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Clinical Chemistry 2 - CEUMLS > Endocrinology Part 1 (Hypothalamus, Pituitary, and Pineal Gland) > Flashcards

Endocrinology Part 1 (Hypothalamus, Pituitary, and Pineal Gland) Flashcards

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1
Q

Controls flow of information between cells and tissues by releasing hormones

A

ENDOCRINE SYSTEM

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2
Q

Substances secreted by endocrine gland that conveys information to its target cells

A

HORMONES

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3
Q

All hormones will act on all cells

A

F (Not ALL hormones will act on all cells; requires
appropriate cell receptor)

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4
Q

Chemical signals produced by specialized cells secreted into the bloodstream and carried to a target tissue (with specific receptor)

A

Hormones

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5
Q

Generally, act at sites distant from their place of origin

Ex: some pituitary hormone acts on thyroid gland,
gonads, adrenal gland

A

Hormones

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6
Q

Regulates cells and organs to maintain homeostasis

Ex:
ADH – regulates water homeostasis

Aldosterone – regulates Na homeostasis

A

Hormones

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7
Q

hormone concentrations are regulated by?

A

feedback mechanisms/loop

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8
Q

Actions of hormones

A

1) Regulatory substance
2) Controls body functions

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8
Q

TYPES OF HORMONE ACTION

A

ENDOCRINE
PARACRINE
AUTOCRINE
JUXTACRINE
INTRACRINE

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9
Q

Acts at a distant site from their place of origin

A

endocrine

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10
Q

Acts on the neighboring cells

A

paracrine

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11
Q

Acts on its self
Ex: hormone produced by hypothalamus will act on hypothalamus

A

autocrine

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12
Q

Remain intact/bound to cell membrane; acts on
adjacent cells by cell-to-cell contact with cell
receptors

A

Juxtacrine

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13
Q

how does juxtacrine acts on adjacent cells

A

cell-to-cell contact

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14
Q

Acts inside the cells (non-producible/released)

A

intracrine

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15
Q

CHEMICAL COMPOSITION/NATURE OF HORMONES

A

PEPTIDES & PROTEINS
STEROID
AMINO ACID DERIVATIVES (Amines)
FATTY ACID DERIVATIVES

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16
Q

chemical composition of water soluble hormones

A

PEPTIDES & PROTEINS

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17
Q

chemical composition of hormones that do not require carrier (transport proteins)

A

PEPTIDES & PROTEINS

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18
Q

Nature of majority of the hormones

A

PEPTIDES & PROTEINS

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19
Q

chemical composition of hormones that is synthesized and stored within cells

A

PEPTIDES & PROTEINS

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20
Q

chemical composition of hormones that is stored inside the cell where they are produced

A

PEPTIDES & PROTEINS

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21
Q

Example of hormone with peptide & protein nature

A

GH – produced by pituitary gland; cells that
produce GH will synthesize GH but they are
retained inside the cell; only released when the
body needs GH

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22
Q

Steroid hormones regulates?

A

sexual dev’t and characteristics

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23
Q

Precursor of steroid hormones

A

cholesterol (a sterol)

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24
Q

Example of steroid hormones

A

Sex hormones
- testosterone
- progesterone
- estrogen
- androgen

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25
Q

Have similarity with peptide & steroid in nature

A

Amino acid derivatives (amines)

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26
Q

Example of amino acid derivatives

A

Catecholamine, Thyroid hormone

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27
Q

Hormone with fatty acid derivative nature includes?

A

eicosanoids

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28
Q

Example of hormones with fatty acid derivative

A

prostaglandins (procoagulants – in relation with
homeostasis; thromboxane A2)

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29
Q

HORMONE TYPES ACCDG TO TRANSPORT

A

FREE
BOUND (to transport proteins)

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30
Q

Nature of free hormones

A

Peptides hormones (water soluble)

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31
Q

Exceptions in free hormones

A

Some are water soluble which do not require transport proteins. However, there are some that REQUIRES TRANSPORT PROTEINS:

  • GH
  • Insulin-like Growth Factor 1 (IGF-I)
  • Insulin-like Growth Factor 2 (IGF-II)
  • Vasopressin
  • Oxytocin
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32
Q

