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Dentistry BDS 2 Sem 1 > Endocrinology > Flashcards

Endocrinology Flashcards

1
Q

How can we classify endocrine organs?

A

Central – organs that are located around the brain regions(I.e pineal gland, hypothalamus, posterior pituitary)

Peripheral – organs that are located outside the brain region (I.e ovaries)

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2
Q

What is the integrated control system?

A

Integrated control system is a process in which both nervous and endocrine system are able to produce homeostatic actions with variable onset duration as well as signal to upregulate or down regulate one another. The main linkage between the systems is hypothalamus. The function of hypothalamus can be describe as ‘mediator’.

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3
Q

Define term endocrine.

A

Endocrine – means secreting substances into the blood stream – thus integrating the substance all around the system

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4
Q

Define term hormone.

A

Hormones are released by endocrine cells and are chemical messengers that regulate activity of target cells.

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5
Q

Define term paracrine.

A

Paracrine hormones are able to influence the activity of nearby cells. Example: histamine released by mast cells.

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6
Q

Define term autocrine.

A

Autocrine hormones are able to influence the activity of the cells that produce the said hormone. Hormone acts on the cell that produced it. Example: white blood cells secrete growth factor for themselves.

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7
Q

Define term neurohormone.

A

Neurohormones are released by neurons into the bloodstream. Example: oxytocin.

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8
Q

What are two ways endocrine cells exist?

A

Single scattered cells (e.g. G cells in stomach) or clumped together into a gland (e.g. adrinal gland).

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9
Q

What are the three major types of hormones?

A
  1. Protein
  2. Amine
  3. Steroids
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10
Q

What are the water soluble and insoluble hormones?

A

Protein and amine hormones are water soluble, while steroid are not water soluble.

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11
Q

What is the mode of action of water soluble hormones?

A

Due to their inability to pass through the phospholipid bi-layer (because they are lipid insoluble), water soluble hormones need to bind to the receptors on the surface of the target cells.

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12
Q

What is the mode of action of steroids?

A

They have a slower mode of action as they are able to only bind with intracellular receptors.

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13
Q

How does a typical endocrine gland develops?

A
  1. The usually arise from modified epithelial cells that are able to form an ingrowth from surface epithelium
  2. The attachment of the ingrowth cells slowly loose attachment to the epithelial surface. Blood capillaries form around ingrown cells
  3. Ingrown cells mature and are able to secrete hormones to the capillaries
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14
Q

Describe the general structure of endocrine glands.

A
  1. They are formed by clumps and strands of cells
  2. Supported by reticular fibres and minimal amount of connective tissue cells
  3. There are minimal barriers between cells and capillaries
  4. Capillaries and fenestrated and sinusoidal in nature to allow for bulk transport
  5. There are no ducts
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15
Q

What are the features of endocrine cells producing water-soluble hormones?

A
  1. Many small membrane bound secretory granules
  2. Polarity is not as obvious
  3. Contain small to moderate amounts of RER and Golgi apparatus
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16
Q

What are the features of endocrine cells producing water-insoluble hormones?

A
  1. Large lipids droplets
  2. Abudance of SER
  3. Lack of secretory granules
  4. Abundance of lysosomes
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17
Q

What are the exocrine and endocrine features of the pancreas?

A

Exocrine – acini

Endocrine – islets of Langerhans

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18
Q

Why do we need to delicate balance in both absorptive and post-absorptive states?

A

The brain must be continuously supplied with glucose. Thus we need a system that is able to regulate the amount of glucose in both fed and starving states.

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19
Q

What are the two main hormones in regulation of fuel metabolism?

A

Insulin in well fed state and glucagon in fasted state.

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20
Q

What is the main determinant of insulin secretion?

A

The blood glucose concentration

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21
Q

What are the immediate, intermediate and long term actions of insulin?

A
  1. Immediate - within seconds – translocation of proteins into cell membrane
  2. Intermediate - 10-15 minutes – phosphorylation of metabolic enzymes
  3. Long term – hours-days – effects on mRNA translation and DNA transcription
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22
Q

What is the impact of insulin on the liver?

A
  1. Increased rate of glycolysis
  2. Increased rate of glycogenesis
  3. Decreased rate of gluconeogenesis
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23
Q

What is the impact of insulin on muscle?

