Hormones Flashcards
Organs in the endocrine system
Hypothalamus & pituitary Thyroid & parathyroid Adrenals Islets of Langerhans Ovaries and testes Placenta Digestive system
Hormone functions
-homeostasis
-regulate growth and development
-sexual maturation, sexual rhythms and reproduction
-regulate energy production
-adapt/adjust to stress/emergency situations
=promote/inhibit production/release of other hormones
hormones composed of amino acid residues, water soluble, and have a short half life
Polypeptide hormones
Function of polypeptide hormones
Interact with target receptors, trigger second messengers to complete specific action of the hormone
derived from amino acids, water soluble, interact with receptors of target cells
amines
half life of polypeptide hormones
<30 minutes
Thyroxine (amine) half life
7-10 days
Catecholamine (amine) half life
<1 minute
Hormones derived from cholesterol cycoperhydrophenathrene ring structure
steroid hormones
steroid hormone characteristics
hydrophobic
- bound reversibly in blood to carrier proteins
- unbound version is active
steroid hormone half life
30-90 minutes
Originate from anterior pituitary gland, specific from another endocrine gland
ex. TSH targets thyroid gland
Tropic hormones
Act on peripheral tissue
exert a feedback effect on the hypothalamus or anterior pitutary gland
ex. growth hormone
direct effector hormones
target receptors
- located on cell membrane/cytoplasm
- binding of hormone to receptor initiates a signal, causing a biological response
defect in target receptor,,,,
- disease
- absence/defect of feedback
ex. goiter formation –> TSH stimulation of thyroid due to decrease in circulating T3 and T4
increase in product causes a decrease in the system
- stabilizes a process
- hormone regulation
negative feedback
increase in product causes increase in activity of system
positive feedbakc
Disorder with a target gland, in presence of normal stimuli
feedback
Primary feedback disorder
Target gland functions normal in the presence of stimuli, abnormal in absence of stimuli
Secondary feedback disorder
Regulation of hormone occurs by controlling rate of _____ rather than rate of _____
synthesis, degredation
Primary control gland of hormones
hypothalamus
hypothalamus role in regulation
releases hormones that stimulate/inhibit secretion of anterior pituitary hormones
- activated by CNS
- emotion or stress to secrete one or more releasing factors
Releases TSH and Prolactin
Thyrotropin Releasing Hormone
Releases LH and FSH
Gonadotropin Releasing Hormone
Releases ACTH
Corticotropin releasing hormone
Releases GH
Growth hormone releasing hormone
Inhibits GH and TSH release
Somatostatin
Inhibits Prolactin release
Prolactin Inhibiting Hormone
Small gland located at the base of the skull
lies within sella turcica
Anterior pitutary
Where hormones which target other endocrine gland are stored
Anterior pituitary
Stores and releases oxytocin and vasopressin (ADH). Releases both tropic and direct effector hormones
Posterior pituitary
Targets gonads, tropic hormone, function in ovulation and testosterone production
Luteinizing hormone
targets gonads, tropic hormone, functions in estrogen synthesis and spermatogenesis
Follicle stimulating hormone
Targets thyroid, tropic hormone, stimulates thyroid hormone production
Thyroid stimulating hormone
Targets adrenal cortex, tropic hormone, stimulates synthesis and secretion of glucocorticoid hormones
Adrenocorticotropin hormone (ACTH)
Targets liver and bone, direct effector hormone, stimulates tissue growth
Growth hormone
Targets breast, direct effector, functions in secretion
Prolactin
also called somatotropin, peptide with direct effector functions
Growth hormone
inhibited by somatostatin, release is stimulated by GHRH
growth hormone
amphibolic
influences both anabolic and catabolic processes
growth hormone and metabolism
- effective transition from a fed state to fasting state
- antagonizes effect of insulin on glucose
- hepatic gluconeogenesis
- enhances protein synthesis
diurnal variation of growth hormone
- secretion in pulse every 2-3 hours
- peaks at onset of sleep
elevated growth hormone
- adenomas on pituitary
- acromegaly
- artherosclerosis, diabetes, arthritis, hypertension
- shortened life expectancy
Decreased growth hormone
- tumors, pituitary abnormalities
- GH replacement therapy possible
Genetic defects with decreased GH
- recessive GHRH gene
- loss of GH gene
- GH insensitivity
- lesions of pituitary or hypothalamus
prolactin is stimulated by
TRH
prolactin is inhibited by
Prolactin inhibiting factor (dopamine)
prolactin elevation symptoms
- tumor
- premenopausal women, menstrual irregularities
- oligospermia/impotence
most common pituitary tumor
prolactinoma
promotes growth and uptake of iodine by thyroid gland.