Enumerate bound proteins

A

Steroid & Thyroid Hormones
* Albumin
* Corticosteroid-binding globulin (CBG)
* Sex hormone-binding globulin (SHBG)
* Thyroxine-binding globulin (TBG)

Amines (catecholamines)
* Serum proteins
* TBG

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33
Q

T/F
Both FREE and BOUND proteins have hormonal activity

A

F
*only FREE hormones have hormonal activity
*transport proteins must detach to bound hormones to exhibit hormonal activity

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34
Q

MAIN HORMONE PRODUCING GLANDS

A

HYPOTHALAMUS
PITUITARY
PINEAL
THYROID
PARATHYROID
ADRENAL
PANCREAS
OVARIES
TESTIS

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35
Q

Hypothalamus is responsible for these activities

A

1) Sleep
2) Thirst
3) Mood
4) Hunger
5) sex drive

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36
Q

Gland that secrete regulatory hormones (releasing, inhibitory)

A

hypothalamus

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37
Q

2 types of regulatory hormones produced by hypothalamus

A
  • releasing hormones
  • inhibitory hormones
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38
Q

Controls other glands by production of
stimulating hormone (tropic hormones)

A

Pituitary (master gland)

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39
Q

Pituitary gland produce hormones that triggers?

A

growth

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40
Q

T/F
Majority of pituitary hormone acts on another gland

A

T

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41
Q

Action of pituitary to stimulate thyroid gland to produce thyroid hormones

A

Release thyroid-stimulating hormone (TSH)

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42
Q

Gland that secretes melatonin (for sleep cycle)

A

Pineal gland

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43
Q

Gland that secretes hormones assoc. with calorie burning and heart rate

A

Thyroid gland

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44
Q

Secretes hormone that controls calcium and phosphate homeostasis

A

Parathyroid gland

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45
Q

Secretes sex drive hormones and stress hormones

A

Adrenal gland

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46
Q

Secretes insulin (for glucose homeostasis)

A

Pancreas

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47
Q

Gland that is both an exocrine and endocrine? what is the action?

A

Pancreas

  • Exocrine – secretes enzymes
  • Endocrine – secretes hormones
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48
Q

Hormones secreted by ovaries

A
  • female sex hormones (progesterone & estrogen)
  • testosterone
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49
Q

Hormones secreted by testes

A

testosterone

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50
Q

Amount of substance in a system regulates its own concentration

A

NEGATIVE FEEDBACK

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51
Q

Increased or decreased hormone levels will stimulate hormone inhibition or production, respectively

A

NEGATIVE FEEDBACK

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52
Q

Hormones released by an endocrine gland induces
more stimulating hormones to be released

A

POSITIVE FEEDBACK

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53
Q

The more hormone is secreted, the more action is stimulated

A

POSITIVE FEEDBACK LOOP

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54
Q

associated glands in ultrashort feedback loop

A

Hypothalamus and pituitary

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55
Q

associated glands in short feedback loop

A

Pituitary and target gland

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56
Q

associated glands in long feedback loop

A

Hypothalamus, pituitary, and target gland

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57
Q

Majority of endocrine functions are regulated through this gland

A

pituitary gland

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58
Q

Secretion of pituitary gland is regulated or controlled by?

A

hypothalamus

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59
Q

Hormone production involves 2 glands in CNS:

A

hypothalamus, pituitary

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60
Q

Glands other than hypothalamus & pituitary

A

Peripheral glands

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61
Q

Hormone secretion by peripheral glands is stimulated by these glands

A

hypothalamus & pituitary

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62
Q

Stimulating thyroid gland to produce its hormone is an example of what feedback loop

A

negative

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63
Q

Stimulating oxytocin production is an example of what feedback loop

A

positive

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64
Q

what is the term when hypothalamus, pituitary, and thyroid gland is involved in the process?

A

Hypothalamic pituitary thyroidal axis

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65
Q

Explain the events in hypothalamic pituitary thyroidal axis

A

1) Hypothalamus will secrete regulatory (releasing) hormones for thyroid → thyrotropin-releasing hormone (TRH).

