Endocrine Flashcards
1
Q
What are the 3 chemical classes of hormones?
A
Steroids
Peptides
Biogenic Amines
2
Q
Name 8 steroid hormones
A
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
3
Q
Steroid hormones are:
A. Lipid soluble and pass through plasma membrane
B. Water-soluble and use external cell receptors to enter cell
A
A. Lipid soluble
4
Q
Name the 3 types of peptide hormones
A
Oligopeptides
Polypeptides
Glycoprotiens
5
Q
Oligopeptides are 3-10aa long. Name 2 of them and where they are released
A
Oxytocin and Anti-diuretic Hormone (ADH)
Posterior pituitary
6
Q
Polypeptides are 14-199aa long. Name 2 of them and the function of each
A
Insulin: lower BGL
Glucagon: increase BGL
7
Q
Name the 2 glycoproteins
A
FSH, TSH
8
Q
Peptide hormones are:
A: Water soluble
B: lipid soluble
A
A. Water soluble
9
Q
Biogenic amines are:
A. Lipid soluble
B. Water soluble
A
B. Water soluble (except thyroid hormone TH)
10
Q
Name the 4 water soluble monoamines and the 1 that isn’t
A
Water soluble: Dopamine Epinephrine Norepinephrine Melatonin
Non-water soluble Thyroid Hormone (TH)
11
Q
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
A
D. Peptides because they’re water soluble (stored in vesicles)
12
Q
Local hormones are not circulated in the blood, but rather act on the releasing cell, which are called _______, or neighboring cells, which are called ________.
A
Autocrine
Paracrine
13
Q
The main group of local hormones are called what?
A
Eicosanoids
14
Q
Eicosanoids, the main group of local hormones, are derived from what acid?
A
Arachadonic acid, a 20 carbon fatty acid cleaved from phospholipid membrane
15
Q
Name the 3 groups of eicosanoid local hormones
A
Prostaglandins
Thromboxanes
Leukotrienes
16
Q
What are prostaglandins?
A
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
17
Q
What are thromboxanes?
A
Local hormones of 20 carbon arachadonic acid
Vasoconstrict
Aid in platelet aggregation
18
Q
What are leukotrienes?
A
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
19
Q
Steroid hormones are bound to _______ _________ during transportation in the blood so they don’t act everywhere in the body.
A
Carrier protein
20
Q
Steroid hormones enter the cell directly through the _______ __________.
A
Lipid membrane
21
Q
________ 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.
A
Steroid
Longer
22
Q
Do water soluble hormones enter the cell through :
A. the lipid membrane
B. Binding to membrane protein receptors
A
B. Binding to membrane protein receptors
23
Q
Once a water soluble hormone binds the membrane receptor protein, a GTP binds, becomes GDP, and activates a ___ protein.
A
G protein
24
Q
Path 1: The activated G protein goes to what enzyme bound to the cell membrane?
A
Adenylate cyclase
25
Activated G protein binds to adenylate cyclase, which turns ATP into
_________ ______.
Cyclic AMP or cAMP (2nd messenger)
26
- cAMP binds to and activates a
| __________ kinase.
Protein
27
Path 2: The activated G protein goes to what enzyme?
Phospholipase C
28
Phospholipase C converts PIP2 into what two things?
IP3
| DAG
29
2nd messenger IP3 can bind to endoplasmic reticulum, which causes the release of what?
Calcium (Ca 2+)
30
-cAMP can bind to ion channels which allows ____ to flow down concentration gradient into cell.
Ca2+
31
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
32
Calmodulin is activated once _____ binds to it, causing further downstream cellular responses, such as activating protein kinases.
Calcium
33
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
34
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
35
Protein hormones use the
______ _________ pathway, regulating existing enzymes, while steroid hormones influence _______ _________, creating new enzymes.
2nd messenger
| Gene expression
36
Protein hormones act ______ while steroid hormones act ______.
Quickly
| Slowly
37
Protein hormones longevity of effect is _______ while steroid hormone longevity of effect is more ___________.
Temporary
| Permanent
38
Which hormone requires a carrier protein?
A. Protein
B. Steroid
B. Steroid
39
Hydrophilic hormones require a transport protein to travel in blood.
