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Endocrine Part I Key Points Flashcards

1
Q

What is true about hormone structures?

A

Either hydrophilic or hydrophobic with hydrophilic hormones having the greatest effects through membrane surface receptors and second messenger systems.

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2
Q

What is hydrophobic membranes?

A

Travel in the blood bound to carrier proteins, diffusing into cells to link with receptors that bind to DNA, altering transcription and translation

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3
Q

Where is hypothalamus found?

A

Below thalamus base of the brain on each side of the midline surrounding the third ventricle and lying above the pituitary gland

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4
Q

What is the function of hypothalamus?

A

Hypothalamic nuclei interact by synaptic connections, produce peptide neurotransmitters, and regulate sleep and waking, food intake, thirst, temp regulation, and autonomic hormones

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5
Q

What hormone does hypothalamus release?

A

Neuroendocrine cells with axons traveling in pituitary stalk, where they release pituitary-controlling hormones

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6
Q

What are the six anterior pituitary hormones and what controls it?

A

Nuclei neuroendocrine cells secrete releasing and inhibiting hormones that control release of all six anterior hormones
- TRH
- GnRH
- Growth hormone
- Corticotropin-releasing hormone (CRH)
- Inhibiting hormones (somatostatin and dopamine)

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7
Q

What does TRH regulates?

A

Regulates pituitary production and release of TSH

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8
Q

What does GnRH regulates?

A

Regulates both LH and FSH

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9
Q

What is growth hormone responsible for?

A

Releasing hormone GHRH regulates GH

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10
Q

What is corticotropin responsible for?

A

Releasing hormone (CRH) regulates the production and release of ACTH

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11
Q

What are the two hypothalamic inhibiting hormones?

A

somatostatin (SST-GH inhibiting hormone
Neurotransmitter dopamine that serves as inhibitor of inhibits PRL secretion

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12
Q

What connects the hypothalamus to the pituitary gland?

A

Infundibulum (pituitary stalk) and has blood vessel that receive hypothalamic hormones and axons of AVP and OT neurons

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13
Q

What does the posterior pituitary gland hold?

A

Site of AVP and OT secretion

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14
Q

What does the anterior pituitary contains?

A

Endocrine cells that secrete ACTH, TSH, LH, FSH, GH, and PRL

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15
Q

What produces AVP and OT?

A

Neuroendocrine cells in the paraventricular and supraoptic nuclei

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16
Q

What does AVP secretion stimulated by?

A

Increased blood osmolality (detected by ant hypothalamic osmoreceptors) and by hypotension and hypovolemia sensed by baroreceptors

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17
Q

What does angiotensin II receptor do in hypothalamus?

A

Stimulate AVP secretion and also cause thirst

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18
Q

How is OT secretion stimulated?

A

Labor and during milk let down when lactating

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19
Q

What organ is at the base of the brain, contains neurons that control many homeostatic functions?

A

Hypothalamus

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20
Q

What is referred to as the hypothalamic-pituitary axis?

A

Neuroendocrine cells within several hypothalamic nuclei produce hormones that stimulate or inhibit function of anterior pituitary endocrine cells

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21
Q

What hormones are secreted from the posterior pituitary gland by terminals of hypothalamic neuroendocrine cells?

A

Vasopressin and Oxytocin

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22
Q

What does absence of vasopressin secretion leads to?

A

Production of copious amounts of very dilute urine and hyperosmolality

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23
Q

What does excessive vasopressin leads to?

A

Abnormal water retention, decreased urine production, and dilutional hyponatremia

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24
Q

Ant pituitary endocrine cells produce hormones with stimulatory actions on endocrine target glands (adrenal, thyroid, gonads) or modulatory actions on all body tissues (growth hormone or breast (PRL). True or False

