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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
What does the pineal gland secrete
Melatonin
26
What does melatonin do
Regulates cardiac rhythms and reproductive systems | Role in inset if puberty
27
Where is the thyroid gland
Two lobes on either side of the trachea with a small bridge that connect the two (isthmus)
28
What regulates thyroid hormones secretion
Thyrotropin releasing hormone and thyroid stimulating hormone
29
Thyroid hormone is secreted in response to what
TSH (thyroid stimulating hormone)
30
What is thyroid hormone bound to
Thyroxine binding globulin Thyroxine binding prealbumin Albumin Lipoproteins
31
What does thyroid hormone affect
Growth/maturation of tissues Cell metabolism Heat production Oxygen consumption
32
Where are parathyroid glands located
Behind the upper and lower poles of the thyroid gland
33
What does the parathyroid gland produce
Parathyroid hormone
34
What does parathyroid hormone do
Increases serum calcium and decreases serum phosphate | Antagonist of calcitonin = bone reabsorption and serum calcium)
35
What is a cofactor for parathyroid hormone
Vitamin D | Needed for function
36
Where are the adrenal glands located
Upper pole of each kidney
37
Three parts of the adrenal cortex
``` Zona glomerulosa (top layer) Zona fasciculata (middle layer) Zona reticularis (bottom layer) ```
38
Adrenal medulla nerves supplied by
Sympathetic nervous system
39
Adrenal cortex stimulated by
Adrenocorticotropic hormone
40
Glucocorticoid hormones effects
Carbohydrate metabolism | Anti-inflammatory and growth suppressing
41
Most potent natural glucocorticoid
Cortisol
42
Adrenal medulla cells
Chromaffin cells (pheochromocytes)
43
Adrenal medulla secrets
Catecholamines -> epinephrine and norepinephrine
44
When is cortisol secrete
During stress
45
What type of tissue does cortisol reach
All tissues
46
What does cortisol stimulate
Gluconeogenesis
47
What does cortisol do
``` Elevates blood glucose Affects protein metabolism Anti-inflammatory and immunosuppressive agent Promotes resolution and repair Induce T cell apoptosis ```
48
Abnormal levels of cortisol linked to
``` Obesity Sleep deprivation Lipid abnormalities Hypertension Diabetes Atherosclerosis Loss of bone density ```
49
Catecholamines released from
Adrenal medulla | Releases epinephrine
50
Catecholamines receptors
Alpha adrenergic: alpha 1 and alpha 2 | Beta adrenergic: beta 1 and beta 2
51
Catecholamines increase
Proinflammatory cytokines production Heart rate Blood pressure
52
Peripheral (immune) corticotropic releasing hormone
Proinflammatory Mast cells targeted Induced acute inflammation and allergic reaction
53
Neuropeptide Y
Sympathetic neurotransmitter | Growth factor
54
Hormone regulation controlled by what organs (9)
``` Hypothalamus Anterior pituitary Posterior pituitary Thyroid Parathyroid Adrenal cortex Ovary Testes Pancreas ```
55
Consequences of impaired hormonal regulation include alteration in
``` Growth and development Cognition Metabolism Reproduction Adaptive responses ```
56
``` Mechanism of hormonal alterations Failure of: Dysfunction of: Secretory: Endocrine glands: Endocrine glands: Increased: Ectopic: ```
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
Target cell failure | Cell surface receptors associated disorders
``` Decreased number of receptors Impaired receptor function Antibodies against certain receptors Antibodies that mimic hormone action Unusual expression of receptor function ```
58
Target cell failure | Intracellular disorders
Defects in postreceptor signalling cascades | Inadequate synthesis of second messenger
59
Diseases of the posterior pituitary
Syndrome of inappropriate antidiuretic hormone secretion | Diabetes insipidus
60
Syndrome of inappropriate antidiuretic hormone secretion
``` Hyper secretion of ADH Clinical manifestations are: Enhanced renal water retention Hyponatremia Serum hypo-osmolality ```
61
Diabetes insipidus
``` Insufficiency of ADH Polyuria and polydipsia (Partial or total inability to concentrate urine) Clinical manifestations: Enhanced water excretion Hypernatremia Serum hyperosmolality ```
62
Diabetes insipidus neurogenic vs nephrogenic
Neurogenic: Insufficient amounts of ADH Nephrogenic: Inadequate response to AHD
63
Diseases of the anterior pituitary (5)
``` Hyperpituitarism Hypopituitarism Panhypopituitarism Hypersecretion of growth hormone Hyoersecretion of prolactin ```
64
Hyperpituitarism
Commonly caused by benign, slow growing pituitary adenoma Manifestations: Headache Fatigue Visual changes Hyposecretion of other anterior pituitary hormones
65
Hypopituitarism
``` Pituitary infarction: Sheehan’s syndrome Hemorrhage Shock Head trauma Infection Tumour ```
66
Panhypopituitarism
ACTH deficiency TSH deficiency FSH and LH deficiency GH deficiency
67
Hypersecretion of growth hormone
Acromegaly: Hypersecretion of GH during adulthood Giantism: Hypersecretion of GH in children/adolescents