A. True
B. False
B. False
40
Many hormones follow a __________ rhythm.
Circadian
41
Removal of hormone from the blood is usually via the _____ or _______.
Liver
| Kidneys
42
Half-life of each hormone varies and increases due to what?
Where it’s binding
43
Cells _______ receptors in response to reduced hormone concentration in the blood.
Up-regulate
44
Cells ________ receptors in response to elevated hormone concentration in the blood.
Down-regulate
45
Name the 3 different hormone interaction effects
Synergistic
Permissive
Antagonistic
46
Explain synergistic hormone interactions and provide example
Hormones work together to produce greater effect
| Ex: epi and glucagon
47
Explain permissive hormone interactions and provide example
First hormone allows action of second hormone
| Ex: Thyroid Hormone (TH) and epinephrine
48
Explain antagonistic hormone interactions and provide an example
One hormone causes opposite effect of another hormone
| Ex: insulin/glucagon
49
The hypothalamus is directly connected to the __________ pituitary.
Posterior
50
The anterior pit is also known as the ____________, and the posterior pit is also known as the ___________.
Adenohypophysis
| Neurohypophysis
51
The _____________-__________ portal system uses blood to transport hormones from the hypothalamus to the anterior pituitary.
Hypothalamo-hypophyseal
52
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)
```
53
What does “-trophic” or “-tropic” mean?
Stimulating the activity of another endocrine gland
54
TRH (thyrotropin releasing hormone) stimulates the ant pit to release what?
TSH (Thyroid Stimulating hormone)
55
TSH from the ant pit stimulates the thyroid to release what?
TH thyroid hormone
56
What element of the periodic table is essential for the production of several thyroid hormones?
Iodine
57
Iodine is used to make T3 and T4, which ___________ the basal metabolic rate.
Increase
58
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.
1. Increase in body temp
2. Increase in heart rate and contraction
3. Glycogen breakdown and gluconeogenesis for cells to use as energy
4. Increase in resp rate to accommodate for metabolic increase
5. Activation of the nervous system leads to improved concentration and faster reflexes
59
The thyroid also produces ___________, which reduces blood calcium, in opposition to the parathyroid.
Calcitonin
60
T4 contains ___ Iodine atoms.
| T3 contains ___.
4
| 3
61
30-40% of ____ is converted to ___ at the tissues
T4
| T3
62
The major form of TH in the blood is ____, which has a longer half life than ____.
T4
| T3
63
____ is converted into the active form, ____, inside cells.
T4
| T3
64
What stimulates the hypothalamus to release GHRH?
Age
Time of day (more in morning)
Nutrient levels in the blood
Stress and exercise
65
GHRH stimulates the ant pit to release what?
GH (growth hormone)
66
GH goes directly to effector cells/organs, but it also goes to the ____, where _____ is produced.
Liver
| IGF1
67
Both GH and IGF1 ______ target cells (effectors)
Stimulate
68
GH and IGF act on adipose connective tissue how?
Increased lypolysis
| Decreased lipogenesis
69
GH and IGF act on the liver how?
Increased glycogenolysis
Increased gluconeogenesis
Decreased glycogenesis
70
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
71
What provides negative feedback to the ant pit?
1. GH
2. IGF
3. GH and IGF
1. GH alone
72
What provides negative feedback to the hypothalamus?
A. GH
B. IGF
C. Both GH and IGF1
C. Both
73
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
74
Name the two catecholamines released from the adrenal medulla.
Norepi
| Epi
75
Z. Glomerulosa secretes what?
Type
Ex
Function
Mineralocorticoids
Aldosterone
Salt/H2O retention
76
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
```
77
Z. Reticularis secretes what?
Type
Ex
Function
Gonadocorticoids
Androgens (ex DHEA)
Development of male and female sex organs
78
Moving on to the fucking parathyroid
UV light converts cholesterol into what?
Cholecalciferol
| You can also obtain cholecalciferol through food
79
Cholecalciferol is converted to ________ in the _______.
Calcidiol
| Liver
80
Calcidiol is converted to _______ in the ________.
Calcitriol
| Kidneys
81
PTH works synergistically at the kidneys to increase production of ________.
Calcitriol, the active form of Vit D (duh)
82
Calcitriol stimulates the absorption of __________ ions from the small intestine into the blood.