TSH
under negative feedback control by thyroxine
TSH
TSH and hypothyroidism
serum TSH is elevated due to absence of negative feedback
adrenal steroids
-glucocorticoids (cortisol)
-mineralcorticoids (aldosterone)
androgen (sex hormone precursors)
diurnal variation of ACTH
peak: 6-8 am
lowest: 6-11 pm
stimulates the production of adrenal steroids
ACTH
hypothalamus secreted GNRH which is responsible for secretion of both gonadotropins __ and __
FSH and LG
serves to promote ovulation, formation of corpus luteum, and secretion of progesterone and androgens
Luteinizing hormone
stimulates growth of follicles and development of seminiferous tubules, spermatogenesis
Follicle-stimulating hormone
lactation, stimulates smooth muscle (urine), enhance labor (posterior pituitary hormone)
oxytocin
regulates water excretion in renal tubules (posterior pituititary hormone)
vasopressin(ADH)
_____ osmolality receptors and blood pressure regulate the release of ______
hypothalamus, vasopressin
deficiency of ADH is associated with ______
diabetes insipidus
neurogenic/hypothalamuc diabetes insipidus
absence of deficient ADH secretion
Nephrogenic diabetes insipidus
Renal resistance to action of ADH, synthesis is normal but renal response is defective
continuous production of ADH in the absence of known stimuli
SIADH
SIADH causes
tumor, CNS injury, pulmonary disease, infection, stress, drugs
SIADH lab results
decreased Na+ (serum)
Decreased serum osmolality
Increased Na+ (urine)
Increased urine osmolality
pyramid shaped gland located medial to kidneys
Adrenal glands
Anatomy of adrenal glands
inner/outer medulla
hormones synthesized from cholesterol precursor
Adrenal microscopic anatomy
- zona glomerulosa
- zona Fasciculata
- zona Reticularis
- Adrenal medulla
Zona _____ is the outermost layer, synthesizes mineralcorticoids
Glomerulosa
Zona ______, middle layer, synthesize glucocorticoids
Fasciculata
Zona ______, inner layer, secretes gondaocoricoids
Reticularis
Adrenal Medulla synthesizes _____
catecholamines
G zone hormone (blood pressure and serum potassium)
Aldosterone
F zone hormone (Blood pressure and glucose)
Cortisol
R zone hormone (virulization and Sex)
Testosterone and Estradol
mineralocorticoids
regulate electrolytes, critical for sodium retention, potassium, and acid-base homeostasis
Aldosterone
controlled by RAAS, promote potassium secretion, increases plasma sodium, increases water retetention
adrenal insuffciency, low glucocorticoids and mineralcorticoids
Addison’s disease
Primary Addison’s disease
Atrophy or destruction of adrenal cortex. Idiopathic or autosimmune destruction
Secondary Addison’s disease
Hypothalamic/pituitary disease
how to diagnose Addison’s disease
ACTH stimulation test
Clinical features of addison’s disease
decreased cortisol, decreased aldosterone, decreased Na+, increased K+, increased H+, decreased pH, increased ACTH, anemia
manifestations of Addison’s disease
increased skin pigmentation, tiredness, intestinal issues, hypotension, hypoglycemia, hyperkalemia, hyponatremia, hypochloremia, loss of body hair, depression
Hallmarks of Addison’s disease
Low cortisol, Low Aldosterone, High Renin, Increased ACTH
Conn’s Syndrome
Hyperaldosteronism
Primary hyperaldosteronism
Aldosterone-secreting adrenal adenoma of adrenal cortex. (decreased renin, hypertension)
Secondary hyperaldosteronism
Disorder within RAAS system
Conn’s Syndrome lab results
- decreased K+
- increased Na+
- increased Aldosterone
- acid/base imbalance (alkalosis)
- decreased renin
manifestation of Conn’s syndrome
- muscle weakness
- increased urination
- hypertension
- cardiac arrhythmias
primary glucocorticoids
cortisol
glucocorticoid functions
- insulin antagonist
- mobilizes fat for energy
- break down muscle
- maintain blood pressure
- reduce inflammatory response
- stress response
cortisol regulation
hypothalamus secretes CRH, CRH activates ACTH, ACTH controls cortisol production
low cortisol = ____ release
increased ACTH
prolonged exogenous steroid use
Cushing’s syndrome
Primary cushing’s syndrome
Adrenal adenoma
Increased cortisol, increased ACTH
Secondary cushin’s syndrome
Pituitary adenoma
- increased Cortisol
- increased ACTH
manifestations of Cushing’s syndrome
Weight gain, buffalo hump back, muscle wasting, easy bruising, hypertension, osteoporosis, hyperglycemia, increased lipids, decreased HDL