2) TRH directly acts on pituitary gland to stimulate tropic hormone → thyroid-stimulating hormone (TSH) or thyrotropin.

3) TSH will stimulate thyroid gland to produce thyroid hormone.

4) Continuous process to increase thyroid hormone until it becomes in excess.

5) Thyroid gland will send signal to hypothalamus to stop production.

6) Hypothalamus will inhibit TRH release (following
processes will not continue).

✓ If in cases of low thyroid hormone: thyroid
gland will send signal to hypothalamus to start
production of TRH (further processes will follow)
✓ Equalized thyroid hormones will send another
feedback to stop.

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66
Q

substance released by hypothalamus to stimulate thyroid gland secretion of thyroid hormones

A

thyrotropin-releasing hormone (TRH)

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67
Q

function of TRH

A

directly acts on pituitary gland to stimulate tropic
hormone → thyroid-stimulating hormone (TSH) or
thyrotropin

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68
Q

function of TSH

A

stimulate thyroid gland to produce thyroid hormone

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69
Q

signal is sent by a peripheral gland (target gland) to this gland to stop production of hormones in cases of excess production? what is the action?

A

hypothalamus
inhibit TRH release (or other releasing hormones required)

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70
Q

Acts on uterus during labor involving uterine contraction (Ferguson reflex)

A

oxytocin

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71
Q

uterine contraction is aka

A

Ferguson reflex

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72
Q

mechanism of oxytocin

A

The more oxytocin, the more contraction

The more the contraction, the more it stimulates oxytocin production

Until it reaches parturition (giving birth)

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73
Q

2 MODULATION OF HORMONE LEVEL

A

HYPOTHALAMIC-PITUITARY-END ORGAN (PERIPHERAL GLAND) SYSTEM

FREE-STANDING ENDOCRINE GLAND SYSTEM

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74
Q

Regulation is CNS input

A

HYPOTHALAMIC-PITUITARY-END ORGAN (PERIPHERAL GLAND) SYSTEM

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75
Q

Regulation is Varied input

A

FREE-STANDING ENDOCRINE GLAND SYSTEM

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76
Q

Enumerate activities under HYPOTHALAMIC-PITUITARY-END ORGAN (PERIPHERAL GLAND) SYSTEM

A
  • Regulation: CNS input (signal sent by peripheral gland to the hypothalamus)
  • Hypothalamus (Releasing hormone)
  • Pituitary (Tropic/Stimulating hormone)
  • Peripheral Glands (Hormone)
  • Target cell (Effect) with appropriate cell receptor
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77
Q

Enumerate activities under FREE-STANDING ENDOCRINE GLAND SYSTEM

A
  • Regulation: Varied Input (depends on target cell or substance that is regulated by the hormone)
  • Free-Standing Endocrine Gland (Hormone)
  • Target cell (Effect) with appropriate cell receptor
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78
Q

Modulation wherein hormone concentration depends on the substance that it regulates

A

FREE-STANDING ENDOCRINE GLAND SYSTEM

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79
Q

example hormones of FREE-STANDING ENDOCRINE GLAND SYSTEM

A

Parathyroid hormone – Ca and PO4 homeostasis
Insulin – glucose homeostasis during ↑ GLU

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80
Q

Mount a response to a hormone

A

TARGET ORGAN

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81
Q

Express appropriate cognate hormone receptor/
appropriate cell receptor

A

TARGET ORGAN

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82
Q

3 TYPES OF HORMONE RECEPTORS

A

Cell Surface Receptors
Intracellular Receptors
Multiple Receptors

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83
Q

Cell Surface Receptors

A

Insulin
GH
PRL
Leptin
Catecholamine

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84
Q

hunger hormone secreted by
adipocytes/fat cells; mechanism

A

Leptin

Fat individuals – frequent
hunger promotion due to ↑
Adipocytes (↑ Leptin)

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85
Q

Intracellular Receptors

A

Steroids
Thyroid hormones

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86
Q

Multiple Receptors

A

Estrogen
Progestins

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87
Q

location of hypothalamus

A

walls and floor of 3rd ventricle (above pituitary gland)

