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Dental Physio > Endocrine - Pt 2 Thyroid/Growth Hormone > Flashcards

Endocrine - Pt 2 Thyroid/Growth Hormone Flashcards

1
Q

One of the main goals of the endocrine system is to properly maintain [] []

A

energy metabolism

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2
Q

The main sites of hormonal action, in regards to maintaining energy metabolism, are the [], [] [], and []

A

The main sites of hormonal action, in regards to maintaining energy metabolism, are the liver, adipose tissue, and muscle

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3
Q
  • The goal of hormonal energy metabolism maintenance is to keep a constant supply of [] to the tissues
  • Blood glucose is closely monitored and maintained between [] - [] mg/dL under normal conditions
  • This is important for the tissues that rely heavily on glucose: [], [] [], and []
A
  • The goal of hormonal energy metabolism maintenance is to keep a constant supply of glucose to the tissues
  • Blood glucose is closely monitored and maintained between 90 - 120 mg/dL under normal conditions
  • This is important for the tissues that rely heavily on glucose: brain, nervous tissue, and RBCs.
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4
Q

T/F

The majority of energy stored in the body is stored as glucose/glucose derivatives.

A

FALSE

The majority of energy is stored in the form of fat (76%) or protein (23%)

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5
Q
  1. Glycogenesis = …
  2. Glycogenolysis = …
  3. Gluconeogenesis = …
  4. Lipogenesis = …
  5. Lipolysis = …
  6. Proteolysis = …
A
  1. Glycogenesis = glycogen formation
  2. Glycogenolysis = glycogen breakdown
  3. Gluconeogenesis = Formation of new glucose
  4. Lipogenesis = Synthesis of lipids
  5. Lipolysis = lipid breakdown
  6. Proteolysis = protein breakdown
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6
Q

T/F

You expect to see glycogenesis, lipogenesis, and protein Syntheis during fasting state.

A

FALSE

You expect to see those things in a fed state when you have “energy” to spare.

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7
Q

T/F

You would expect to see gluconeogenesis, lipolysis, proteolysis, and glycogenolysis during a fasting state.

A

True!

While fasting you are starved of glucose. So you run all these processes to hopefully fuel your body with glucose.

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8
Q

During starvations:

Rank, sequentially, which energy source is used during a starved state, from last to first: Lipid, protein, carbohydrate.

A

Proteins –> Lipids –> Carbohydrates

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9
Q
  • While “starved” your body produces [] [] as an alternative energy source for hte brain
  • This is common in [] [] - which causes a metabolic acidosis called []
    • One way for a dentist to see this is through the patients [] [] due to acetone.
A
  • While “starved” your body produces ketone bodies as an alternative energy source for hte brain
  • This is common in Diabetes Mellitus - which causes a metabolic acidosis called ketoacidosis
    • One way for a dentist to see this is through the patients bad breath due to acetone.
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10
Q

Thryoid Hormones:

  1. Synthesized by [] cells of hte thyroid gland
  2. Requires [] in diet
  3. T3 - []
  4. T4 - [] or []
  5. Which thyroid hormone is more active and which is greater in number?
A
  1. Synthesized by follicular epithelial cells of hte thyroid gland
  2. Requires iodine in diet
  3. T3 - triiodothyronine
  4. T4 - tetraiodothyronine, or thyroxine
  5. T3 - more active and there is more T4
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11
Q

Thyroid Hormones:

  • [] => enzyme that synthesizes T4 –> T3 at [] tissues.
    • This is required because [] is more active but [] is more abundant.
A
  • Monoiodinase => enzyme that synthesizes T4 –> T3 at target tissues.
    • This is required because T3 is more active but T4 is more abundant.
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12
Q

Thyroid Hormone Actions:

  1. Acts on virtually every [] system in the human body
  2. Acts synergistically with [] and [] to increase bone formation
  3. Increases [] metabolic rate = induces synthesis and activity of [] pumps
  4. Increases [] - positive inotrope ( []) and chronotrope ([])
  5. Increases [] Rate
  6. In perinatal period - essential for normal maturation of []…deficiency can lead to []
A
  1. Acts on virtually every organ system in the human body
  2. Acts synergistically with GH and somatomedins to increase bone formation
  3. Increases basal metabolic rate = induces synthesis and activity of Na+/K+ pumps
  4. Increases CO - positive inotrope (contractility) and chronotrope (Rate)
  5. Increases Respiratory Rate
  6. In perinatal period - essential for normal maturation of CNS…deficiency can lead to cretinism
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13
Q

Do the symptoms show hypo- or hyper-thyroidism?

