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Physiology Block III > Hypothalamopituitary Axis & Adrenal > Flashcards

Hypothalamopituitary Axis & Adrenal Flashcards

1
Q

What are the 3 classes of hormones?

A

Amines
Steroids
Peptides

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2
Q

Amine hormones are all derivatives of:

A

Tyrosine

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3
Q

T/F. The amine hormone formed by any given tissue depends on the synthetic enzymes that it possess

A

TRUE

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4
Q

What enzyme is in the ADRENAL medulla that produces EPINEPHRINE?

A

Enzyme 3 = PNMT

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5
Q

What hormone that is categorized as an amine is NOT produced in the Adrenal Gland?

A

Thyroid hormone

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6
Q

A steroid secreting cell would be dominated by (Granular or Agranular) Endoplasmic Reticulum?

A

Agranular - associated with lipid-soluble substances

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7
Q

The cortical portion of the medulla does not create amines (N, NE), instead if we deliver cholesterol they’ll make:

A

STEROIDS (cortisol, aldosterone, sex hormones)

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8
Q

What are the 3 zones of the medullary cortex and what specific steroids do they produce?

A

Zona Reticularis –> Androgens,
Zona Fasciculata –> Cortisol,
Zona Glomerulosa –> Aldosterone

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9
Q

What is an example of a GLUCOcorticoid?

A

CORTISOL

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10
Q

What is an example of a MINERALOcorticoid?

A

Aldosterone

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11
Q

What is an example of an Androgen?

A

DHEA and androstenedione

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12
Q

What is the FIRST RATE-LIMITING enzyme involved in creating steroids from Cholesterol?

A

Cholesterol desmolase

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13
Q

Which hormone controls the activity of Cholesterol desmolase?

A

ACTH

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14
Q

What other hormone can step in and activate cholesterol desmolase in the absence of ACTH?

A

Luteinizing hormone (LH)

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15
Q

What role does ANGIOTENSIN II have in steroid syntheisis?

A

It activates an enzyme (aldosterone synthase) in the last step in the formation of ALDOSTERONE (a mineralocorticoid)

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16
Q

What enzyme is another regulatory step in the formation of Aldosterone?

A

21B-hydroxylase

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17
Q

What enzyme is CRUCIAL in the formation of Cortisol and Androgens?

A

17a - hydroxylase

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18
Q

T/F. Steroid hormones have a direct action on a systolic or nuclear receptor that controls gene transcription.

A

True (they are lipid-soluble and do not require a receptor and can move in cell freely into cytoplasm to influence)

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19
Q

When GROWTH HORMONE binds to its TYROSINE KINASE receptor it phosphorylates a second messenger to have a DIRECT EFFECT ON_______

A

TRANSCRIPTION

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20
Q

T/F. Like growth hormone, CORTISOL is released in a pulsatile fashion throughout the day.

A

TRUE - it has a DIURNAL pattern of release

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21
Q

The LOWEST secretory rate of CORTISOL occurs:

a. Late morning
b. Afternoon
c. Late evening/early morning

A

C - preparing for sleep!

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22
Q

What does the HPA in “HPA-Axis” stand for?

A

Hypothalamus,
Pituitary,
Adrenal Gland

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23
Q

Neural inputs from the brain travel from the _______ to the ______________ to the ____________, which releases cortisol onto TARGET tissues.

A

Hypothalamus,
Anterior Pituitary,
Adrenal gland

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24
Q

_____ causes the Hypothalmus to release ______ which travels to the _______ Pituitary to stimulate it to release _________, which travels to the Adrenal Gland to release ______, which has metabolic effects on target tissues.

A

STRESS causes the Hypothalmus to release CRH which travels to the ANTERIOR Pituitary to stimulate it to release _ACTH, which travels to the Adrenal Gland to release _CORTISOL, which has metabolic effects on target tissues.

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25
Q

Which steroid has all the SAME FEEDBACK mechanisms as cortisol, and such can be used clinically to determine if the HPA axis is defective.

A

DEXAMETHASONE

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26
Q

T/F. Glucosteroids stimulate bone formation.

A

FALSE - it inhibits it (most of its actions are CATABOLIC)

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27
Q

Cortisol acts in unison or in contradiction to INSULIN?

A

CONTRADICTION - has ANTI-Insulin effects (is catabolic)

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28
Q

What is Cortisol’s effect on vascular responsiveness to catecholamines (E, NE)?

A

Produces adrenergic receptors and ENHANCES responsiveness of the system.

29
Q

What effects does Cortisol have on GFR?

A

Increase. It increases the sympathetic NS response

30
Q

What electrolyte findings are related to Aldosterone?

A

Increase K + H SECRETION (becomes MORE alkaline),

Increase Na REABSORPTION

31
Q

T/F. Biosynthesis of ALDOSTERONE depends, in part on the secretion of ACTH.

A

True. - All steroids do

32
Q

What are some STIMULATORY factors on ACTH secretion and thus steroid formation?

A

STRESS!,
Decreased blood cortisol levels (+feedback),
Beta-blockers

33
Q

What are some INHIBITORY factors on ACTH secretion and thus steroid formation?

A

Increased blood cortisol levels (- feedback),
Opioids,
somatostatin

34
Q

What are some SYMPTOMS of ADRENAL INSUFFICIENCY and thus DECREASED CORTISOL?

A

weakness, lethargy, appetite loss, low BP, hypoglycemia,

35
Q

Would adrenal insufficiency be primary or secondary if labs showed low ACTH AND low Cortisol levels?

A

SECONDARY - due to loss of pituitary

36
Q

If ACTH was High and Cortisol was still low, where is the problem?

