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4 - Med > Endocrinology Physiology > Flashcards

Endocrinology Physiology Flashcards

1
Q

What are the major endocrine organs ? (7)

A
  • Pituitary
  • thyroid
  • parathyroid
  • pancreas
  • adrenal
  • ovaries
  • testes
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2
Q

name the hormone produced from all of these organs
- heart
- liver
- kidney
- GI tract
- blood vessels

A
  • heart (ANP)
  • Liver (IGF-1)
  • Kidney (erythropoietin)
  • GI tract (Gastrin, incretin)
  • blood vessels: NO, endothelin
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3
Q

what are the two broad categories of hormones ?

A
  • water soluble
  • lipid soluble
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4
Q

describe water soluble hormones ? are they bound to proteins ? where do they bind to receptors ?
give examples

A

unbound to proteins so bind to surface receptors (can just dissolve in water so don’t need something to help with transport)
- peptides
(stored in vesicles and then released, shorter half life + faster clearance)

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5
Q

describe lipid soluble hormones ? are they bound to proteins ? where do they bind to receptors ?
give examples

A

bound to proteins so diffuse into cells + bind to receptors
- steroid hormones, thyroid hormones

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6
Q

what is leptin ? where is it released from ? where does it act on ?

A

eat => increased fat stores => leptin release => bind to receptors in hypothalamus => increase satiety

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7
Q

how do you know when to stop eating after a meal ? what makes you feel full ?

A

stretching of stomach by X nerve and release of CCK => brain tells you to stop eating (induces satiety)

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8
Q

what effects does CCK have ?

A

(induces satiety)
- delays gastric emptying
- gall bladder contraction and bile excretion
- insulin release

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9
Q

what is grehlin and what does it cause ?

A

elicits starvation signal
- grehlin => increase appetite + increase GH release
(vid vagal nerve)

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10
Q

Name the 6 hormones produced by the anterior pituitary ? (6)

A
  • FSH
  • LH
  • ACTH
  • TSH
  • GH
  • Prolactin
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11
Q

name the 2 hormones produced by the posterior pituitary ?

A
  • oxytocin
  • ADH
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12
Q

explain whether AP or PP stores and release hormones. ya know

A
  • AP: produces and releases hormones
  • PP: releases hormones produces by hypothalamus (so PP hormone secretion depends on stimulating or inhibiting hormones form hypothalamus)
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13
Q

describe the vasculature of the AP ?

A

has no arterial blood supply
- receives blood through portal venous circulation form hypothalamus

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14
Q

what is thyroid hormone basic function ?

A

BMR, growth

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15
Q

what is parathyroid basic function ?

A

calcium regulation

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16
Q

what is cortisol basic function ?

A
  • stress response
  • ## glucose regulation
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17
Q

what is aldosterone basic function ?

A
  • BP
  • sodium regulation
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18
Q

what is ANP basic function ?

A

sodium regulation

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19
Q

what is vit D basic function ?

A

calcium regulation

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20
Q

what does TRH stimulate release of from pituitary ? what does this hormone then cause ?

A

TSH release from pituitary
- controls how much energy your body uses (metabolic rate)

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21
Q

what does CRH stimulate release of from pituitary ? what does this hormone then cause ?

A

ACTH release from pituitary
- regulates glucocorticoid synthesis
- acutely stimulates cortisol release

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22
Q

what does GHRH stimulate release of from pituitary ? what does this hormone then cause ?

A

GH release from pituitary
- linear growth (children)
- acquisition of bone mass
- stimulates protein synthesis, lipolysis, glucose metabolism
(muscle + bone)

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23
Q

what does GnRH stimulate release of from pituitary ? what does this hormone then cause ?

A

LH + FSH release from pituitary
- LH: causes estradiol secretion from theca cells (female) and testosterone from leading cells (male)
- FSH: causes inhibit secretion from sertolli cells (male) and granuloma cells (female)

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24
Q

what does dopamine stimulate release of from pituitary ? what does this hormone then cause ?

A

reduces prolactin release from pituitary
- positive feedback
- milk production => increased prolactin

