Endocrine Physiology Flashcards

1
Q

Transport of Steroid Hormones

A

Bound to proteins

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2
Q

Active form of Steroid Hormones

A

Free & Unbound Form

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3
Q

Main site of inactivation of Hormones

A

Liver

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4
Q

Mechanism for removal of hormones

A

Kidneys, Liver

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5
Q

Onset of hormonal effects

A

Seconds to months

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6
Q

Number of hormones receptors

A

Variable

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7
Q

Minimum amount of hormone to produce effect

A

1 picogram per ml

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8
Q

Epi + NE effects on the heart

A

Additive effects (synergy)

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9
Q

FSH & Testosterone on spermatogenesis

A

Complementary effects (synergy)

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10
Q

Cortisol on NE and Epi in blood vessels; T3 on Epi in Lipolysis

A

Permissive effects

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11
Q

Estrogen blocking Prolactin effect on breast during pregnancy

A

Antagonistic effects

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12
Q

2 ways to regulate hormone effects

A

Hormone secretionHormone receptors

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13
Q

Self-limiting; More common; Hormone has biologic actions that directly or indirectly, inhibit further secretion of the hormone

A

Negative feedback

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14
Q

Self-augmenting; Rare, exploding; Hormone has biologic actions that directly or indirectly, stimulate further secretion of the hormone

A

Positive feedback

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15
Q

Hormone feeds back all the way to HPA

A

Long-loop feedback

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16
Q

Hormone from Pituitary feeds back to the Hypothalamus

A

Short-loop feedback

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17
Q

Hypothalamic hormone feeds back on its own secretion

A

Ultra-short-loop feedback

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18
Q

Example of negative feedback that does not utilize HPA

A

Insulin

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19
Q

Examples of Positive Feedback

A

Estrogen-induced LH & FSH surge, Oxytocin during labor and lactation

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20
Q

Decrease in receptor number or receptor affinity

A

Down-regulation of receptors

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21
Q

Increase in receptor number or receptor affinity

A

Up-regulation of receptors

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22
Q

Lies in sella turcica; Connected to the median eminence of Hypothalamus via Pituitary/Hypophysial stalk

A

Pituitary Gland

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23
Q

Transmit hypothalamic hormones to the pituitary without passing through the systemic circulation

A

Hypothalamic-Hypophysial Portal Blood Vessels

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24
Q

Adenohypophysis; Derived from oral ectoderm (Rathke’s Pouch); With Basophilic and Acidophilic Cells

A

Anterior Pituitary

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25
Q

Neurohypophysis; Derived from neural ectoderm (neural outgrowth of hypothalamus); With Pituicytes

A

Posterior Pituitary

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26
Q

From Basophilic Cells

A

FSHLHACTHTSHMSH

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27
Q

From Acidophilic Cells

A

GHProlactin

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28
Q

From Pituicytes

A

VasopressinOxytocin

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29
Q

If the pituitary stalk is damaged, all anterior pituitary hormones would decrease, EXCEPT

A

Prolactin

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30
Q

In terms of number, what are the top 2 cells in the anterior pituitary?

A

Somatotropes (40%) Corticotropes (20%)

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31
Q

What are the 3 families of hormones in the anterior pituitary?

A

TSH, LH, FSHMSH, ACTHGH, Prolactin

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32
Q

Both catabolic and anabolic; Released in pulsatile fashion (every 2 hours); Nocturnal peak: 1 hour after Stage 3 or 4 sleep

A

Growth Hormone

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33
Q

Growth Hormone

A

Somatotropin

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34
Q

Stops Growth Hormone

A

Somatostatin

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35
Q

IGF

A

Somatomedin

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36
Q

Direct Actions of GH

A

Increases blood glucose levels (Diabetogenic Effect)Increased protein deposition in muscles and other tissuesRequires adequate insulin and carbohydrate concentrateIncreased lipolysisIncreased Insulin-like Growth Factor (IGF) productionPossible anti-aging effects

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37
Q

Indirect Actions of GH

A

Increases Bone Length and Bone thicknessIncreases protein synthesis in muscles and most organs

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38
Q

Secretion of GH INCREASED

A

Starvation HypoglycemiaLow fatty acid levelsExerciseExcitementTraumaTestosteroneEstrogenGHRHDeep sleep

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39
Q

Secretion of GH DECREASED

A

HyperglycemiaHigh fatty acids levelsAging ObesitySomatostatin/SRIF (Somatostatin-release Inhibiting Hormone)Exogenous GHSomatomedins

