GH stimulates the ___ system

A

Immune System

69
Q

what are clinical manifestations of acromegaly?

A 
large: tongue, lips, fingers, toes, jaw bone, ears, and skull bones. 
increase in blood glucose 
joint paint 
barrel chest
CV diseases
70
Q

how do we treat hypersecretion of GH?

A

Somatostatin analog (octreotide)
surgery if drug therapy fails
radiation if drug therapy and surgery fail to treat tumor

71
Q

What does Somatostatin analog (octreotide) do?

A

inhibits GH, glucagon, and insulin

72
Q

What are the effects of hyposecretion of GH in children?

A

growth failure
increased percentage of fat and reduced lean mass
poor strength and development of bones
poor immune function

73
Q

what does young adult onset of hyposecretion of GH cause?

A 
poor lactation 
poor immune system function 
low blood glucose 
depression 
decreased mass of bone
74
Q

inhibition of somatostatin reduces___

A

fat gain

75
Q

Prolactin is stimulated by

A

TRH and Oxytocin

76
Q

stress an high estrogen, ovulation and suckling inhibit or stimulate prolactin?

A

stimulate

77
Q

Prolactin is inhibited by

A

somato and dopamine

78
Q

plasma prolactin causes the hypothalamus to increase___

A

dopamine

79
Q

Dopamine release and decrease the release of various stimulatory factors and therefore

A

PRL inhibits it’s own release

80
Q

estrogen and progesterone together ____ prolactin

A

inhibit

81
Q

prolactin induces proliferation of

A

glandular tissue of the mammary glands

82
Q

prolactin regulates synthesis of ___ by the mammary glands

A

milk protein

83
Q

prolactin inhibits the release of ____ and ____ from pituitary

A

LH and FSH

84
Q

Prolactin blocks the effects of ___ and ___ on the gonads

A

LH and FSH

85
Q

Prolactin stimulates the ___ system

A

immune

86
Q

prolactin is negatively regulated by the ____

A

hypothalamus
PIF
dopamine

87
Q

what are the effects of hypersecretion of prolactin in females?

A

amenorrhea
galactorrhea
hirsutism
osteopenia

88
Q

what are the effects of hypersecretion of prolactin in males?

A

hypogonadism
impaired libido
gynecomastia (rarely)
infertility

89
Q

what are the manifestations of hyposecretion of prolactin?

A

poor milk production

poor function of immune system

90
Q

thyroid hormone is stimulated by

A

TRH

cold

91
Q

Thyroid hormone if inhibited by

A

SRIH
dopamine
stress

92
Q

___ increases the release of T3 and T4 from the thyroid gland

A

TSH

93
Q

how is over 2/3 of the body’s T3 produced?

A

by the tissues deiodinating T4 to T3

94
Q

T3 inhibts release of

A

TRH and TSH

95
Q

T3 increases release of

A

SRIH

96
Q

how does T3 effects cellular activity?

A

by binding to an intracellular receptor and interacts with DNA to increase mRNA synthesis

97
Q

how does T3 effect metabolism?

A

treatment with thyroid increases metabolic rate

98
Q

what are clinical manifestations of hyperthyroidism?

A 
increased HR 
increased BP 
High body temp
head aches 
muscle weakness due to decreased muscle mass 
weight loss 
nervousness, inability to concentrate 
irritable 
difficulty in sleeping 
increased blood clorring
99
Q

how do you treat hyperthyroidism?

A

drugs that inhibit iodine utilization
radioactive iodine
surgery

100
Q

what are the effects of excess thyroid during pregnancy?

A

reduced birth weight

increased risk of malformation

Pathohysiology (16 decks)

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