Exam 4: Renal & Endocrine Flashcards
1
Q
What do the kidneys do to blood?
A
Filters it
2
Q
What is the primary nitrogenous waste?
A
Urea
3
Q
Where does the N in urea come from?
A
The breakdown of proteins (Amino acids, DNA, RNA)
4
Q
What is the term used for the measure of nitrogenous waste in blood?
A
Blood Urine Nitrogen (BUN)
5
Q
What is a normal BUN?
A
7-18 md/dL
6
Q
What does BUN help measure? (What organ’s functioning does it test?)
A
Kidney function
7
Q
Where does creatinine come from?
A
The breakdown of creatine phosphate
8
Q
What is creatine phosphate used for?
A
Transferring a phosphate to ADP to make ATP
9
Q
What is a normal creatinine level in humans?
A
0.7-1.2 mg/dL
10
Q
What enzyme carries out the reaction where creatine phosphate + ADP –> creatinine + ATP?
A
Creatine kinase
11
Q
What % of blood is protein?
A
7%
12
Q
What % of urine is protein?
A
0.03%
13
Q
Should there be a lot or a little protein in urine?
A
There should be VERY LITTLE protein in urine
14
Q
How many liters of fluid do the kidneys filter daily?
A
180L
15
Q
What % of fluid that the kidneys filter gets reabsorbed?
A
99.3%
16
Q
What hormone does the kidneys produce that regulates the production of blood cells?
A
Erythropoietin
17
Q
What hormone does the kidneys produce that increases intestinal absorption of Ca++ and PO4-3?
A
Vitamin D3
18
Q
What does the body do with the increased Ca++ and PO4-3 absorption brought by vitamin D3?
A
Build bones
19
Q
What hormone is produced in the juxtaglomerular apparatus?
A
Renin
20
Q
Renin is produced when BP and sodium levels are high or low?
A
Low
21
Q
Renin is produced when potassium levels are high or low?
A
High
22
Q
What does renin split? What does it turn into?
A
Renin splits angiotensinogen into angiotensin 1
23
Q
What splits angiotensin 1 into angiotensin 2?
A
Angiotensin-converting enzyme (ACE)
24
Q
What does angiotensin 2 do to blood vessels?
A
Vasoconstricts, thus raising BP
25
What hormones does angiotensin 2 trigger the release of?
Aldosterone and vasopressin/antidiuretic hormone (ADH)
26
What do aldosterone and vasopressin/ADH do? (Retention or release)
Causes the kidneys to retain sodium and water
27
Does the retention of sodium and water raise or lower BP and blood volume?
Increases blood volume and blood pressure
28
What is the process of eliminating nitrogenous wastes?
Excretion
29
What do the kidneys do to the pH of blood?
Buffers the blood (maintains a stable level)
30
What do the kidneys do for blood volume and fluid osmolarity?
Balance fluid levels and electrolytes
31
What are the kidneys involved in detoxifying?
Reactive Oxygen Species (ROS) and free radicals
32
Where are the bladder and kidneys located anatomically?
Retroperitoneal (outside/below the peritoneum)
33
What are the basic filtering units of the kidneys?
Nephron
34
How many nephrons per kidney?
1 million
35
What level of nephron filtration is like "windows" or "holes" in the glomerular capillaries?
Fenestrae
36
What level of filtration in the nephron repels proteins that are smaller than the opening of fenestrae and podocytes?
Basement membrane
37
What type of charge does the basement membrane in nephrons have?
Negative charge
38
What level of filtration in the nephron are cells with filtration slits that cover the glomerular capillaries?
Podocytes
39
What are the two types of nephrons?
Cortical
Juxtamedullary
40
Where are cortical nephrons?
Superficial in the cortex
41
Where are juxtamedullary nephrons?
Deep in the cortex
42
Which nephron's loop of Henle goes deeper into the medulla?
Juxtamedullary goes deep into the medulla
Cortical does NOT
43
Which arteriole brings unfiltered (dirty) blood to the corpuscle?
Afferent arteriole
44
Which arteriole brings filtered (clean) blood back to the circulatory system?
Efferent arteriole
45
What is the outer shell of the renal corpuscle?
Bowman's capsule
46
What tissue is the Bowman's capsule made of?
Simple squamous epi
47
Where is filtrate collected in the renal corpuscle?
Bowman's space
48
What fills capillaries in the renal corpuscle with fenestrae?
Glomerular capillaries (glomerulus)
49
What are the cells with filtration slits in the renal corpuscle that cover glomerular capillaries?
Podocytes
50
What in the nephron takes filtrate from the corpuscle to the loop of Henle?
Proximal convoluted tubule
51
Which limb of the loop of Henle is where WATER leaves?
Thick descending limb
52
What is the concentrating limb in the loop of Henle? Why?
The thick descending limb, as water is leaving
53
Which limb of the loop of Henle is where SALT leaves?
Thick ascending limb
54
What is the diluting limb in the loop of Henle? Why?
Thick ascending limb, as salt is leaving
55
What in the nephron sends the message to the juxtaglomerular apparatus to release renin?
Macula densa
56
Where is the macula densa located?
Distal convoluted tubule
57
What % of water reabsorption is in the proximal convoluted tubules?
65%
58
What % of water reabsorption is in the loop of Henle?
15%
59
What % of water reabsorption is in the distal convoluted tubules?
10%
60
What % of water reabsorption is in the collecting duct?
9.3%
61
What % of water is left to eliminate after the rest is reabsorbed?
0.7%
62
Where does water go from the collecting duct?
Papilla
63
Where does water go from the papilla?
Minor calyx
64
Where does water go from the minor calyx?
Major calyx
65
Where does water go from the major calyx?
