Hormons

Question 1

Múltiple endocrine neoplasia MEN

Answer 1

MEN 1: hyperparathyroidismo, endocrine pancreas, pituitary adenomas

MEN 2A: medullary carcinoma of thyroid, pheocromocytoma, hyperparathyroidismo

MEN 2B: medullary carcinoma of thyroid, pheocromocytoma

Question 2

Sequential loss of function of hypopituitarism

Answer 2

GH, LH-FSH, TSH, ACTH, prolactin

Question 3

Function of ADH

Answer 3

Major controller of water excretion and regulator extracellular osmolarity

Question 4

Stimulates ADH

Answer 4

Angiotensin II
CRH

Descenso de la osmolaridad en el 1%
Descenso del volumen en 10-15%

Question 5

ADH receptors

Answer 5

V1 constrict smooth muscle

V2 collecting tubules -> acuaporinas -> reabsorption of water and urea

Question 6

Action ANP

Answer 6

Increase glomerular filtration:
Dilatation afferent arteriole
Contrición efferent arteriole

Increases Na loss and water loss

Inhibits aldosterone release

Question 7

Central diabetes insipidus

Sectioning of pituitary stalk: triphasic response

Answer 7

1. Diabetes insipidus
2. SIADH
3. Return diabetes insipidus

Question 8

Central diabetes insipidus treatment

Answer 8

Replacing ADH:
Vasopresin
Desmopresin

Question 9

Difference between central and nephogenic diabetes

Answer 9

Central: sufficient ADH isn’t available, respond to therapy

Nephrogenic: inability of the kidneys to respond to ADH, not respond to therapy

Question 10

Hormones of anterior pituitary

Answer 10

TRH 😌 TSH

CRH 😌 ACTH

GnRH 😌 FSH 😌😌 LH

GHRH 😌 GH
SST 😔 GH

Dopamine 😔 prolactin
TSH (elevada anormalmente) 😌 prolactin

Question 11

Manage of rapidly hypomatremia (<48h) and severe (Na <120)

Answer 11

Treated aggressively with hypertonic saline 3% and diuretics
Or ADH antagonist

Question 12

Manage of slow-well tolerate hyponatremia

Answer 12

Replacement slow in days

Aggressive treatment result “central pontine myelinolysis”

Question 13

Regions of the medullary adrenal gland

Answer 13

Zona glomerulosA -> Aldosterone

Zona fasCiCulata -> Cortisol

Zona reticulariS -> androgenS

Question 14

Stimulus of adrenal medullary hormones

Answer 14

Angiotensina II and K -> aldosterone

ACTH -> cortisol and androgens

Question 15

ANP stimulus

Answer 15

Stretch right atrium

Question 16

Feedback to ACTH

Answer 16

Cortisol

Question 17

Principal mineralocorticoide

Answer 17

Aldosterone

Question 18

Principal glucocorticoids

Answer 18

Cortisol

Question 19

Function of 11-deoxycorticosterone

Answer 19

Weak mineralocorticoid

Question 20

Stress hormones (contrarregulatory hormones, opposite to insulin): mobilize energy store, and all of them rise plasma glucose

Answer 20

GH: lipolysis
Glucagon: glycogenolysis
Cortisol: mobilizes fat, protein, carbohydrate
Epinephrine: glycogenolysis, lipolysis

Question 21

Permissive action of cortisol

Answer 21

Enhances capacity of glucagon and catecholamines

Glucagon: glycogenolysis
Catecholamines: beta receptor; lipolysis and bronchodilator. Alfa receptor; pivotal in blood pressure regulation. ( hasn’t protein effect)

Question 22

Hypothalamic hormones synthesized in neuron cell body

Answer 22

Paraventeicular: CRH, TSH, SST
Preoptico: GnRH
Arcuato: dopamine, GHRH

Question 23

Effect of aldosterone

Answer 23

Principal cells: increase Na channels (epithelial Na channels ENaC) that reabsorbe Na and create a negative luminal place that attract K
In the luminal membrane

And activates Na/K ATPase in the basal membrane

Increase Na and water re absorption and K excretion

Intercalated cell: active H ATPase that pump out H, so results in metabolic alkalosis

Question 24

Pancreatic islets

Answer 24

Alfa: 20% glucagon
Beta: 60-75% insulina
Delta: 5% somatostatina