Endocrinology Flashcards
composed of specialized organs
capable of producing hormones
Endocrine system
endocrine glands communicate with each other through hormones
Feedback mechanisms
increase leads to increase or decrease leads to decrease
Positive feedback
increase leads to
decrease or decrease leads to increase
Negative feedback
mechanism responsible for
the production of thyroid hormones
Hypothalamus-Pituitary gland-Thyroid
gland Axis (HPTA)
secreted in one location and release into blood circulation
Endocrine
secreted in endocrine cells and sometimes released in interstitial space
Autocrine
secreted in endocrine and released in interstitial space
Paracrine
secreted in endocrine cells remains inside the synthesis of origin to affect its own function
Intracrine
secreted in endocrine cells and released into the lumen of the gut and interacts with receptors of cells at a distant site
Juxtacrine
secreted in neurons and released into extracellular space
Neurocrine
secreted in neurons and released from nerve endings
Neuroendocrine
Proteins/Polypeptides
GHRH, CRH, TRH, GnRH,
somatostatin, PRF, ADH,
oxytocin, GH, ACTH, PRL,
calcitonin, hPL, PTH, insulin,
glucagon
Glycoprotein
TSH, FSH, LH,
hCG, EPO
Steroids
cortisol, aldosterone,
estrogen,
progesterone,
testosterone
Amino Acid derivatives
melatonin, serotonin:
thyroid hormones, epinephrine,
norepinephrine:
a neurotransmitter that mediated satisfaction, happiness, and optimism
Serotonin
metabolite of serotonin
5-HIAA (5 hydroxy indole acetic acid)
Low serotonin
Obsessive Compulsive Disorder
Fear of contamination or dirt
MYSOPHOBIA
Located in the lower portion of the brain
Above the pituitary gland
HYPOTHALAMUS
Hypothalamus is Connected to the pituitary gland through the
infundibular stalk
Releasing hormones:
TRH, CRH, GnRH, GHRH,
PRF
Inhibiting hormones:
PIF, GHIH
Suppression of synthesis of prolactin
Prolactin inhibitory factor
Inhibits the release of different hormones- GH, TH, gastrin, secretin,
motilin, glucagon, insulin
Growth hormone inhibiting hormone/ Somatostatin
Pea-sized organ. Located at the base of the brain, located below the
hypothalamus
PITUITARY GLAND
Anterior HORMONES OFTHE PITUITARY GLAND
Thyroid-stimulating hormone
Adrenocorticotropic hormone
Growth hormone
Prolactin
Follicle-stimulating hormone
Luteinizing hormone
Posterior HORMONES OFTHE PITUITARY GLAND
DOES NOT PRODUCE ANY HORMONE but serves as storage site for ADH and Oxytocin
The stimulus for release of ADH
HYPEROSMOLAR PLASMA
Problem on ADH
Diabetes insipidius
(-) ADH
Central or Hypothalamic or Neurogenic DI
(-) ADH receptor
Nephrogenic DI
Stimulus of oxytocin
skin-to-skin contact (hugs
MILK PRODUCTION
Prolactin
MILK SECRETION
Oxytocin
Hyposecretion of GH/Somatotropin
Pituitary Dwarfism
Hypersecretion of GH/Somatotropin
Gigantism (Child)
Acromegaly (Adult)
Stimulates adrenocortical steroid formation and secretion
ADRENOCORTICOTROPIC HORMONE
Stimulate the thyroid gland to release thyroid hormones
THYROID STIMULATING HORMONE/
THYROTROPIN
Female: ovulation, follicle development with LH, estrogen production
Male: spermatogenesis, seminiferous tubule development
FOLLICLE STIMULATING HORMONE
✓ Female: progesterone production
✓ Male: testosterone production
LUTEINIZING HORMONE
Raises pain threshold and influence extrapyramidal motor activity
BETA-ENDORPHINS
Butterfly-shaped organ, located on the lower portion of the neck; lobes are separated by ligaments known
as ISTHMUS
THYROID GLAND
two major cell types of the thyroid gland
follicular cells and the
parafollicular cells (calcitonin)
I
monoatomic iodine
I2
diatomic iodine
MIT
monoiodotyrosine
DIT
diiodotyrosine
T3
triiodothyronine
T4
tetraiodothyronine/thyroxine
TPO
thyroid peroxidase
TGB
thyroglobulin
IODINE + TYROSINE =
MIT or DIT
Stimulates release of TSH
THYROTROPIN-RELEASING HORMONE (TRH)
increase production and release of thyroid hormone
THYROTROPIN/ THYROID STIMULATING HORMONE (TSH)
PROTEIN CARRIERS OF THYROID HORMONES
THYROXINE BINDING GLOBULIN
TRANSTHYRETIN
THYROXINE BINDING ALBUMIN
70%T4, most ofT3
THYROXINE BINDING GLOBULIN
20%T4
TRANSTHYRETIN
10%T4
THYROXINE BINDING ALBUMIN
The major product of the thyroid gland
Most predominant thyroid hormone
A good indicator of thyroid secretory rate
TETRAIODOTHYRONINE/THYROXINE
3–8 times more metabolically active compared toT4
T3
Synthesized by the parafollicular cells of the thyroid gland
plays a role in calcium and phosphorus metabolism
CALCITONIN
- Obese/ Fat
- Decreased appetite