Renal pelvis
66
Where does water go from the renal pelvis?
Ureter
67
Where does water go from the ureter?
Urinary bladder
68
Where does water go from the urinary bladder?
Urethra
69
What mOSM is isotonic in the cortex?
~300 mOsm (280-296 mOsm)
70
Where is the water reabsorbed so that it can find its way back to the blood?
Peritubular capillaries
71
What do Na+ and urea make the deep medulla compared to the cortex? (Hypo, hyper, isotonic)
Hypertonic
72
What is the medulla concentrated to in mOsm?
1200-1500 mOsm
73
What hormone makes the Na-K pump:
3 Na+ H2O goes back to blood
2 K+ excreted in urine
Aldosterone
74
Is this water retention or loss?
3 Na+ H2O goes back to blood
2 K+ excreted in urine
Water retention
75
What hormone makes the Na-K pump:
3 Na+ H2O excreted in urine
2 K+ back to blood
Atrial natriuretic peptide (ANP)
76
Is this water retention or loss?
3 Na+ H2O excreted in urine
2 K+ back to blood
Water loss
77
What hormone turns on genes that produce more water channel proteins?
Antidiuretic hormone (ADH)
78
What does producing more water channel proteins do? (Make you pee more or less?)
Make you pee LESS (ANTI-diuretic)
79
Does water passively or actively exit the urine to be returned to blood when more water channels are opened [thanks to ADH]? Why?
PASSIVE, because the medulla is so hypertonic
80
What does ADH do to urea?
Causes its reabsorption
81
Where do aldosterone, ANP, and ADH have their effects take place?
At the distal convoluted tubules and their collecting ducts
82
What is the last 0.7% of water that is filtered out regulated by?
Hormones
83
What hormone is associated with water retention?
Aldosterone
84
What hormone is associated with water loss?
Atrial natriuretic hormone (ANP)
85
What elemental levels can abnormal levels of aldosterone or ANP have clinical effects on?
K levels
86
What is an example effect from abnormal K levels caused by abnormal aldosterone/ANP?
Cardiac arrhythmias
87
Does ADH cause vasoconstriction or vasodilation?
Vasoconstriction
88
Where is ADH produced?
Hypothalamus
89
Where is ADH stored and released from?
Posterior pituitary gland (Neurohypophysis)
90
What is the primary hormone responsible for tonicity homeostasis and BP control?
ADH/vasopressin
91
What is the mOsm for hyperosmolarity?
>280-296 mOsm
92
What states trigger ADH release to initiate water retention for dilution of conditions/bring it back to isotonicity?
Hyperosmolar states
93
What sort of diets/conditions would result in increased ADH secretion?
High salt diets and hypertension (high BP)
94
What does ADH do for arterial blood volume and pressure?
Increase effective arterial blood volume and increase blood pressure to maintain tissue perfusion
95
When BP drops or blood becomes hypertonic (hyperosmotic), what turns on protein synthesis to increase the # of water channels in the renal tubules to allow more water retention?
ADH
96
What hormone causes an increase in ADH release during times of a woman's cycle? (This can be to the point of edema and BP rise)
Estrogen
97
What inhibits ADH when you drink?
Ethanol
98
What inhibits ADH in the sympathetic NS?
Epinephrine and norepinephrine
99
What kind of drug are epi and norepi?
Alpha-adrenergic agonists
100
What hormone released from the heart inhibits ADH?
Atrial natriuretic peptide (ANP)
101
What does GFR stand for?
Glomerular filtration rate
102
What does GFR measure?
Quantity of filtrate that passes through the glomerulus per unit time
103
What is a normal GFR? (in ml/min)
125 ml/min
104
What is a normal GFR? (in L/hour)
7.5 L/hour
105
What is a normal GFR? (in L/day)
180 L/day
106
What % of water is reabsorbed from the filtrate?
99.3%
107
What must the GFR be maintained at REGARDLESS of changes in overall BP?
125 ml/min
108
What would happen without the autoregulation mechanisms within the kidneys if there was a slight increase in renal BP?
A drastic increase in filtration
109
What would happen without the autoregulation mechanisms within the kidneys if there was a slight decrease in renal blood pressure (15%)?
Filtration would stop entirely
110
What is the glomerular (blood) hydrostatic pressure in mm Hg?
55 mmHg
111
What is the blood colloid osmotic pressure in mm Hg?
30 mmHg
112
What is the capsular hydrostatic pressure in mm Hg?
15 mmHg
113
What is the net filtration pressure in mm Hg?
10 mmHg
114
How do you calculate the net filtration pressure? (What values do you use)
Blood HP - (Blood CP + Bowman's capsule HP)
55 - (30+15) = 10
115
Is hydrostatic pressure (HP) a pushing or pulling force?
Pushing
116
Is colloid pressure (CP) a pushing or pulling force?
Pulling
117
How much pressure pushes out the arteriole?
55 mmHg
118
How much pressure is pulled in the arteriole? (Total. Includes HP + CP)
45 mmHg
119
What goes with the 10mmHg pushing force out of the blood?
Urea, Na+, water
120
What forces increase GFR?
Plasma HP
Bowman capsule CP
121
What forces decrease GFR?
Plasma CP
Bowman capsule HP
122
What is another way of saying plasma/glomerular hydrostatic pressure?
BP in capillaries
123
What pressure is pushing out of blood?
Plasma/glomerular HP
124
What pressure is pulling back in the blood?
Plasma CP
125
What pressure is pushing back in towards the blood?
Bowman's capsule HP
126
What pressure is pulling out of blood?
Bowman's capsule CP
127
What is Bowman's capsule CP in mmHg?
Near 0 mmHg
128
What is the filtering pressure of the kidneys? (in mmHg)
10 mmHg
129
Would this increase or decrease GFR?