Calcium
83
Calcitriol increases absorption of calcium from the ________ also.
Kidney
84
PTH also increases _____________ activity to increase calcium.
Osteoclast
85
An increase in plasma Calcium has a ________ __________ effect on the parathyroid.
Negative feedback
86
Estrogen aka estradiol, is responsible for secondary sex characteristics in females. It also promotes __________ growth and development of the ___________.
Endometrium
| Fetus
87
________ is produced in the ovary and is responsible for maintaining pregnancy.
Progesterone
88
_______ is released from the ovaries when a female is ready to ovulate an egg.
Inhibin
89
The testis are an _______ and ________ gland
Exocrine
| Endocrine
90
The testis secrete what?
Testosterone, which is responsible for male secondary sex characteristics
91
Also sperm development
That’s all
92
Inhibin does what??
Inhibits follicle stimulating secretion
93
The pancreas secretes both ______ and ________ hormones.
Exocrine
| Endocrine
94
The pancreas secretes exocrine hormones, producing ______ ______ in the epithelium of the ducts.
Digestive enzymes
95
The pancreas also secretes endocrine hormones, such as ______ and ______, which decrease or increase BGL, respectively.
Insulin
| Glucagon
96
Other endocrine glands/organs:
| The skin does what to cholesterol w/ UV help
Converts it to cholecalciferol
97
The ________ gland produces melatonin.
Pineal
98
The liver produces ________, which becomes angiotensin after combining with renin from the kidneys.
Angiotensinogen
99
The liver also transforms cholecalciferol into __________.
Calcidiol
100
The liver ALSO converts GH into _ _ _.
IGF
101
The kidney converts calcidiol into what?
Calcitriol
102
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
```
103
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.
104
_______ disease is a deficiency of the production of cortisol (and aldosterone)
Addison’s
105
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
```
106
Which president is thought to have Addison’s disease?
JFK, had the orange skin
107
________ disease is excess cortisol due to a pituitary or adrenal tumor.
Cushing’s
108
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
```
109
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)
110
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
111
Micro adenoma are less than what?
1cm or 10mm
112
Macro adenoma are greater than what?
1cm or 10mm
113
The most common pituitary benign adenoma is a __________.
Prolactinoma, which causes galactorrhea, infertility, and amenorrhea
114
A prolactinoma causes what in males?
Decreased libido and impotence
115
A ________ agonist will decrease tumor size and symptoms.
Dopamine
116
GH secreting adenomas:
| In children it causes _________ism.
Gigantism
117
In adults, a GH adenoma causes _____megaly.
Acromegaly
118
Abnormal GH levels also stimulate IGF1, and pts will have abnormal _______ tolerance tests and ______.
Glucose
| DM
119
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.
120
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
121
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
122
Exophthalmos is mcc by?
Grave’s disease, hyperthyroidism
123
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
124
Most thyroid tumors/cancers are found in :
A. Men
B. Women
B. Women
125
What is the dx and tx for thyroid cancers?
Ultrasound with biopsy
| Surgery, radioactive iodine ablation, TSH suppression with exogenous thyroxine
126
Primary hyperparathyroidism is secondary to inappropriate excess secretion of parathyroid hormone resulting in a hyper_____ and hypo______.
Hypercalcemia
| Hypophosphatemia
127
Primary hyperparathyroidism is caused by a single parathyroid ________ in 80-85% of pts.
Adenoma
128
10-15% of hyperparathyroidism is caused by parathyroid __________.
Hyperplasia
129
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
130
Where does the pancreas sit in relations to the other organs of the abdomen?
Retroperitoneal
131
What is the triad for Zollinger-Ellison Syndrome caused by a gastrinoma?
1. Fulminating (rapidly growing) peptic ulcer disease
2. Gastric acid hypersecretion
3. Non-beta islet cell tumors of pancreas
132
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
133
```
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
134
TNM classification, Mets:
Mo
M1,M2,M3
Mo: no evidence of distant Mets
| M#: ascending degrees of metastatic involvement of host including distant nodes
135
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
136
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+
137
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
138
How many tickles does it take to make an octopus laugh?
Ten tickles, get it?
139
_______ 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