- Inactivity
- Increased TAG and
Cholesterol - Myxedema
- Cold Intolerance
HYPOTHYROIDISM
- Thin/ Slim
- Increased appetite
- Hyperactivity
- Increased ALP
- Exophthalmia
- Heat Intolerance
HYPERTHYROIDISM
NormalT3/T4, HighTSH
Subclinical Hypothyroidism
NormalT3/T4, LowTSH
Subclinical Hyperthyroidism
AUTOIMMUNE DISORDERS OF THE THYROID HORMONE
HASHIMOTO’S THYROIDITIS
GRAVE’S DISEASE
The most common cause of primary
hypothyroidism
HASHIMOTO’S THYROIDITIS
Anti-microsomal antibodies
(anti-thyroid peroxidase antibody)
* Anti-thyroglobulin antibodies
* “Chronic lymphocytic thyroiditis”
HASHIMOTO’S THYROIDITIS
Anti-TSH receptor antibodies or
Thyroid stimulating immunoglobulin
GRAVE’S DISEASE
A most common cause of hyperthyroidism
GRAVE’S DISEASE
MOST SEVERE FORM OF HYPOTHYROIDISM
MYXEDEMA COMA
Monoatomic iodine + Tyrosine=
Monoidodotyrosine
Diatomic iodine + Tyrosine =
Diaodotyrosine
MIT + DIT
T3
DIT + DIT =
T4
✓ Routinely used to detect thyroid dysfunction
✓ Aids in early diagnosis of hypothyroidism
✓ Monitor thyroid hormone replacement therapy
TSH assay
Reference range of TSH ASSAY
0.4 – 4.5 mIU/L
✓ Measures the relationship between TRH and TSH
✓ Helpful in the detection of thyroid hormone resistance
TRH stimulation test
✓ Measure ability of thyroid gland to trap iodine
✓ Helps establish the cause of hyperthyroidism
Radioactive iodine uptake
✓ Postoperative marker of thyroid cancer
✓ Differentiates subacute thyroiditis from
thyrotoxicosis factitia
Thyroglobulin assay
✓ Confirm results of FT3 and FT4
✓ Distinguish between hyperthyroidism and euthyroidism
Thyroxine binding globulin assay
✓ Indirect estimate of the binding capacity of the plasma thyroid-binding proteins
✓ Inversely related to the unoccupied binding sites on TBG
T3 uptake test/ Thyroid Hormone Binding Ratio (THBR)
o Available binding sites: INCREASED
o T3U test or THBR: DECREASED
Hypothyroidism
o Available binding sites: DECREASED
o T3U test or THBR: INCREASED
Hyperthyroidism
Free T4 index
THBR x Total T4
THBR:
𝑇3𝑈 𝑂𝐹 𝑃𝐴𝑇𝐼𝐸𝑁𝑇 / 𝑇3𝑈 𝑂𝐹 𝑆𝐸𝑅𝑈𝑀 𝑃𝑂𝑂𝐿/𝐶𝑂𝑁𝑇𝑅𝑂L
Pyramid-like organs located above the kidneys
ADRENAL GLAND
OUTER ADRENAL CORTEX is composed of?
Zona Glomerulosa
Zona fasciculata
Zona Reticularis
Major mineralocorticoid
Aldosterone
Function: Sodium reabsorption
Aldosterone
Aldosterone is regulated by?
RAAS
Major glucocorticoid
Cortisol
Exhibits diurnal variation
✓ Increases blood glucose levels
Cortisol
Principal adrenal androgen
DHEA DIHYDROEPIANDROSTERONE
FUNCTIONS OF ANGIOTENSIN II
- Sodium reabsorption
- Vasoconstriction
- Increased aldosterone biosynthesis
- Trigger release of ADH for water reabsorption
Pyramid like organs located above the kidneys
ADRENAL GLAND
PRIMARY AMINE
NOREPINEPHRINE
The major metabolite of Norepinephrine
VANILLYLMANDELIC ACID (VMA)
- Neurotransmitter of both CNS and SNS
- Highest concentration in the brain
NOREPINEPHRINE (PRIMARY AMINE)
- Neurotransmitter of both CNS and SNS
- Produced only in adrenal gland from norepinephrine; flight or fight hormone, released in response to physiologic and psychologic stress
EPINEPHRINE (SECONDARY AMINE; ADRENALINE)
Most abundant medullary hormone
EPINEPHRINE
- Highest concentration in the brain
- Major intact catecholamine in urine
DOPAMINE (PRIMARY AMINE)
Major metabolite of dopamine
HOMOVANILLIC ACID (HVA)
It has both endocrine (Glucagon, Insulin, Somatostatin) and exocrine (amylase, lipase) functions
PANCREAS
hyperglycemic agent; produced by the ALPHA CELLS of the pancreas
Glucagon
hypoglycemic agent; produced by the BETA CELLS of pancreas
Insulin
inhibits the action of insulin and glucagon;
produced by the DELTA CELLS of the pancreas
Somatostatin
hydrolyze the glycosidic bonds in starch molecules, converting complex carbohydrates to simple sugars
Amylase
breaks down fats in food so they can be absorbed in the intestines
Lipase
most potent male sex hormone
Testosterone
most potent female sex hormone
Estrogen
post-menopausal
Estrone
responsible for menstrual cycle, moodiness
Estradiol
pregnancy, produced by placenta
Estriol
sudden drop of estrogen because of placental removal
POST-PARTUM DEPRESSION
QUADRUPLETEST FOR DOWN SYNDROME (Trisomy 21)
- hCG
- InhibinA
- Alpha-fetoprotein
- estriol
Trisomy 13
Patau Syndrome
Trisomy 18
Edward Syndrome
Trisomy 21
Down Syndrome
Produced by the placenta
Marker of pregnancy and testicular cancer
Human Chrorionic Gonadotropin
hCG is increased in
Down syndrome
Choriocarcinoma
Molar pregnancy
hCG is decreased in
Ectopic pregnancy