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25
what are the 2 parts to the adrenal gland ?
- adrenal cortex - adrenal medulla
26
what is made in the adrenal cortex ?
corticosteroids
27
what is made in the adrenal medulla ? from what cells
catecholamines (mainly form chromatin cells)
28
what are the different sections to the adrenal cortex ?
- zona glomerulosa - zona fascicolata - zona reticularis
29
what does zona glomerulosa produce ? what is the action of this ?
affects GLOMerulus - mineralocorticoids (aldosterone) (SALT)
30
what does zona fasciculata produce ? (type of hormone and example) what is the action of this ?
act Fast (stress, cortisol) - glucocorticoids (cortisol) (SUGAR, STRESS)
31
what does zona reticularis produce ? (type of hormone and example) what is the action of this ?
androgen precursor to be converted to oestrogen + testosterone in gonads - androgens (DHEA) (SEX)
32
what does GH act on ? stimulate secretion of what ?
acts on liver to secrete IGF-1 which acts on bone + other (growth)
33
in a fasting state, where does glucose come from ? by what process ?
all glucose comes from liver (little bit form kidney) by glycogenolysis
34
after feeding, describe the glucose and insulin levels ?
high glucose => high insulin => replenish glycogen stores in liver and muscles
35
describe the actions of insulin (4)
- decrease glycogenolysis - decrease gluconeogensis - increase glucose uptake into glucose dependant cells - decrease lipolysis - oppose glucagon
36
what is the action of glucagon ?
- increase hepatic glucose output - increase peripheral release of gluconeogneic precursors
37
where does gluconeogenesis take place ? how do the precursors get here ?
in the liver - precursors transported to the liver to make glucose (FFA from lipids provide energy to drive this process)
38
what are insulins counter regulatory hormones ?
- Glucagon - Ad - cortisol - GH
39
what do Alpha, beta and gamma cells of islets of langerhan produce ?
alpha: glucagon beta: insulin gamma: somatostatin
40
how does high glucose lead to insulin release ? on a cellular level
glucose enters beta cells (facilitated diffusion through GLUT 2 glucose transporter) => Ca2+ flood in => insulin release
41
does the action of insulin at a cellular level
insulin travels to muscle + fat cells => binds to insulin receptor => intracellular signalling cascade => GLUT-4 vesicles travel to + incorporate themselves within membrane => glucose enters cell through GLUT 4 transporter
42
how is Ad response level affected in diabetes ? what does this then mean ?
Ad defence level is reset at a lower blood glucose level = BAD (glucose level needs to be even lower to elicit response) - brain doesn't work properly so doesn't recognise that glucose levels too low
43
describe the arterial supply of the thyroid gland ? why is this important ?
- superior thyroid artery (branch of external carotid) - inferior thyroid artery (branch of thyocervical trunk) (has rich arterial supply because needs iodine)
44
describe the venous drainage of the thyroid gland ?
superior, middle and inferior thyroid veins => internal jugular
45
what are the 2 different forms of thyroid hormone ?
T3, T4 - the thyroid produces mainly T4 and then peripheral conversion to T3 (at target tissue) - T3 then stimulates cellular oxy consumption and energy generation
46
patients with which other conditions should get screening for thyroid disease ? (7)
- AF - hyperlipidaemia - DM - patients on amiodarone - patients with down/turners/addisons
47
in what 3 forms is calcium present in the body ?
- ionised (most useful to cell/metabolically active) - protein bound (not metabolically active) - complexed
48
what is calcium regulation controlled by ? how does small change in calcium affect this ?
small changes in serum Ca2+ (ionised) => big PTH change - small range because Ca2+ essential for functioning of nerves and muscles (heart)
49
how does low calcium affect PTH ? what affects does this then have ?
low Ca2+ => high PTH => - Bone: increase bone resorption - kidneys: increase Ca reabsorption, decrease phosphate reabsorption (when one up the other down) - Gut: increase active Vit D formation => increase Ca absorption from GI tract
50
how does PTH affect vit D regulation ?
increase PTH => increase conversion of Vit D to active form in liver => increase Ca2+ + Pi intestinal absorption
51
what is calcitonin ? secreted from where ? in response to what ?
hormone secreted by C cells in thyroid when Ca is high to lower it
52
how could low serum albumin affect Ca measurement ?
low serum albumin => low serum calcium but no necessarily low Ca2+ so need to correct
53
what electrolyte is needed to excrete PTH ? how could this present
if patient presents with low CA and low PTH then could have low Mg because Mg is needed to excrete PTH
54
vit D deficiency: describe the PTH, Ca2+, Phosphate levels ?
- PTH: high - Ca: low - Phosphate: low (appropriate PTH response)
55
hypoparathyroidism: describe the PTH, Ca2+, Phosphate levels ?
- PTH: low - Ca: low - High: high (inappropriate PTH response)
56
pseudohypoparathyroidism: describe the PTH, Ca2+, Phosphate levels ?
- PTH: high - Ca: low - Phosphate: high (appropriate - parathyroid doing what its meant to) (pseudo...: resistance to PTH - target organs don't respond)
57
malignancy: describe the PTH, Ca2+, Phosphate levels ?
- PTH: low - Ca: high - Phosphate: varies depending on cancer (appropriate PTH)
58
primary hyperparathyroidism: describe the PTH, Ca2+, Phosphate levels ?
- PTH: high - Ca: high - Phosphate: low (inappropriate PTH)
59
where is phosphate absorbed ?
absorbed in small intestine: passive at high conc, active at low conc (Na dependant)
60
what is involved in phosphate regulation ? main regulator ?
- PTH - active Vit D - FGF-23 (main regulator)
61
what is FGF-23 ? produced where ? in response to what ?
produced by osteocytes in response to high phosphate (to lower it)
62
what are the actions of FGF-23 ? (3)
- decreases expression of Na transporter in renal tubule (=> increase renal excretion) - reduce vit D synthesis - reduce gut absorption
63
major extracellular cation ? anion? intracellular cation ?
major extracellular cation: Na anion: Cl intracellular cation: K
64
describe how changes in plasma osmolality leads to ADH changes ? and what this causes ?
reduces plasma osmolality => increased cellular hydration => decrease thirst (so reduces water uptake) + reduces Ash (vasopressin) secretion => increase ruine water excretion by kidneys => reduces total body water
65
where is ADH synthesised ? acts on what ?
synthesised in hypothalamus + acts on collecting duct - concentrates urine: stops 180L daily filtrate being excreted
66
how to DPP-4 inhibitors work ? what are they also known as ? give example of one
gliptins (sitagliptin) - reduce peripheral breakdown of incretins (GLP-1: hormone released by small intestine in response to an oral glucose load)
67
when are gliptins used ? useful in which patients
used when triple combo of drugs has failed - useful in patients who are obese
68
how does metformin work ?
increases peripheral insulin sensitivity and reduces hepatic gluconeogenesis
69
how do sulfonylureas work ? name one
gliclazide - augment pancreatic insulin secretion
70
gliclazide SE ?
(sulphonylurea) - weight gain (=> increase insulin => increase fat storage)
71
how do SGLT2 inhibitors work ? name one
dapagliflozin - lower blood sugar levels by preventing kidneys from reabsorbing glucose
72
Dapagliflozin SE ? (2)
(SGLT2 inhibitor) - SE: euglycaemic ketoacidosis - increased UTI risk

4 - Med (21 decks)

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