Endocrinology and Thyroid Flashcards

1
Q

Endocrinology

A

The study of the endocrine system, the hormones it secretes and its disorders

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2
Q

Endocrine gland

A

Organs that secrete hormones, which play an important role in homeostasis, into the blood or lymph e.g. pancreas

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3
Q

Hormone

A

A chemical messenger dispersed by the blood that act on target organs to produce effects distant from their point of release e.g. insulin

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4
Q

Exocrine gland

A

A gland that secretes its products through a duct to the outer surface of the body or an organ e.g. salivary gland

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5
Q

Endocrine signalling

A

Secretory cells release hormone through the blood to initiate response in distant target cells e.g. growth hormone from pituitary

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6
Q

Paracrine signalling

A

Secretion of a substance by one cell, which then acts on adjacent cells e.g. release of acetlycholine

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7
Q

Autocrine signalling

A

Secretion of a substance by a cell, which acts on surface receptors of the same cell

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8
Q

Main endocrine glands

A
Hypothalamus
Pituitary 
Thyroid
Pancreas
Kidney 
Ovary 
testes
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9
Q

Types of hormones

A

Polypeptides e.g. insulin

  • synthesised on the RER and sent to golgi for packaging and excretion
  • stimulus for exocytosis due to membrane depolarisation as a result of increase cAMP and protein kinase action
  • water soluble

Modified amino acids e.g. thyroid hormones

  • thyroid hormones synthesise in glandullar cells by adding iodine to tyrosines
  • secreted when amines split from thyroglobulin
  • combines with plasma proteins for transport

Steroid hormones e.g. glucocorticoids

  • secreted by adrenal cortex, ovaries, testes
  • lipid soluble molecules synthesised from cholesterol
  • rapidly mobilised in cytosol due to large stores of cholesterol readily available
  • simply diffuse across the membrane due to high lipid solubility
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10
Q

Endocrine system

A
  • Receives chemical and physical stimuli

- Releases a chemical signal that will elicit a change in tissue

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11
Q

Steroid hormone synthesis

A
  • No gene activation
  • Regulated by increased conc. of cAMP and Ca2+
  • Cholesterol is converted to pregnenolone which undergoes further enzymatic transformation in synthesis of derivative steroid hormones
  • Steroidogenic acute regulatory protein mediates acute regulation of steroid hormone
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12
Q

Water-soluble hormones

A
  • Dissolved in the blood plasma
  • Transported from their sites of synthesis to target tissues
  • Cannot pass through membranes therefore bind to cell surface receptors including G-Protein-coupled protein receptors and Tyrosine-Kinase receptor system
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13
Q

Hydrophobic (fat soluble) hormones

A
  • Transported in the blood bound to plasma protein

- Biologically inactive hormone is protected from degradation

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14
Q

Hormone receptors

A
  • Hormones need to bind to specific protein receptors found either in or on cell membranes; in the cytoplasm or in the nucleus of the target cell
  • Down-regulation: Increased hormone concentration and increased binding between hormone and target cell can decrease number of active cells
  • Up-regulation: Stimulating hormone induces greater than normal formation of receptors by the target cell
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15
Q

Protein hormone signalling

A
  • Peptide hormones bind to membrane receptors
  • Binding activates an effector protein
  • Signal is transmitted intracellularly via second messengers such as cAMP, which amplify the signal
  • Stimulation or inhibition of a G-protein subunit can activate or inhibit an effector enzyme
  • Effector enzyme increases or decreases the intracellular second messenger
  • The second messenger then initiate a series of phosphorylation or dephosphorylation reactions
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16
Q

Water soluble hormones

A
  • Hydrophobic so therefore cannot pass through the cellular membrane
  • Binds to cell surface receptors such as G-protein-coupled protein receptors and the tyrosine-kinase receptor system
  • G-protein receptor activates adenylyl cyclase which makes cAMP from ATP. This can result in opening or closing of membrane ion channels and activation of gene transcription
  • Binding to the tyrosine-kinase receptor system activates enzymes that bring about phosphorylation and other signalling cascades such as activation of transcription proteins
17
Q

Steroid hormones

A
  • Steroid hormones diffuse into the cell through the lipid bilayer
  • Receptors for these molecules are found intracellularly
  • Binding of a steroid ligand causes release of associated proteins
  • The ligand-receptor complex translocates to the nucleus where it binds to DNA, to enhance gene transcription and protein synthesis
18
Q

Steroid hormone metabolism

A
  • Binding to plasma proteins protects them from degradation
  • The liver is the principal site of steroid metabolism
  • The biological activity of the hormones is decreased and their water solubility is increased by conjugation to facilitate urinary excretion
  • Rate of metabolism is dependent on age and comorbidities
19
Q

Negative feedback

A

A trophic hormone stimulates the production and secretion of a second hormone in a target cell that acts on the original gland to decrease secretion of the trophic hormone

e.g. thyroid-stimulating hormone and the thyroid gland

20
Q

Positive feedback

A

Rare, only seen with oestrogen causing luteinising hormone. Increased levels of effector hormone increase levels of tropic and trophic hormones

21
Q

Primary hormone dysfunction

A

Production of too much effector hormone by the endocrine gland

22
Q

Secondary hormone dysfunction

A

Overstimulation of the effector endocrine gland by excessive tropic hormone

23
Q

Excess hormone

A

Due to neoplasm, hyperplasia and ectopic production

24
Q

Too little hormone

A

Due to gland destruction from disease and trauma or underdeveloped gland

25
Q

Failure to respond to hormone

A

Due to receptor problems or intracellular signal defects

26
Q

Cushing’s disease (hyperadrenalism)

A
  • Caused by excess cortisol
  • Involves selective accumulation of adbominal fat
  • Think skin reveals blood flow
  • Symptoms include depression, central weight gain, psychosis, think skin and polyuria
  • Treated by surgery or drugs to reduce cortisol
27
Q

Addison’s Disease (Hypoadrenalism)

A
  • Caused by destruction of adrenal cortex, resulting in reduced glucocorticoids and sex steroids production
  • Symptoms include weight loss, depression, nausea and weakness
  • Treated by hormone replacement therapy
28
Q

Primary hyperparathyroidism

A
  • Caused by parathyroid gland disease most commonly due to a parathyroid tumour
  • Hormone is secreted without proper regulation
  • Includes chronic elevation in blood calcium, kidney stones and decalcification of bone
29
Q

Secondary hyperparathyroidsm

A
  • A disease outside the parathyroid gland that leads to excessive parathyroid hormone secretion
  • Caused by kidney disease, as failure to reabsorb calcium stimulates continual secretion of parathyroid hormone to maintain normal calcium levels in blood
  • Can also be caused by calcium deficient diet
  • Clinical significance include decalcification of bone