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Endo > Endocrine Control of Growth (Nutting) > Flashcards

Endocrine Control of Growth (Nutting) Flashcards

1
Q

What is catch up growth?

A

(growth is stunted by illness) → catch up growth is the growth “spurt” that occurs to bring height or weight back up to ~nml

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2
Q

What is compensatory growth?

A

when parts of an organ is removed, the remaining organ hypertrophies to compensate
(i.e. kidney, liver, adrenals)

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3
Q

What are the requirements for growth

A
  1. proper nutrition
  2. sufficient hormones at the right time
  3. good psychosocial environment
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4
Q

What hormones play a role in normal somatic growth?

A 
GH, IGF-1
Vit D
Sex hormones
insulin 
TH
GI hormones (for nutrition digestion and abs)
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5
Q

What hormones are needed for juvenile stage of growth? Adolescent?

A

juvenile: GH + T3 + Vit D + insulin
adeoles: GH + T3 + Vit D + insulin + sec hormones

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6
Q

Is psychosocial dwarfism reversible

A

yes, they must be removed from envrio

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7
Q

how does excess and deficient growth hormone effect linear growth, skeletal maturation, and adult stature (if untreated)

A

Excess:
liner growth: ↑
skeletal maturation: nml
adult stature: ↑ = giantism

Deficient:
liner growth: ↓
skeletal maturation: delayed
adult stature: ↓ = hyposomatotrophic dwarfism

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8
Q

how does excess and deficient thyroid hormone effect linear growth, skeletal maturation, and adult stature (if untreated)

A

Excess:
liner growth: slight ↑
skeletal maturation: slight advanced
adult stature: minimal

Deficient:
liner growth: ↓
skeletal maturation: delayed
adult stature ↓

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9
Q

how does excess cortisol effect linear growth, skeletal maturation, and adult stature (if untreated)

A

Excess:
liner growth: ↓
skeletal maturation delayed
adult stature: ↓

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10
Q

how does excess and deficient androgen effect linear growth, skeletal maturation, and adult stature (if untreated)

A

Excess:
liner growth: ↑ then ↓
skeletal maturation: advanced
adult stature: ↓

Deficient:
liner growth: ↑ in extremities
skeletal maturation: delayed (adolescent)
adult stature: eunuchoidal (tall, long arms and legs)

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11
Q

how does deficient estrogen effect linear growth, skeletal maturation, and adult stature (if untreated)

A

Deficient:
liner growth: ↑ extremities
skeletal maturation: delayed (adolescent)
adult stature: ↑

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12
Q

somatamedin is aka

A

IGF-1

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13
Q

somatocrinin is aka

A

GHRH

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14
Q

eunuchoidal adult stature

A

untreated androgen deficiency

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15
Q

somatotrophin is aka

A

GH

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16
Q

structure of GH

A

22K from (90%) and 20K form (10%)

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17
Q

isolated GH deficiency leads to what condition/dz

A

hyposomatotrophic dwarfism

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18
Q

Why are cows given GH?

A

increases milk production

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19
Q

What hormones promote tallness?

A

GH + T3, which is permissive

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20
Q

What inhibits tallness?

A

gonadal steroids

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21
Q

effect of GH on bone

A

↑long bone growth at epiphyseal growth plate

↑ bone thickening (acromegaly)

22
Q

tibia test

A

the more growth hormone there is the wider the tibial plate is (less GH = narrower plate)

23
Q

IGF-1 deficiency leads to what condition/dz

A

laron dwarfism

pygmies

24
Q

effect of GH on DNA

A

↑ synthesis ∴ ↑ cel l #?

25
Q

effect of GH on RNA

A

↑ t ,m, and rRNA to increase protein synthesis

26
Q

how does GH affect fat metabolism

A

delayed effect to ↑ lipolysis ∴ ↑ FFA

27
Q

effect of GH on carbohydrate metabolims

A

MILDLY impairs glc uptake and utilization, GH must be ↑↑↑ for a long time to cause insulin resistance/T2DM

28
Q

what is the somatomedin hypothesis vs the dual effector hypothesis

A

both explain hoe GH increases growth

somatomedin hypot:
GH acts on the liver to ↑ IGF-1 secretion which directly acts on long bones/other target to ↑ growth
(i.e. says GH has indirect action)

dual effector hypoth:
GH acts on the liver to ↑ IGF-1 secretion which directly acts on long bones/other target to ↑ growth
but GH also acts directly on bones, muscle, adipose, etc to ↑ growth

29
Q

What is the secretion pattern of GH and when is it secreted?

A

episodic (ultradian)

major secretion at night (w/ deep sleep)

30
Q

How do you treat kids with GH insensitivity due to GH receptor mutation

A

give them IGF-1

31
Q

What is the major side effect of IGF-1 therapy

A

hypoglycemia (IGF = INSULIN LIKE growth factor)

32
Q

How do serum IGF-1 levels compare in acrogmegaly, hypopituitarism, and normal pts?

A

acro: HIGH, 4-10 U/mL
nml: present, 1-2 U/mL
hypopit: almost absent, <.1

33
Q 
What effect does GH have on ... and what does this change correlate to?
nitrogen
sodium
potassium
phosphorus
A

nitrogen ↑ = ↑pro synthesis
sodium ↑ = ↑extracellular space
potassium ↑ = ↑ intracellular space
phosphorus ↑ = ↑ bone growth

34
Q

What effect does GH have on T3 actions?

A

↑ sensitivity GHRH
↑ synthesis somatotrophs
↑ responsiveness of target cells

35
Q

What effect does low dose cortisone have on GH? larger dose?

A

small = no effect, GH still growth promoting

high = ↓GH effectiveness

36
Q

Is insulin required for growth?

A

yes

*in rats, no insulin = no growth

37
Q

somatostatin inc or dec GH

38
Q

IGF-1 inc or dec GH

A

dec (negative feedback)

39
Q

exercise inc or dec GH

40
Q

postprandial hyperglycemia inc or dec GH

41
Q

TH inc or dec GH

42
Q

estrogens inc or dec GH

43
Q

hyoiglycemia inc or dec GH

44
Q

glucocorticoids inc or dec GH

45
Q

hyperthyroidism inc or dec GH

46
Q

hypothyroidism inc or dec GH

47
Q

progesterone inc or dec GH

48
Q

GH conc inc or dec with age

A

inc unitl we are ~24 and then falls

49
Q

testosterone inc or dec GH

50
Q

insulin inc or dec GH

51
Q

What hormones are responsible for the pubertal growth spurt?

A

GH and IGF-1

52
Q

how is GH affected in psychosocial deprivation? how is it measured?

A

decreased; measure IGF-1

Endo (28 decks)

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