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Fundies Second test > Endocrinology > Flashcards

Endocrinology Flashcards

1
Q

secretion from neurons reach the blood stream and influence cells some distance away

A

neuroendocrine

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2
Q

Hormone classifications (3)

A
  1. proteins and peptides
  2. steroids (cholesterol derived)
  3. aa tyrosine derived (epi, norepi, dopa, thyroxine)
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3
Q

______ _______ usually controls secretion of hormones; less often by ________ _________ (oxytocin cervix dilation)

A

negative feedback,

positive feedback

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4
Q

adrenal medulla is modified _______ ________

A

neural tissue

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5
Q

amino acid based hormone classifications (4)

A
  1. simple aa, peptide & protein
  2. can’t enter cell
  3. 2nd messenger use
  4. most common
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6
Q

Steroid hormone classifications (5)

A
  1. cholesterol derived
  2. can enter cells
  3. direct action
  4. gonadal and adrenocortical
  5. usually slower overall effect
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7
Q

lab test for hormones

A

Challenging (small amounts)

-radioimmunoassay (bound/free ratio)

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8
Q

Pituitary components

A
  1. anterior pituitary (adrenohypoghysis)

2. posterior pituitary (neurohypophysis)

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9
Q

Posterior pituitary releases _________ and _______- both made in the ___________, particularly in the ____ _____ & ____________ nuclei. Released directly into circ.

A

ADH and Oxytocin,
hypothalamus,
supra optic &paraventricular nuclei

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10
Q

embriologic derivation:
anterior pituitary:
posterior pituitary:

A
  • oral cavity pouch

- down growth of 3rd ventricle

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11
Q

Hormones released by anterior pituitary(6)

GOAT FLAP

A
  1. Growth GH
  2. Ox
  3. adrenocorticotrophic ACTH
  4. Thyroid stimulating TSH (thyrotropin)
  5. Follicle Stimulating FSH
  6. Luteinizing LH
  7. ADH
  8. Prolactin
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12
Q

Hypothalamus controls pituitary by_________ _______ ________, released into ________-________ portal blood vessels.

A

hypothalamic releasing hormones, (^ concentration vs. syst)

hypothalamic-hypophysial

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13
Q

__________hypothalamus monitors body fluid _________ (CSF 3rd vent–directly adjacent). _____ secreted to adjust for _______ changes.

A

osmoreceptors,
osmolarity,
ADH,
osmolarity

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14
Q

ADH acts on ______ _____ of the ____ renal tubules and _____ _____ to INCREASE H2O reabsorption

A

Principle cells,
DISTAL,
collecting ducts

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15
Q

baroreceptors in the ____ _____, _____ ____, and carotid artery sense _______/ _____ and signal the hypothal via the _____ nerve to ^v ADH secretion

A

left atrium, aortic arch,
hypoveolemia/ hypervolemia,
vagus

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16
Q

Diabetes insipidus DI can be:

A
  1. central DI

2. nephrogenic DI (osmolar gradient lost)

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17
Q

ADH pathophys characterized by decrease in plasma osmolarity, decreased serum Na+ (too much total body water)

A 
SIADH syndrom of inappropriate ADH secretion
usually from (OAT CELL CARCINOMA of lung)
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18
Q

Functions: uterine contration, milk “let down”, milk ejeciton

A

oxytocin

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19
Q

oxytocin release stimulated by

A
  1. nipple stim
  2. sight, sound, smell infant
  3. cervical dilation (positive feedback)
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20
Q

6 anterior pituitary hormones produced by 5 cell types: (5)

A
  • trophes:
    1. thyrotrophes
    2. corticotrophes
    3. lactotrophes
    4. gonadotrophes
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21
Q

Growth Hormone (GH) actions (4)

A

aka somatotropin

  1. ^ linear growth
  2. ^ protein synthesis
  3. ^ fat utilizaiton for energy
  4. ^ insulin resistance – DIABETOGENIC–wants body to use fats before glucose
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22
Q

excess GH:

deficiency in GH:

A
  • -Acromegaly(when growth plates already closed-over ^time) vs. gigantism (^ GH before plates closed)
  • -pituitary dwarf (no linear growth)
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23
Q

XRH

A

released by hypothalamus to stimulate pituitary

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24
Q

GH secretion stimulated by: (4)

A
  1. fasting
  2. starving
  3. ^ aa in plasm
  4. exercise
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25
Q
  • -GH opposed by

- -GH mediated by

A

somatostatin

somatomedin

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26
Q

pregnancy and suckling stimulate production and release of ______. Dopamine inhibits release. Hormone inhibits _____ , and promotes ______ development.

A

prolactin,
ovulation,
breasts

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27
Q

galactorrhea cause from. This along with _______ presenting symptoms of pituitary adenoma.

A

^ prolactin–headache

  1. v dopamine
  2. pituitary tumor
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28
Q

TSH–in response to ____

A

thyroid stimulating hormone (thyrotropin),

thyroid releasing hormone (TRH)

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29
Q

TSH actions (2)

A

Thyroid stimulating hormone (thyrotropin)
1. regulates growth of thyroid
2. regulates secretion T3 & T4
Negative feedback to HYPO and PIT

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30
Q

ACTH from ___-_______. Released by _________-______ _____

A

adrenocorticotrophic hormone from pro-opiomelanocortin,

corticotrophin-rleasing hormone

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31
Q

ACTH modulates ________ secretion from the zona __________ of adrenal _______

A

cortisol,
fasciculate,
cortex

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32
Q

FSH under control of ______.

A

Follicle stimulation hormone,

Release controlled by GnRH (gonadotropin releasing hormone

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33
Q

FSh actions (2)

A
  1. stim development of ovary follicles

2. stim spermatogenesis

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34
Q

LH under control by _____. Hormone stimulates development of _____ ______ in women. Stimulates ________ ______ for Leydig cells of ____ in men.

A

Luteinizing Hormone–GnRH,
corpus luteum,
testosterone secretion,
testis

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35
Q

T3 and T4 are highly _____ ______ in blood. So effects will be ______; long ____-_____. Less than __% free in serum, rest bound to ______-____ ______.

A 
protein bound,
steady,
half-life,
1%,
thyroxine-binding globulin
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36
Q

steroid hormones secreted by follicles and corpus luteum of ovaries. Negative feedback to hypothalamus ^v release of ____ and ____

A

Estrogen and Progesterone,

FSH & LH

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37
Q

T4 ==> T3 functions (slide 23)

turns into

A 
^ Na+ K+ ATPase
^ basal Metabolic rate 
^ O2 consumption
^cardiac output
(think of hypo/hyperthyroidism symptoms)
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38
Q

__________hypothalamus monitors body fluid _________ (CSF 3rd vent–directly adjacent). _____ secreted to adjust for _______ changes.

A

osmoreceptors,
osmolarity,
ADH,
osmolarity

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39
Q

ADH acts on ______ _____ of the ____ renal tubules and _____ _____ to INCREASE H2O reabsorption

A

Principle cells,
DISTAL,
collecting ducts

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40
Q

baroreceptors in the ____ _____, _____ ____, and carotid artery sense _______/ _____ and signal the hypothal via the _____ nerve to ^v ADH secretion

A

left atrium, aortic arch,
hypoveolemia/ hypervolemia,
vagus

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41
Q

Diabetes insipidus DI can be:

A
  1. central DI

2. nephrogenic DI (osmolar gradient lost)

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42
Q

ADH pathophys characterized by decrease in plasma osmolarity, decreased serum Na+ (too much total body water)

A 
SIADH syndrom of inappropriate ADH secretion
usually from (OAT CELL CARCINOMA of lung)
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43
Q

Functions: uterine contration, milk “let down”, milk ejeciton

A

oxytocin

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44
Q

oxytocin release stimulated by

A
  1. nipple stim
  2. sight, sound, smell infant
  3. cervical dilation (positive feedback)
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45
Q

