Hormones

Question 1

Which amines act via cAMP?

Answer 1

Adrenaline
Pituitary hormones (not GH, PRL)

Question 2

Which proteins act via cAMP?

Answer 2

Glucagon
Somatostatin

Question 3

What is cAMP?

Answer 3

Regulator of cellular function.
A second messenger

Question 4

How does cAMP act?

Answer 4

via separate G protein: Gs + Gi

Question 5

What is Gs?

Answer 5

A stimulatory protein, it raises levels of cAMP intracellulary

Question 6

What is Gi?
What does it do?

Answer 6

Inhibitory protein, decreases the levels of cAMP intracellularly

Question 7

If Gs is ‘on’ or mutated..what condition occurs?

Answer 7

on = Acromegaly

mutated -> hyperfunction = McCune Albright

Question 8

Which hormones act at Tyrosine Kinase Receptors?

Answer 8

Insulin
GH + PRL

Question 9

In starvation all hormones levels fall except…

Answer 9

Glucagon

Question 10

In starvation and stress (anorexia) all hormones levels fall except…

Answer 10

Glucagon
GH
Glucocorticoids

Question 11

What condition is caused by XS prolactin?

Answer 11

Galactorrhoea

Question 12

Which medications cause a rise in galactorrhoea?

Answer 12

SSRIs
Anti-emetics (metoclopromide)

Question 13

What effect does a seizure have on the anterior pituitary?

Answer 13

causes a rised PRL -> glactorrhoea

Question 14

How is prolactin suppressed?

Answer 14

Dopamine agonists

Question 15

Name two Dopamine agonists:

Answer 15

Bromocriptine
Cabergaline

Question 16

Name 2 conditions causing Gynaecomastia

Answer 16

Kallmans
Kleinfelters

Question 17

Name 3 the causes of gynaecomastia

Answer 17

Hypogonadism
Hyperthyroisidm
ETOH

Question 18

Name 2 drugs known to cause gynaecomastia

Answer 18

Digoxin
Spironolactone

Question 19

Which tumours are most likely to cause gynaecomastia?

Answer 19

eostrogen producing:
- lung
- pancreatic
- gastric seminoma

Question 20

Regarding Calcium haemostasis, how does parathyroid control calcium levels?

Answer 20

Parathyroid hormones:
Mobilise ca++ from bone
Inhibit ca++ at kidney

Question 21

how does vitamin D control calcium levels?

Answer 21

controls absorption at gut

Question 22

Vitamin D undergoes 2 stage activation, where does this occur?

Answer 22

1. Liver = 25-hydroxylation
2. Kidney = 1-hydroxylation

Question 23

How does ANP lower circulating volume?

Answer 23

naturetic = promotes Na++ excretion to reduce circulating volume.

Question 24

Where is ANP released from?

Answer 24

R atrium > ventricle

Question 25

Where is BNP released from?

Answer 25

Ventricle (esp in HF)

Question 26

What is the role of BNP?

Answer 26

Acts locally, to reduce ventricular fibrosis

Question 27

Where is CNP released from?

Answer 27

From vascular endothelium (not cardiac myoctyes)

Question 28

Name the hormones of the anterior pituitary

Answer 28

LH, FSH, TSH, GH, ATCH, PRL

Question 29

Which 2 hormones are secreted form the postereior pituitary?

Answer 29

ADH (aka Vasopressin), Oxytocin

Question 30

10% of pituitary tumours produce XS ACTH, what does this cause?

Answer 30

Cushings

Question 31

What is Nelsons syndrome?

Answer 31

growth of a pit. tumor in the pituitary gland post adrenalectomy (for cushings) No longer opposed by high cortisol levels

Question 32

What is pituitary apoplexy?

Answer 32

Sudden haemorrhage into a pituitary tumour

Question 33

How would pituitary apoplexy present?

Answer 33

Headache neck stiffness, blindness -> Shock

Question 34

How is pituitary apoplexy treated?

Answer 34

Steroids first

Question 35

What is cranial diabetes insipidus?

Answer 35

pituitary failure to secrete ADH

Question 36

What is nephrogenic diabetes insipidus?

Answer 36

resistance: failure for ADH to act at kindey

Question 37

How is diabetes insipidus investigated?

Answer 37

1. water deprivation test - polydipsia v polyuria 2. DDAVP (synthetic ADH)

Question 38

What is SIADH?

Answer 38

Syndrome of high ADH 'concentrated, salty piss' (dilute serum sodium)

Question 39

In maintaining haemostasis, what prompts ADH release?

Answer 39

1. increasing plasma osmolality 2. hypovolaemia

Question 40

How does ADH act?

Answer 40

water retention at the distal tubule.

Question 41

How do high levels of ADH cause hyponatremia?

Answer 41

-> Water retention = poor PU. Water intake > urine output = development of hyponatremia. Dilute blood + Conc. urine.

Question 42

Which drugs have potential to cause SIADH?

Answer 42

opiates duiretics carbemazepine sulphonylurea

Question 43

What lung pathology has potential to cause SIADH?

Answer 43

Lung injury, Pneumonia SCLC

Question 44

What CNS related pathology has potential to cause SIADH?

Answer 44

Seizure Cerebrovascular accidents Head injury (almost any CNS insult)

Question 45

Outline the order of development in female puberty

Answer 45

Growth (height) Breast development Menstruation Pubic hair (girls grow breasts then menstruate in public)

Question 46

Outline the order of development in male puberty

Answer 46

Scrotal thickening Testicular enlargement Pubic hair Growth of phallus + height (boys get thick testicles before they publicly grow)

Question 47

What is meant by precocious puberty?

Answer 47

*Multiple* signs of puberty develop before age 8 F and age 9 M

Question 48

Causes of female Precocious puberty include:

Answer 48

1. Adrenal or ovarian tumour 2. Exogenous estrogen 3. McCune Albright (G protein dysfunction)

Question 49

Causes of male Precocious puberty include:

Answer 49

1. C.A.H 2. Testotoxicosis 3. Adrenal tumour

Question 50

Which cause of delayed puberty with normal height features anosmia?

Answer 50

Kallmans XY

Question 51

Which cause of delayed puberty with normal height features Gynaecomastia + small testes?

Answer 51

Kleinfelters XXY

Question 52

Which cause of delayed puberty with reduced height features deafness and aortic root dilation?

Answer 52

Turners XO