Cortisol diurnal variation
Peak: morning
Lowest: late-evening
Dexamethasone test
causes suppresion of pituitary output of ACTH and yields lowered morning cortisol
Cushing’s System and diurnal variation
Loss of diurnal variation, cortisol remains high, negative feedback lost
dexamethasone supression test protocol
- measure baseline serum cortisol
- give 1.0 mg of dex at night
- measure serum cortisol next morning
dexamethasone suppression test interpretation
- suppression to <5ug/dL rules out Cushing’s
- Patients with Cushing’s syndrome will fail to suppress morning cortisol
primary hyperaldosteronism hormones
high aldosterone, normal cortisol, low renin
secondary hyperaldosteronism
high aldosterone, normal cortisol, high renin
addison’s disease hormones
low aldosterone, low cortisol, high renin
cushing’s syndrome hormone
low aldosterone, high cortisol, low renin
cotecholamines
nonsteroid, amine-type hormone. Derrived from tyrosine, circulate low levels, rapidly fluctuate
catecholamine hormones
norepinephrine, noradrenaline, epinphrine, adrenaline, dopamine
pheochromocytoma
tumor in neurochromaffin cells of adrenal medulla that produces excess catecholamines, causes hypertension, headache, sweating, anxiety
neuroblastoma
common malignant tumor in pediatric patients, tachycardia, diarrhea. Increased VMA, HVA
testosterone
maintains secondary sex characteristics and sperm, 95% bound to albumin
hormonal control of testicular function
hypothalamus generates GNRH in pulse-like fashion, GNRH is released an determine rate of production of LH and FSH, LH and FSH activate testosterone production,
Klinefelter’s syndrome XXY
Impotence, decreased testosterone, increased FSH and LH. Gynecomastia, type 2 diabetes
estrogen functions
promotes breast, uterine, vaginal development. Secondary sex characteristics, produced by placenta and ovaries
Progesterone function
prepares endometrium for implantation, responsible for increase in body temperature at time of ovulation
FSH function
promote growth of follicles, stimulates estrogen production
LH functions
triggers ovulation
estradiol (E2)
Primary sex hormone of childbearing women, aids in release of egg from ovaries, reduction causes hot flashes and night sweats
estriol (E3)
Secreted from placenta during pregnancy
Estrone (E1)
Main estrogen present after menopause
hormone high in follicular phase of menses
FSH
hormone high in mid-cycle
LH
hormone high in luteal phase of menses
progesterone
hCG
classic hormone marker of pregnancy
human placental lactogen
produced by placenta
aids in hCG estrogen and progesterone synthesis
mammary gland development
progesterone and uterus
Promote growth and thickening and ensures adequate uterine blood supply and helps maintain endometrium
amenorrhea
absence of menses
primary amenorrhea
never menstruated by age 16
secondary ammenorhea
had at least one menstrual cycle but ceases for at least six months
oligomenorrhea
irregular menses
cycle length 35-40 days
menorrhagia
uterine bleeding >7 days
polycystic ovary syndrome
infertility, hirsutim, anovulation glucose intolerance, hypertension
cysts on ovaries
hirsutism
male pattern growth in women, loss of female sex characteristics
hyperesterinism
overproduction of estrogen
hypoestrinism
decreased estrogen
ex. Turner syndrome
lab tests for reproductive disorders
- total testosterone
- total estrogen
- unconjugated estriol
stimulation test (endocrine)
evaluates suspected hypo functioning gland. ex. ACTH stimulation test
suppression test (endocrine hormone assessment)
evaluate suspected hyper functioning gland. Dexamethasone test for Cushing syndrome
excess growth hormone
gigantism
growth hormone deficiency
dwarfism
ADH deficiency
D. insipidus
ADH excess
SIADH
thyroid hormone deficiency
hypothyroidism
thyroid hormone excess
hyperthyroidism
parathyroid hormone deficiency
hypoparathyroidism (RARE)
parathyroid hormone excess
hyperparathyroidism
parathyroid hormone excess
hyperparathyroidism
gucocorticoid deficiency
Addison’s disease
glucocorticoid excess
Cushing’s syndrome
ACTH deficiency
Addison’s disease (Secondary)
ACTH excess
Cushing’s syndrome
Mineralcorticoids deficiency
Addison’t disease
Mineralocorticoids excess
Conn’s Syndrome
Insulin deficiency
D. melltius
Insulin excess
Insulin shock