6 anterior pituitary hormones produced by 5 cell types: (5)

A
  • trophes:
    1. thyrotrophes
    2. corticotrophes
    3. lactotrophes
    4. gonadotrophes
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46
Q

Growth Hormone (GH) actions (4)

A

aka somatotropin

  1. ^ linear growth
  2. ^ protein synthesis
  3. ^ fat utilizaiton for energy
  4. ^ insulin resistance – DIABETOGENIC–wants body to use fats before glucose
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47
Q

excess GH:

deficiency in GH:

A
  • -Acromegaly(when growth plates already closed-over ^time) vs. gigantism (^ GH before plates closed)
  • -pituitary dwarf (no linear growth)
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48
Q

XRH

A

released by hypothalamus to stimulate pituitary

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49
Q

GH secretion stimulated by: (4)

A
  1. fasting
  2. starving
  3. ^ aa in plasm
  4. exercise
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50
Q
  • -GH opposed by

- -GH mediated by

A

somatostatin

somatomedin

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51
Q

pregnancy and suckling stimulate production and release of ______. Dopamine inhibits release. Hormone inhibits _____ , and promotes ______ development.

A

prolactin,
ovulation,
breasts

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52
Q

Zona Glomerulus affects the ______

A

Glomerulus of kidney (Aldosterone)

53
Q

TSH–in response to ____

A

thyroid stimulating hormone (thyrotropin),

thyroid releasing hormone (TRH)

54
Q

TSH actions (2)

A
  1. regulates growth of thyroid
  2. regulates secretion T3 & T4
    Negative feedback to HYPO and PIT
55
Q

ACTH from ___-_______. Released by _________-______ _____

A

adrenocorticotrophic hormone from pro-opiomelanocortin,

corticotrophin-rleasing hormone

56
Q

ACTH modulates ________ secretion from the zona __________ of adrenal _______

A

cortisol,
fasciculate,
cortex

57
Q

FSH under control of ______.

A

Follicle stimulation hormone,

Release controlled by GnRH (gonadotropin releasing hormone

58
Q

FSh actions (2)

A
  1. stim development of ovary follicles

2. stim spermatogenesis

59
Q

LH under control by _____. Hormone stimulates development of _____ ______ in women. Stimulates ________ ______ for Leydig cells of ____ in men.

A

Luteinizing Hormone–GnRH,
corpus luteum (temporary structure in women’s follical during luteal phase, releases ^ progesterone/estrodial),
testosterone secretion,
testis

60
Q

T3 and T4 are highly _____ ______ in blood. So effects will be ______; long ____-_____

A

protein bound,
steady,
half-life

61
Q

steroid hormones secreted by follicles and corpus luteum of ovaries. Negative feedback to hypothalamus ^v release of ____ and ____

A

Estrogen and Progesterone,

FSH & LH

62
Q

T4 ==> T3 functions (slide 23)

turns into

A 
^ Na+ K+ ATPase
^ basal Metabolic rate 
^ O2 consumption
^cardiac output
(think of hypo/hyperthyroidism symptoms)
63
Q

Hormone affects every organ system in body, mediate cellular metabolic rate.

A

Thyroid Hormones:

  1. T3-triodothyronine – ^active than T4
  2. T4 -thyroxin–target tissue converts to T3
64
Q

Thyroid gland composed of ^# of _____ filled with _____ _____, made up of thyroglobulin containing ______ ______

A

follicles,
colloid material,
thyroid hormone

65
Q

_______ _____ of thyroid concentrates ______ in gland (30X greater than in blood).

A

iodide pump,

iodide,

66
Q

Thyroid hormone affects ____, increasing _______. Effects last several days. Effects:

A 
DNA,
transcription
1. ^ thermogenesis, sweating
2. ^ rate /depth of respiration
3. ^cardiac output 
4. etc. ^ metabolic excitation
67
Q

hyperthyroidism aka

A

Graves’ Disease–autoimmunce process destroying negative feedback receptors
read abt symptoms