A

Increased glucose uptake into muscles

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24
Q

What is the impact of insulin of adipose tissues?

A

Increased uptake of glucose & fatty acids

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25
Q

What is the main stimulant for glucagon release?

A

Sympathetic stimulation

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26
Q

What is the impact of glucagon on the liver?

A
  1. Decrease in glycogen synthesis
  2. Increase in glycogenolysis
  3. Increase in gluconeogenesis
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27
Q

What is the impact of glucagon on the adipose tissue?

A
  1. Increase in lipolysis
  2. Decrease triglyceride synthesis
  3. Increase circulating free fatty acids
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28
Q

What is the aetiology of Type 1 DM?

A

Largely caused by a autoimmune attack of the beta cells.

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29
Q

What is the aetiology of Type 2 DM?

A

Strong genetic influence. May develop as a result of other endocrine diseases

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30
Q

What are two main complications from Type 2 DM?

A

Glucotoxicity and lipotoxicity

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31
Q

What is the link between diabetes and the damage to blood vessels?

A

Glucotoxicity may cause damage to the small blood vessels. This may affect the eye, the kidney etc.

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32
Q

What is the link between diabetes and oral health?

A

Diabetes causes a reduced blood supply to the gums, decrease salivary flow, decreased pH and lower salivary calcium concentration.

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33
Q

What is the function of the hypothalamus?

A

The main function is to provide the linkage between nervous and endocrine systems

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34
Q

What makes up the hypothalamus?

A

The hypothalamus is comprised of nerves. It regulates hormone production and release, contraction of the uterus during labour, milk production and release, kidney function and growth and development.

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35
Q

What are the two lobes of the pituitary gland?

A

Anterior and posterior (anterior being more vascular and posterior being more neural). They are two independent structures that develop independently embryologically.

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36
Q

What two clusters of the hypothalamus have their endings located in the pituitary gland?

A

The paraventricular nucleus and the supraoptic nucleus

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37
Q

What are the hormones release by posterior pituitary gland?

A

ADH & oxytocin. They are produced in the supraoptic nucleus and paraventricular nucleus and then move into the pituitary gland which distributes it into the blood stream

38
Q

What are the triggers for ADH release?

A
  1. Increase in osmolarity
  2. Decrease in blood pressure
  3. Fight of Flight response
39
Q

What are the main ways ADH affects blood pressure?

A
  1. Increase in aquaporins to increase water reabsorption
  2. Vasocontriction
  3. Increase in aldosterone secretion
40
Q

What regulate the secretion of hormones from the anterior pituitary gland?

A

The hypophysiotropic hormones coming from the hypothalamus

41
Q

What is stress?

A

It is the nonspecific response of the body to any demand made upon it

42
Q

What are the three stages of general adaption syndrome?

A
  1. Alarm reaction: Flight or Fight
  2. Resistance stage
  3. Allostatic overload – stress mediators can have both protective and damaging effects
43
Q

What happens during the alarm reaction?

A
  1. Release of noradrenaline from sympathetic nerve terminals
  2. Secretion of adrenaline and noradrenaline from the adrenal medulla
44
Q

What does the adrenal medulla secrete?

A

The catecholamines – adrenaline and noradrenaline

45
Q

How can we describe the adrenal medulla?

A

We can describe it as a modified sympathetic ganglion. Meaning when it receives sympathetic stimulation, it releases hormones.

46
Q

What supports the actions of catecholamines?

A

A hypophysiotropic hormone corticotrophin releasing hormone stimulate the secretion of adrenocorticotrophic hormone from anterior pituitary. It acts primarily on zona fasciculata to stimulate the release of glucocoricoids

47
Q

What is the pattern of cortisol release?

A

It follow circadian diurnal rhythms

48
Q

What are the main functions of cortisol?

A

Primary role is increasing blood glucose at the expense of fats and protein. It stimulates hepatic gluconeogenesis and inhibits glucose uptake in tissues

49
Q

What are the actions of cortisol on cardiovascular function?

A

Cortisol increases the sensitivity of the heart and vasculate to adrenaline, noradrenaline and angiotensin II.

50
Q

What is the main function of aldosterone?

