Endocrinology Flashcards
1
Q
What are some examples of the derivative tyrosine
A
epi, norepi, and thyroxine
2
Q
An increase in functioning of target cell which send which type of feedback to the endocrine gland (positive/negative?)
A
negative
3
Q
how would negative feedback alter the rate of releasing hormone
A
decrease
4
Q
What is one example of the positive feedback resulting in increased hormone release
A
Dilation of cervix during labor, stimulates post. pituitary to secrete more oxycotin=more dilation
5
Q
what receptor type is usually amplifying hormone signal
A
G-protein coupling (cAMP, cGMP, phospholipase C, Ca++, calmodulin)
6
Q
What type of hormone acts by entering the cell and binding to an intracellular receptor.
A
Steroids
7
Q
What is the result of a steroid binding with a intracellular receptor?
A
activates a gene, causing transcription, translation of proteins.
8
Q
Which hormone-receptor system would elicit a faster response between cell surface or intracellular?
A
cell surface (such as G-protein)
9
Q
Would epinephrine or prednisone cause a more immediate response
A
epi
10
Q
What is the anterior pituitary also called
A
adenohypophysis
11
Q
Where is the anterior pituitary or adenohypophysis derived from
A
embryonic cells from the oral cavity(Rathke’s pouch)
12
Q
Embryonic cells from Rathke’s Pouch is responsible for producing:
A
the anterior pituitary
13
Q
Neurohypophysis is another name for which component of the endocrine system
A
posterior pituitary gland
14
Q
How is the posterior pituitary gland produced
A
formed by down growth of cell axons from the 3rd ventricle
15
Q
Histamine that is released by mast cells diffuse into the ECF to the stomach and influence gastric parietal cells to secrete H+. This is an example of what type of signaling system
A
paracrine
16
Q
Where are the neuron cell bodies that produce ADH & oxytocin
A
supra optic & paraventricular nuclei of the hypothalamus
17
Q
How does the hypothalamus link to the anterior pituitary gland
A
through the hypothalamic-hypophysial portal blood vessels
18
Q
Describe the portal system seen in the anterior pituitary gland
A
capillary beds connected via veins
19
Q
Why would you pee a lot after drinking alcohol?
A
inhibits ADH release
20
Q
Pain, nausea, hypoglycemia would cause what to ADH
A
stimulate release of ADH
21
Q
What does ADH regulate:
A
osmolarity in the body
22
Q
What cells do ADH act on increasing H2O reabsorption
A
principle cells in the distal renal tubules & collecting ducts
23
Q
This hormone is responsible for uterine contraction, milk production, and ejection
A
oxytocin
24
Q
This hormone can help reduce postpartum bleeding
A
ocytocin
25
HOw many hormones are produced by the Anterior pituitary gland
6 GH, TSH, LH, FSH, ACTH, Prolactin
26
Whats the difference between the anterior and posterior pituitary glands
portal vein system
27
How many cells are responsible for producing the hormones of the anterior pituitary? list them
5, somatotrophin(GH) thyrotrophes(TSH), gonadotrophes(FSH & LH) corticotrophs(ACTH) lactotrophs (prolactin)
28
HOw is prolactin inhibited from being released
dopamine
29
What is pregnancies effect on prolactin (specifically the high levels of estrogen/progesterone?
inhibits action of prolactin
30
What is galactorrhea
milk production unassociated with pregnancy/nursing.
31
what causes galactorrhea
hypothalamic-hypophysial portal tract interrupted (damage to pituitary, adenoma of the pituitary), or destruction of dopamine that inhibits the prolactin normal release.
-
32
How could we treat galactorrhea if it was a result of destructed dopamine
dopamine agonist (bromocriptine)
33
what is the 'pulsatile release' refer to in regards to the growth hormone
the largest burst occurs within the 1st hour of falling asleep
34
Why is T3 secreted from the thyroid gland have a "steady-state"
highly protein bound (not active when bound), with a long half life
35
acromegaly would result from a problem in which gland
pituitary
36
what is the mechanism of Grave's Disease
an autoimmune disorder results from antibodies that act against TSH receptors; result in an increased release of T3/T4
37
describe what you would see in someone who has myxedema
puffiness of skin, non-pitting edema, pleural, cardiac effusions
38
what pathology would myxedema be associated with?