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88
Q

hypothalamus is connected to posterior pituitary gland by this structure

A

pituitary stalk (infundibulum)

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89
Q

Majority of the hormone produced by this gland has direct effect on pituitary gland

A

hypothalamus

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90
Q

Hypothalamus is part of this feedback mechanism

A

NEGATIVE feedback loop

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91
Q

Releasing hormones produced by hypothalamus

A
  1. Thyrotropin-releasing hormone (TRH)
  2. Growth hormone-releasing hormone (GHRH)
  3. Gonadotropin-releasing hormone (GnRH)
  4. Corticotropin-releasing hormone (CRH)
  5. Prolactin-releasing factor (PRF)
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92
Q

Inhibiting hormones produced by hypothalamus

A
  1. Prolactin-inhibiting factor (PIF)
  2. Vasopressin (inhibit urine output)
  3. Oxytocin
  4. Somatostatin
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93
Q

Pituitary gland is aka

A

hypophysis (meaning: below the hypothalamus)

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94
Q

pituitary literally means

A

“spit mucus”
(believed in the past that the mucus secreted is necessary for growth)

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95
Q

Pituitary gland is previously referred to as

A

master gland

(they believed that no pituitary, no growth)

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96
Q

Pituitary gland is presently referred to as

A

transponders

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97
Q

Reason why pituitary gland is characterized as transponders

A

Translate neural/CNS input (signal sent by
peripheral gland) from hypothalamus into a
hormonal product

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98
Q

location of pituitary gland

A

base of the skull in the pocket of the
sphenoid bone (sella turcica/Turkish saddle)

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99
Q

depression of sphenoid bone is aka

A

sella turcica/Turkish saddle

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100
Q

Largest portion of pituitary gland

A

Anterior pituitary gland (Adenohypophysis)

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101
Q

Function of anterior pituitary gland (adenohypophysis)

A

Secretes and produce hormones

102
Q

aka Posterior pituitary gland

A

Neurohypophysis

103
Q

aka Anterior pituitary gland

A

Adenohypophysis

104
Q

aka Intermediate lobe

A

Pars intermedialis

105
Q

function of posterior pituitary gland

A

Only secretes

ADH and oxytocin storage

106
Q

Poorly developed; no function
Mistaken as nodules or benign cyst

A

Intermediate lobe (Pars intermedialis)

107
Q

Hormones produced in anterior pituitary gland

A

GH
PRL
LH, FSH
TSH
ACTH

108
Q

Specialized cells for GH production

A

Somatotrophs

109
Q

Specialized cells for PRL production

A

Lactotrophs

110
Q

Specialized cells for LH, FSH production

A

Gonadotrophs

111
Q

Specialized cells for TSH production

A

Thyrotrophs

112
Q

Specialized cells for ACTH production

A

Corticotrophs

113
Q

2 types of hormones secreted by anterior pituitary gland

A

Direct effector hormones
Tropic/stimulating hormones

114
Q

types of hormones secreted by anterior pituitary gland that act on peripheral tissues

A

Direct effector hormones

115
Q

Example of direct effector hormones

A

GH, prolactin

116
Q

types of hormones secreted by anterior pituitary gland that acts on another endocrine gland

A

Tropic/stimulating hormones

117
Q

Examples of Tropic/stimulating hormones

A

LH, FSH, TSH, ACTH

118
Q

aka GH

A

SOMATOTROPIN

119
Q

hormones that are structurally similar with each other

A

GH
Prolactin
Human placental lactogen

120
Q

Most abundant hormone secreted by pituitary gland

A

GH

121
Q

GH directly acts on this organ? what is produced?

A

liver

stimulate liver to produce growth factors

122
Q

essential for LINEAR/LONGITUDINAL GROWTH

A

growth factors

123
Q

A peptide hormone but an exception as it requires
transport protein (IGFBP-3)

A

GH

124
Q

GH production is heavily modulated by other factors such as

A

Ghrelin

125
Q

An enteric hormone, potent stimulator of GH receptors

A

Ghrelin

126
Q

Ghrelin is responsible for?