Increase glomerular/plasma HP (AKA BP)
Increase
130
Would this increase or decrease GFR?
Decrease Bowman's capsule HP
Increase
131
Would this increase or decrease GFR?
Increase plasma CP
Decrease
132
Would this increase or decrease GFR?
Decrease Bowman's capsule CP
Decrease
133
How would liver failure affect GFR?
Decrease GFR
134
What mechanism within the loop of Henle creates a hypertonic medulla?
Counter current multiplier
135
What mechanism within the vasa recta helps maintain the hypertonic medulla?
Counter current exchanger
136
Does water go towards the hypertonic or hypotonic according to the rules of osmosis?
Water goes to the hypertonic (where there is more solute and less water)
137
What does the body change in order to maintain a steady filtration rate/GFR?
BP
138
What intrinsic controls (autoregulation) are used to regulate GFR?
Myogenic mechanism
Tubuloglomerular feedback mechanism
139
What does the myogenic mechanism do in response to an increase in BP?
An increase in BP stretches/dilates the afferent arteriole, so the muscles vasoconstrict to reduce filtration back to normal
140
What does the tubuloglomerular feedback mechanism do in response to an increase in BP?
The macula densa causes vasoconstriction of the afferent arteriole to reduce filtration
141
What does the tubuloglomerular feedback mechanism do in response to a decrease in BP?
The macula densa causes vasodilation of the afferent arteriole to increase filtration
142
How does the body use neural control to regulate GFR?
When your body has a fight or flight response, BP increases
143
What hormone/NT causes vasoconstriction of the afferent arteriole to regulate filtration?
Epinephrine
144
What system in the kidneys helps regulate the GFR if blood pressure drops?
Renin-angiotensin system
145
Where in the kidneys/what structure is where the renin-angiotensin system works?
Juxtaglomerular apparatus, specifically, the macula densa
146
What are the tubules in the kidney that monitors blood pressure through urine flow?
Macula densa
147
Does the macula densa monitor blood pressure directly or indirectly?
Indirectly, as it bases blood pressure off of the urine output
148
In what two situations might the macula densa activate means to control BP?
Increased flow or increased urine concentration signals the macula densa to get to work and do the opposite (decrease flow and decrease concentration)
149
What does the juxtaglomerular apparatus signal the release of?
Renin
150
Where is renin released from?
Granular cells in the afferent arteriole
151
Where does renin turn angiotensinogen into angiotensin 1?
The liver
152
What type of substance is renin?
An enzyme
153
Where does ACE turn angiotensin 1 into angiotensin 2?
The lungs
154
Does angiotensin 2 cause vasoconstriction or vasodilation? How does this affect BP?
Vasoconstriction, increases BP
155
What hormone is released by angiotensin 2?
Aldosterone
156
Where is aldosterone released from?
The adrenal cortex
157
What is the adrenal cortex?
The outer part of the kidney
158
What type of hormone is aldosterone?
A steroid
159
Where does aldosterone go after it is released from the adrenal cortex?
Into the kidney
160
What does aldosterone do in the kidney?
Turns on the Na-K pump
161
What goes on in the renal Na-K pump? Out/In from where specifically?
3 Na OUT of urine, into blood
2 K INto urine, out of blood
162
What follows Na to increase BP?
Water
163
What blocks ACE to lower BP?
ACE inhibitors
164
What is water loss that you're generally unaware of?
Insensible water loss
165
What is water loss you are aware of?
Sensible water loss
166
Where does insensible water loss happen?
Exhaled from lungs
Perspiration from the skin (NOT sweating from exercise...casual sweat)
Excreted in feces
167
Where does sensible water loss happen?
Urine
Sweating from exercise
168
How much urine is excreted daily (in mL)?
1000-1500 mL/day
169
What is retained thanks to estrogen and what is released? (Think what might cause menstrual-related edema)
NaCl is retained
ADH is released
170
What drug causes Na resorption/retention resulting in water retention?
Prednisone
171
What sort of drug is prednisone?
A steroidal anti-inflammatory drug
172
What is it called when increased BP forces more fluid out of the glomerulus?
Pressure diuresis
173
What can cause water loss through pressure diuresis?
Hypertension (high BP) with loss of autoregulatory mechanisms
174
How might tissue damage result in edema?
Tissue damage releases "solute" particles into the interstitium
175
When solute particles are released into the interstitium due to tissue damage, does the interstitium become hypertonic, hypotonic, or stay isotonic?
It becomes hypertonic due to the increase of solute particles
176
What mechanism pertaining to the capillaries, along with tissue damage, results in edema?
Increased capillary permeability
177
As blood approaches the capillary, where does fluid go?
Fluid leaks out into the extracellular matrix (ECF)
178
As the remaining blood (that didn't leak out) courses through the capillary, what does it become?
More concentrated, or hypertonic
179
What happens to fluid that is hypertonic in the capillary as it approaches the venous end?
It pulls fluid in from the ECF
180
What % of the ECF is drained by lymphatic vessels?
10%
181
What continuously happens to the interstitium, thanks to fluid being pushed in and out?
It is "washed" by fluid
182
What happens if the lymphatics are blocked by worms, tumors, etc.?
Massive swelling, such as in elephantiasis
183
If there is high HP, will fluid be pushed out, pulled in, pushed in, pulled out?
Pushed out
184
If there is low CP will fluid be pushed out, pulled in, pushed in, pulled out?
Pulled in
185
If there is low HP, will fluid be pushed out, pulled in, pushed in, pulled out?
Pushed in
186
If there is high CP, will fluid be pushed out, pulled in, pushed in, pulled out?
