Endocrine Flashcards
What are the 3 chemical classes of hormones?
Steroids
Peptides
Biogenic Amines
Name 8 steroid hormones
Aldosterone (mineralocorticoid)renal cortex Z. Glomerulosa)
Androgens (ex: DHEA, renal cortex Z. Reticularis)
Calcitriol (made from calcidiol in kidneys)
Corticosterone
Cortisol (glucocorticoid; renal cortex Z. Fasciculata)
Estrogens
Progesterone
Testosterone
Steroid hormones are:
A. Lipid soluble and pass through plasma membrane
B. Water-soluble and use external cell receptors to enter cell
A. Lipid soluble
Name the 3 types of peptide hormones
Oligopeptides
Polypeptides
Glycoprotiens
Oligopeptides are 3-10aa long. Name 2 of them and where they are released
Oxytocin and Anti-diuretic Hormone (ADH)
Posterior pituitary
Polypeptides are 14-199aa long. Name 2 of them and the function of each
Insulin: lower BGL
Glucagon: increase BGL
Name the 2 glycoproteins
FSH, TSH
Peptide hormones are:
A: Water soluble
B: lipid soluble
A. Water soluble
Biogenic amines are:
A. Lipid soluble
B. Water soluble
B. Water soluble (except thyroid hormone TH)
Name the 4 water soluble monoamines and the 1 that isn’t
Water soluble: Dopamine Epinephrine Norepinephrine Melatonin
Non-water soluble Thyroid Hormone (TH)
Releasing hormones (& inhibiting hormones) are produced in neurons in the hypothalamus. They are stored in vesicles inside the cells until they are released. What does this suggest about the chemical nature of releasing hormones? A. They’re most likely cabs B. They’re most likely nucleic acids C. They’re most likely steroids D. They’re most likely peptides
D. Peptides because they’re water soluble (stored in vesicles)
Local hormones are not circulated in the blood, but rather act on the releasing cell, which are called _______, or neighboring cells, which are called ________.
Autocrine
Paracrine
The main group of local hormones are called what?
Eicosanoids
Eicosanoids, the main group of local hormones, are derived from what acid?
Arachadonic acid, a 20 carbon fatty acid cleaved from phospholipid membrane
Name the 3 groups of eicosanoid local hormones
Prostaglandins
Thromboxanes
Leukotrienes
What are prostaglandins?
Local eicosanoid hormones that can act as autocrine or paracrine.
Differ from endocrine hormones in that they are made throughout the body instead of just one place.
Vasodilator part of inflammation
Inhibit platelet aggregation
What are thromboxanes?
Local hormones of 20 carbon arachadonic acid
Vasoconstrict
Aid in platelet aggregation
What are leukotrienes?
20 carbon arachadonic acid eicosanoid local hormone
Made in leukocytes
Can be autocrine or paracrine
Usually accompanied by production of histamines and prostaglandins during inflammation
Trigger constriction of bronchioles and are major contributor to asthma and allergic rhinitis
Steroid hormones are bound to _______ _________ during transportation in the blood so they don’t act everywhere in the body.
Carrier protein
Steroid hormones enter the cell directly through the _______ __________.
Lipid membrane
________ hormones have to enter the cell, change the machinery, and then produce a product. They stay in the cell for ________ periods of time in contrast to water-soluble hormones.
Steroid
Longer
Do water soluble hormones enter the cell through :
A. the lipid membrane
B. Binding to membrane protein receptors
B. Binding to membrane protein receptors
Once a water soluble hormone binds the membrane receptor protein, a GTP binds, becomes GDP, and activates a ___ protein.
G protein
Path 1: The activated G protein goes to what enzyme bound to the cell membrane?
Adenylate cyclase
Activated G protein binds to adenylate cyclase, which turns ATP into
_________ ______.
Cyclic AMP or cAMP (2nd messenger)
- cAMP binds to and activates a
__________ kinase.
Protein
Path 2: The activated G protein goes to what enzyme?
Phospholipase C
Phospholipase C converts PIP2 into what two things?
IP3
DAG
2nd messenger IP3 can bind to endoplasmic reticulum, which causes the release of what?
Calcium (Ca 2+)
-cAMP can bind to ion channels which allows ____ to flow down concentration gradient into cell.
Ca2+
The released calcium from the binding of IP3 to the endoplasmic reticulum (sarcoplasmic reticulum in muscle cells), along with DAG, activate Protein Kinase C, which does what?
Adds phosphates to target proteins, which cause cellular responses
Calmodulin is activated once _____ binds to it, causing further downstream cellular responses, such as activating protein kinases.
Calcium
The benefit of water soluble hormones is that you already have the cellular machinery; it’s just a matter of turning it on. This is faster than _____soluble hormones.
