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Hormonal Regulation Flashcards

1
Q

Hormone regulation

A

Physiological mechanisms that regulate secretions and actions of hormones in the endocrine system

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2
Q

Endocrine system function

A

Differentiation of reproductive system and CNS in fetus
Stimulation of growth and development
Coordination of male and female reproductive systems
Maintenance of internal environment
Adaptation to emergency demands of the body

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3
Q

Genella characteristics of hormones

A

Specific rates and rhythms of secretion
Feedback systems
Only affect target cells with correct receptors
Excreted by kidneys or deactivated by liver or cellular mechanisms

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4
Q

When are hormones released

A

In response to alteration in cellular environment

Maintain a regulated level of certain substances or other hormones

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5
Q

Hormones are regulated by

A

Chemical, hormonal or neural factors

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6
Q

How do water soluble hormones circulate

A

Freely in unbound forms
Short acting
Cannot diffuse across plasma membranes
Bund to surface receptors

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7
Q

How do lipid soluble hormones circulate

A

Bound to a carrier

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8
Q

Water soluble hormones response time

A

Short acting

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9
Q

Water soluble hormones can or cannot diffuse across plasma membrane

A

Can’t

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10
Q

What type of receptors to Water soluble hormones bind to

A

Surface receptors

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11
Q

Lipid soluble hormones response time

A

Rapid and long acting

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12
Q

Can Lipid soluble hormones diffuse across plasma membranes

A

Yes

Diffuse freely

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13
Q

What type of receptors do Lipid soluble hormones bind to

A

Diffuse across plasma membranes and bind to cytosolic or nuclear receptors

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14
Q

Water soluble hormones

First messenger

A

Hormone

Signal transduction

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15
Q

Water soluble hormones

Second messenger

A 
Calcium 
Cyclic adenosine monophosphate (cAMP)
Cyclic guanosine monophosphate (cGMP)
Tyrosine kinase system 
Inositol triphosphate
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16
Q

Hypothalamic-pituitary-adrenal-axis

A

Hypothalamus release corticotropin releasing hormone
Pituitary releases adrenocorticotropic hormone
Adrenals secrete cortisol and catecholamines

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17
Q

Anterior pituitary releases

A 
Adrenocorticotropic hormone 
Melanocyte-stimulating hormone 
Somatotropic hormones 
Glycoprotein hormones 
Luteinizing hormone 
Beta-lipotropin 
Beta-endorphins
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18
Q

Somatotropic hormones

A

Growth hormone

Prolactin

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19
Q

Gycloprotein hormones

A

Follicle stimulating hormone
Luteinizing hormone
Thyroid stimulating hormone

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20
Q

Posterior pituitary hormones are synthesized with

A

Their binding proteins in the supraoptic and paraventricular nuclei of the hypothalamus

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21
Q

Hormones secreted by the posterior pituitary

A

Antidiuretic hormone

Oxytocin

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22
Q

Antidiuretic hormone controls

A

Plasma osmolality

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23
Q

Oxytocin controls

A

Uterine contractions and milk ejection in lactating women

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24
Q

Where is the pineal gland located

A

Near the centre lf the brain

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25
Q

What does the pineal gland secrete

A

Melatonin

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26
Q

What does melatonin do

A

Regulates cardiac rhythms and reproductive systems

Role in inset if puberty

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27
Q

Where is the thyroid gland

A

Two lobes on either side of the trachea with a small bridge that connect the two (isthmus)

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28
Q

What regulates thyroid hormones secretion

A

Thyrotropin releasing hormone and thyroid stimulating hormone

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29
Q

Thyroid hormone is secreted in response to what

A

TSH (thyroid stimulating hormone)