Pulled out
187
What is another name for the extracellular matrix?
Interstitium
188
What condition can be caused by hypotension due to post-surgical blood loss, sepsis, obstetric complications, burns, ROS?
Renal failure
189
What pathology is classified as "significant" loss of renal function?
Renal failure
190
At what mL/day urine output do you have anuria?
< 50 mL/day
191
What can low glomerular pressure or nephritis, transfusion reactions, and crush injuries cause?
Anuria
192
What pathology is classified as only 25% normal renal functioning?
Renal insufficiency
193
What does the GFR drop to in renal insufficiency?
25-30 mL/min
194
What pathology is when renal function drops to 10% of normal?
End stage renal failure (ESRF)
195
What causes azotemia?
Abnormal increase in BUN
Abnormal increase in creatinine
196
What is azotemia with neurological complications called?
Uremia
197
What is seen in uremia?
Edema, encephalopathy, nausea/vomiting, anorexia, ulcers, CHF
198
With uremia, what is retained?
Na...So also water!
199
Increased Na and water seen in uremia results in?
Increased renin, hypertension (fluid overload)
200
What pathology is where renal failure is so severe that there is glomerular damage, protein loss, edema?
Nephrotic syndrome
201
How much protein is lost in nephrotic syndrome? In g/day
3.5-10 g/day
202
Why is edema seen in nephrotic syndrome?
Due to the loss of plasma proteins
203
How much protein is lost in nephrotic syndrome? In %
Up to 20% loss
204
What is it called when the skin is pressed and a depression forms for some time after it is no longer depressed?
Pitting edema
205
Where is pitting edema seen?
Nephrotic syndrome
206
What system is activated in nephrotic syndrome?
Renin-angiotensin system
207
What is released in the nephrotic syndrome?
Increased ADH release
208
What is the urine output in diabetes mellitus?
Up to 12x normal
209
What diabetes is juvenile onset?
Type 1
210
What % of diabetes is type 1?
10%
211
What is destroyed in type 1 diabetes?
Autoimmune destruction of beta cells
212
What is there a deficiency of in type 1 diabetes?
Insulin
213
Is type 1 diabetes hyper- or hypo- glycemia?
Hyperglycemia, as the lack of insulin means glucose stays in plasma
214
What mg/dL is hyperglycemia?
>200 mg/dL glucose in blood
215
What is hypervolemia?
Fluid overload
216
What causes hypervolemia/what disease is it associated with?
Hyperglycemia in type 1 diabetes
217
What does hypervolemia cause?
Hypertension
218
What is increased frequency of urination?
Polyuria
219
What is increased frequency of drinking?
Polydipsia
220
What is toxic production of ketones causing a "fruity" breath?
Ketoacidosis
221
What are pressure diuresis, polyuria, polydipsia, and ketoacidosis associated with?
Type 1 diabetes
222
Are people with type 1 diabetes overweight or underweight?
Underweight, due to loss of fat and proteins
223
What diabetes is adult onset or insulin resistant?
Type 2
224
What % of diabetes is type 2?
90%
225
What is destroyed in type 2 diabetes?
Insulin receptors (insulin is present, it just has little effect)
226
What is type 2 diabetes attributed to?
Obesity
227
What % of children born after 2000 will acquire type 2 diabetes?
1/3 (33%)
228
What is the most common cause of neuropathy in the western world?
Diabetes
229
What is the damage of capillaries throughout the body?
Microvascular disease
230
What is the destruction of vessels, associated with below the knee amputations?
Peripheral vascular disease
231
What is the clogging of capillaries of the retina?
Retinopathy
232
What is the most common cause of end-stage renal disease in the west?
Nephropathy
233
What is the urine output in diabetes insipidus?
24x normal
234
What is the difference between neurogenic and nephrogenic diabetes insipidus?
Neurogenic: Hypothalamus doesn't produce enough ADH
Nephrogenic: There's not enough ADH receptors in the collecting ducts
235
What is inflammation of the urinary bladder?
Cystitis
236
Is cystitis more common in males or females? How much more?
10x more common in females
237
What is inflammation of the glomeruli called?
Glomerulonephritis
238
What causes glomerulonephritis?
Immune problems, drugs/toxins, diabetes, vascular disease
239
What urine conditions are seen in glomerulonephritis?
Hematuria and proteinuria
240
What is blood in urine?
Hematuria
241
What is excessive protein in urine?
Proteinuria
242
What color is hematuria and why?
Brownish due to reactions with acid
243
How much protein is peed daily in proteinuria? What protein especially?
3-5 g/day, especially albumin
244
What is the inflammation of the renal pelvis and insterstitum?
Pyelonephritis
245
What causes pyelopnephritis?
Bacterial and fungal infections
246
What are symptoms of pyleonephritis?
Fever, chills, flank and groin pain
247
What is the most common cause of renal failure?
Acute tubular necrosis
248
What are the two forms of acute tubular necrosis?
Post ischemic (surgery, sepsis, burns)
Nephrotoxic
249
What is the most common kidney stone? What %?
Calcium oxylate 85%
250
What is the 2nd most common kidney stone? What %?
Struvic stones 15%
251
What molecules are associated with struvic stones?
Mg, NH4, P
252
What is the 3rd most common kidney stone? What %?
Uric acid 7%
253
What is the 4th (least) common kidney stone? What %?
Cystine <1%
254
What system do scientists sometimes combine the endocrine system with because they're so closely related? What is this mega-system called?
The nervous system
Neuroendocrine system
255
What do neurons release? Do they need receptors?
Neurotransmitters DO need receptors
256
What do endocrine glands release? Do they need receptors?
Hormones DO need receptors
257
Is epinephrine from a neuron a hormone or NT?
