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MB2: Endocrinology > Endocrine Principles > Flashcards

Endocrine Principles Flashcards

1
Q

examples of peptide hormones

A

oxytocin
GH
FSH

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2
Q

what amino acid is adrenaline derived from

A

tyrosine

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3
Q

what amino acid is melatonin derived from

A

tryptophan

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4
Q

describe the action ofd tyrosine kinase receptors and what hormone receptor is TK

A

extracellular region that acts with ligand, translated to tyrosine kinase domain intracellularly
Insulin

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5
Q

describe the action of GPCR, their transmembrane domain

A

7 fold transmembrane domain
ligand binds to extracellular domain to evoke intracellular response by intracellular domain activating alpha/beta/gamma subunits to mediate effect

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6
Q

what hormones utilise steroid hormone receptors and how do they work

A

intracellular in cytoplasm or nucleus and bind to DNA response elements to evoke change in gene transcription
oestrogen, testosterone, glucocorticoid

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7
Q

describe the hypothalamic-pituitary axis

A

specialised neurons in hypothalamus release specific hormones to act on pituitary gland to release endocrine glands
controlled by -ve feedback

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8
Q

factors affecting clinical hormone measurement

A 
pattern of secretion 
carrier protein presence 
interfering agents 
hormone stability and 1/2 life 
absolute concn
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9
Q

true/false - thyroid function should be measured in acute illness

A

false - it forms little value unless considered central to clinical practice, ie thyroid storm

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10
Q

describe the thyroid axis

A

hypothalamus releases TRH to anterior pituitary to release TSH
TSH stimulated thyroid to release FT4, FT3, liothyronine
FT4 and FT3 have negative feedback on pituitary and hypothalamus to keep concn in a narrow window

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11
Q

raised TSH with low FT4 and FT3 is indicative of?

A

hypothyroidism

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12
Q

low TSH with high FT4 and FT3 is indicative of?

A

hyperthyroidism

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13
Q

when is TSH not a reliable marker of thyroid function

A

anterior pituitary dysfunction

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14
Q

describe the hypothalmic-pituitary-adrenal axis

A

hypothalamus secretes CRH to ant pituitary to release ACTH on adrenal cortex tp secrete cortisol
-ve feedback on ant pituitary and hypothalamus

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15
Q

what rhythm does cortisol production have and rescribe it

A

circadian
rise in morning and slowly drops over day until nearly zero at night
rises again in anticipation for day ahead

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16
Q

describe the hypothalamic-pituitary gonadal axis

A

hypothalamis neurons stimulated to cause GnRH secretion to act on ant pituitary to release FSH/LH
these can also act on endocrine cells to secrete steroid/peptide hormones
-ve feedback

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17
Q

rhythm of testosterone

A

highest in morning, dips and begins to rise again early evening and overnight
circadian

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18
Q

describe prolactin secretion

A

secreted by ant pituitary but under inhibitory control by tonic dopamine
after secretion excess prolactin -ve feedback to hypothalamus to increase dopamine secretion again

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19
Q

dynaic testing - a suppression test is used for

A

hormone excess

20
Q

dynamic testing - a stimulation test is used for

A

hormone deficiency

21
Q

what is primary adrenal failure also known as

A

addisons disease

22
Q

what is an excess of cortisol known as and what are possible causes

A

cushings syndrome
exogenous steroids
pituitary/adrenal origin
ectopic ACTH

23
Q

stimulation test for addisons?

A

synacthen test

24
Q

stimulation test for cushings and how does ACTH help

A

dexamethasone suppression test
failure to suppress is cushings
measure of high ACTH determines whether its cushings or ectopic ACTH
measure of low ACTH implies adrenal origin

25
Q

features of cushings syndrome

A 
cushingoid appearance 
hirtuism
acne 
abdominal striae 
interscapular fat pad 
proximal myopathy 
osteoporosis 
hypertension 
impaired glucose tolerance
26
Q

autocrine regulation

A

chemicals released from cells bind to receptors on the cells that are releasing them

27
Q

paracrine regulation

A

cell modulates an adjacent cell

28
Q

endocrine regulation

A

chemicals released from secretory cells into circulatory cells to reach target tissue and evoke response

29
Q

what are hormones

A

substance elaborated by one cell to regulate another by autocrine, paracrine or endocrine route

30
Q

what does the hypothalamus do

A

controls activity of secretion of ant pituitary
controls post pituitary by neural control
synthesises post pituitary hormones
neural control over adrenal medulla

31
Q

how do steroid hormones travel in blood

A

travel either free or bound to carrier proteins

32
Q

mechanism of action of steroid hormones

A

diffuse through cell membrane
bind to hormone receptor to form a complex within the cell
binds to DNA to activate specific genes
leads to production of key substances

33
Q

true/false - amine derived hormones such as catecholamines or thyroid hormones cannot be stored in their synthesising organ

A

false - they can

34
Q

describe insulin secretion from elevated blood glucose

A

increased blood glucose travels into B cell by GLUT2
converted to G-6-P by glucokinase and metabolised in the metabolism
ATP acts to close ATP K channel and cause membrane depolarisation
opening of Ca channels increases intracellular Ca and so triggers secretion of insulin

35
Q

what effects do carrier proteins have on hormone transport

A

facilitates transport
increases half life
reservoir for hormone

36
Q

how can those with leptin deficiency/defective receptors develop diabetes?

A

leptin in high quantities can suppress appetite and increase thermogenesis so in lack of receptor or leptin this can cause unrestrained appetite

37
Q

mechanism of action of orlistat

A

lipase inhibitor so blocks up to 1/3 ingested fat being absorbed

38
Q

3 types of bariatric surgery?

A

gastric bypass
sleeve gastrectomy
roux-en-Y gastric bypass

39
Q

why is is harder to lose weight at a lower weight

A

adaptive thermogenesis -resting metabolic rate is higher in obese and falls in weight loss
lower the BMR the harder it is to lose this weight and keep it off

40
Q

what do alpha cells secrete

A

glucagon

41
Q

what do beta cells secrete

A

insulin

42
Q

waht do delta cells secrete

A

somatostatin

43
Q

what do PP cells secrete

A

pancreatic polypeptide

44
Q

what do epsilon cells secrete

A

ghrelin

45
Q

true/false - in T2DM glucagon secretion is suppressed

A

false - due to insulin resistance glucagon may remain active and so can lead to further hyperglycaemia

46
Q

what is the incretin effect

A

oral glucose administration induces greater insulin secretion than IV administration of an isoglycaemic dose of insulin
this is because GLP-1 is produced to stimulate beta cells further

47
Q

what breaks down GLP-1

A

DPPIV

MB2: Endocrinology (13 decks)

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