A
  1. Nutrient sensing
  2. Appetite
  3. Glucose Regulation
127
Q

1/3 of the total pituitary weight (most abundant cell in anterior pituitary gland)

A

Somatotrophs

128
Q

release of GH is STIMULATED by this substance produced by hypothalamus

A

GHRH

129
Q

release of GH is INHIBITED by this substance produced by hypothalamus

A

Somatostatin

130
Q

manner of GH secretion? what is the interval? what is the most reproducible peak?

A

pulses

Ave. pulse interval: 2-3 hrs
Most reproducible peak: Onset of sleep

131
Q

Method for GH measurement

A

Chemiluminescence Immunoassay

132
Q

GH Reference Value

A

<7 ng/ml (fasting state)

133
Q

GH secretion is STIMULATED by these modifiers

A
  • Sleep (deep sleep) *major contributor
  • Exercise
  • Physiologic stress
  • Amino acids (arginine)
  • Hypoglycemia
  • Sex steroids (estradiol)
  • a-agonists (norepinephrine)
  • b-blockers (propranolol)
134
Q

GH secretion is INHIBITED by these modifiers

A
  • glucose loading
  • emotional/psychogenic stress
  • nutritional deficiencies
  • insulin deficiency
  • thyroxine (T4) deficiency
  • b-agonist (epinephrine)
  • a-blockers (phentolamine)
135
Q

In hypoglycemia, GH secretion is increased/decrease? reason?

A

increased GH

to increase GLU

136
Q

In exercise, GH secretion is increased/decreased? reason?

A

increased GH

since it utilizes energy, requires GH to increase GLU

137
Q

In glucose loading, GH secretion is increased/decreased? reason?

A

inhibited GH

no need to increase GLU

138
Q

Actions of GH

A

1) amphibolic
2) effective transition from fed state → fasting state
3) insulin antagonists
4) promotes hepatic gluconeogenesis
5) stimulates lipolysis

139
Q

explain GH as an amphibolic hormone

A

directly influences both anabolic (req. energy) and
catabolic (prod. energy, still req. energy) processes

140
Q

Actions of GH which increases glucose

A
  1. insulin antagonists
  2. promotes hepatic gluconeogenesis
  3. stimulates lipolysis
141
Q

associated with GH, these are GF secreted by liver
structurally similar to insulin

A

Somatomedins

142
Q

aka Somatomedins

A

Insulin-like Growth Factors (IGF)

143
Q

major GF induced by GH

A

Somatomedin C (IGF-1)

144
Q

Biologic amplifier of GH levels (most potent)

A

Somatomedin C (IGF-1)

145
Q

Transport protein of somatomedin C (IGF-1)

A

Insulin-like Growth Factor Binding Protein-3 (IGFBP-3)

146
Q

↑ GH is seen in

A
  1. Acromegaly
  2. Gigantism
  3. Chronic malnutrition
  4. Renal disease
  5. Cirrhosis
  6. Sepsis
147
Q

↓ GH is seen in

A
  1. Idiopathic GH deficiency (among children)
  2. Pituitary Adenoma (among adults)
148
Q

↑GH + closed epiphyseal plate
diffused overgrowth/lateral

A

Acromegaly

149
Q

↑GH + open epiphyseal plate
linear/longitudinal growth

A

Gigantism

150
Q

Pathologic or autonomous GH excess – unregulated GH regardless of GHRH presence or absence

A

Acromegaly

151
Q

Progressive enlargement of hands, feet, facial bones, mandible bones of the skull

A

Acromegaly

152
Q

Manifestations of acromegaly

A
  • Diffused growth
  • Glucose intolerance/overt diabetes (↑ GH = ↑ Glu)
  • Excessive sweating
  • Heat intolerance
  • Advanced cases: significant gaps between teeth
153
Q

GH level in acromegaly

A

> 50 ng/ml

154
Q

TESTS for Acromegaly

A

SCREENING: Somatomedin C (IGF-1) measurement
CONFIRMATORY: OGTT

155
Q

Patient preparation for OGTT (test for acromegaly)? What is the effect?