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30
Q

What is thyroid hormone bound to

A

Thyroxine binding globulin
Thyroxine binding prealbumin
Albumin
Lipoproteins

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31
Q

What does thyroid hormone affect

A

Growth/maturation of tissues
Cell metabolism
Heat production
Oxygen consumption

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32
Q

Where are parathyroid glands located

A

Behind the upper and lower poles of the thyroid gland

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33
Q

What does the parathyroid gland produce

A

Parathyroid hormone

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34
Q

What does parathyroid hormone do

A

Increases serum calcium and decreases serum phosphate

Antagonist of calcitonin = bone reabsorption and serum calcium)

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35
Q

What is a cofactor for parathyroid hormone

A

Vitamin D

Needed for function

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36
Q

Where are the adrenal glands located

A

Upper pole of each kidney

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37
Q

Three parts of the adrenal cortex

A 
Zona glomerulosa (top layer)
Zona fasciculata (middle layer)
Zona reticularis (bottom layer)
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38
Q

Adrenal medulla nerves supplied by

A

Sympathetic nervous system

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39
Q

Adrenal cortex stimulated by

A

Adrenocorticotropic hormone

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40
Q

Glucocorticoid hormones effects

A

Carbohydrate metabolism

Anti-inflammatory and growth suppressing

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41
Q

Most potent natural glucocorticoid

A

Cortisol

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42
Q

Adrenal medulla cells

A

Chromaffin cells (pheochromocytes)

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43
Q

Adrenal medulla secrets

A

Catecholamines -> epinephrine and norepinephrine

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44
Q

When is cortisol secrete

A

During stress

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45
Q

What type of tissue does cortisol reach

A

All tissues

46
Q

What does cortisol stimulate

A

Gluconeogenesis

47
Q

What does cortisol do

A 
Elevates blood glucose 
Affects protein metabolism 
Anti-inflammatory and immunosuppressive agent 
Promotes resolution and repair 
Induce T cell apoptosis
48
Q

Abnormal levels of cortisol linked to

A 
Obesity 
Sleep deprivation 
Lipid abnormalities 
Hypertension 
Diabetes 
Atherosclerosis 
Loss of bone density
49
Q

Catecholamines released from

A

Adrenal medulla

Releases epinephrine

50
Q

Catecholamines receptors

A

Alpha adrenergic: alpha 1 and alpha 2

Beta adrenergic: beta 1 and beta 2

51
Q

Catecholamines increase

A

Proinflammatory cytokines production
Heart rate
Blood pressure

52
Q

Peripheral (immune) corticotropic releasing hormone

A

Proinflammatory
Mast cells targeted
Induced acute inflammation and allergic reaction

53
Q

Neuropeptide Y

A

Sympathetic neurotransmitter

Growth factor

54
Q

Hormone regulation controlled by what organs (9)

A 
Hypothalamus 
Anterior pituitary 
Posterior pituitary 
Thyroid 
Parathyroid 
Adrenal cortex 
Ovary 
Testes 
Pancreas
55
Q

Consequences of impaired hormonal regulation include alteration in

A 
Growth and development 
Cognition 
Metabolism 
Reproduction 
Adaptive responses
56
Q 
Mechanism of hormonal alterations 
Failure of:
Dysfunction of:
Secretory:
Endocrine glands:
Endocrine glands:
Increased:
Ectopic:
A

Feedback systems
Endocrine glands
Cells unable to produce, obtain, or convert hormone precursor
Synthesizes or releases excessive hormone
Fail to produce adequate amounts of hormones
Hormone degradation or inactivation
Hormone release

57
Q

Target cell failure

Cell surface receptors associated disorders

A 
Decreased number of receptors 
Impaired receptor function 
Antibodies against certain receptors 
Antibodies that mimic hormone action 
Unusual expression of receptor function
58
Q

Target cell failure

Intracellular disorders

A

Defects in postreceptor signalling cascades

Inadequate synthesis of second messenger

59
Q

Diseases of the posterior pituitary

A

Syndrome of inappropriate antidiuretic hormone secretion

Diabetes insipidus

60
Q

Syndrome of inappropriate antidiuretic hormone secretion

A 
Hyper secretion of ADH
Clinical manifestations are:
Enhanced renal water retention 
Hyponatremia 
Serum hypo-osmolality
61
Q