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40
Q

Secretion of GH requires

A

Normal plasma levels of thyroid hormones

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41
Q

Decreased GH, MCC of Dwarfism, Defect in FGF receptor 3

A

Achondroplasia (AD)

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42
Q

Increased GH, With skeletal deformities (large hands, feet, membranous bones)

A

Acromegaly

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43
Q

Increased GH, Without skeletal deformities, symmetrical

A

Gigantism

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44
Q

Stimulates milk production (lactogenesis); Inhibits ovulation or spermatogenesis; Stimulates breast development during puberty and pregnancy

A

Prolactin

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45
Q

Prolactin Stimulation

A

PregnancyBreast feedingSleepStressTRHDopamine antagonists

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46
Q

Prolactin Inhibition

A

DopamineBromocriptineSomatostatinProlactin (negative feedback)

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47
Q

Aka ADH or AVP; Secreted by supraoptic nuclei of the hypothalamus; Responds to ECF changes detected by osmoreceptors in the Organum Vasculosum

A

Vasopressin

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48
Q

Most potent stimulus for Vasopressin

A

Increases plasma osmolality

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49
Q

Effects of Vasopressin

A

Increases water permeability via insertion of AQP2 in the late distal tubule and collecting duct (V2 receptors); Acts within 5-10 minsPeripheral vasoconstriction (V1 receptors)

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50
Q

Urine volume in Central Diabetes Insipidus

A

High

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51
Q

Urine volume in Peripheral Diabetes Insipidus

A

High

52
Q

Urine volume in SIADH

A

Low

53
Q

Urine Osmolarity in Central Diabetes Insipidus

A

Low

54
Q

Urine Osmolarity in Peripheral Diabetes Insipidus

A

Low

55
Q

Urine Osmolarity in SIADH

A

High

56
Q

ADH levels in Central Diabetes Insipidus

A

Low

57
Q

ADH levels in Peripheral Diabetes Insipidus

A

High

58
Q

ADH levels in SIADH

A

High

59
Q

Treatment in Central Diabetes Insipidus

A

DDAVP (ADH analog)

60
Q

Treatment in Peripheral Diabetes Insipidus

A

Thiazide diuretics

61
Q

Treatment in SIADH

A

Demeclocycline (ADH antagonist)

62
Q

In SIADH, the brain reduces intracellular osmolytes to prevent cell swelling. What happens if you rapidly correct the hyponatremia?

A

Osmotic Demyelination Syndrome ( Central Pontine Myelinolysis)

63
Q

From paraventricular nuclei of the hypothalamus; Milk ejection (contraction of myoepithelial cells); uterine contraction

A

Oxytocin

64
Q

Stimuli for Oxytocin

A

Suckling of the breastSight, sound, smell of infantOrgasmDilation of cervix

65
Q

Synthesized by the follicular epithelial cells of the thyroid

A

Thyroid Hormones

66
Q

Actions Thyroid Hormones

A

Increases mitochondria and Na-K-ATPase pump activityIncreases cholesterol secretion to bile and number of liver LDL receptorsFor bone formation and bone maturation

67
Q

Regulation of Thyroid Hormone Secretion

A

Mediated by TRH and TSH levels

68
Q

RDA of Iodine per day

A

150ug

69
Q

High levels of iodine inhibiting organification and iodine thyroid hormone synthesis

A

Wolff-Chaikoff Effect

70
Q

Bone Age < Chronological Age

A

Hypothyroidism

71
Q

Liver and Kidney Failure: TBG levels?

A

Decreased TBG

72
Q

Estrogen or pregnancy: TBG levels?

A

Increased TBG

73
Q

Enzyme that converts T4 to T3

A

5’ Iodinase

74
Q

T4 can also be converted to

A

rT3 (inactive)

75
Q

Fever, changes in sensorium, tachycardia in pts w/ hyperthyroidism

A

Thyroid Storm

76
Q

Increase thyroid size due to trophic effects of high levels of TSH and TSH-like substances

A

Goiter

77
Q

Thyroid diseases with goiter

A

Graves diseaseTSH-secreting tumorHashimoto’s diseaseIodine Deficiency

78
Q

Thyroid diseases with no goiter

A

Ingestion of T4, TSH deficiency

79
Q

Aldosterone (Mineralocorticoid)

A

Zona Glomerulosa

80
Q

Cortisol, Corticosterone (Glucocorticoids)