Lipid
What makes a cell a target of a particular hormone?
The presence of a receptor for that particular hormone for water soluble hormones
For steroid hormones, it depends on the carrier protein that releases at specific effector organ cells
Protein hormones use the
______ _________ pathway, regulating existing enzymes, while steroid hormones influence _______ _________, creating new enzymes.
2nd messenger
Gene expression
Protein hormones act ______ while steroid hormones act ______.
Quickly
Slowly
Protein hormones longevity of effect is _______ while steroid hormone longevity of effect is more ___________.
Temporary
Permanent
Which hormone requires a carrier protein?
A. Protein
B. Steroid
B. Steroid
Hydrophilic hormones require a transport protein to travel in blood.
A. True
B. False
B. False
Many hormones follow a __________ rhythm.
Circadian
Removal of hormone from the blood is usually via the _____ or _______.
Liver
Kidneys
Half-life of each hormone varies and increases due to what?
Where it’s binding
Cells _______ receptors in response to reduced hormone concentration in the blood.
Up-regulate
Cells ________ receptors in response to elevated hormone concentration in the blood.
Down-regulate
Name the 3 different hormone interaction effects
Synergistic
Permissive
Antagonistic
Explain synergistic hormone interactions and provide example
Hormones work together to produce greater effect
Ex: epi and glucagon
Explain permissive hormone interactions and provide example
First hormone allows action of second hormone
Ex: Thyroid Hormone (TH) and epinephrine
Explain antagonistic hormone interactions and provide an example
One hormone causes opposite effect of another hormone
Ex: insulin/glucagon
The hypothalamus is directly connected to the __________ pituitary.
Posterior
The anterior pit is also known as the ____________, and the posterior pit is also known as the ___________.
Adenohypophysis
Neurohypophysis
The _____________-__________ portal system uses blood to transport hormones from the hypothalamus to the anterior pituitary.
Hypothalamo-hypophyseal
Name the 5 releasing hormones released from the hypothalamus to the anterior pituitary
TRH (thyrotropin releasing hormone) PRH (prolactin releasing hormone) GnRH (gonadotropin releasing hormone) CRH (corticotropin releasinghormone) GHRH (Growth hormone releasing hormone)
What does “-trophic” or “-tropic” mean?
Stimulating the activity of another endocrine gland
TRH (thyrotropin releasing hormone) stimulates the ant pit to release what?
TSH (Thyroid Stimulating hormone)
TSH from the ant pit stimulates the thyroid to release what?
TH thyroid hormone
What element of the periodic table is essential for the production of several thyroid hormones?
Iodine
Iodine is used to make T3 and T4, which ___________ the basal metabolic rate.
Increase
T3 and T4, causing an increase in metabolic rate, make all of the cells in the body work harder, so the cells need more energy too. This has several effects. Name 5 of them.
- Increase in body temp
- Increase in heart rate and contraction
- Glycogen breakdown and gluconeogenesis for cells to use as energy
- Increase in resp rate to accommodate for metabolic increase
- Activation of the nervous system leads to improved concentration and faster reflexes
The thyroid also produces ___________, which reduces blood calcium, in opposition to the parathyroid.
Calcitonin
T4 contains ___ Iodine atoms.
T3 contains ___.
4
3
30-40% of ____ is converted to ___ at the tissues
T4
T3
The major form of TH in the blood is ____, which has a longer half life than ____.
T4
T3
____ is converted into the active form, ____, inside cells.
T4
T3
What stimulates the hypothalamus to release GHRH?
Age
Time of day (more in morning)
Nutrient levels in the blood
Stress and exercise
GHRH stimulates the ant pit to release what?
GH (growth hormone)
GH goes directly to effector cells/organs, but it also goes to the ____, where _____ is produced.
Liver
IGF1
Both GH and IGF1 ______ target cells (effectors)
Stimulate
GH and IGF act on adipose connective tissue how?
Increased lypolysis
Decreased lipogenesis
GH and IGF act on the liver how?
Increased glycogenolysis
Increased gluconeogenesis
Decreased glycogenesis
GH and IGF1 act on all cells, to include muscle and bone cells, how?
Increased growth
Increased amino acid uptake, which results in protein synthesis
Cell division
Cell differentiations
What provides negative feedback to the ant pit?
- GH
- IGF
- GH and IGF
- GH alone
What provides negative feedback to the hypothalamus?
A. GH
B. IGF
C. Both GH and IGF1
C. Both
What is the net effect of GH?
Increased protein synthesis, cell division, and cell differentiation, esp in cartilage, bone, and muscle.
Release of stored nutrients into the blood
Name the two catecholamines released from the adrenal medulla.