  • Hypoventilation -
  • Exophthalmos -
  • Increased cardiac Output -
  • Myxedema -
  • Goiter -
A
  • Hypoventilation - hypothyroidism
  • Exophthalmos - - Hyperthyroidism
  • Increased cardiac Output - Hyperthyroidism
  • Myxedema - Hypothroidism
  • Goiter - Both!
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14
Q

Origin of thyroid hormone disturbance helps classify the disorder…

  • 1° - origin is the [] []
  • 2° - origin is the [] []
  • 3° - Origin is the []
  • []-[] - disturbance is at a site other than the hypothalamic-pituitary-thyroid axis
A
  • 1° - origin is the thyroid gland
  • 2° - origin is the anterior pituitary
  • 3° - Origin is the hypothalamus
  • Ectopic-Origin - disturbance is at a site other than the hypothalamic-pituitary-thyroid axis
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15
Q

[] deficiencies often lead to hypothyroidism, and are one of the major causes of [] development.

A

Iodine deficiencies often lead to hypothyroidism, and are one of the major causes of goiter development.

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16
Q

[] [] is an autoimmune disease in which antithyroid antibodes are produces. This is a common example of [] hypothyroidism

A

Hashimoto’s Thyroiditis is an autoimmune disease in which antithyroid antibodes are produces. This is a common example of primary hypothyroidism

17
Q
  • Grave’s disease is an autoimmune disease in which the body produces [] [] [] (TSI) which are similar in structure to [].
  • TSI stimulates the thyroid gland and results in an [] of the thyroid hormones.
A
  • Grave’s disease is an autoimmune disease in which the body produces thyroid stimulating immunoglobulins (TSI) which are similar in structure to TSH.
  • TSI stimulates the thyroid gland and results in an overproduction of the thyroid hormones.
18
Q

Thyroid Hormone Production:

  1. 1st Step - Iodide []. Iodide is brought into follicular cells from the diet by [] transporters located on the [] membrane.
    1. These transporters use [] [] transport with Na+ to push I- [] its concentration gradient
  2. 2nd Step - within the follicular cell, Iodide is oxidized into [] via the enzyme [] []
A
  1. 1st Step - Iodide trapping. Iodide is brought into follicular cells from the diet by symport transporters located on the basolateral membrane.
    1. These transporters use secondary active transport with Na+ to push I- against its concentration gradient
  2. 2nd Step - within the follicular cell, Iodide is oxidized into Iodine via the enzyme thyroid peroxidase
19
Q

Thyroid Hormone Production:

  1. Thyroglobulin is produced in the [] cells and released into the colloid
  2. Thyroglobulin can now become [] at [] residues.
    1. Each residue can have either 1 or 2 Iodines added. For T1 ([]) or T2 ([])
  3. Now the T1 and T2 can join to form either [] or [] which are still attached to [] at this time.
A
  1. Thyroglobulin is produced in the follicular cells and released into the colloid
  2. Thyroglobulin can now become iodinated at tyrosine residues.
    1. Each residue can have either 1 or 2 Iodines added. For T1 (MIT) or T2 (DIT)
  3. Now the T1 and T2 can join to form either T3 or T<strong>4</strong> which are still attached to thyroglobulin at this time.
20
Q

Thyroid Hormone Production:

  • Once the thyroglobulin is endocytosed into the follicle cell, it fuses with a [] creating and [].
  • Theses enzymes break down the thyroglobulin and release [] and [].
  • Thyroid hormones then diffuse into capillaries where they bind to transporter proteins, like []-[] [].
  • [] of thyroid hormones are bound to transporter proteins.
A
  • Once the thyroglobulin is endocytosed into the follicle cell, it fuses with a lysosome creating and endolysosome.
  • Theses enzymes break down the thyroglobulin and release T3 and T4.
  • Thyroid hormones then diffuse into capillaries where they bind to transporter proteins, like thyroxine-binding globulins.
  • 99% of thyroid hormones are bound to transporter proteins.
21
Q
  • At the tissues…T4 diffuses into the [] and is converted into T3 via [].
  • T3 then diffuses into the [] and binds to a [] [] receptor.
    • This complex binds to the [] [] [] [], on DNA, and initiates transcription/translation…ultimaley making the protein that can initiate the hormone []
A
  • At the tissues…T4 diffuses into the cytosol and is converted into T3 via monodeiodinase.
  • T3 then diffuses into the nucleus and binds to a thyroid hormone receptor.
    • This complex binds to the thyroid hormone response element, on DNA, and initiates transcription/translation…ultimaley making the protein that can initiate the hormone response
22
Q

An abnormal increase in TSH levels, is usually a sign of a [] disorder

A

Goiter

23
Q
  • Growth hormone can act directly on target tissues such as skeletal [], [], [] []
  • It can also indirectly through []
A
  • Growth hormone can act directly on target tissues such as skeletal muscle, liver, adipose tissue
  • It can also indirectly through IGFs
24
Q
  • Growth hormone acts to mobilize energy stores by
    • decreasing [] uptake and use by muscle and adipose tissue
    • Increase []
A
  • Growth hormone acts to mobilize energy stores by
    • decreasing glucose uptake and use by muscle and adipose tissue
    • Increase lipolysis
25
Q
  • There are growth hormone receptors in the liver, which lead to the production of []-[] [] [], or IGFs.
  • These are produced in []-[] organs like the liver, kidney, and muscle
  • IGFs mediate growth of [] [] and [] by increasing the uptake of [] [] and stimulating [] of DNA, RNA, and proteins.
A
  • There are growth hormone receptors in the liver, which lead to the production of Insulin-like growth factors, or IGFs.
  • These are produced in non-endocrine organs like the liver, kidney, and muscle
  • IGFs mediate growth of soft tissues and bone by increasing the uptake of amino acids and stimulating synthesis of DNA, RNA, and proteins.
26
Q

The general theme of factors which stimulate/inhibit growth hormone release:

  • Stimulate - when our nutrient levels are [], and at night, 1-2 hours after [] onset
  • Inhibit - when we have an [] in nutrients.
A
  • Stimulate - when our nutrient levels are low, and at night, 1-2 hours after sleep onset
  • Inhibit - when we have an excess in nutrients.
27
Q

During pregnancy, high levels of estrogen inhibit the breakdown of TBG by the liver, and TBG levels []. What are the other effects…

  • Total T3 and T4 (bound/unbound) - []
  • Free, physiologically active T3 and T4 - []
  • Thyroid disorder? - []
A

During pregnancy, high levels of estrogen inhibit the breakdown of TBG by the liver, and TBG levels rise. What are the other effects…

  • Total T3 and T4 (bound/unbound) - increase
  • Free, physiologically active T3 and T4 - unchanged
  • Thyroid disorder? - euthyroidism
28
Q

T/F

The visible epiphysial line is a defining characteristic of adolescent bone growth.

A

FALSE

An adolescent bone will have a visible epiphysial plate

29
Q

Adults afflicted with Hypersecretion GH will exhibit signs…

  1. Usually due to GH-secreting pituitary []
  2. [] bone growth
  3. [] hand and foot size, and organ size
  4. [] of tongue,
  5. [] of facial feature
  6. insulin []
  7. glucose []
A
  1. Usually due to GH-secreting pituitary adenoma
  2. Periosteal bone growth
  3. Increased hand and foot size, and organ size
  4. enlargement of tongue,
  5. coarsening of facial feature
  6. insulin resistance
  7. glucose intolerance
30
Q

Hyposecretion of GH –>

  1. Childhood
    1. leads to []
  2. Adulst
    1. Leads to a mild []
A
  1. Childhood
    1. leads to dwarfism
  2. Adulst
    1. Leads to a mild hypoglycemia

Dental Physio (36 decks)

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