extra Flashcards
____ has a higher affinity for B2
EPI
What receptors respond best to NE?
All alpha and B3
What receptor responds equally to NE and Epi?
B1
What happens to CRH, ACTH and cortisol levels during a steroid adminisation (other than cortisol)
CRH: decrease
ACTH: decrease
Cortisol: decrease (but symptoms of excess)
Primary chronic adrenocorticoinsuffiency. aka
addisons
Addisons disease sx
malaise, fatique, weightloss, hyperpigmentation
Pituitary somatotroph adenoma
-> increase GH secretion
Cortisol: goal is to
increase blood glucose levels
Liver: increase gluconeogenesis and glycogenolysis
Muscle: protein breakdown
Fat: lipolysis
What would you see in a patient with Cushing syndrome on dexamethosome test?
Adrenal tumor: ACTH will decrease but cortisol will be high and cortisol fails to be supressed
Conn’s syndrome
-> primary hyperaldosteronism
Cosyntropin (synthetic ACTH) stimulation test to test for
primary/secondary adrenal insuffiency
In acromegaly, high plasma levels of GH cause cause what?
insulin resistance. Thus, liver makes alot of glucose and uptake by the peripheraly tissues is impaired.
During exercise, glucose utilization. by the muscle is what??
increased. which is largely. dependent on insulin.
Exposure to UV light does what?
convert choesterol -> 25 hydroxycholeciferol
What is this: cells secrete chemicals into the ECF that act on cells in the same tissue.
paracrine
What would you see in a patient with a. low Na+ diet
Aldosterone
Cortisol
K+
High
Normal
normal
Although aldosterone increases K+ secreteion, this is offset by a. low distal tubular flow. rate. Thus, there is little change on K+ excretion or plasma K+ concentration
In patients with nephrogenic DBI: kidneys do not respond app to ADH.
How is the Urine osmolarity. affected and plasma osmolarity affected
cant form concentrated urine
Changes in plasma osmolarity. will produce normal ADH secretion responess
A 30-year-old woman reports to the clinic for a routine physical examination. e examination reveals she is pregnant. Her plasma levels of TSH are high, but her total thyroid hormone concentration is normal. Which of the following best re ects the patient’s clinical state?
A) Graves’ disease
B) Hashimoto’s disease
C) A pituitary tumor secreting TSH
D) A hypothalamic tumor secreting thyrotropin-
releasing hormone (TRH)
E) e patient is taking thyroid extract
B.
As a result of negative feedback, plasma levels of
TSH are a sensitive index of circulating levels of un-
bound (free) thyroid hormones. High plasma levels of
TSH indicate inappropriately low levels of free thyroid hormones in the circulation, such as are present with autoimmune destruction of the thyroid gland in persons with Hashimoto’s disease. However, because elevated plasma levels of estrogen in pregnancy increase
hepatic production of TBG, the total amount (bound
+ free) of thyroid hormones in the circulation is ele-
vated. Plasma levels of thyroid hormones are elevated
in persons with Graves’ disease and in patients with
a pituitary TSH-secreting tumor, as well in patients
given thyroid extract for therapy.
What affects does glucagon have on muscle?
no effects on muscle
A large dose of insulinis administered intravenously to a patient. Which set of hormonal changes is most likely to occur in the plasma in response to the insulin injection?
GH
Glucagon
EPI
increase
increase
increase
GH, glucagon, EPI all want to increase glucose levels.
- Which of the following increases the rate of excretion of calcium ions by the kidney?
A) A decrease in calcitonin concentration in the plasma
B) An increase in phosphate ion concentration in the
plasma
C) A decrease in the plasma level of PTH
D) Metabolic alkalosis
c. PTH increases absorption of Ca2+ in the renal tubules. Thus, a. decrease of PTH would increase rate of exxretion
EXOPTHLAMOS is caused by. what
Graves dz, in particular to the immunoglobins
How does hemorrage affect atrial stretch receptors and arterial. baroreceptors and ADH secretion.
Decreases the activation of both,
causing an INCREASE in ADH secretion.
Conn Syndrome
Aterial pressire:
ECF volume
Na+ excretion
increase
increase
not change; rise in arterial pressure offsets the Na+ retaining affects of aldosterone, limiting Na+and permitting daily Na+ balance
A chronic increase in the plasma concentration of thyroxine-binding globulin (TBG) would result in which of the following?
A) An increased delivery of T4 to target cells
B) A decrease in plasma free [T4]
C) An increase in the conversion of T4 to triiodothyro- nine (T3) in peripheral tissues
D) An increase in TSH secretion
E) No change in metabolic rate
E.
