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AHP II > Endocrine, Kidney, and Calcium Regulation > Flashcards

Endocrine, Kidney, and Calcium Regulation Flashcards

1
Q

Physiology of the adrenal gland

A

2 divisions- Inner medulla and outer cortex.

The cortex can be divided further into the inner zona recticularis, middle zona fasciculata, and outer zona glomerulus.

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2
Q

What does the medulla and cortex of the adrenal gland release?

A

The medulla releases epinephrine and norepinephrine.

The cortex can be divided into 3 layers from inner to outer:

  1. Zona reticularis releases androgens and cortisol
  2. Zona fasciculata releases cortisol and androgens
  3. Zona glomerulosa releases aldosterone (can be released by itself or stimulated to release by RAAS system)
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3
Q

Adrenal gland insufficiency

  1. Caused by what?
  2. How does it affect other systems?
  3. May lead to
A
  1. Caused primarily by autoimmune attack.
  2. Without the release of aldosterone, there will be less Na+ reabsorption and K+ excretion. (imbalance)
  3. Imbalance may lead to hypotension since aldosterone works to increase BP when it is low.
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4
Q

Primary adrenal insufficiency is known as

A

Addison’s Disease. Any type of disfunction of the zona glomerulosa.

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5
Q

Vasopressin/ADH is released from the posterior pituitary and packaged into secretory vesicles with a carrier protein called

A

Neurophysin.

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6
Q

The posterior pituitary receives axons from which nuclei in the hypothalamus?

A

Receives axons from the supraoptic nuclei and the paraventricular nuclei.

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7
Q

The most common disease of humans and mammals related to antidiuretic hormone is

A

Diabetes inspidus.

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8
Q

Diabetes inspipidus can arise from 2 situations

A
  1. Hypothalamic (central) diabetes. Results from deficiency in secretion of ADH from the posterior pituitary. Could be due to head trauma, or infection.
  2. Nephrogenic Diabetes. Occurs when the kidney is unable to respond to ADH. Usually due to renal disease, or mutations in the ADH receptor. Usually associated with AQP2 not functioning properly.
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9
Q

Main sign of either type of diabetes insipidus

A

Excessive urine production.

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10
Q

Nephrogenic Diabetes Insipidus occurs due to the loss of function of which aquaporin?

A

Kidney is unable to respond properly to ADH. usually due to loss of function of AQP2.

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11
Q

2 hormone that originate in the Kidney

A
  1. Epo. Causes RBC production in the bone marrow.

2. Calcetrol (D3)

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12
Q

If visiting Denver, how long will it take for EPO to turn on/adjust?

A

2 weeks.

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13
Q

When is Epo secreted

A

In response to hypoxia. Stimulates RBC production.

Produced by fibroblasts in the kidney associated with the proximal convoluted tubule and peritubular capillaries.

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14
Q

Activated vitamin D is called

A

Calciferol. Fat soluble essential vitamin that helps to prevent skeletal disease by maintaining normal levels of calcium and phosphorous in the blood.

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15
Q

There are forms of activated and inactivated vitamin D. The kidney and GI tract can respond to which types?

A

Kidney can respond to all forms of Vitamin D. The GI tract can only respond to activated Vitamin D

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16
Q

Where is vitamin D’s receptor on a cell?

A

It is inside the cell on the nucleus. It is a lipid so it can travel through the membrane.

Majority of receptors are found in the cells of the small intestine.

Vit D binds to nuclear receptor, initiates mRNA to be produced to make calcium channels and put them on the cell membrane.

Allows calcium to enter the cell and be escorted by a calcium binding protein.

17
Q

Hyperparathyroidism

A

Release of too much parathyroid hormone. Can cause hypoglycemia or hypertension.

18
Q

Hyperglycemia

A

Secondary effect of hyperparathyroidism. Too much calcium in the blood

19
Q

Parathyroid hormone affects calcium levels how?

A

Increases levels of calcium in the blood. Causes reabsorption from kidneys and bones.

20
Q

Hypoparathyroidism

A

Not enough parathyroid hormone release. Low levels of calcium in the blood. Easy fix- take calcium supplement.

21
Q

Cells of the parathyroid gland (2)

A
  1. Chief cells: Make the parathyroid hormone

2. Oxyphil cells. No clue.

22
Q

How does vitamin D affect calcium levels

A

Vit D promotes bone reabsorption back into the body, but also helps in remineralization of bone by osteoblasts as well.

23
Q

Where are osteoblasts, osteocytes, and osteoclasts located at in the bone

A

Osteoblasts surround bone that is being made. They secrete it.

Osteocytes are found in the center of the bone being made. They are isolated, but connected by cannaliculi.

Osteoclasts chew up bone and release calcium. Creates a pit called Howship Lacunae.

24
Q

PTH. In addition to stimulating bone reabsorption, it also produces ___, which helps stimulate osteoblasts to remineralize the bone

A

Growth Factor

25
Q

Thyroid gland contains which types of cells

A

Has cuboidal follicle cells. In between, are “C” cells. They make 3 proteins

26
Q

What 3 peptides do C cells make of the thyroid?

A

Procalcitonin and calcitonin-gene related peptide or CGRP (alpha and beta)

27
Q

CGRP is a peptide created by C cells of the thyroid. Now in a new drug that is treating

A

Migraines.

28
Q

How is calcitonin derived?

A

C cells of the thyroid make precursor called procalcitonin. Then calcitonin is derived from this. It is a 32 amino acid peptide.

29
Q

Action of calcitonin?

A

Inhibition of bone reabsorption. Osteoclasts have receptors for calcitonin, causing them to stop. Antagonist of parathyroid hormone.

30
Q

What stimulates calcitonin to be released?

A

Elevated serum levels of calcium or GI levels such as gastrin.

31
Q

Which organs clear the serum of calcitonin once calcium levels are restored?

A

Kidney, liver, and bone clear the serum of calcitonin through a G protein receptor.

32
Q

Paget’s disease.

A

Excessive bone reabsorption and bone formation.

33
Q

Which two hormones that are highly active during puberty favor bone growth?

A

Estrogen and androgens. As people age, these hormones decrease, causing a decline in calcium. They favor bone growth by inhibiting hormones that cause reabsorption.

34
Q

Lack of vitamin D is linked to which diseases?

A 
AMD
Cardiovascular disease 
Diabetes 
Obesity 
Leukemia
35
Q

What is vitamin D dependent rickets type II

A

Impaired calcium absorption. Generally the receptor that doesn’t work is in the intestinal epithelium.

36
Q

Risk factors for osteoperosis

A

Older than 50
Female
Dark skin that cannot absorb Vitamin D from the sun as easily
Poor skin integrity due to non healthy epithelial cells
obesity
malabsorption

AHP II (11 decks)

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