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Endocrinology > Final > Flashcards

Final Flashcards

1
Q

Is thyroid hormone lipophilic or hydrophilic?

A

Hydrophilic

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2
Q

What breaks down thuroglobulin in the lysosomes?

A

Pro teases

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3
Q

What transporters in the vascular system bind the most T4 and T3, T4, or T3?

A

TBG binds the most of both, trans thyretin binds more T4 than T3 and plasma albumin binds more T3 than T4

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4
Q

What does thyroid hormone do daily generally?

A

Increases the expression of genes involved in aerobic metabolism

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5
Q

Where does thyroid hormone work to increase aerobic metabolism and what does it do there?

A

Heart- increase expression of epinephrine receptors and myosin gene expression
Adipose- stimulates lipolysis
Muscle-protein breakdown to amino acids
Gut-increase glucose absorption
Increase body temperature due to ATP production process

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6
Q

Thyroid hormone functions during fetal development

A

Stimulates cell maturation and surfactant production, affects brain development by influencing the rate that neurons mature, and growth by increasing expression of GH receptors

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7
Q

What is observed during cretinism?

A

The thyroid is not present and this won’t be detected until birth. Body growth will be inhibited and mental retardation. Usually last a year before death

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8
Q

What are the symptoms of myxedema?

A 
Hypoactive thyroid
Low metabolic rate—> weight gain
Decreased cardiac output
Hypotension
Drop in body temp
Lethargy
TRH is above normal, TSH is above normal, TH is below normal
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9
Q

What could be causes of myxedema?

A 
No TSH receptors
Few iodine transporters
Defect in TG gene expression
Hashimotos disease-malfunction in surface proteins where body thinks thyroid is foreign and attacks it
Pituitary not functional
Hypothalamus not functional
End organ resistance
Plasma binding protein deficiency
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10
Q

What would be observed if the pituitary was not functional for the thyroid pathway?

A

High TRH
Low TSH
Low Tx

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11
Q

What would be observed if the hypothalamus was not functional?

A

No TRH
No TSH
No Tx

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12
Q

What happens during end organ resistance

A

There are no thyroid hormone receptors on target cells so all hormone levels will be above normal but nothing will happen

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13
Q

What happens in plasma binding protein deficiency?

A

This is a liver defect where the body plasma binding proteins are not being made so thyroid hormone will be lost at the kidney.
TH below normal
TSH above normal
TRH above normal

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14
Q

What are the symptoms of hyperthyroidism?

A

High metabolic rate, increase in cardiac output, hypertension, increase in body temperature, weight loss, excitability

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15
Q

What could cause hypertension?

A

A pituitary adenoma
TRH neurons or pituitary thyrotropes not responding to negative feedback
Overproduction of TRH
Graves’ disease or Lats

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16
Q

What happens in Graves’ disease or LATS

A

A clone of beta lymphocytes makes an antibody that binds to the TSH receptor. The receptor is activated but this binding isn’t reversible so thyroid hormone is always high.
TSH and TRH are low, TH is high

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17
Q

What does the adrenal cortex do in order to produce normal sex differentiation?

A

It produces cortisol and small amounts of androgens

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18
Q

How does pseudohermaphroditism occur?

A

In a genetic female, the adrenal cortex overproduces androgens at the 10th week to cause masculinized brain and external genitalia

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19
Q

What is the structure of CRH?

A

A polypeptide that is found at the end of the precursor

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20
Q

What is POMC?

A

The precursor for ACTH, ACTH is found in the middle of this precursor

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21
Q

How do you get ACTH from POMC?

A

Through prohormone convertase

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22
Q

From outside to inside what are the layers of the adrenal cortex?

A

Glomerulosa, fasciculata, reticularis

23
Q

Where is the melanocortin 2 receptor found?

A

In the adrenal cortex

24
Q

How many melanocortin receptors are there?

A

5

25
Q

What happens if the MRAP is not present on the melanocortin 2 receptor?

A

The receptor doesn’t work—> type 2 familial glucocorticoid deficiency
MC2R misfiled and will be degraded

26
Q

What does cortisol do for the fetus, neonate, and adult?