Hypothyroidism
39
Would you expect the T3/T4 levels to be high, low, or the same with someone who is diagnosed with Grave's Disease
Raised
40
Cretinism causing a look of thick, pale skin with a floppy tongue is caused by what
lack of TSH within the thyroid
41
What is a classic presentation of iodine deficiency
Goiter (high TRH, high TSH, low T3/T4)
42
What are you to see with the TRH, TSH, and T3/T4 levels with a pituitary adenoma
Low TRH, high TSH, high T3/T4
43
What findings would be seen in Grave's Disease (TRH/TSH/T3/T4) levels
Low TRH, low TSH, high T3/T4
44
The adrenal medulla is responsible for the production of
catecholamine
45
What are the catecholamines produced in the adrenal medulla
epinephrine and norepinephrine
46
the adrenal cortex is responsible for
steroid hormones
47
The three cortical adrenal layers include:
zona reticularis, zona fasciculate and zona glomerulosa
48
What is zona resicularis responsible for
androgens
49
what is zona fasciculate do
glucorticoids (cortisol)
50
what is zona glomerulosa do
mineralocorticoids (aldosterone)
51
what the difference in release of mileralocorticoids (aldosterone) when compared to androgens & glucorticoids (cortisol)
it is controlled by the RAAS system whereas the latter two are produced AND released by ACTH
52
What is one thing to be aware of when reading lab results on hormone levels (hint what does it measure)
they measure immunologic amounts NOT biological activity hence the #'s may be normal, but that doesn't necessarily mean they are functional
53
In terms of concentration- how do the hypothalamic releasing hormones compare with the hormones released into the systemic circulation?
They are much more highly concentrated
54
how would alcohol and or ANP affect ADH
inhibit the release
55
What controls the pituitary to release ADH
osmoreceptors in the hypothalamus, barorecptors in the aortic arch, L atrium, and carotid artery sense hypovolemia/hypervolemia also signaling the hypothalamus via vegas nerve
56
where are the baroreceptors located that are responsible for sensing hypo/hyper volemia
aortic arch, L atrium, and carotid artery
57
how do baroreceptors signal the hypothalamus neuronally to increase/decrease ADH secretion
via the vegas nerve
58
HOw would you describe nephrogenic DI (diabetes insipidus)
loss of osmolar gradient so the loop of Henle can't concentrate the urine
59
how would you describe Central DI
no ADH is released from the brain
60
Oat cell carcinoma of the lung is a condition closely associated with SIADH.... how could you explain these similarities
Low Na+ serum
61
this hormones actions are mediated through somatomedins
Growth Hormone
62
what acts as a type of negative feedback for growth hormone
somatostatins
63
what are 4 actions that growth hormone causes
increases linear growth in bones
increases protein synthesis
promotes utilization of fats as energy and this leads to a type of diabetogenic (increase in insulin resistance)
64
How would starvation, fasting, and exercise affect the rate of Growth Hormone secretion
it would increase (may utilize fat stores for energy)
65
Which hormone is responsible for lactogenesis
prolactin
66
this hormone is responsible for breast development at puberty & pregnancy
prolactin
67
This hormone inhibits ovulation by inhibiting gonadotrophin-releasing hormone
prolactin
68
Secondary to spermatogenesis, infertility in males can be caused by excess of this hormone
prolactin
69
If a patient were to present to you with a headache and galactorrhea, we can assume?
pituitary adenoma
70
A failure to lactate or "empty sella syndrome" would cause us to believe what condition
prolactin deficient
71
what is empty sella syndrome
the pituitary has shrunk so the bony saddle appears partially empty
72
This hormone stimulates development of follicles in the ovary and spermatogenesis
follicle stimulating hormone
73
this hormone stimulates development of corpus luteum in the ovaries & testosterone secretion from the Leydig cells of testis
Luteinizing hormone
74
luteinizing & FSH are both under control of
gonadotrophin releasing hormone
75
Whats the more active form between T3/T4
T3
76
the thyroid hormone is contained primarily:
thyroglobulin
77
this hormone is comprised of a large number of follicles that are filled with colloid material
thyroid
78
This hormone is actually apart of a family including MSH, Beta-endorphin and alpha/beta lipotropin
ACTH
79
ACTH produces & stimulates to secrete these two hormones? from these zona's? in the adrenal cortex
cortisol from zona fasciculate & androgens from the zona reticularis
80
What stimulates the secretion of the ACTH from the anterior pituitary
the corticotrophin releasing hormone (CRH) from the hypothalamus
81
glucocorticoids/androgens are secreted pulsatile and diurnal, how do you best explain this?
Peak release is in early morning. Diurnal=daily
82
this test is a method evaluating the functioning of the pituitary-adrenal axis
dexamethasone suppression test (DST) a blood test to measure cortisol levels in the adrenal gland, often diagnose Cushing syndrome
83
This hormone stimulates gleuconeogenesis & glycogen storage
cortisol
84
This hormone is an antiinfammatory inhibiting prostaglandins, leukotrienes/histamines/serotonin
glucocorticoids (cortisol)
85
this hormone suppresses the immune response & inhibits bone formation
cortisol
86
this hormone maintains vascular response to catecholamines & increases GFR
cortisol
87
What mechanism of aldosterone's function would cause metabolic alkadosis
increased secretion of H+
88
An abnormal function in the DHEA (dehydro-epiandrosterone) in a female would cause what charecteristic
masculinization
89
Addison's disease is associated with which gland
adrenal cortex
90
What is the difference between primary and secondary adrenal insufficiency
primary is failure of the gland itself whereas secondary is failure to stimulate the gland
91
How could we have primary destruction of the adrenal gland
autoimmune disease, metastatic lung cancer
92
Hyperpigmentation of the nails/hands and gumlines would be associated with this disease
Addison's
93
In a secondary cause of insufficient adrenal hormones, a pituitary hormone would lack this which would also be a sign to rule out primary
no hyperpigmentation
94
these symtpoms would be seen in both primary and secondary causes of adrenal insufficiency (Addison's desease)
hypoglycemia, anorexia, and weakness.