A

overnight fasting

Normally: decreased Glu = increased GH

156
Q

Glucose Load administered for OGTT (test for acromegaly)? What is the effect?

A

100g oral GL

Normally: increased Glu = decreased GH (or undetectable)
Acromegaly = still INCREASED GH

157
Q

Blood collection interval for OGTT (test for acromegaly)

A

thrice (0 hr, 1hr, 2hr)

*all have increased GH in acromegaly

158
Q

another case that has ↑ IGF-1 aside from acromegaly; autonomous IGF-1 production

A

Hepatoma (liver cancer)

159
Q

TESTS for GH deficiency

A

Insulin-induced Hypoglycemia
Combination infusions of GHRH and L-arginine
L-arginine + oral Levodopa (L-DOPA) infusion

160
Q

previous gold standard for GH deficiency testing? what is the normal and abnormal results?

A

Insulin-induced Hypoglycemia

Normally, in hypoglycemia: ↑ GH (to ↑ Glu)
GH deficiency: ↓ GH (regardless of ↑/↓ Glu)

161
Q

Reference interval for GH deficiency tests

A

3-5 ng/ml (less likely to have GHD)

162
Q

Value for GH deficiency test that signifies GHD

A

<3 ng/ml

163
Q

aka PROLACTIN

A

Stress hormone

164
Q

has vital function in reproduction, lactation initiation and maintenance

A

prolactin

165
Q

release of prolactin is STIMULATED by these substances produced by hypothalamus

A

TRH
Estrogen

166
Q

release of prolactin is INHIBITED by this substance

A

Dopamine (Prolactin Inhibitory Factor)

167
Q

what is unique in regulation of prolactin

A

tonic inhibition

(NO direct signaling to hypothalamus to stop
production; instead, it produce dopamine)

168
Q

Increased PRL is seen in

A

Medications
Tumors (prolactinoma)
Trauma
Inflammation
Hypogonadism

169
Q

Result of increased PRL in postpartum lactating women, no ovulation or menstruation (↓ FSH & LH - necessary for ovulation)

A

hypogonadism

170
Q

Reference value of PRL in male and female

A

Male: 1-20 ng/ml
Female: 1-25 ng/ml

171
Q

Highest PRL level is during

A

Sleep (4pm – 8am)
–> Other ref.: 8pm to 10pm

172
Q

Method for PRL measurement

A

Immunometric assay

173
Q

Autonomous secretion of prolactin due to pituitary tumor

A

Prolactinoma

174
Q

Most common type of functional pituitary tumor

A

Prolactinoma

175
Q

PRL level in prolactinoma

A

> 150 ng/ml

176
Q

If PRL level is >200 ng/ml, it causes?

A

anovulation, cessation of ovulation

177
Q

Manifestation of prolactinoma

A

Elderly: hypogonadism, osteoporosis

Premenopausal women: amenorrhea,
infertility, galactorrhea, breast discharge

Men/Postmenopausal women: Pituitary
mass, Reduced libido, Erectile dysfunction

178
Q

normal prolactin but lactating; common
among women who had several pregnancies

A

Idiopathic Galactorrhea

179
Q

medications that can cause hyperprolactinemia? give the examples

A

Dopamine antagonists

  1. Phenothiazines
  2. Butyrophenones
  3. Metoclopramide
  4. Reserpine
  5. Tricyclic antidepressants
  6. Alpha-methyldopa
180
Q

Enumerate Tropic/Stimulating Pituitary Hormones

A

Gonadotropins (FSH/LH)
Thyroid-Stimulating Hormone (TSH)/Thyrotropin
Adrenocorticotropic hormone (ACTH)

181
Q

Markers in diagnosing fertility and menstrual cycle disorder

A

Gonadotropins (FSH/LH)

182
Q

function of FSH and LH in male

A

FSH – spermatogenesis
LH – helps Leydig cells to prod. testosterone

183
Q

function of LH in female

A

ovulation

184
Q

Diagnosis clue of premature menopause

A

↑ FSH

185
Q

↑ FSH, LH indicates?