Epinephrine from a neuron is a NT
258
Is epinephrine from the adrenal medulla a hormone or NT?
Epinephrine from the adrenal medulla is a hormone
259
Do hormones take effect near where they are released?
NO, they usually travel great distances
260
Do endocrine glands have ducts?
NO. They secrete directly into capillaries/blood
261
What is SIMILAR to the endocrine (but not part of it) where the molecule has its effects on the same cell that produces it?
Autocrine
262
What is SIMILAR to the endocrine (but not part of it) where the molecule has its effects near to the cell that produces it?
Paracrine
263
What system secretes products into the lumen of organs via ducts?
Exocrine
264
What are examples of exocrine products?
Digestive enzymes, tears, mucus, bicarb, sweat, oils, wax
265
What are the basic building blocks of polypeptide chains/proteins?
Amino acids
266
How many different amino acids are there?
20
267
What are the bonds that hold amino acids together?
Peptide bonds
268
Are peptide bonds held together by H bonds, covalent, ionic?
Covalent
269
What is a long chain (or polymer) of amino acids?
Peptide/polypeptide chain
270
What is a sequence of DNA nucleotides that carry the code/recipe for a polypeptide?
Gene
271
What is a SMALL chain of linked amino acids?
Peptide
272
What is a LONG chain of linked amino acids?
Polypeptide
273
What do functional/mature proteins consist of?
1 or more polypeptide chains
274
Are proteins 2D or 3D?
3D
275
How can proteins change shape?
Changes in heat and pH
276
What are amino acid or protein-based hormones made of?
Amino acids or peptides/polypeptides
277
Do amino acid/protein-based hormones cross cell membranes easily?
NO
278
Are amino acid/protein-based hormones water or lipid soluble?
Water
279
Are amino acid/protein-based hormones polar or nonpolar?
Polar
280
Are amino acid/protein-based hormones hydrophilic or hydrophobic?
Hydrophilic
281
Are amino acid/protein-based hormones lipophilic or lipophobic?
Lipophobic
282
Where are the receptors of amino acid/protein-based hormones usually?
On the cell membrane
283
What are amine hormones?
Modified amino acids
284
What are examples of amine hormones?
Dopamine, epinephrine, norepinephrine, melatonin
285
What are peptide/protein hormones made of?
Multiple amino acids connected by peptide bonds
286
What are examples of peptide hormones?
ADH, ANP
287
What are examples of protein hormones?
Growth H, FSH, Luteinizing hormone, human Chorionic Gonadotropin (hCG)
288
Are peptide hormones or protein hormones larger?
Protein hormones (they have multiple polypeptide chains)
289
What hormones are made of complex ringed lipid molecules?
Steroids
290
What are all steroid molecules derived from?
Cholesterol
291
Where are the receptors for steroids?
In the cytoplasm and nucleoplasm
292
Once steroids are bound to their receptors, where does the steroid-receptor complex bind to to turn genes on/off?
Directly on the DNA
293
Are steroids water or lipid soluble?
Lipid
294
Do steroids cross membranes easily?
Yes
295
Are steroids hydrophilic or hydropohobic?
Hydrophobic
296
What are examples of steroids?
Testosterone, cortisol, aldosterone, progesterone, estrogen
297
Where do arachidonic acid based hormones come from?
Special phospholipids in the cell membrane
298
What hormones are long, ringed fatty acids that are physiologically active?
Arachidonic acid based hormones
299
What are arachidonic acid based hormones precursor to?
Eicosanoids, leukotrienes, thromboxanes
300
What are eicosanoids made from?
Arachidonic acid
301
What enzyme converts arachidonic acid into prostaglandins and thromboxane?
Cyclooxygenase
302
What abbreviations are for cyclooxygenase?
COX 1 and COX 2
303
What are the functions of prostaglandins?
Inflammation, pain, uterine contraction, blood clotting...
304
Do prostaglandins vasodilate or vasoconstrict?
Vasodilate
305
What allergic reaction can prostaglandins help induce?
Anaphylaxis
306
What is produced by platelets causing them to aggregate and begin the clotting process?
Thromboxanes
307
Do thromboxanes cause vasodilation or vasoconstriction?
Vasoconstriction
308
What produces leukotrienes?
Leukocytes and mast cells
309
What do leukotrienes cause?
Inflammation, and the release of histamine and prostaglandins to increase inflammation
310
What does NSAIDS stand for?
Non-Steroidal Anti-Inflammatory Drugs
311
How do NSAIDS work?
Inhibit prostaglandin synthesis by inhibiting cyclooxygenase
312
What are examples of NSAIDS?
Ibuprofen, Asprin, naproxen, Indomethacin
313
What is the mechanism for Acetaminophen?
Unknown! It isn't an NSAID though
314
What must hormones have for effects to take place?
Functioning receptors
315
What do steroidal hormones form in the nucleus?
Dimers
316
What are dimers?
Two hormone-receptor complexes
317
What do steroidal dimers do?
Bind directly to the two sides of DNA to activate/deactivate genes
318
Are hormone diseases caused by deficiency in the hormone, or the receptors?
Both
319
What is signal transduction?
The series of reactions when a hormone binds to its receptor on the cell membrane and genes are turned on/off
320
What are the "first messengers" in signal transduction?
The hormones
321
Where is the "second messenger"?
Near the cytoplasmic surface of the receptor (just inside the cell membrane)
322
What does the second messenger do?
Transmits the message of the hormone (first messenger) to the next set of chemical reactions
323
What does the Cyclic AMP (cAMP) System use?
A cyclic form of Adenosine Monophosphate
324
What happens after the hormone binds to its receptor in cAMP system?
The receptor activates the G protein on the membrane
325
What activates G protein?