A

The main function of aldosterone is to increase the reabsorption of sodium whilst increasing the excretion of potassium

51
Q

How can adrenal hypersecretion occur and what can it lead to?

A

Phaeochromocytoma – adrenal medulla tumour. This could lead to elevated heart rate, systemic hypertension, anxiety, hyperglycemia and more.

52
Q

How can we classify the way thyroid hormones act?

A

We can separate them into 2 categories:

  1. Effects on metabolic pathways – increase of basal metabolic rate
  2. Effects on cellular differentiation and development
53
Q

What is a functional unit of the thyroid gland?

A

A thyroid follicle which secretes thyroid hormones (T3 and T4) as well as a C cell which secretes calcitonin

54
Q

What are thyroid hormones?

A

It is two iodine-containing hormones derived from the amino acid tyrosine that are produced by the thyroid follicles

55
Q

What is the process of thyroid hormone synthesis?

A
  1. Synthesis of thyroglobulin in the cell of the thyroid follicle
  2. Thyroglobulin is moved into the follicular space
  3. Iodine is moved into the cells from the blood stream via Sodium-Iodine transporter
  4. Iodine is move into the follicular space and is oxidised by thyroperoxidase
  5. Iodination of thyroglobulin occurs which lead to conjugation when iodine is bound to tyrosine residues
  6. The resulted T3 andT4 precursors is than move back into the cell via endocytosis
  7. Inside the vesicle, proteolysis occurs and complete forms of T3 and T4 are produced
  8. T3 and T4 are move into the blood stream
56
Q

What initiate the production of thyroglobulin?

A

TSH

57
Q

What is important about iodine?

A

Iodine needs to be taken from the diet

58
Q

What is the peripheral conversion of T4 to T3?

A

Only 10% of the T3 comes from the thyroid, most of it comes from conversion of T4 into T3 in other tissues

59
Q

What regulates the release of thyroid hormones?

A

Hypothalamus releases the hormone TRH which triggers the release of hormone TSH which binds with receptors on the thyroid gland and causes the release of T3 and T4

60
Q

What are the effects of TSH?

A
  1. Non-genomic effects – enhances iodine pump, increase iodination, increases proteolysis of thyroglobulin
  2. Genomic effects – promoting general gene transcription for proteins related to production of T3 and T4
61
Q

What are the two main dysfunction related to thyroid function?

A
  1. Hypothyroidism

2. Hyperthyroidism

62
Q

What are some of the oral manifestations of hyperthyroidism?

A
  1. Increase susceptibility to caries and periodontal disease
  2. Accelerated dental eruption
  3. Burning mouth syndrome
  4. Maxillary or mandibular osteoporosis
  5. Increased levels of anxiety
63
Q

What are some of the oral manifestations of hypothyroidism?

A
  1. Salivary gland enlargement
  2. Macroglossia
  3. Glossitis
  4. Delayed dental eruption
  5. Compromised periodontal health
  6. Dysgeusia
64
Q

What are some of the functions of the calcium?

A
  1. Muscle contractility
  2. Neurotransmitter release
  3. Blood clotting
  4. Maintenanc of cellular integrity
  5. Bone and teeth structure and strength
65
Q

What are some of the ways free plasma calcium controlled?

A
  1. Absorption/excretion involving intestines and kidneys

2. Exchange between fixed and free pools

66
Q

What are the three main hormones that regulate plasma calcium?

A
  1. Parathyroid hormone
  2. Calcitonin
  3. Vitamin D
67
Q

How does the parathyroid work?

A
  1. it is the main hormone in regulation of plasma calcium levels
  2. The receptors on the parathyroid gland sense the levels of calcium and release parathyroid hormone
  3. Parathyroid hormone bind with osteoblasts and cause an increase in production RANKL
  4. RANKL mobilises osteoclasts which breakdown bone in order to release more into the plasma
68
Q

How does PTH effect on kidneys?

A
  1. Conservation of calcium

2. Enhances action of vitamin D which enhance responsiveness of bones to PTH

69
Q

What is the function of calcitonin?

A

Decrease the movement of calcium from the labile pool and inhibits osteoclast activity in bones

70
Q

What is the mode of action vitamin D?