A

Post-menopause (↓ estrogen)

186
Q

Estrogen regulation is under this loop? give the process?

A

NEGATIVE feedback loop

  • ↓ estrogen signals hypothalamus to ↑ estrogen
  • Hypothalamus will ↑ GnRH
  • GnRH will directly act on pituitary gland
  • Pituitary gland will secrete FSH & LH
  • FSH & LH will act on gonads to produce estrogen
187
Q

Problem in post-menopausal women

A

Estrogen can no longer be produced due to ruptured gland in ovaries.
Even ↑ FSH, LH: there will be no estrogen production

188
Q

Regulates thyroid hormone production

A

Thyroid-Stimulating Hormone (TSH)/Thyrotropin

189
Q

Main stimulus for uptake of iodide by thyroid gland

A

Thyroid-Stimulating Hormone (TSH)/Thyrotropin

190
Q

required by thyroid gland for production (TSH aids in uptake of iodine into the follicular cells of thyroid gland)

A

iodine

191
Q

Acts to increase the number and size of follicular cells of thyroid gland

A

Thyroid-Stimulating Hormone (TSH)/Thyrotropin

192
Q

Produced in response to ↓ plasma cortisol

A

Adrenocorticotropic hormone (ACTH)

193
Q

Regulator of adrenal androgen synthesis

A

Adrenocorticotropic hormone (ACTH)

194
Q

hormone that requires EDTA plastic tube for collection

A

Adrenocorticotropic hormone (ACTH)

195
Q

Specimen for ACTH

A

EDTA (plastic tube)
*glass tubes – not used; ACTH adheres to the wall of glass (false ↓ ACTH)

196
Q

Best time to collect specimen for ACTH

A

8-10 am (ACTH exhibits diurnal variation)

↑ conc. – 6-8 am
↓ conc. – 6-11 pm

197
Q

Conditions associated with HYPOPITUITARISM

A

Panhypopituitarism
Monotropic Hormone Deficiency
Sheehan’s Syndrome
Kallmann Syndrome

198
Q

Complete pituitary function loss (all hormones secreted by pituitary gland is decreased/no function)

A

Panhypopituitarism

199
Q

Loss of 1 single pituitary hormone

A

Monotropic Hormone Deficiency

200
Q

Postpartum ischemic necrosis of pituitary following a complicated delivery; Failure to lactate

A

Sheehan’s Syndrome

201
Q

aka Kallmann Syndrome

A

Idiopathic hypopituitarism (there is loss of pituitary functions)

202
Q

Never produce but secretes hormones from hypothalamus

A

POSTERIOR PITUITARY GLAND

203
Q

Storage region for vasopressin and oxytocin (both produced from the supraoptic and paraventricular nuclei of hypothalamus)

A

POSTERIOR PITUITARY GLAND

204
Q

Synthesized by paraventricular nuclei of hypothalamus

A

OXYTOCIN

205
Q

Critical role of oxytocin

A

lactation

206
Q

Major role of oxytocin

A

labor & parturition → positive feedback loop
o Uterine contraction (Ferguson reflex)

207
Q

how is oxytocin released

A

neural stimulation of touch receptors (birth canal, uterus and breasts)

208
Q

has structure similar with oxytocin

A

VASOPRESSIN /ADH/Arginine vasopressin

209
Q

Regulates water homeostasis (water reabsorption in collecting duct)

A

VASOPRESSIN /ADH/Arginine vasopressin

210
Q

urine output in increased ADH? example?

A

decreased urine output
SIADH

211
Q

urine output in decreased ADH? example?