Guanosine Triphosphate (GTP)
326
What deactivates G protein?
Guanosine Diphosphate (GDP)
327
What does G protein activate (or deactivate) in cAMP?
Adenylate cyclase
328
What does the enzyme adenylate cyclase do?
Produces cAMP from ATP
329
What is the second messenger in the cAMP system?
cAMP, a cytoplasmic protein that turns reactions on/off
330
What enzyme does cAMP activate?
Protein Kinase A (PKA)
331
What does PKA do?
Phosphorylates another enzyme that phosphorylates another....etc.
332
What enzyme destroys cAMP (thus turning it off)?
Phosphodiesterase
333
What is another name for the PIP2 second messenger system?
Calcium signal system
334
What happens after the hormone binds to its receptor in PIP2 system?
The receptor activates the G protein (just like in cAMP)
335
What does the activated G protein bind to in PIP2?
The enzyme phospholipase C
336
What does phospholipase C do?
Splits PIP2 into DAG and IP3
337
What are the second messengers in PIP2?
DAG and IP3
338
What does DAG do?
Activates the enzyme protein kinase C
339
What does protein kinase C do?
Continues the signal transduction
340
What does IP3 do?
Causes the release of Ca ions
341
What do the Ca ions released by IP3 do?
1. Activates more kinase enzymes, which can include cAMP and PKC
2. Regulate ion channels
342
What is the protein activated by Ca ions which can itself activate other proteins?
Calmodulin
343
What is up-regulation?
Increasing the # of receptors in the cell membrane
344
Does up-regulation make the cell more or less sensitive to hormones? Does this increase or decrease the hormone's effect?
More, increases the effect
345
Does down-regulation make the cell more or less sensitive to hormones? Does this increase or decrease the hormone's effect?
Less, decreases the effect
346
What is down-regulation?
Decreasing the # of receptors in the cell membrane
347
What is it called when 2+ hormones (or drugs, toxins, etc.) produce an effect that is greater than the sum of their individual effects?
Synergistic effect
348
What is permissive action?
1 hormone makes the target organ much more sensitive to another hormone
349
Is permissive action up or down-regulation?
Up-regulation
350
What is an example of permissive action?
Estrogen causes an up-regulation of progesterone receptors in the uterus, making the uterus more sensitive to progesterone
351
What is it called when 2 hormones have opposite effects?
Antagonistic effect
352
What is this an example of:
Insulin lowers plasma glucose levels, while glucagon increases plasma glucose levels?
Antagonistic effect
353
What are hormones that stimulate the release of another hormone? They are often referred to as "stimulatory" or "excitatory" hormones?
Tropins
354
What are hormones that inhibit the release of another hormone? They are referred to as "inhibitory" hormones?
Statins
355
Where do most hormones produced by the hypothalamus have their effects on?
The Anterior pituitary gland
356
Gonadotropin Releasing Hormone in the hypothalamus causes the release of what where?
2 gonadotropins (follicle stimulating hormone FSH and Luteinizing hormone) released from the anterior pituitary gland
357
What does FSH do in females?
Females: Causes granulosa cells in the ovarian follicles to activate an enzyme to change testosterone into estrogen
358
What enzyme changes testosterone into estrogen?
Aromatase
359
What does FSH do in males?
Stimulates spermatogenesis (development of sperm)
360
What does Luteinizing hormone do in females?
Causes ovulation (release of oocyte from ovaries)
361
What does Luteinizing hormone do in males?
Stimulates cells to produce testosterone
362
What cells produce testosterone?
Leydig cells (interstitial cells) of the testes
363
What is the relationship called between the hypothalamus, pituitary gland, and the gonads?
Hypothalamic-hypophyseal-gonadal axis
364
What sort of feedback is involved when the hypo releases gonadotropin releasing hormone causing release of FSH & LH, which release testosterone that inhibits the hypo?
Negative feedback loop
365
Thyrotropin/Thyroid Releasing Hormone in the hypothalamus causes the release of what where?
Thyroid stimulating hormone released in anterior pituitary gland
366
What is another name for thyroid stimulating hormone?
Thyrotropin
367
What does thyrotropin do?
Causes the thyroid's follicular cells to release T4
368
What is the name for T4?
Thyroxin
369
Is T3 or T4 inactive?
T4 is inactive
370
Where is thyroxine (T4) released from?
The colloid
371
Where does T4 go after it is released?
To the cells which will chop off an iodide to make T3
372
What is T3 called?
Triiodothyronine
373
What does T3 do?
Increases metabolism
374
What does estrogen regulate?
Secondary sexual characteristics and the uterus
375
What does calcitonin do?
Activates osteoblasts to make bone, thus decreasing blood Ca levels
376
Where is calcitonin released from?
Parafollicular cells
377
What does parathyroid hormone do?
Activates osteoclasts which resorb bone and increase plasma Ca
378
What produces parathyroid hormone?
Parathyroid glands
379
What causes reabsorption of Ca and excretion of P by the kidneys?
Parathyroid hormone
380
What vitamin does parathyroid hormone activate that causes an increase in Ca absorption?
Vitamin D
381
What does corticotropin releasing hormone in the hypo release from the anterior pituitary?
Pro-opiomelanocortin
382
What is pro-opiomelanocortin chopped up into?
Adrenocorticotropic hormone (ACTH)
Beta-Endorphin
Enkephalin
Melanocyte stimulating hormone
383
What does adrenocorticotropic hormone do?
Increase cortisol from the adrenal cortex
384
What does beta-endorphin do?
Causes runner's high and reduces pain
385
What is beta-endorphin an example of?
Endogenous opiate
386
What is an example of an endogenous opiate other than beta-endorphin?
