Endocrinology Flashcards
Describe endocrine signalling
Hormone secretion into the blood by an endocrine gland. Hormone is transported by the blood to a distant target site
What are the six steps of hormone communication?
1) synthesis by endocrine cells
2) release of hormone by endocrine cells
3) Transport of hormone to target site through bloodstream
4) DETECTION of hormone by a specific receptor
5) CHANGE in cellular metabolism triggered by the hormone-receptor interactions
6) removal of hormone, (typically terminates cellular response)
What are the classical endocrine organs?
Brain Thyroid & Parathyroid Heart Adrenal Glands Kidneys Pancreas Ovaries/Testis
How are the hypothalamus and anterior pituitary connected?
Via the blood vessels of the pituitary stalk
What are the 4 classes of hormones based on structure?
Peptides/proteins
Steroids
Amines
Ionic Calcium
True/False? Thyroid hormone receptors are in the same family as steroid receptors
True
What are 4 properties of hormone receptors?
Specificity
Affinity
Saturability
Measurable effect
3 mechanisms by which a hormone can exert effects on target cells?
1) direct effects on function at the cell membrane
2) intracellular effects mediated by second messenger systems
3) intracellular effects mediated by genomic/nuclear action
What are the 2 anatomically distinct tissues of the pituitary gland?
Anterior pituitary (endocrine tissue) Posterior pituitary (neural tissue)
Why are Oxytocin and Vasopressin structurally similar?
Common precursor hypothesis:
Both control smooth muscle tone (but in different ways)
What is the only non-peptidic pituitary hormone?
Dopamine (Prolactin Inhibiting Hormone)
What are the two hormones secreted by the posterior pituitary?
Oxytocin and Vasopressin
What are the effects of oxytocin in females?
Dilation of cervix during parturition
secretion of milk
pro-social behaviour
What are the effects of oxytocin in males?
Ejaculation of sperm
Prosocial behavior
What is the major component of the thyroid colloid?
Thyroglobulin, source of thyroid hormones
What are the thyroid hormones?
Thyroxine (T4) and triiodothyronine (T3)
True/False? Humans barely have a large enough Thyroid gland - removal of 3g is enough to cause hypofunction
False
What hormone controls synthesis of thyroglobulin?
TSH
What do thyroid hormones contain?
Iodine
What is the difference between T3 and rT3?
T3 has 2 Iodines on its first aromatic ring, rT3 has 2 iodines on its second aromatic ring (not endocrine)
How are thyroid hormones synthesized?
1) molecular iodine is used for iodination of tyrosine residues of TGB to form Monoiodotyrosine and diiodotyrosine
2) Oxidative coupling of two DIT forms T4, while one MIT and one DIT forms T3
(hormones stay linked to TGB)
Rate of all steps increased by TSH
What is the Hypothalamic-end organ axis for Thyroid hormones?
Hypothalamus: Thyrotropin releasing hormone
Anterior pituitary: Thyroid Stimulating Hormone
Thyroid: T3/T4
What happens when Iodine supply is low?
TRH/TSH levels increase, stimulating thyroid follicular cells to form a goiter
Since the thyroid cannot produce hormones without Iodine, it is a non-toxic goiter
What are the key effects of thyroid hormones? (5)
Stimulation of calorigenesis in most cells Increased carbohydrate storage Lipid change Protein synthesis Promote normal growth
True/False? T4/T3 increase BMR
True
How do Thyroid hormones work?
Like steroids, enter cell nucleus, bind receptor, and alter transcription of specific genes
Do thyroid hormones need to enter the cell to exert an effect?
No. Induces some effects just from binding membrane (there is a thyroid hormone specific receptor in the inner mitochondrial membrane)
Are thyroid hormones blocked by inhibitors of protein synthesis?
No
What is the effect of T4/T3 acting directly at plasma membrane?
Increase in uptake of amino acids (independent of protein synthesis)
Why do workers at nuclear power plants take iodine supplements?