68
Hypersecretion of prolactin
``` Caused by prolactinomas Females: Increased levels of prolactin causes amenorrhea, galactorrhea, hirsutism, osteopenia Males: Hypogonadism Erectile dysfunction ```
69
Primary hypothyroidism
``` Autoimmune thryoiditis (Hashimoto’s disease) Subacute thyroiditis Painless thyroiditis Postpartum thyroiditis Myxedema coma ```
70
Hyperthyroidism causes
Thyrotoxosis Graves’ disease (pretibial myxedema) Nodular thyroid disease = goitre Thyrotoxic crisis (thyroid storm)
71
Primary hypothyroidism
Abnormality of the thyroid itself
72
Secondary hypothyroidism
Pituitary gland dysfunction | Does not secrete thyroid stimulating hormone
73
Tertiary hypothyroidism
Hypothalamus gland does not secrete thyrotropin releasing hormone-> reduces TSH and thyroid hormone levels
74
Congenital hypothyroidism
``` Hyposecretion of thyroid hormone during youth Low metabolic rate Short stature Severely delayed sexual development Possible intellectual disabilities ```
75
Myxedema
``` 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
How do drugs for hypothyroidism work
Replace what the thyroid gland cannot produce | Work the same as endogenous (natural in the body) thyroid hormone
77
Euthyroid
Normal thyroid levels
78
Synthetic thyroid hormone T4 drugs
Levothyroxine | Synthroid, eltroxin, euthyrox
79
Synthetic thyroid hormone T3 drugs
Liothyronine | Cytomel
80
Natural thyroid hormone T3 and T4 drugs
Desiccated thyroid | Thyroid
81
Causes of hyperthyroidism
Graves’ disease Mutinodular disease Plummer’s disease (toxic nodular disease) Thyroid storm
82
Hyperthyroidism affects — body systems | Results in — in metabolism
Multiple | Increased
83
Hyperthyroidism symptoms
``` Diarrhea Flushing Increased appetite Muscle weakness Sleep disorders Altered menstrual flow Fatigue Palpitations Nervousness Heat intolerance Irritability ```
84
What is a goitre
Enlargement of thyroid gland
85
Goitre results from
Overstimulation by elevated levels of thyroid stimulating hormone TSH becomes elevated because there is little or no thyroid hormone in circulation
86
Symptoms of goitre
``` Cold intolerance Unintentional weight gain Depression Dry, brittle hair and nails Fatigue ```
87
Pharmacotherapy for hyperthyroidism
Radioactive iodine Surgery Anti thyroid drugs Potassium iodine
88
Radioactive iodine
I131 | Destroys the thyroid gland “ablation”
89
Surgery
Removes all parts of the thyroid gland | Will need lifelong thyroid hormone replacement
90
Antithyroid drugs
Thioamide derivatives | Ex. Thiamazole (Tapazole), propylthiouracil
91
Potassium iodine
Prevents the surge in thyroid hormones that occurs after surgical treatment or during radioactive iodine treatment May cause liver and bone marrow toxicity
92
Alterations of the parathyroid
Hyperparathyroidism | Hypoparathyroidism
93
Two types of Hyperparathyroidism and manifestations
``` Primary and secondary Manifestations Hypercalcemia Hypophosphatemia Hypercalciuria: kidney stones Pathological fractures ```
94
Primary hyperparathathyroidism
Excess secretion of PTH from one or more parathyroid glands
95
Secondary hyperparathyroidism
Increase in PTH secondary to chronic hypocalcemia
96
Hypoparathyroidism
Abnormally low PTH levels
97
Hypoparathyroidism is usually caused by
Parathyroid damage in thyroid surgery
98
Hypoparathyroidism manifestations
Hypocalcemia - Chvostek’s and Trousseau’s signs Hyperphosphatemia
99
Thyroid carcinoma is the most common
Endocrine malignancy
100
Thyroid carcinoma most common cause
Ionizing radiation
101
How to treat thyroid carcinoma
Thyroidectomy Suppression therapy Radiation Chemotherapy
102
Alterations of adrenal function
``` Cushing’s disease Cushing’s syndrome Congenital adrenal hyperplasia Hyperaldosteronism Hypersecretion of adrenal androgens and estrogens Adrenocortical hypofunction Adrenal medulla hyperfunction ```
103
Cushing’s disease
Excessive anterior pituitary secretion if ACTH
104
Cushing’s syndrome
Manifestations resulting from chronic excess cortisol
105
Hyperaldosteronism
Primary (Conn’s syndrome) and secondary
106
Hypersecretion of adrenal androgens and estrogens
Feminization | Virilization
107
Adrenocortical hypofunction
Addison’s disease (primary adrenal insufficiency) - addisonian crisis Secondary hypocortisolism
108
Adrenal medulla hyperfunction caused by
Tumours derived from the chromaffin cells of the adrenal medulla
109
Diagnostic test for alterations of adrenal function
``` Lab tests: Hormone level Stimulation of suppression testing Imaging Biopsy ```
110
Antithyroid medications considerations
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
How to monitor therapeutic response of antithyroid medications
Thyroid drugs: Decreased symptoms for hypothyroidism, improved energy levels, improved mental and physical stamina Antithyroid drugs: No evidence of hyperthyroidism

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