Norepi
Epi
Z. Glomerulosa secretes what?
Type
Ex
Function
Mineralocorticoids
Aldosterone
Salt/H2O retention
Z. Fasciculata secretes what?
Type
Ex
Function
Glucocorticoids Cortisol Immune suppressant Increase BGL through gluconeogenesis Decrease bone formation Aids in metabolism of fat, protein, carbs
Z. Reticularis secretes what?
Type
Ex
Function
Gonadocorticoids
Androgens (ex DHEA)
Development of male and female sex organs
Moving on to the fucking parathyroid
UV light converts cholesterol into what?
Cholecalciferol
You can also obtain cholecalciferol through food
Cholecalciferol is converted to ________ in the _______.
Calcidiol
Liver
Calcidiol is converted to _______ in the ________.
Calcitriol
Kidneys
PTH works synergistically at the kidneys to increase production of ________.
Calcitriol, the active form of Vit D (duh)
Calcitriol stimulates the absorption of __________ ions from the small intestine into the blood.
Calcium
Calcitriol increases absorption of calcium from the ________ also.
Kidney
PTH also increases _____________ activity to increase calcium.
Osteoclast
An increase in plasma Calcium has a ________ __________ effect on the parathyroid.
Negative feedback
Estrogen aka estradiol, is responsible for secondary sex characteristics in females. It also promotes __________ growth and development of the ___________.
Endometrium
Fetus
________ is produced in the ovary and is responsible for maintaining pregnancy.
Progesterone
_______ is released from the ovaries when a female is ready to ovulate an egg.
Inhibin
The testis are an _______ and ________ gland
Exocrine
Endocrine
The testis secrete what?
Testosterone, which is responsible for male secondary sex characteristics
Also sperm development
That’s all
Inhibin does what??
Inhibits follicle stimulating secretion
The pancreas secretes both ______ and ________ hormones.
Exocrine
Endocrine
The pancreas secretes exocrine hormones, producing ______ ______ in the epithelium of the ducts.
Digestive enzymes
The pancreas also secretes endocrine hormones, such as ______ and ______, which decrease or increase BGL, respectively.
Insulin
Glucagon
Other endocrine glands/organs:
The skin does what to cholesterol w/ UV help
Converts it to cholecalciferol
The ________ gland produces melatonin.
Pineal
The liver produces ________, which becomes angiotensin after combining with renin from the kidneys.
Angiotensinogen
The liver also transforms cholecalciferol into __________.
Calcidiol
The liver ALSO converts GH into _ _ _.
IGF
The kidney converts calcidiol into what?
Calcitriol
The kidney also secretes _______ which combines with _______ from the liver, to create _______, which goes to the ______ and is converted by ______ to ________, which causes _________. This is important for our HTN pts who need an ACEI, such as _________.
I know this slide is confusing, but flip it over and learn it.
Renin Angiotensinogen Angiotensin 1 Lungs ACE (angiotensin converting enzyme) Angiotensin 2 Vasoconstriction Lisinopril
the heart also acts as an endocrine gland, secreting ANP (atrial natriuretic peptide), which does what?
Causes a reduction in extracellular fluid (ECF) volume by increasing renal sodium excretion.
_______ disease is a deficiency of the production of cortisol (and aldosterone)
Addison’s
Symptoms related to Addison’s and low cortisol include what?
Weight loss Low BGL or hypoglycemia Chronic fatigue Muscle weakness Loss of appetite Hypotension Dark/orange color of skin
Which president is thought to have Addison’s disease?
JFK, had the orange skin
________ disease is excess cortisol due to a pituitary or adrenal tumor.
Cushing’s
Symptoms related to high cortisol or Cushing’s disease are?
Weight gain Buffalo hump Central/trunkal obesity Moon facies Hyperglycemia Break down of muscle and bone protein Water and salt retention Prone to infections and poor healing
Cushing’s disease, characterized by sustained high levels of cortisol, can be caused by a tumor in the ______ _____, which secretes _ _ _ _.
Ant pit
ACTH (adrenocorticotropic hormone)
An anterior pituitary tumor would _______ production of ACTH (adrenocorticotropic hormone), causing the adrenal cortex to produce more cortisol, which would cause the hypothalamus to _________ production of CRH (corticotropin releasing hormone).
But an adrenal tumor would increase cortisol on its own, so ______ and ____ would be low.
increase
Decrease
ACTH
CRH
Micro adenoma are less than what?
1cm or 10mm
Macro adenoma are greater than what?
1cm or 10mm
The most common pituitary benign adenoma is a __________.
Prolactinoma, which causes galactorrhea, infertility, and amenorrhea
A prolactinoma causes what in males?