68
Q

Hypothyroidism symptoms:

A

v metabolic rate resulting in:

  1. cold intolerance
  2. weight gain
  3. lethargy
  4. hyxedema (puffiness of skin)
69
Q

deficient dietary iodine resulting in decreased T3/T4 secretion there for high TSH levels –> stimulate thyroid growth =

A

thyroid goiter

70
Q

Adrenal gland CORTICAL Zones and products mnemonic (steroid hormones)

A

Go Find Rex, Make Good Sex

  1. Zona Glomerulosa = Mineralocorticoids (aldosterone)
  2. Zona Fasciculata = Glucocorticoids (cortisol)
  3. Zona Reticularis = Androgens
71
Q

Adrenal Medulla makes ___________: _______ & ________

A

catecholamines:

epinephrine & norepinephrine

72
Q

ACTH stimulated by ____ from hypothalamus. ACTH stimulates the SYNTHETIC pathways to make the _______ _____ derived from ________.

A

CRH (corticotrophin releasing hormone),
adrenocortical hormones,
cholesterol

73
Q

secretion of ______ from Zona glomerulosa stimulated by ____–also stimulated by ______ __

A

aldosterone,
Renin,
angiotensin II

74
Q

PRODUCTION and SECRETION from Zona fasciculate and Zona reticularis under direct control of _____.

A

ACTH

75
Q

*T3 and T4 need _______ for synthesis

A

IODINE (for test should know at which level problem is (hyp, pit, thyroid, diet) in relation to symptoms and lab test values)

76
Q

Glucocorticoid(cortisol) /androgen secretion from adrenal glad controlled by _____ ______ of _______ to pituitary. Release peaks in early _______.

A

negative feedback,
cortisol,
morning

77
Q

Zona Glomerulus affects the ______

A

Glomerulus of kidney (Aldosterone)

78
Q
  • Cortisol (glucocorticoid) is the _____ hormone. Peaks in ____. Functions: (5)

Study actions deeply!

A 
stress,
morning,
Functions:
1. catabolism--glycogen storage
2. antiinflammatory-- (v response to hist, sero, protag)
3. suppresses immune response
4. ^ GFR
5. inhibits bone formation
79
Q

Aldosterone functions:(3)

A
  1. ^ Na+ reabsorption–ECF vol expansion
  2. ^ renal K+ secretion
  3. ^ renal H+ secretion–metabolic alkalosis
80
Q

Adrenal Androgens & function: (video) (4)

A
  1. dehydro-epiandrosterone DHE and androstenedione
  2. DHE minor role in males
  3. DHE major androgen in females
  4. may cause “masculinization” in females
81
Q

Leptin made by _______ ______. Adjusts ______ _____ & _______ ______

A

adipose tissue/ fat cels,
hunger sensation,
Energy expenditure

82
Q

Failure of adrenal gland (causes: autoimmune, cancer) – disease and symptoms

A 
(PRIMARY) Addison's disease (adrenal insufficiency)
symp:
  1. hypoglycemia
  2. anorexia
  3. weakness
  4. HYPERPIGMENTATION
83
Q

Failure to stimulate adrenal gland (causes: iatrogenic, pit tumor, hypo disorder): disease, symptoms, and RX

A

(SECONDARY) Addison’s disease–adrenal insufficiency
Symp:
1. same as primary minus hyperpigmentation
RX: replace steroids

84
Q

Excess glucocorticoids aka–caused by?