A

Fetus-stimulates maturation Of organ systems
Neonate- promotes development of CNS
Adult- maintains integrity of endothelial cells in circulatory system by telling them to maintain their shape, without BP would decrease
Also works in suppression of inflammation and allergic reactions
Organ transplant procedures
Lactating female

27
Q

What does cortisol do in organ transplant procedures

A

Decrease the immune response, patients take this

28
Q

What does cortisol do in lactating female?

A

Promotes lactogenesis with prolactin

29
Q

What happens if you have really low cortisol?

A

The inflammatory response will go out of control

30
Q

What happens if you have really high cortisol?

A

You suppress the immune system and there is a higher likelihood of infection

31
Q

What problems can impact the development in the HPA

A

Mutation in CRH gene, defect in release of CRH gene, mutation on CRH receptor, mutation in POMC gene or prohormone convertases, familial glucocorticoid deficiency

32
Q

What happens in familial glucocorticoid deficiency type 1?

A

There is a point mutation in the melanocortin-2 receptor

33
Q

What happens in familial glucocorticoid type 2?

A

The MRAP Is defective

34
Q

What happens in familial clucocorticoid deficiency type 3?

A

There are mutations in StAR

35
Q

What type of hormone is cortisol?

A

Steroid

36
Q

Symptoms of hypersecretion of cortisol?

A

Muscle atrophy, osteopenia, osteoporosis, drop in growth rate, increase in skin pigmentation, pooR WOUND HEALING

37
Q

Cushing Syndrome type 1

A

There is a tumor in the corticotrope which causes increase in release of ACTH, CRH and AVP not detectable

38
Q

Cushing’s syndrome type 2

A

CRH and AVP are hypersecreted. There may end up being a tumor of the corticotrope because of constant stimulation

39
Q

If you suspect cushings type 1 but removal of pituitary doesn’t fix it

A

There could be an ectopic tumor in the lungs where expression of POMC gene occurs.

40
Q

What is the animal model for Cushing’s syndrome and why?

A

Pacific salmon. When salmon migrated back to stream, it hypersecretes ACTH which causes bond demineralization, muscle atrophy, impairment of immune system, better nervous system

41
Q

What happens if there is hyposecretion of cortisol?

A

There is a drop in blood pressure, drop in gluconeogenesis, drop in NOR and EPI production, increase in skin pigmentation
ACTH High, Androgens low, and cortisol low
There is degeneration of the adrenal cortex because of Addison’s

42
Q

What is Nelson’s syndrome?

A

A secondary syndrome of Addison’s disease where a tumor of the corticotropes develops

43
Q

What are the 2 posterior pituitary hormones?

A

Vasopressin and oxytocin

44
Q

What happens with oxytocin in lactation?

A

The newborn sucks on a nipple which activates stretch receptors, these activate inerneurons that go to magnocellular neurons and oxytocin is released. The oxytocin goes to the myoeptithelial cell and contracts the alveolus to release milk

45
Q

What happens in birth with oxytocin?

A

The fetal pituitary gland is releasing cortisol that goes to the placenta which releases prostaglandins which cause the uterus to have contractions. The newborns head against the cervix also causes contraction of myometrial cells

46
Q

What are the functions of vasopressin?

A

It causes vasoconstriction and water reabsorption

47
Q

What happens in diabetes insipid is?

A

There is damage to magnocellular neurons so there is polyuria and polydipsia because the cells don’t fire to release vasopressin

48
Q

What is the cause of nephrogenic diabetes insipidus

A

A problem with vasopressin receptors on collecting duct cells

49
Q

What happens if you lose sodium?

A

Dehydration, drop in blood pressure, interference with resting potential of cells, death

50
Q

Where can sodium be lost?

A

Sweat glands, filtration at nephron

51
Q

What is conns syndrome and what does it cause

A

Cons syndrome is an adrenal carsinoma that results in hypersecretion of aldosterone, an increase in sodium in the blood, and increased blood pressure

52
Q

What happens with renin secreting tumor?

A

There is hypersecretion of renin and more angiotensin 2 is made and more aldosterone is made

53
Q

What happens in malignant hypertension?

A

There is damage to arteries supplying the kidney so there is a decrease in blood volume, the JGA activates the renin/angiotensin/aldosterone pathway

54
Q

What are the functions of calcium?

A

Activates clotting factors, facilitates contraction of striated muscle and cardiac muscle, conducts electrical signals in neurons, initiates regulated secretion, and acts as second messenger in IP3

Endocrinology (4 decks)

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