95
This one symptom would help determine as to whether Addison's disease is caused by a primary or secondary failure
hyperpigmentation
96
If you had insufficient cortisol secretion with no sign of hyperpigmentation, we could assume the problem is
a pituitary tumor
97
What are the hallmark signs of Cushing Syndrome
Round Face, Buffalo Bump, abdominal striae, hyperpigmentation, HTN, Hyperglycemia
98
What are some causes of Cushing Syndrome
excess cortisol caused by pituitary adenoma, adrenal adenoma, and iatrogenic
99
What is the most common cause of Cushing Syndrome in developed countries?
iatrogenic causes
100
In Empty Sella Syndrme ( a secondary hypothyroidism) what are the TRH, TSH and T3/T4 levels
High TRH, Low TSH, Low T3/T4
101
If there are low levels of T3/T4, caused by a problem in the hypothalamus. How would you see the TRH & TSH levels
low TRH low TSH
102
Estrogen and Progesterone are a negative feedback for what hormones?
they act on hypothalamus to inhibit FSH & LH
103
HOw does the FSH & LH act to increase estrogen and progesterone?
it acts on ovaries to make it
104
Insulin dependent diabetes mellitus refers to which type
Type I
105
What is the mechanism of Type I DM
Beta cells are destroyed so u have inadequate insulin secretion
106
Polyuria, polydipsia and polyphagia are hallmark signs of this problem
high glucose levels in Type I DM
107
what is ketoacidosis
increased use of fatty acids/amino acid for energy particularly in Type I DM
108
Insulin is produced by which type of cells
beta cells
109
How can you explain hyperkalemia in a type I diabetic
since insulin promotes the uptake of K+ into the cell, Type I diabetics don't make adequate insulin and hence more K+ is left outside the cells
110
What would u assume is the problem if a patient presets with fruity smelling breath
They are experiencing ketoacidosis and may have Type I diabetes
111
What are three things that can increase Insulin secretion
GIP (gastric inhibitory peptide) GLP-1 (glucagon like peptide) and sulfonylureas
112
Why would Metformin help treat Type II diabetics (think what their pathophys is)
improves tissues usage of insulin.... counteracts the "insulin resistance
113
Which type of diabetes is described as insulin resistance
Type II (make enough insulin, but cells don't utilize it)
114
If you were to treat a hyperkalemic patient with a normal blood glucose level, which pairing of treatment could u use
insulin with glucose
115
What opposes insulin and is referred to as the Hormone of Starvation
Glucagon
116
What 3 things does Glucagon act on
gluceoneogenesis, Glycogenolysis, increased lipolysis
117
Somatostatin
acts as a "stop" for growth hormone release produced by hypothalamus; stimulated by ingestion of food
118
What are the hallmark signs of hypocalcemia
hyperreflexia, muscle cramping, spontaneous twitching, tingling & numbness, Chvostek sign, and Trosseau sign
119
hallmark signs of hypercalcemia
polyuria, polydipsia, hyporeflexia, constipation, lethargy, coma, and death
120
What is the Chvostek sign
twitching of facial muscle caused by tapping o facial nerve
121
What is the Trosseau sign
carpopedal spasm with inflation of BP cuff
122
How can Chronic Renal failure be caused/linked to problems with parathyroid hormone?
It is a secondary form of hyperparathyroidism
123
How can you have a vitamin D deficiency even if you are getting enough from the sun or your diet? (how is it processed)
Vitamin D is inactive until it is first synthesized by the liver and modified by the kidney. The kidney can make it active (1,25-dihydroxycholecalciferol) or inactive based on body needs
124
What is the hallmark Vitamin D deficient condition
Rickets in children
125
What can you use to treat a mild form of hyperparathyroidism? It also can help treat renal failure
Calcitonin
126
How does Calcitonin work to treat hyperparathyroidism?
opposes action of PTH, lowering serum Ca++ levels and stimulates deposition of bone when serum Ca++ high.
127
What causes Conn's Syndrome
primary hyperaldosteronism
128
What are some symptoms of Conn's Syndrome
increase in ECF volume HTN, hypokalemia, metabolic alkalosis
129
What is spironolactone's mechanism if given to treat Conn's Syndrome
an aldosterone antagonist