Diabetes insipidus

A 
Insufficiency of ADH 
Polyuria and polydipsia (Partial or total inability to concentrate urine)
Clinical manifestations:
Enhanced water excretion 
Hypernatremia
Serum hyperosmolality
62
Q

Diabetes insipidus neurogenic vs nephrogenic

A

Neurogenic:
Insufficient amounts of ADH
Nephrogenic:
Inadequate response to AHD

63
Q

Diseases of the anterior pituitary (5)

A 
Hyperpituitarism 
Hypopituitarism 
Panhypopituitarism 
Hypersecretion of growth hormone 
Hyoersecretion of prolactin
64
Q

Hyperpituitarism

A

Commonly caused by benign, slow growing pituitary adenoma
Manifestations:
Headache
Fatigue
Visual changes
Hyposecretion of other anterior pituitary hormones

65
Q

Hypopituitarism

A 
Pituitary infarction:
Sheehan’s syndrome 
Hemorrhage 
Shock 
Head trauma 
Infection 
Tumour
66
Q

Panhypopituitarism

A

ACTH deficiency
TSH deficiency
FSH and LH deficiency
GH deficiency

67
Q

Hypersecretion of growth hormone

A

Acromegaly:
Hypersecretion of GH during adulthood
Giantism:
Hypersecretion of GH in children/adolescents

68
Q

Hypersecretion of prolactin

A 
Caused by prolactinomas 
Females:
Increased levels of prolactin causes amenorrhea, galactorrhea, hirsutism, osteopenia
Males:
Hypogonadism 
Erectile dysfunction
69
Q

Primary hypothyroidism

A 
Autoimmune thryoiditis (Hashimoto’s disease)
Subacute thyroiditis
Painless thyroiditis
Postpartum thyroiditis
Myxedema coma
70
Q

Hyperthyroidism causes

A

Thyrotoxosis
Graves’ disease (pretibial myxedema)
Nodular thyroid disease = goitre
Thyrotoxic crisis (thyroid storm)

71
Q

Primary hypothyroidism

A

Abnormality of the thyroid itself

72
Q

Secondary hypothyroidism

A

Pituitary gland dysfunction

Does not secrete thyroid stimulating hormone

73
Q

Tertiary hypothyroidism

A

Hypothalamus gland does not secrete thyrotropin releasing hormone-> reduces TSH and thyroid hormone levels

74
Q

Congenital hypothyroidism

A 
Hyposecretion of thyroid hormone during youth 
Low metabolic rate  
Short stature 
Severely delayed sexual development 
Possible intellectual disabilities
75
Q

Myxedema

A 
Hyposecretion of thyroid hormone during adulthood 
Decreased metabolic rate 
Loss of mental and physical stamina 
Weight gain 
Loss of hair 
Firm edema 
Yellow dullness of the skin
76
Q

How do drugs for hypothyroidism work

A

Replace what the thyroid gland cannot produce

Work the same as endogenous (natural in the body) thyroid hormone

77
Q

Euthyroid

A

Normal thyroid levels

78
Q

Synthetic thyroid hormone T4 drugs

A

Levothyroxine

Synthroid, eltroxin, euthyrox

79
Q

Synthetic thyroid hormone T3 drugs

A

Liothyronine

Cytomel

80
Q

Natural thyroid hormone T3 and T4 drugs

A

Desiccated thyroid

Thyroid

81
Q

Causes of hyperthyroidism

A

Graves’ disease
Mutinodular disease
Plummer’s disease (toxic nodular disease)
Thyroid storm

82
Q

Hyperthyroidism affects — body systems

Results in — in metabolism

A

Multiple

Increased

83
Q

Hyperthyroidism symptoms

A 
Diarrhea 
Flushing 
Increased appetite 
Muscle weakness 
Sleep disorders 
Altered menstrual flow 
Fatigue 
Palpitations 
Nervousness 
Heat intolerance 
Irritability
84
Q