A

True

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25
What is tropic or trophic (growth-promoting) hormones?
Ant pituitary hormones that stimulate growth and secretion of target glands
26
What pattern does secretion of hormones often occurs?
Pulsatile pattern with pulses lasting several minutes
27
How does hormone levels demonstrate regular times cycles of secretion?
Ultradian, circadian, or infradian rhythms
28
What is the key regulator of many hormones?
Negative feedback inhibition including hypothalamic-releasing hormones and pituitary trophic hormones
29
What is the major functions of the pituitary gland?
Secretion of growth hormone and prolactin that influence target tissues - Secretion of trophic hormones that stimulate target gland growth and hormone secretion ( ACTH, TSH, Gonadotrophic hormones--- LH, FSH)
30
What does pituitary disorders include?
Hormone-secreting neoplasms
31
What is the key regulator of adrenal steroidogenesis?
Adrenocorticotrophic hormone (ACTH)
32
What does the adrenal gland modulates?
Vascular volume, metabolism, immune responses, vascular function, connective tissue integrity, and secondary sex characteristics
33
What does adrenal steroid production requires?
Adequate cholesterol and multiple synthetic enzymes
34
What results in pathological changes in steroid hormone levels?
Genetic mutations altering one or more of enzymes
35
What is aldosterone secretion?
Outermost layer of adrenal cortex controls ECF volume and regulates sodium retention, potassium excretion, and BP
36
What is the consequence of abnormal aldosterone secretion?
Dysregulation of BP and potassium levels
37
What part of the adrenal cortex synthesizes and releases glucocorticoids (stress) hormones?
Zona Fasciculata
38
What is glucrocorticoid (stress) hormone function?
Manage blood glucose level, fat storage, BP, protein balance, and immunity
39
What does excess cortisol promotes?
Hyperglycemia, abnormal fat distribution, bone breakdown, fluid retention, and thinning of skin and hair
40
What is catecholamines and where does it produced?
Produced in adrenal medulla and released in response to sympathetic stimulation as part of stress response
41
What is pheochromocytomas?
Tumors of chromaffin cells of the medulla that produce excess catecholamines, causing HTN that is refractory to medical management
42
What does pediatric endocrine disorders include?
Abnormalities of GH, producing short stature or gigantism Congenital adrenal hyperplasia, genetic defect of adrenal steroid synthesis result in deficiency of aldosterone and cortisol and excess production of adrenal androgens
43
What is the older adults endocrine functions?
Lower levels of GHs and sex steroids but may have hyperactive cortisol responses to stress
44
What is the most common thyroid disorder in children?
Congenital hypothyroidism - Either gland does not form properly or enzymes deficiencies that do not support hormone formation
45
What happens if congenital hypothyroidism is not treated?
Need tx ASAP to support normal brain development and prevent intellectual disability and stunted growth
46
What is the endocrine disease manifestations in older adults?
Altered presentations of thyroid disease. Develop fewer symptoms and harder to diagnose.
47
What is the cardiovascular consequences of hyperthyroidism in older adults?
A-fib and heart failure
48
What is thyroid hormones?
Synthesizes extracellularly, secreted as relatively inactive compound (T4) and metabolized in target tissues that either to active form (T3) or to an inactive form (rT3)
49
What is an absolute requirement for thyroid hormone synthesis?
Iodine - No iodine = hypothyroidism is inevitable
50
Why does thyroid hormone acts by nuclear receptor?
To alter protein transcription and translation
51
What does thyroid hormone stimulates?
Mitochondrial activity and increases basal metabolic rate while having stimulating effects on growth and development; brain development and maintenance of normal neurological function and maintenance of healthy bone, muscle, cardo activity, and conn. tissues
52
What does the hypothalamic-pituitary-thyroid axis consists of?
Hypothalamic thyrotropin-releasing hormone (TRH) which stimulates pituitary thyroid-stimulating hormone TSH to stimulate thyroid synthesis and secretion of thyroid hormone
53
What is a major feedback of thyroid hormone?
At the level of pituitary, reducing TSH secretion by negative feedback (excess T4) and increasing TSH secretion by positive feedback or loss of negative feedback (low T4)
54
What is the functional indicator of the amount of thyroid hormone?
Blood levels of TSH as they reflect the effectiveness of thyroid hormone feedback
55
What is true about TSH levels in primary hypothyroidism?
TSH levels are high because of loss of negative feedback
56
What is true about TSH levels in primary hyperthyroidism?
TSH levels are low because of excessive negative feedback
57
What is the common mechanisms of thyroid disease?
Autoimmune attack
58
What is Hashimoto thyroiditis?
After a precipitating event, antibodies and complement damage follicle cells, releasing colloid that provokes further antibody formation - Anti-TPO antibodies are among the laboratory assay
59
What happen in Graves disease?
Antibodies to TSH receptors bind to receptors and perpetually activate them, causing unrestrained thyroid hormone synthesis and release
60
What is another mechanism of hypothyroidism?
Iodine deficiency, common in certain parts of the world
61
What is the physical findings in hypothyroidism?
Body functions cool down and slow down - Cold intolerance can develop, decreased HR, resp rate, and GI peristalsis, and hyporeflexia.
62
What are the mechanisms for hyperthyroidism?
Toxic multinodular goiter and thyroid producing adenoma (common in older adults)
63
What are the physical findings for hyperthyroidism?
Body functions accelerate. Heat intolerance, greater catabolic activity; increased HR, systolic BP, and pulse pressure; increased GI and hyperreflexia
64
What endocrine disorders lack and have excess hormones?
Addisons = lack Cushing and Graves = excess

Patho (8 decks)

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