Enkephalin
387
What is another name for melanocyte stimulating hormone?
Melanotropin
388
What does the pro in pro-opiomelanocortin mean?
Because it is the first or pro-hormone to be made into other hormones
389
What does the opio in pro-opiomelanocortin mean?
Because it can be chopped into the endogenous opiates (beta endorphin and enkephalin)
390
What does the melano in pro-opiomelanocortin mean?
Because it can be chopped up into melanocyte stimulating hormone
391
What does the cortin in pro-opiomelanocortin mean?
Because it stimulates the release of cortisol from the adrenal cortex
392
What is the outer layer of the adrenal gland?
Adrenal cortex
393
What hormone class is the adrenal cortex part of?
Steroids
394
What is the outer 1/3 of the adrenal cortex called?
Zona glomerulosa
395
What subclass is found in the zona glomerulosa?
Mineralocorticoids
396
What is an example of a mineralocorticoid and its function?
Aldosterone (water retention)
397
What is the middle 1/3 of the adrenal cortex?
Zona fasciculata
398
What is the subclass in the zona fasciculata?
Glucocorticoids
399
What is an example of a glucocorticoid and its function?
Cortisol (anti-stress)
400
When are cortisol levels highest?
The morning
401
What is the deepest/inner 1/3 of the adrenal cortex?
Zona reticularis
402
What is the subclass for the zona reticularis?
Sex steroids
403
What are examples of sex steroids?
Androgens (like testosterone and estrogen)
404
Are estrogen and androgens stopped being produced after menopause?
Estrogen is stopped, but androgen continues. This can cause clinical manifestations
405
What is the inner layer of the adrenal cortex called?
Adrenal medulla
406
What subclass of hormones are in the adrenal medulla?
Sympathetic hormones
407
What are examples of sympathetic hormones?
Epi, norepi, dopamine, serotonin
408
When is cortisol released?
In response to stress (physical, pathological, emotional)
409
What effect does cortisol have on fats, proteins, and carbs? (Does it increase or decrease blood glucose levels?)
Increase
410
What is gluconeogenesis?
Producing glucose from non-carbs such as proteins and lipids
411
What is glycogenolysis?
Breaking down glycogen to release glucose into the blood
412
What does cortisol counteract? What might this do to the body?
Cortisol counteracts insulin, which may result in hyperglycemia
413
What can constantly high cortisol do to insulin?
Create insulin resistance
414
Does cortisol increase or decrease amino acid entry into muscles?
Decrease
415
Does cortisol increase or decrease hunger when high?
Increase
416
What does cortisol do to the immune system?
Cortisol is anti-inflammatory
417
What does cortisol reduce the release of as an anti-inflammatory?
Proinflammatory cytokines
Histamines
418
What does cortisol help control in the lymphatic system?
Control B lymphocyte functions and prevents T lymphocyte proliferations
419
Does cortisol down or up regulate epinephrine receptors?
Upregulate
420
Does cortisol cause vasoconstriction or vasodilation? What does this do to BP?
Vasoconstriction, raises BP
421
How does cortisol effect Na and P?
Has an anti-diuretic effect (increases Na retention and P loss)
422
How do high levels of cortisol affect the reproductive system?
Can cause infertility and miscarriage
423
How does cortisol affect: Ca absorption
Decrease
424
How does cortisol affect: bone formation
Decrease
425
How does cortisol affect: collagen formation
Decrease/inhibits
426
How does cortisol affect: Plasma amino acid levels
Increase
427
How does cortisol affect: gastric acid production
Increase
428
What does long-term cortisol levels do to the brain?
Damages hippocampus, impairing learning and memory retrieval
429
Can high levels of cortisol interfere with the negative feedback loop controlling the amount of cortisol?
Yes
430
Where are catecholamines/adrenergic hormones produced?
Adrenal medulla
431
What are the fight or flight sympathetic hormones?
Catecholamines/adrenergic hormones
432
What is the body's main source of catecholamines?
Epinephrine
433
Does epinephrine and norepi cause vasodilation or vasoconstriction? What does this do to BP?
Vasoconstriction, raising BP
434
What do epi and norepi tend to do to insulin?
Reduces its release
435
What does prolactin releasing hormone in the hypo effect in the anterior pituitary?
Prolactin
436
What does prolactin do?
Stimulates lactation (production of milk)
437
What is prolactin inhibited by?
Dopamine
438
What does growth hormone releasing hormone in the hypo effect in the anterior pituitary?
Growth hormone and Insulin-like growth factor
439
What does insulin-like growth factor do?
Stimulates mitosis
440
What does somatostatin in the hypo affect in the anterior pituitary?
DECREASES growth hormone
441
What hormones are made by the hypo but are stored and released from the POSTERIOR pituitary?
ADH and oxytocin
442
What does oxytocin do?
Causes uterine contraction (as seen in labor) and causes milk let down
443
What sort of states release ADH release?
Hyperosmolar (high concentration)
444
What dietary choices might increase secretion of ADH?
High salt diets
445
What hormone inhibits appetite?
Leptin
446
What produces leptin?
Adipocytes
447
What do alpha cells in the islets of langerhans produce?
Glucagon
448
What do beta cells in the islets of langerhans produce?
Insulin
449
What do delta cells in the islets of langerhans produce?
Somatostatin
450
Are the acinar cells of the pancreas endocrine?
NO, they're exocrine.
451
What do acinar cells produce?
Digestive enzymes and bicarb ions
452
What is prominent in the anterior, superior mediastinum (above the heart) of juveniles?
Thymus
453
What does the thymus do?
Supports T-lymphocyte maturation
454
What do T-lymphocytes do?
Help the immune system
455
What is the thymus replaced by in adults?