A

Cushing’s syndrome:

  1. iatrogenic
  2. pituitary adenoma w/ ^ ACTH release
  3. Adrenal adenoma
85
Q
  • Cushing’s syndrome symp + RX
A 
Symp: 1.hyperglycemia
2. HTN
3. muscle wasting
4. moon face
5. buffalo hump
6. abdominal striae
RX depends on cause: 
1. adrenalectomy
2. pit surgery
86
Q

makes MSH melanocyte stimulating hormone

A

pituitary gland–overproduction can cause hyperpigmentation

87
Q

Primary hyperaldosteronism aka–tumor–RX

A

Conn’s syndrome–Spironolactone (aldo antagonist)/ surg

88
Q

Main extracellular buffer (alkaline)

A

Bicarb CO3—released by pancreas into small intestines

CO2 + H2O –> H2CO3 (carb acid) –> CO3- + H2

89
Q

Pancreas hormones and cell mnemonic GIS

A

AG (starvation)
BI (plenty)
DS (inhibitory)

90
Q

Hormone that regulates insulin and glucagon–

also known at Growth Hormone Inhibitory Hormone

A

Somatostatin

91
Q

empty sella syndrome

A

pituitary sits in sella tersica–

92
Q

iodine needed for synthesis of ____ & _____. Thus low levels in diet will lead to higher release of _____ from pituitary. And ______ will result.

A

T3& T4,
TSH,
goiter

93
Q

to check integrity of pituitary-adrenal axis (based on negative feedback loop)

A

Dexamethasone suppression test (pituitary will react to dex same way as cortisol–then check cortisol next morning) If you give dex and cortisol down next day = normal. If you give dex and cortisol high next day = adrenal producing cortisol on its own=disfunction

94
Q

negative feedback for FSH and LH controlled by

A

levels of progesterone/ estrodile in blood – intermediary in contrast to T3/T4 feedback for thyroid/pit/hypo system

95
Q

opposes aldosterone–need to be wary of ________ due to interplay of Na+ and K+ by aldo in kidney (to keep me electrically neutral)

A

spironolactone,

hyperkalemia (K+ not be excreted by aldo)

96
Q

Symptoms of Conn Syndrome (3) + treatment

A
  1. hypertension
  2. hypokalemia
  3. metabolic alkalosis
  4. RX w/ spironolatone (aldo antagonist)
97
Q

Hormone of abundance + actions (4)

A

Insulin,

  1. decrease blood glucose
  2. decrese blood lipid levels
  3. decrease blood aa concentration
  4. ^ K+ uptake by cells
98
Q

Preproinsulin –>

A

proinsulin –> insulin

99
Q

Diabetes type I aka; cause

A

Insulin dependent diabetes mellitus IDDM–inadequate insulin secretion secondary to DESTRUCTION of BETA cells

100
Q

Type I diabetes characterized by (7)

A
  1. hyperglycemia
  2. polyuria
  3. ketoacidosis (because using fat/aa for energy)
  4. polydipsea
  5. polyphagia (cellular starvation)
  6. hyperkalemia (insulin promotes K+ cell uptake)
  7. diabetic ketoacidosis, coma
101
Q

Type II diabetes mellitus aka + cause

A

Non-insulin dependent diabetes lmellitus NIDDM,
–adequate insulin secretion–cells “insulin resistant”
(not prone to ketosis because insulin working somewhat)

102
Q

Type II diabetes mellitus characterized by (2)

A
  1. abnormal glucose levels

2. metabolic derangements of Type I

103
Q

Diabetic coma caused by

A

hyperosmolarity cause neurons not to work right

104
Q

Hormone of starvation (____), stimulated by _______ blood glucose. Increases blood glucose concentraiton by: (3)

A 
glucagon,
decreased,
1. glycogenolysis (break down glycogen)
2. gluconeogenesis
3. increased lipolysis
105
Q

________ produced and released from hypothalamus stimulated by food ingestion. Modulates response of _____/____ to food ingestion–affects rest of body in _______ manner.