A

increased urine output
Diabetes insipidus

212
Q

Stimulates FVII and vWF

A

VASOPRESSIN /ADH/Arginine vasopressin

213
Q

Synthesized by magnicellular neurons of supraoptic

A

VASOPRESSIN /ADH/Arginine vasopressin

214
Q

Reference value of ADH

A

0.5-2 pg/uL

215
Q

2 types of Diabetes Insipidus

A

Nephrogenic DI
Neurogenic DI / True DI / Hypothalamic DI / Central DI / Cranial DI

216
Q

Polyuria (due to kidney resistance to ADH; no
receptors), normal ADH, and milder symptoms

A

Nephrogenic DI

217
Q

Polyuria, ↓ ADH

A

Neurogenic DI / True DI / Hypothalamic DI / Central DI / Cranial DI

218
Q

Same symptoms for 2 Types of DI

A
  1. ADH deficiency (except nephrogenic)
  2. Severe polyuria (↑ urine output; hyperosmotic blood)
  3. Polydipsia (↑ thirst promotion)
  4. Occasional polyphagia
219
Q

Hyperosmosis promotes:

A

ADH secretion
Thirst

220
Q

TEST for DI

A

Overnight Water Deprivation Test

221
Q

Definitive test for Diabetes Insipidus

A

Overnight Water Deprivation Test

222
Q

Px Preparation in overnight water deprivation test? what will be the effect in ADH?

A

8-12 hrs fasting w/o water intake

o normal: hyperosmolality, promotes ↑ ADH
o DI: hyperosmolality, still ↓ ADH

223
Q

Overnight Water Deprivation Test value for diabetes insipidus

A

≤300 mOsm/kg

224
Q

aka PINEAL GLAND

A

CONARIUM/EPIPHYSIS CEREBRI

225
Q

Pineal gland is attached to this structure

A

midbrain

226
Q

Function of pineal gland

A

secretes melatonin

227
Q

Melatonin is for

A

a) Sleep cycle
b) ↓ skin pigmentation

228
Q

control the secretion of melatonin produced by pineal gland

A

nerve stimuli

229
Q

melatonin secretion is stimulated and inhibited during

A

stimulated: darkness (Circadian rhythm at night)
Inhibited: light (daytime or ↑ screen time)

230
Q

Pituitary gland is called as master gland due to this reason

A

It controls other glands

231
Q

releasing hormone produced by hypothalamus will act directly on?

A

pituitary gland

232
Q

markedly increased GH level is seen during

A

deep sleep

233
Q

end product of anabolic and catabolic processes

A

energy

234
Q

T/F
Manifestation of Prolactinoma depends on age group and onset of menopause

A

T

235
Q

amino acid can stimulate/decrease GH secretion? what is the example?

A

stimulate
Ex: arginine

236
Q

sex steroids can stimulate/inhibit GH secretion? what is the example?

A

stimulate
Ex: estradiol

237
Q

a-agonist can stimulate/inhibit GH secretion? what is the example?

A

stimulate
Ex: norepinephrine

238
Q

b-blockers can stimulate/inhibit GH secretion? what is the example?

A

stimulate
Ex: propanolol

239
Q

b-agonist can stimulate/inhibit GH secretion? what is the example?

A

inhibit
Ex: epinephrine

240
Q

a-blockers can stimulate/inhibit GH secretion? what is the example?

A

inhibit
Ex: phentolamine

241
Q

GH secretion during:

physiologic stress?
emotional/psychogenic stress?

A

physiologic stress: stimulates GH
emotional/psychogenic stress: inhibits GH

242
Q

highest conc of ACTH is seen during

A

6-8am

243
Q

lowest conc of ACTH is seen during

A

6-11pm

244
Q

corresponding amino acid of leucine in structure of oxytocin to vasopressin

A

arginine

245
Q

corresponding amino acid of isoleucine in structure of oxytocin to vasopressin

A

phenylalanine

246
Q

synthetic ADH for treatment

A

desmopressin

247
Q

receptor of ADH responsible for water permeability? what is the channel?

A

V2 receptors
aquaporin-2

248
Q

receptor of ADH responsible for vasoconstriction

A

V1 receptor

249
Q

immediate detectable lost hormones

A

tropic hormones (ACTH, TSH, LH, FSH)

250
Q

Delayed unnoticeable lost hormones

A

direct effectors (GH and prolactin)

251
Q

It is where 80-90% of the blood supply and hypothalamic factors pass and received by anterior pituitary gland

A

hypothalamic–hypophyseal portal system

252
Q

Level of prolactin that can cause anovulation

A

> 200 ng/ml

Clinical Chemistry 2 - CEUMLS (9 decks)

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