A

Zona Fasciculata

81
Q

De-hydro-epi-androsterone (DHEA) and Androstenedione (weak androgens)

A

Zona Reticularis

82
Q

Inhibits 11beta-hydroxylase

A

Metyrapone

83
Q

Inhibits Desmolase

A

Ketoconazole

84
Q

Adrenal Androgens in Males and Females respectively

A

Insignificant, Significant (respectively)

85
Q

Need ACTH for 1st step but otherwise controlled by RAAS

A

Zona Glomerulosa

86
Q

Characteristics of cortisol secretion

A

Pulsatile, diurnal

87
Q

4 Diabetogenic hormones

A

GHCortisolGlucagonEpinephrine

88
Q

Triggers for Aldosterone Secretion

A

Dec ECF volumeHyperkalemia

89
Q

Islets of Langerhans: Secrete Insulin and Amylin

A

Beta Cell 60%

90
Q

Islets of Langerhans: Secrete Glucagon

A

Alpha Cell 25%

91
Q

Islets of Langerhans: Secrete Somatostatin

A

Delta Cell 10%

92
Q

Islets of Langerhans: Secrete Pancreatic Polypeptide

A

F Cell/ PP Cell 5%

93
Q

A protein that contains an A chain and B chain joined by disulfide bonds

A

Insulin

94
Q

Main determinant of Insulin Secretion

A

Blood Glucose levels

95
Q

Half-life of Insulin

A

6 minutes

96
Q

Degradation of Insulin by

A

Insulinase (in the liver)

97
Q

Increases glucose uptake into cells; Increases glycogen formation; Decreases glycogenolysis;Decreases gluconeogenesis

A

Decreased Blood Glucose

98
Q

Increases amino acid uptake ➡️ Increases protein synthesis

A

Decreased blood amino acids

99
Q

Increases fat deposition

A

Decreased blood fatty acids

100
Q

Decreases lipolysis

A

Decreased blood ketoacids

101
Q

Increases K uptake into cells

A

Decreased blood potassium

102
Q

Effect of insulin on the brain

A

None

103
Q

Insulin: 2nd messenger

A

Tyrosine kinase

104
Q

Glucagon: 2nd messenger

A

cAMP

105
Q

Marker for endogenous insulin

A

C peptide

106
Q

When proinsulin becomes insulin, what part is cleaved off?

A

C Peptide (connecting peptide)

107
Q

GLUT transport is found in Beta Cells

A

GLUT-2

108
Q

Oral vs IV Glucose: greater insulin secretion

A

Oral glucose

109
Q

Secrete collagen and ground substance where calcium precipitates; Bone resorption

A

Osteoblast

110
Q

Secrete lysosomal enzymes, citric acid and Lactic acid

A

Osteoclasts

111
Q

Hyperreflexia, spontaneous twitching, muscle cramps and tingling and numbness

A

Hypocalcemia

112
Q

Constipation, polyuria, polydipsia, and neurologic signs of hyporeflexia, lethargy, coma, death

A

Hypercalcemia

113
Q

Signs of hypocalcemia

A

Chvoestek & Trousseau

114
Q

Increased serum anions; effect on calcium levels

A

Hypocalcemia

115
Q

Acidosis: effect on calcium levels

A

Hypercalcemia

116
Q

Alkalosis: effect on calcium levels

A

Hypocalcemia

117
Q

What is the location of PTH receptors?

A

Osteoblast

118
Q

Would thyroidectomy cause hypercalcemia due to absent calcitonin?

A

No, since calcitonin does not participate in minute-to-minute calcium regulation

119
Q

What is secreted by osteoblast to inhibit osteoclastic activity in hyperparathyroidism?

A

Alkaline phosphatase

120
Q

Secreted by chief cells of parathyroid gland

A

PTH

121
Q

Stimulation of PTH

A

HypocalcemiaHypomagnesemia

122
Q

Secreted by parafollicular cells of thyroid gland

A

Calcitonin

123
Q

Stimulation of Calcitonin

A

High plasma Ca

124
Q

What is the treatment for humoral hypercalcemia of malignancy?

A

Furosemide (inhibits renal Ca reabsorption) Etidronate (inhibits bone resorption)

125
Q

Presents with short stature, short neck, obesity, subcutaneous calcification, and shortened fourth metatarsals and metacarpals?

A

Albright Hereditary Osteodystrophy (Pseudohypoparathyroidism Type Ia)

126
Q

Vitamin D resistance is seen in which condition?

A

Chronic renal failure