In the steady state, high plasma levels of TBG would
simply increase the reservoir for hormone and, there-
fore, the total amount of thyroid hormone in the circu-
lation. However, protein-bound hormone is inactive.
The metabolic effects of thyroid hormones and their
feedback inhibition on TSH secretion are determined
by the free thyroid hormone and not the total amount
of thyroid hormone in the circulation. Both the plasma
levels of free thyroid hormone and TSH would be ex-
pected to be normal in the steady state. Consequently,
the metabolic rate would be unchanged.
In response to increased blood levels of glucose,
plasma insulin concentration normally increases
during the 60-minute period following oral intake
of glucose. In type 1 DM, insulin secretion is de-
pressed. In contrast, in type 2 DM, insulin resis-
tance is a common finding and, at least in the early
stages of the disease, there is an abnormally high
rate of insulin secretion.
In Cushing’s syndrome, high plasma levels of
cortisol impair glucose uptake in peripheral tissues,
which tends to increase plasma levels of glucose. As a
result, the insulin response to oral intake of glucose is
enhanced.
Which hormone is not stored in its endocrine-producing gland?
A) T4B) PTH
C) Aldosterone D) ACTH
E) Insulin
ALDOSTERONE bc STEROID HORMONES ARE NOT STORED!!!
Which finding would likely be reported in a patient with a deciency in iodine intake?
A) Weight loss
B) Nervousness
C) Increased sweating
D) Increased synthesis of thyroglobulin
E) Tachycardia
D.
Iodine -> needed to make TH. If def -> cant make TH.
Thus, TSH levels increase -> stimulate formation of thryglobulin -> goiter
chronic cortison treatment would atrophy/hypertrophy adrenal glands
atrophy
Increase in blood glucose will affecr GH secretion how?
supress
Bone is deposited in proportion to the compres-
sional load that the bone must carry. Continual me-
chanical stress stimulates osteoblastic deposition and
calcification of bone.
Which of the following conditions or hormones would most likely increase GH secretion?
A) Hyperglycemia
B) Exercise
C) Somatomedin
D) Somatostatin
E) Aging
Exercise stimulates GH secretion.
Hyperglycemia, somatomedin, and the hypothalamic inhibitoryhormone somatostatin all inhibit GH secretion. GH secretion also decreases as persons age.
Levels of
Aldosterone
cortisol
insulin
in person with. cushings
no change
increase
increase
Person on a long-term Na+ diet will have
alodsterone
ANP
cortisol
high
low
now change
Excess thyrroid hormone
___ HR
___ RR
____ cholesterol
increased
increased
decreased
hich pituitary hormone has a chemical structure most similar to that of ADH?
A) Oxytocin B) ACTH
C) TSH D) FSH
E) Prolactin
A
peptides with 9 AA; structre differs by 2 AA
nhibition of the iodide pump would be expected to cause which change?
A) Increased synthesis of T4
B) Increased synthesis of thyroglobulin
C) Increased metabolic rate D) Decreased TSH secretion
E) Extreme nervousness
B
A 45-year-old woman has a mass in the sella turcica that compresses the portal vessels, disrupting pitu- itary access to hypothalamic secretions. e secretion rate of which hormone would most likely increase in this patient?
A) ACTH B) GH
C) Prolactin D) LH
E) TSH
The primary controllers of ACTH, GH, LH, and
TSH secretion from the pituitary gland are hypotha-
lamic-releasing hormones. They are secreted into the
median eminence and subsequently flow into the hy-
pothalamic-hypophysial portal vessels before bathing
the cells of the anterior pituitary gland. Conversely,
prolactin secretion from the pituitary gland is influ-
enced primarily by the hypothalamic inhibiting hor-
mone dopamine. Consequently, obstruction of blood
flow through the portal vessels would lead to reduced
secretion of ACTH, GH, LH, and TSH, but increased
secretion of prolactin.
B) In primary hyperparathyroidism
___. Vit D
___. plasma phosphate
____ urinary Ca2+ excretion
high plas-
ma levels of PTH increase the formation of
1,25-(OH)2D3, which increases intestinal absorp-
tion of calcium. This action of PTH, along with its
effects to increase bone resorption and renal calci-
um reabsorption, leads to hypercalcemia. However,
because of the high filtered load of calcium, calcium
is excreted in the urine.
Vit D def causes
____ plasma vit D
___ bone resportion
___ intestinal calbindn
decrease
increase.
decrese
RICKETS and OSTE<