Adipose
456
What are gonads?
Primary reproductive organs
457
What cells produce testosterone in females?
Thecal cells
458
What hormone made by the small intestines and stomach causes HCl production?
Gastrin
459
What hormone made by small intestines causes the pancreas to release bicarb and proteases?
Secretin
460
What hormone is made by the small intestines and causes the gallbladder to contract? (Thus forcing bile into the duodenum)
Cholecystokinin
461
What hormone is an endogenous opioid with an unknown function?
Endorphin
462
What hormones are released by the pineal gland?
Serotonin and melatonin
463
What is associated with reduced melatonin levels?
Seasonal affective disorder (SAD) and premenstrual syndrome (PMS)
464
What contains adipocytes, connective tissue matrix, nerve tissue, vascular cells, and immune cells?
Adipose tissue
465
Where are proifnlammatory cytokines found?
Adipose
466
What does adipose tissue act on in obesity?
Appetite and energy balance, immunity, insulin sensitivity, BP, cardiovascular disease...
467
What are examples of proinflammatory cytokines?
Tumor necrosis factor and interleukin 6
468
What do tumor necrosis factor and interleukin 6 cause?
Inflammation, obesity-related insulin resistance
469
What condition is angiotensinogen and angiotensin implicated in?
Hypertension
470
What does plasminogen activating inhibitor (PAI-1) impair?
Fibrinolysis
471
What is fibrinolysis?
Breakdown of blood clots
472
What do adiponectin and leptin do?
Stimulate beta oxidation of fatty acids in skeletal muscles
473
What might adiponectin and leptin do in regards to insulin?
May improve body's sensitivity to insulin and protect against diabetes type 2
474
What pathology is an overactive thyroid that results in elevated thyroid hormones?
Hyperthyroidism
475
What disease is a type of hyperthyroidism?
Grave's disease
476
Is metabolic rate increased or decreased in hyperthyroidism?
Increased
477
Is increased metabolic rate anabolic or catabolic?
Catabolic
478
What causes hyperthyroidism?
Autoimmune issues...Antibodies are produced that stimulate TSH
479
What are signs of hyperthyroidism?
Goiter, nervousness, rapid pulse, bulging eyes, weight loss, sweating
480
What can hyperparathyroidism be caused by?
Hyperthyroidism
481
What levels are increased in hyperparathyroidism?
Blood Ca levels due to increased PTH
482
In hyperparathyroidism, do you see bone thinning or bone thickening?
Bone thinning
483
What is bone thinning called?
Osteoporosis
484
What is an underactive thyroid called?
Hypothyroidism
485
What is the most common type of hypothyroidism in the US?
Hashimoto thyroiditis
486
What is Hashimoto thyroiditis strongly associated with?
Lymphoma
487
What do hypothyroidism symptoms range from?
Asymptomatic to myxedema coma
488
What happens in primary hypothyroidism?
Thyroid gland can't produce hormones
489
What happens in secondary hypothyroidism?
The thyroid is normal, but the hypothalamus or pituitary glands are affected
490
Is T4 increased or decreased in hypothyroidism? Why?
Decreased, due to increased TSH
491
How do you diagnose hypothyroidism?
Elevated serum TSH and decreased T4...Sometimes patients can have an elevated TSH and a normal T4
492
What disease alters the T3/T4 negative feedback loop on TRH and TSH?
Hypothyroidism
493
What are signs of hypothyroidism?
Goiter, weight gain, pallor, fatigue, slowed speech/movement, dull facial expression
494
What is hypercortisolism also called?
Cushing's disease
495
What is cushing's disease often due to?
Increased ACTH from a pituitary adenoma
496
What are characteristic signs of cushings?
Weight gain in face and trunk ("moon face" and "buffalo hump")
497
What is the skin like with cushings?
Fragile, with acne and facial hair growth
498
What is hirsutism?
Abnormal facial hair growth
499
What is hair like in cushings?
Brittle or bald
500
Do people with cushings fail to bruise or bruise easily? Why?
Bruise easily due to decreased collagen
501
Why do people with Cushings have insulin resistance?
Due to increased cortisol
502
Do people with cushings have hypotension or hypertension?
Hypertension
503
When are cushings symptoms often seen?
Prolonged use of corticosteroids like prednisone
504
What is another name for hypocortisolism?
Addison's disease or adrenal insufficiency
505
What is rare, reduced cortisol (and often aldosterone) production by the adrenal cortex?
Addison's disease
506
What kind of disease is Addison's?
Autoimmune
507
What are signs of Addison's?
Weight loss, fever, hypoglycemia, dehydration, fatigue
508
What causes rickets/osteomalacia?
Reduced vitamin D
509
What is osteomalacia in kids?
Rickets
510
What is rickets in adults?
Osteomalacia
511
What is an abnormal increase in growth hormone from childhood?
Giantism
512
What is an abnormal increase in growth hormone from adulthood?
Acromegaly
513
What is an abnormal decrease in growth hormone?
Drawfism
514
What is postmenopausal osteoporosis due to?
Loss of estrogen
515
What are other names for estrogen?
Estradiol
Estradio-17 beta
Estradiol-17 beta
516
In hypoparathyroidism is there more or less Ca in the blood?
Way too little Ca in blood
517
In what disease is there increased neuromuscular irritability (i.e., myalgias, twitching, spasms) due to decreased threshold?
Hypoparathyroidism
518
Is macroglossia (enlarged tongue) in hypothyroidism or hyperthyroidism?
Hypothyroidism
519
What disease can have a "fruity" breath from ketoacidosis?
Type 1 diabetes
520
What's the way to distinguish between diabetes mellitus and diabetes insipidus?
Mellitus: Insulin
Insipidus: ADH
