hormones Flashcards
1
Q
What does oxytocin do?
A
Works on the breast to eject milk
positive feedback with contraction strength
2
Q
what cell in the breast tissue does oxytocin act on?
A
myoepithelial cells
3
Q
What area in the breast tissue does PRL work on?
A
alveolar
4
Q
What area is MSH produced in AP?
A
Pars Nervosa
5
Q
What nucleus releases ADH?
A
Supraoptic
6
Q
What nucleus releases oxytocin?
A
paraventricular
7
Q
What antibody do you test for with graves dz
A
TSI
TSHR
8
Q
What antibody test do you run for hashimotos?
A
Anti TPO
9
Q
What is the release pattern of GH?
A
pulsatile; peaks during sleep
10
Q
What are release triggers for GH?
A
stress exercise DEC glucose/FA high protein meal fasting ghrelin levodopa apomorphine bromocriptine
11
Q
What pathway does GH work through when it binds to its receptor?
A
JAK/STAT (nontyrosine kinase)
12
Q
What are the actions of GH?
A
decreases adiposity
decreases glucose use (inc BG)
13
Q
What are the actions of IGF1?
A
inc lean muscle mass
inc linear growth
inc organ growth
14
Q
What can inc GH cause?
A
children: gigantism
adults: acromegaly
15
Q
What are the characteristics of congenital short stature?
A
normal GH
lack of IGF1 during puberty
16
Q
What pathway/receptor does GHRH work through?
A
G protein
cAMP and inc Ca
17
Q
Is there anything that inhibits GH release?
A
YES! somatostatin
18
Q
What is the release pattern for PRL
A
pulsatile
19
Q
What pathway does PRL work through?
A
JAK/STAT (non tyrosine kinase receptor)
20
Q
What does PRL do?
A
breast development
milk production
inhibition of gonadotropins
21
Q
What stimulates PRL release?
A
suckling, stimulation, stress, sleep, neurogenic reflex, phenothiazines, INC estrogen, pregnancy
22
Q
what inhibits PRL? non hormonal inhibition?
A
dopamine, bromocriptine, apomorphine
23
Q
What can excess PRL cause?
A
galactorrhea, infertility, amenorrhea, decreased libido, dec spermatogenesis
24
Q
What two things are associated with inc PRL?
A
prolactinomas, empty sella syndrome
25
What receptor does TRH work through?
g prot to IP3 to inc Ca
26
What receptor does TSH work through?
g prot to cAMP
27
What are the actions of thyroid hormones?
bone and CNS maturation
inc BMR ( inc heat production)
Inc CO
inc metabolism
28
What are the symptoms of hyperthyroidism?
```
wt loss
sweating
inc CO
tremor/muscle weakness
exopthalmos
```
29
What are the symptoms of hypothyroidism
```
wt gain
cold sensitivity
lethargy, mental slowness
drooping eyelids
myxedema
growth retardation
mental retardation
```
30
What is the treatment for graves?
PTU
31
What is the effect of hyperthyroidism on T4, TSH, and binding proteins?
T4-high
TSH-low
proteins- normal
32
What is the effect of hypothyroidism on T4, TSH, and binding proteins?
T4-low
TSH-high
proteins-normal
33
What will happen with a cholesterol desmolase deficiency?
rate limiting step from cholesterol to pregnenolone
| fatal
34
What will happen with a 3 beta hydroxy steroid dehydrogenase deficiency?
```
no cortisol
no aldo
no androgens
DHEA build up
fatal
```
35
what will happen with a 17 alpha hydroxylase deficiency?
very low cortisol and androgens
inc aldo
both sexes have female phenotype
hypokalemia
36
What will happen with a 21 beta hydroxylase deficiency?
very low cortisol and aldo (na loss and hypotension)
DHEA and androgen build up (virilization, hirsutism, amenorrhea)
females born with ambiguous genitalia and raised as male
associated with congenital adrenal hyperplasia
37
What will happen with a 11 beta hydroxylase deficiency?
```
inc deoxycorticosterone (na ret and htn)
inc DHEA and androgens (virilization)
very low aldo and cortisol (as its the final enzyme needed to create them)
```
38
What enzyme deficiency is most common?
21 beta hydroxylase
39
What stim aldo?
ang II
40
what downregulates aldo?
ANP
41
what are the effects of cortisol?
```
inhibits protein synth
promotes FA use
dec glucose use
stim gluconeogenesis
antiinflammatory
```
42
What receptor does CRH work through?
g prot to cAMP to ca
43
what receptor does ACTH work through
g prot to cAMP
44
what is the release pattern of cortisol?
circadian rhythm
45
what are stimulators of cortisol?
stress, DEC glucose
46
what happens when you lose cortisol?
circulatory failure
inability to readily mobilize energy sources
inhibits t cell production
47
what is the most common cause of congenital adrenal hyperplasia
21 beta hydroxylase
48
what is released from the adrenal medulla?
epi and norepi
49
what is released from the zona glomerulosa
aldo
50
what is released from the zona fasciculata
cortisol
51
what is released from the zona reticulata
androgens
52
what are the signs of cushings?
moon face, striae, truncal obesity, HTN, osteoporosis, protein depletion, mental abnormalities, DM hirsutism
hypokalemia and alkalosis
53
what is the most common cause of cushings?
prednisone use
54
what is the best way to test for cushings?