Decreased libido and impotence
A ________ agonist will decrease tumor size and symptoms.
Dopamine
GH secreting adenomas:
In children it causes _________ism.
Gigantism
In adults, a GH adenoma causes _____megaly.
Acromegaly
Abnormal GH levels also stimulate IGF1, and pts will have abnormal _______ tolerance tests and ______.
Glucose
DM
Describe the 3 steps of the hypothalamic, pituitary, adrenal axis.
Hypothalamus releases CRH (corticotropin releasing hormone)
Ant. Pituitary release ACTH (adrenocorticotropic hormone)
Adrenal cortex Z. Fasciculata releases glucocorticoid: cortisol
BOOM! Never forget, you got this, they chose YOU for a reason. Keep hammering.
Cushing’s syndrome vs Cushing’s disease?
Syndrome: prolonged exposure to cortisol, most common cause is prolonged exposure to corticosteroid meds, second mcc is pituitary adenoma or increased CRH from hypothalamus, adrenal cortical tumors, MEN-1 (multiple endocrine neoplasia, tumors in pituitary ACTH or adrenal cortex)
Disease: increased secretion of ACTH by anterior pituitary, mcc ant pit adenoma
What type of tumor is benign, arising from the Rathke cleft (an embryonic precursor of the adenohypophysis) that can act like a malignant tumor with recurrences and metastases
Craniopharyngioma
Exophthalmos is mcc by?
Grave’s disease, hyperthyroidism
Thyroid tumors are usually benign adenomas, but 4% are cancerous. What are the two most common malignant cancers of the thyroid?
Papillary (most common), Follicular for young women, good prognosis
Anaplastic is least common, in older pts, with poor prognosis
Most thyroid tumors/cancers are found in :
A. Men
B. Women
B. Women
What is the dx and tx for thyroid cancers?
Ultrasound with biopsy
Surgery, radioactive iodine ablation, TSH suppression with exogenous thyroxine
Primary hyperparathyroidism is secondary to inappropriate excess secretion of parathyroid hormone resulting in a hyper_____ and hypo______.
Hypercalcemia
Hypophosphatemia
Primary hyperparathyroidism is caused by a single parathyroid ________ in 80-85% of pts.
Adenoma
10-15% of hyperparathyroidism is caused by parathyroid __________.
Hyperplasia
Primary hyperparathyroidism is usually secondary to a parathyroid adenoma. What does “stones, bones, groans, and moans” mean?
Stones: renal calculus
Bones: osteoporosis, osteomalacia, arthritis
Abd groans: dyspepsia, indigestion, constipation, nausea, vomiting
Psych moans: fatigue, depression, ataxia, psychosis, memory loss
Where does the pancreas sit in relations to the other organs of the abdomen?
Retroperitoneal
What is the triad for Zollinger-Ellison Syndrome caused by a gastrinoma?
- Fulminating (rapidly growing) peptic ulcer disease
- Gastric acid hypersecretion
- Non-beta islet cell tumors of pancreas
TNM classification system:
A tumor described as To?
A tumor described as Tis?
A tumor described as T1,2,3,4
To: no evidence of primary tumor
Tis: tumor in situ (in place)
T#: ascending degrees of tumor size and involvment
TNM classification, Nodes: No? N1a, N2a? N1b, N2b, N3b? Nx?
No: no abnormal regional nodes
N1a: regional nodes, no metastasis
N1b: regional lymph nodes, Mets suspected
Nx: regional nodes cannot be assessed clinically
TNM classification, Mets:
Mo
M1,M2,M3
Mo: no evidence of distant Mets
M#: ascending degrees of metastatic involvement of host including distant nodes
What is the condition called when there is a tumor on the adrenal gland that causes increase in BP, HR and contraction, and hyperhydrosis/diaphoresis secondary to excess norepi?
Pheochromocytoma
A Conn tumor on the adrenal gland causes hyperaldosteronism. The symptoms are an increase in ____ and ____ which leads to an increase in BP, and a decrease in _____.
Na+, water
K+
Go (Z. Glomerulosa). Make (mineralocorticoids). Always (aldosterone)
Find (Z. Fasciculata). Good (glucocorticoids). Carry (cortisol)
Rex (Z. Reticularis). Sex (androgens). Dex (DHEA)
Nothing here to see, please move along
How many tickles does it take to make an octopus laugh?
Ten tickles, get it?
_______ drugs block the cleaved fatty acid from the phospholipid bilayer from becoming arachidonic acid (precursor of eicosanoids), while ________ block arachidonic acid from becoming eicosanoids such as prostaglandins, thromboxanes, and leukotrienes.
Steroids
NSAIDs