A

PRIMARY ADRENAL INSUFFICIENCY. The pituitary is pumping out enough ACTH.

37
Q

Primary Adrenal HYPERplasia, caused by CUSHING’s SYNDROME, would have what kind of Cortisol and ACTH levels?

A

HIGH cortisol,

LOW ACTH

38
Q

If BOTH ACTH and CORTISOL are ELEVATED, what could be the cause?

A

CUSHING’S DISEASE - tumor in the PITUITARY

39
Q

What are some clinical manifestations of Cushing’s Disease?

A

Moon facies,
Buffalo hump,
thinning skin

40
Q

What’s the fancy name for PRIMARY ADRENAL INSUFFICIENCY?

A

Addison’s Disease

41
Q

If Cortisol levels are low, like in Addison’s disease and pituitary insufficiency, what would we expect the BP to be like?

A

LOW

42
Q

In Excess cortisol levels, like in Cushings syndrome and disease, what would be expect BP to be?

A

HIGH

43
Q

What are potential adverse effects of being deficient in 17a-hydroxylase, the enzyme for cortisol and Androgen production?

A

a MASCUlNE HYPOtensive person

44
Q

What 2 PEPTIDE HORMONES are released from the POSTERIOR PITUITARY?

A

ADH (Vasopressin)
&
Oxytocin

45
Q

How is the travel of the signal from the HYPOT to the Anterior pituitary different than that of the POSTERIOR pituitary?

A

Anterior works through a chain of releasing another hormone (CRF). The posterior travels through the stalk via neurons and doesn’t release any hormones until it gets all the way there.

46
Q

What is the name of the stalk that connects the Hypothalamus to the Pituitary?

A

INFUNDIBULUM

47
Q

What is contained in the Infundibulum and which portion of the Pituitary receives its signals from which?

A

Neurons –> POSTERIOR,

Blood vessels –> ANTERIOR

48
Q

T/F. The Anterior and Posterior divisions of the pituitary are derived from the same embryonic origins.

A

FALSE!,

Posterior (neurohypophysis)<– Rathke’s Pouch

49
Q

2 separate NUCLEI in the Hypothalamus will carry signals down their axons to create 2 peptides released at POSTERIOR pituitary, what are they?

A

Supraoptic –> ADH,

Paraventricular –> Oxytocin

50
Q

What does Oxytocin act on?

A

Smooth muscle of breast and uterus

51
Q

Why do we want the nucleus of the Supraoptic to be situated right next to osmolarity sensing cells?

A

Because ti will determine how much ADH we need (antidiuretic hormone).
Hyperosmotic = Increase release of ADH

52
Q

These CAPILLARIES at the base of the hypothalamus flow through the infundibulm and target the ANTERIOR PITUITARY to carry hormones in the HPA axis.

A

MEDIAN EMINENCE

53
Q

Beside just CRH (cortisol releasing hormone), there are many hormones being released by the HYPOTHALAMUS that target the ANTERIOR pituitary, these are called:

A

HYPOPHYSIOTROPHIC HORMONES

54
Q

What are some examples of Hypophysiotrophic hormones being secreted by the Hypothalamus, and what do they secrete at Ant PIT?

A 
CRH --> ACTH, 
GnRh --> FSH, LH, 
GHRH --> Growth hormone, 
SS (somatostatin), 
TRH (thyroid releasing hormone) --> TSH, 
DA -->Prolactin
55
Q

Of the hormones that are secreted by the Anterior Pituitary, which ones have a “UNIVERSAL” effect and target all cells?

A

Growth factor,
thyroid,
Cortisol

56
Q

What are the effects of Growth hormone at the liver and organs and tissues?

A

Liver –> secretes IGF-1 (somatomedin) –> PROMOTES CELL DIVISION

Organs/Tissues –> Protein synthesis + ANTI-INSULIN effects = CHO & Lipid metabolism

57
Q

What is the principle hormone for POSTNATAL GROWTH?

A

GH

58
Q

The effects of growth hormone are not direct, but instead through:

A

Somatomedin (IGF-1)

59
Q

Who are in the GANG OF FIVE ?

All have Anti-Insulin effects that work in CONCERT

A
  1. Glucagon
  2. Cortisol
  3. Epinephrine
  4. Thyroid hormone
  5. Growth hormone
60
Q

What factors INCREASE GH secretion?

A

Hypoglycemia/fasting,
slow-eave sleep,
Fever/emotional trauma,
Estrogen

61
Q

What factors DECREASE GH secretion?

A 
Obesity, 
REM sleep, 
Cortisol, 
Progesterone, 
Somatostatin
62
Q

T/F. Obesity will retard growth

A

TRUE

63
Q

Linear growth of long bones end with the closure of what?

A

Epiphyseal plate at end of puberty

64
Q

Different growth rate for various organs are seen, which organ develops first?

A

Brain, followed by height and reproductive organs last

65
Q

Most ENDOCRINE DISORDERS fall into these 4 categories:

A
  1. HYPOsecretion (too little)
  2. HYPERsecretion
  3. HYPOsensitivity (reduced response)
  4. HYPERsensitivity
66
Q

The most common cause of HYPERsecretion is:

A

TUMOR

67
Q

Excess GH in PRE-Puberty (BEFORE epiphyseal plate closes), can result in what?

A

GIGANTISM

68
Q

Excess GH in POST-Puberty (AFTER plate closes), can result in what?

A

ACROMEGALY

69
Q

Decrease GH in PRE-PUBERTY, can result in what?

A

DWARFISM

Physiology Block III (8 decks)

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