24 hr cortisol
55
What are the steps for suspected hyperadrenalism?
1- low dose dexamethasone suppression test (if normal, not cushings)
2- 24 hr urine cortisol (if normal, not cushings)
3- high dose of dexamethasone suppression test
56
What do the results of the high dose dexamethasone test signify:
1) >50% decrease in cortisol
2) no response
3) ACTH level high
4) ACTH level reduced
1) cushings due to pituitary adenoma
2) ACTH secreting tumor
3) ACTH secreting tumor from another source ie lung
4) adrenal tumor
57
What is conn's syndrome? how is it diagnosed
inc levels of aldo
primary hyperaldosteronism
inc ratio PAC/PRA = 25-50
58
how do you test for primary aldosteronism?
saline suppression test
measure PAC
if falls below 5- normal
if remains above 10- primary
59
How do you test for pheochromocytoma?
24 metanephrine and catecholamine urine collection
60
how do you confirm pheo presence?
give clonidine to suppress
| MRI or CT
61
What test should you always run with a suspected pheo?
MIBG to see if theres any extra adrenal tumors
62
What are the actions of PTH in the kidney?
inc Ca reabsorption
inc PO4 excretion
inc act of vit D
63
What are the actions of PTH in the GI tract?
inc vit D -> inc Ca absorption
64
what are the action of PTH on the bone?
inc bone resorption
through osteoblast cytokines to osteoclasts
RANKL binding RANK
65
What is measured to see if bone is being broken down?
alkaline phosphatase
66
what is the job of calcitonin?
antagonizes PTH
dec bone resorption
dec kidney reabsorption of Ca
67
how does PTH respond in acidosis?
inc ionized Ca
| so no PTH release
68
how does PTH respond in alkalosis?
dec ionized Ca
| inc PTH release
69
what cells secrete PTH?
chief cells
70
Other than calcium, what stimulates PTH?
dec Mg
| inc PO4
71
what does dec PO4 do?
inc vit d activation
72
what does inc PTHrP signify?
malignancy
73
What pathway does Ca inhibition of PTH work through?
G prot with IP3 releases Ca and inhibits PTH release
| stim by Ca
74
what pathway does PTH work through on the kidney?
g prot to camp to protein kinase to phos of phosphate/Na symporter dec the phos reabsorption
75
what is the treatment for hypoparathyroidism
Vit D
| Ca supplement
76
what do the labs look like for primary hyperparathyroidism (PTH, Ca, P, Vit D)
inc PTH
inc Ca
dec P
inc Vit D
77
what do the labs look like for secondary hyperparathyroidism (PTH, Ca, P, Vit D)
inc PTH
dec Ca
dec P
dec Vit D
78
what do the labs look like for primary hypoparathyroidism (PTH, Ca, P, Vit D)
dec PTH
dec Ca
inc P
79
what do the labs look like for secondary hypoparathyroidism (PTH, Ca, PO4, Vit D)
dec PTH
inc Ca
inc P
Inc Vit D possibly
80
what do the labs look like for pseudo hypoparathyroidism (PTH, Ca, P, Vit D)
*resistance to PTH
inc PTH
dec Ca
inc P
81
what do the labs look like for postmeno/immobilization hypoparathyroidism (PTH, Ca, P, Vit D)
dec PTH
inc Ca
inc P
*bone being broken down
82
what do the labs look like for inc PTHrP hypoparathyroidism (PTH, Ca, P, Vit D)
```
dec PTH
inc Vit D
inc Ca
inc urine phosphate
dec P
*acts like PTH
```
83
what do the labs look like for renal failure (PTH, Ca, P, Vit D)
inc PTH
dec Vit D
dec Ca, due to dec in Vit D
dec P
84
What is familial hypocalciuria hypercalcemia?
mutated Ca receptor -> inc Ca levels
| takes mores Ca to turn off PTH than normal
85
what stim act of Vit D
inc PTH
dec Ca
dec P
86
what 3 things stimulate insulin secretion?
inc blood glucose
inc CCK, GIP
inc parasympathetic activity
87
what is insulins action on hepatocytes/
inc hexokinase which leads to inc glycogen
88
how does dec insulin lead to polyphagia?
insulin usually feeds back to the hypothalamus to tell you that you are full
when there is none, the body thinks theres low glucose and tells you to eat
89
how does dec insulin lead to polyuria and polydipsia
inc blood glucose leads to diuresis and inc plasma osmolarity both lead to thirst center activation
90
how does dec insulin lead to kussmaul breathing
leads to inc ketones -> metabolic acidosis -> inc RR