A

Vitamin D binds to VDR and increases DNA transcription

71
Q

What are the main pathways effect your blood pressure?

A

The sympathetic pathway through use of adrenaline and noradrenaline and parasympathetic system

72
Q

What is the difference between the beta and alpha receptor interactions?

A

Beta receptors interaction between adrenaline and noradrenaline are more sensitive than the ones with alpha receptors.

73
Q

What is the first, short term solution to a drop in blood pressure?

A
  1. Blod pressure drop detected by baroreceptors on the aortic arch and carotid sinus
  2. This is relayed to CNS
  3. Autnomus nervous system causes the release the upregulation of sympathetic dive
  4. Release of adrenaline and noradrenaline
74
Q

What is the rapid response of the kidneys to the reduction of blood pressure?

A

When low blood pressure is detected in afferent arteriole, it constricts and reduced GFR

75
Q

What is a long term control of blood pressure in the renal system?

A
  1. Incresin sodium retention
  2. Increasin water reabsorption
  3. Increasin potassium secretion
76
Q

What triggers the activation of the RAAS system?

A
  1. Low blood pressure
  2. Dehydration
  3. Low salt
  4. High potassium
77
Q

What are the actions of aldosterone on a cellular level?

A
  1. Aldsteron combines with cytoplasmic receptors
  2. Hormone-receptr complex initiates transcription
  3. New protein channels and pumps are synthesised
  4. Aldosterone induced proteins modification
  5. Result - increase sodium channel insertion, increased sodium reabsorption and potassium secretion
78
Q

What are the two main action of vasopressin?

A
  1. Increase insertion of aquaporins

2. Increased water intake by inducing thirst

79
Q

What happens when your age in terms of renal function?

A
  1. Decrease GFR due to decrease of number of nephrons
  2. Decrease in secretion of RAAS hormones
  3. Decrease sensativity of the baroreceptors
80
Q

What happens when you age in terms of the vascular system?

A

You get vascular remodelling which increase the stiffness of the arterioles which makes it harder to regulate blood pressure

81
Q

What is the action of ACE inhibitors?

A

They inhibit ACE and reduce the conversion of Angiotensin I into Angiotensin II

82
Q

What are side effects of ACE?

A
  1. Dehydration
  2. ELectrolyte imbalance
  3. Excesive vasodilation
  4. Orthostatic hypotension
  5. Dry cough – build up of bradykinin
83
Q

What is the mode of action of calcium channel blockers?

A

They promote relaxation of vascular smooth muscle as interfere with calcium entry

84
Q

What is growth?

A

It is the organized addition of new tissue that occurs normally in development.

85
Q

What are the main factors influencing growth?

A
  1. Genetics
  2. Nutrition
  3. Growth hormone
  4. Chronic stress and disease
86
Q

What is the growth hormone?

A

It is a polypeptide hormone produced in anterior pituitary. It is regulate by GHRH and GHIH. It targets many tissues. It alters gene transcription. It promotes using fat stores and promote protein synthesis.

87
Q

What are IGFs?

A

IGFs are Insulin-like growth factors. They are peptide hormones that have strong mitogenic properties – meaning they promote cell division. They are mainly produced in the liver. There are released by presence of the growth hormone.

88
Q

What is the importance of IGF-1 in terms of bone?

A
  1. It stimulate proliferation of epiphyseal cartilage
  2. It increases conversion of cartilage to new bone
  3. It increase the proliferation of periosteal osteoblasts
  4. It increase bone remodelling
89
Q

What happens during the menopause?

A

Ovarian secretion of oestrogen decreases and secretion of FSH and LH increase rather abruptly in bout sixth decade in women

90
Q

What happens to bones as a result of reduced secretion of oestrogen?

A

It causes a decrease in bone mineral density. Oestrogen decrease the production of cytokines by bone marrow and immune cells. Without oestrogen, the cytokines are able to accumulate, osteoclasts are able to proliferate, secretion of osteoprotegrin decreases

91
Q

What happens to cardiovascular system as a result of reduction of oestrogen secretion?

A

Oestrogen aids in production of nitric oxide which causes dilation of blood vessels. With lack of oestrogen, lower levels of nitric oxide result in stiffer blood vessels

Dentistry BDS 2 Sem 1 (15 decks)

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