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Pathophysiology > GH, Cortisol, Prolactin, Lipids > Flashcards

GH, Cortisol, Prolactin, Lipids Flashcards

1
Q

What is growth hormone stimulated by and what is it inhibited by?

A

stimulated by GHRH from the hypothalamus

also stimulated by Gherlin (a peptide hormone secreted by the stomach and poorly misunderstood)

inhibited by somatostatin from the hypothalamus, pancreas, stomach and intestines

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2
Q

What are the Major effects of Growth Hormone?

A
  1. induces precursor cells in bone and other tissues to secrete IGF-1 which stimulates cell division
  2. stimulates protein synthesis in muscle
  3. anti-insulin effects (gluconeogenesis)
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3
Q

What is gigantism caused by?

A

excess growth hormone from birth

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4
Q

What is proportionate dwarfism caused by?

A

deficient growth hormone from birth

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5
Q

What is the increased number of deaths associated with acromegaly (and gigantism) caused ?

A

cardiac hypertrophy
hypertension
atherosclerosis
type 2 DM that leads to coronary artery disease

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6
Q

What are symptoms of acromegaly?

A 
enlarged hands and feet
coarsened enlarged facial features
coarse, oily, thickened skin
a deepened, husky voice due to enlarged vocal cords and sinuses
increased chest size (barrel chest)
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7
Q

What are the three zones of the adrenal cortex and what do they make?

A
  1. glomerulosa (outer) aldosterone
  2. fasciculata (middle) cortisol
  3. reticular (inner) androgens
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8
Q

The adrenal glands respond to stress (trauma, infection, pain, sleep deprivation, fright, emotional stress) by increasing the release of what (two things, from the cortex and the medulla)

A

cortisol from the cortex and epinephrine from the medulla

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9
Q

What are the physiological functions of cortisol?

A
  1. permissive: permits actions of epinephrine and NE on muscle and blood vessels
  2. maintains glucose
  3. decreased inflammatory response (such as capillary permeability and production of prostaglandins)

it’s also important for fetal development

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10
Q

What effects does cortisol have on organic metabolism?

A

stimulation of protein catabolism in bone, lymph, muscle, and elsewhere

stimulation of TG catabolism in adipose tissue, with release of glycerol and fatty acids into the blood

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11
Q

What effects does cortisol have on vasculature?

A

enhanced vasculature reactivity (increased ability to maintain vasoconstriction in response to norepinephrine and other stimuli)

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12
Q

Other than inflammation and specific immune responses, what else does cortisol inhibit?

A

nonessential functions like reproduction and growth

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13
Q

An examination of a patient with adrenal insufficiency (low cortisol) will reveal ____ blood pressure and _____ blood sugar.

A

low BP (in part because cortisol is needed to permit the full extent of epinephrine)

low blood sugar

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14
Q

What is Addison’s disease classified as?

A

primary adrenal insufficiency

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15
Q

What is often the etiology of Addison’s disease?

A

autoimmune

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16
Q

Decreased aldosterone often occurs along with cortisol hyposecretion in Addison’s disease. What does this cause?

A

an imbalance in Na+, K+, and water in the bloodstream

can lead to hypotension

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17
Q

Addisonian crisis is a crisis level of low adrenal function. If a patient goes off cortisol replacement, what are some symptoms that they can experience?

A

severe vomiting/diarrhea resulting in dehydration

hypotension

arrhythmias (due to electrolyte disturbances–hyperkalemia, hyponatremia)

18
Q

What is Cushing’s syndrome?

A

primary or secondary hypersecretion

19
Q

What is Cushing’s syndrome often caused by?

A

tumors within the pituitary or adrenal

20
Q

What is Cushing’s DISEASE?

A

secondary hyper secretion due to ELEVATED ACTH?

21
Q

What are symptoms of Cushing’s syndrome?

A 
osteoporosis 
muscle weakness
thin skin, purple growth striae
hyperglycemia 
immunosuppression
redistribution of fat (buffalo hump, abdominal fat, and moon face)
hypertension
22
Q

Treating Cushing’s Syndrome depends on the cause but what are two ways?

A

surgical removal of pituitary tumor

adrenalectomy

23
Q

What is iatrogenic Cushing’s syndrome?

A

cushion’s syndrome as a result of chronic glucocorticoid treatment

24
Q

What are two actions of prolactin?

A
  1. increases breast milk production

2. increases smooth muscle contraction within the milk ducts

25
Q

Pituitary tumors most commonly secrete what hormones?

A

GH and prolactin

most pituitary tumors arise from cells of the anterior pituitary

26
Q

Most pituitary tumors are microadenomas found incidentally and they are hormonally _____.

A

silent

27
Q

How can you treat a prolactinoma? (think about what inhibits PL)

A

dopamine agonists

or surgical tumor excision

28
Q

Most carbs in the diet are consumed as disaccharides or polysaccharides but only _______ are absorbed by the intestinal cells for use in the body.

A

monosaccharides

29
Q

Carbohydrate Absorption and digestions starts in the ______ with _____.

A

mouth

salivary amylase and mechanical digestion

30
Q

In the intestine, what breaks polysaccharides down?

A

pancreatic amylase

31
Q

What does the final breaking down of disaccharides?

A

brush border (microvilli)

32
Q

How do monosaccharides cross through the intestinal epithelial cell?

A

First by facilitated diffusion using a sodium channel

then moves from high to low concentration towards the back of the luminal cell

where they are transported out AGAIN with a Na/K ATPase pump (active)

33
Q

Where is the first place that peptides are digested?

A

in the stomach by pepsin

34
Q

What are proteins digested in the small intestine by?

A

trypsin and chymotrypsin are the major proteases secreted by the pancreas

35
Q

What percentage of protein digestion happens in the stomach?

A

20%

we can survive without it

36
Q

When lipids reach the duodenum, they trigger the release of what?

A

cholecystokinin (CCK)

37
Q

CCK is an endocrine hormone that travels to the bloodstream to the pancreas, liver, and gallbladder.

It causes the pancreas to release ____.

the liver to produce ______.

and the gallbladder to release _______.

A

pancreas releases lipase

liver produces bile

gallbladder releases bile salts

38
Q

Why are bile salts called “emulsifiers”? (think about their anatomy)

A

They have a hydrophobic side (dissolves with the oil of the lipid drop)

AND

a hydrophilic side (dissolves with the water of the digestive tract)

39
Q

Where are bile salts made?

A

in the liver

but then they are stored in the gall bladder

40
Q

What is the stimulus for CCK release?

A

fats and proteins in the SI

Pathophysiology (4 decks)

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