A

somatostatin,
glucose/glucagon,
inhibitory

106
Q

drug for Type II diabetes that ^ tissue usage of insulin

A

metformin

107
Q

Ca ++ concentrations:

A

Protein bound: 40% (unfilterable)
Ion complexed: 10% (ultafilterable)
Active ionized form: 50% (ultrafilterable + active)

108
Q

*hyocalcemia causes: (6)

A
  1. hyperreflexia
  2. muscle cramping
  3. spontaneous twitching
  4. tingling/ numbness
  5. chvostek sign (facial twitch when CN 7 tapped)
  6. Trosseau sign (carpopedal spasm–w/ BP cuff inflation)
109
Q

*Hypercalcemia causes: (5)

A
  1. polyuria
  2. polydipsia
  3. hyporeflexia
  4. consipation
  5. lethargy, coma, death
110
Q

Ca++ and H+ both bind to _________, so ^v H+ (pH change) in blood can can alter ____ binding, and ^v levels in blood, (____________/__________) symptoms

A

albumin,
Ca++,
(Hypo/hypercalcemia)

111
Q

*GIP/GLP-1
Gastric inhibitory peptide
Glucagon-like peptide (glucagon analog)

A

INCREASE insulin secretion,
OPPOSE actions of glucagon
(for type II diabetes)

112
Q

serum _______ stimulates release of insulin–if Beta cells get worn out by overuse, a ____ __ ________ will start to look like a ____ __ ________

A

glucose,
Type II diabetic
Type I diabetic

113
Q

Increased ________ concentration increases complexed Ca++, decreasing free ______ concentrations

A

phosphate,

Ca++

114
Q

Decreased _______ concentration increases _______ Ca++, increasing free Ca++ concentrations

A

phosphate,

complexed

115
Q

Somatostatin made in:

aka growth hormone inhibiting hormone GHIH

A
  1. hypothalamus
  2. liver
  3. GI tract
    Stimulated by food ingestion
116
Q

Secretion of _______ ______ stimulated by decreased serum Ca++ concentration

A

parathyroid hormone

117
Q

Parathyroid hormone effects:(3)

A
  1. Bone (^ resorption–>^ Ca++ & phosphate in ECF)
  2. kidney (^ Ca++ reabsorption; v phosphate reabsorption)
  3. small intestine (^ Ca++ absorption via VITAMIN D)
118
Q

PRIMARY Hyperparathyroidism, as from ______ ______, may cause (3) ______, _______ ______, and ________

A

parathyroid ADENOMA,

  1. hypercalcemia,
  2. kidney stone (Ca++/Phosphate)
  3. hypophosphatemia
119
Q

SECONDARY hyperparathyroidism, as from excessive ___ ______ secondary hypocalcemia as from: (3) _______, _______, _________

A

PTH secretion,

  1. Vit D deficiency
  2. Renal failure
  3. PTH secretion tumor
120
Q

PTH wants to increase:

A

Ca++ concentration in serum

121
Q

Hypoparathyroidism usually from: clincaly we’ll see

A

treatment of thyroid gland resulting in destruction of parathyroid glands.
-hypocalcemia/hyperphosphatemia

122
Q

2nd major regulatory hormone for Ca++ & phosphate

A

Vitamin D aka cholecalciferol

123
Q

_____ modifies vitamin-D to make inactive form then ______ further modifies into _______ or ______ form

A

liver,
kidney,
active/inactive

124
Q

Actions of active vitamin-D derivative (4)

A
  1. ^ mineralization of new bone
    • ^ Ca++ / phosphate absorption by SMALL INTESTINES
  3. Kidney–^ reabsorption of Ca++ & phosphate
  4. Bone–stim bone “REMODELING”
125
Q

ppl with chronic renal failure will have _______ due to inability to excrete _________, thus ____ will be taken out of bones. SECONDARY HYPERPARATHYROIDISM

A

osteoporosis,
phosphate,
Ca+

126
Q

Vitamin D deficiency will cause:
______ in children:
______ in adults:

A
  • Rickets (can’t mineralize bones)

- osteomalacia, osteoporosis (from renal failure–no active D)

127
Q

_______ opposes PTH by lowering serum free ____. Made in thyroid–stims Ca++ into bones.

A

calcitonin,

Ca++

128
Q

^v Ca++ chart on pg 17 of outline

A

*

129
Q

bones made of–thus vitamin D wants to save ______

A

calciumphosphate –bound,

both

Fundies Second test (8 decks)

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