What is a goitre

A

Enlargement of thyroid gland

85
Q

Goitre results from

A

Overstimulation by elevated levels of thyroid stimulating hormone
TSH becomes elevated because there is little or no thyroid hormone in circulation

86
Q

Symptoms of goitre

A 
Cold intolerance 
Unintentional weight gain 
Depression 
Dry, brittle hair and nails 
Fatigue
87
Q

Pharmacotherapy for hyperthyroidism

A

Radioactive iodine
Surgery
Anti thyroid drugs
Potassium iodine

88
Q

Radioactive iodine

A

I131

Destroys the thyroid gland “ablation”

89
Q

Surgery

A

Removes all parts of the thyroid gland

Will need lifelong thyroid hormone replacement

90
Q

Antithyroid drugs

A

Thioamide derivatives

Ex. Thiamazole (Tapazole), propylthiouracil

91
Q

Potassium iodine

A

Prevents the surge in thyroid hormones that occurs after surgical treatment or during radioactive iodine treatment
May cause liver and bone marrow toxicity

92
Q

Alterations of the parathyroid

A

Hyperparathyroidism

Hypoparathyroidism

93
Q

Two types of Hyperparathyroidism and manifestations

A 
Primary and secondary 
Manifestations 
Hypercalcemia
Hypophosphatemia
Hypercalciuria: kidney stones 
Pathological fractures
94
Q

Primary hyperparathathyroidism

A

Excess secretion of PTH from one or more parathyroid glands

95
Q

Secondary hyperparathyroidism

A

Increase in PTH secondary to chronic hypocalcemia

96
Q

Hypoparathyroidism

A

Abnormally low PTH levels

97
Q

Hypoparathyroidism is usually caused by

A

Parathyroid damage in thyroid surgery

98
Q

Hypoparathyroidism manifestations

A

Hypocalcemia
- Chvostek’s and Trousseau’s signs
Hyperphosphatemia

99
Q

Thyroid carcinoma is the most common

A

Endocrine malignancy

100
Q

Thyroid carcinoma most common cause

A

Ionizing radiation

101
Q

How to treat thyroid carcinoma

A

Thyroidectomy
Suppression therapy
Radiation
Chemotherapy

102
Q

Alterations of adrenal function

A 
Cushing’s disease 
Cushing’s syndrome 
Congenital adrenal hyperplasia 
Hyperaldosteronism
Hypersecretion of adrenal androgens and estrogens 
Adrenocortical hypofunction 
Adrenal medulla hyperfunction
103
Q

Cushing’s disease

A

Excessive anterior pituitary secretion if ACTH

104
Q

Cushing’s syndrome

A

Manifestations resulting from chronic excess cortisol

105
Q

Hyperaldosteronism

A

Primary (Conn’s syndrome) and secondary

106
Q

Hypersecretion of adrenal androgens and estrogens

A

Feminization

Virilization

107
Q

Adrenocortical hypofunction

A

Addison’s disease (primary adrenal insufficiency)
- addisonian crisis
Secondary hypocortisolism

108
Q

Adrenal medulla hyperfunction caused by

A

Tumours derived from the chromaffin cells of the adrenal medulla

109
Q

Diagnostic test for alterations of adrenal function

A 
Lab tests:
Hormone level 
Stimulation of suppression testing 
Imaging 
Biopsy
110
Q

Antithyroid medications considerations

A

Better tolerated with food
Give at the same time everyday to maintain consistent blood levels
Do not stop abruptly
Avoid consumption of foods high in iodine

111
Q

How to monitor therapeutic response of antithyroid medications

A

Thyroid drugs:
Decreased symptoms for hypothyroidism, improved energy levels, improved mental and physical stamina
Antithyroid drugs:
No evidence of hyperthyroidism

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