Excess stable iodine (127I) can protect the gland by saturating the transport system and diluting the amount of radioactive iodine entering the thyroid gland
True/False? Radioactive iodine is used to treat thyroid cancer
True, and it’s real good at it
What happens if you don’t have enough thyroid hormone?
Hypothyroidism
What happens if you have too much thyroid hormone?
Hyperthyroidism
What are the 14 signs of hyperthyroidism?
Elevated thyroid hormone levels Elevated BMR Increased perspiration Rapid pulse Increased body temperature Heat intolerance Warm, moist palms Nervousness, anxiety, excitability, restlessness, insomnia Weight loss Muscle wasting Increased appetite Menstrual irregularities Exophthalmos Goiter
What are the 14 signs of hypothyroidism?
Decreased Thyroid hormone levels Low BMR Decreased perspiration Slow pulse Lowered Body temperature Cold Intolerance Coarse, Dry skin, subdermal thickening Lethargy, decreased mentation, depression, paranoia, sleeplessness, tiredness Weight gain Loss of hair, dry and brittle texture Edema of face and eyelids Menstrual irregularities Carotenemia Goiter
What are the Different types of hypothyroidism?
Primary Hypothyroidism (myxedema) - Atrophy of thyroid - Autoimmune thyroiditis (Hashimoto's) - Non-toxic Goitre Secondary Hypothyroidism - Not enough TSH (pituitary-level) Tertiary Hypothyroidism - Not enough TRH (hypothalamus-level) Infantile Hypothyroidism - Causes cretinism/retardation
What is the treatment for all types of hypothyroidism?
Thyroid supplements
What are the different types of hyperthyroidism?
Primary Hyperthyroidism - Graves disease (LATS acts like TSH) - Thyroid adenoma (produces T3/T4 regardless of TSH) Secondary Hyperthyroidism - Pituitary tumor, unregulated TSH Tertiary Hyperthyroidism - Hypothalamic tumor, unregulated TRH
What are the treatments for the different types of hyperthyroidism?
Surgery/replacement therapy
Administration of radioactive iodide to kill cancerous follicles
Antithyroid drugs (propylthiouracil) which blocks addition of iodine to TGB
True/False? 100% of Calcium in circulation is bound to albumin
False, 50% bound 50% free
Where is most of the body’s calcium stored?
Bone
What are the three main hormones involved in Calcium homeostasis and what do they do?
Parathyroid hormone - Increases circulating levels of Ca Calcitonin (C cells of Thyroid) - Lowers circulating Ca Vitamin D - Increases circulating Ca
How can [Ca] be decreased?
Deposited in bone
Excreted in urine
How can [Ca] be increased?
Absorbed from food
Resorbed from bone
Reabsorbed from kidneys
True/False? You can live without Parathyroid Glands
FALSE
What does PTH do?
Increases [Ca] in blood
- increases bone demineralization
- Increases reabsorption of Ca from kidneys
- Stimulates synthesis of Vitamin D
- Facilitates absorption of Ca from gut
How is PTH release controlled?
Direct [Ca]
What are symptoms and treatment of hypoparathyroidism?
Low [Vitamin D]
Tetany, convulsions, spasms (asphyxiation)
Treatment: administration of Vitamin D and Ca supplements
What are symptoms and treatment of hyperparathyroidism?
Caused by parathyroid adenoma High [Vitamin D] High PTH stimulates bone resorption/calcium reabsorption from kidney high [Ca] Kidney Stones Calcification of vessels Arrhythmia
Treatment: removal of affected parathyroid/replacement therapy of Ca/Vit D
True/False? Vitamin D is actually a vitamin
False
How is Vitamin D synthesized?
Dehydrocholesterol in skin + UVB
Hydroxylation in liver
Hydroxylation in kidney/peripheral tissues
1,25-dihydroxyvitamin D3
What is Vitamin D’s physiological function?
Increase calcium absorption from intestine (mainly)
Regulates immune system
Anticancer properties
How is Vitamin D synthesis controlled?
Increased when [Ca] is low (or when PTH high)
Decreased when [Ca] high