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Block 3 Week 5 > Intro to Endocrin > Flashcards

Intro to Endocrin Flashcards

1
Q

What is the study of hormones?

A

endocrinology

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2
Q

Do endocrine glands have ducts?

A

no

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3
Q

Where do endocrine glands secrete horomones?

A

into interstitutium to the circulation

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4
Q

How does the endocrine system maintain homeostasis?

A 
regulate salt/water balances
blood volume/pressure
regulate calcium and phosphate
regulated response to stress
regulation o reproduction, development and growth
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5
Q

What does the hypothalamus reslease?

A

GHRH, CRH, TRH, GnRH

Some inhibitory: somatostatin, dopamine, vasopressin, oxytocin

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6
Q

What do adrenal glands secrete?

A

cortisol, aldosterone, adrenal androgens, epinephrine, norepinephrine

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7
Q

What does ovaries secrete?

A

estrogen and progesterone

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8
Q

What does the pituitary glands secrete?

A

growth hormones, prolactin, ACTH, MSH,TSH, FSH, and LH

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9
Q

What does the thyroid secrete?

A

T3, T4 and calcitonin

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10
Q

What does the parathryoid gland secrete?

A

parathyroid hormone

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11
Q

What does the pancreas secrete?

A

insulin, glucagon, somatostatin

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12
Q

What does the testes secrete?

A

testosterone

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13
Q

(blank) is a molecule functioning as a message to convey information.

A

hormone (steroids, amines, peptides)

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14
Q

What does a target organ do?

A

responds to hormone

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15
Q

What is an intracellular molecule that translates the message conveyed by hormones acting on the cell surface receptor?

A

second messenger

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16
Q

When a hormone secretion has an action on a receptor in the same cell then what kind of secretion is this?

A

autocrine

ex. insulin inhibiting its own release

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17
Q

When a hormone secretion has an action on a neighboring cell then what kind of secretion is this?

A

paracrine

ex. estrogen acting on the ovaries

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18
Q

When a hormone secretion has an action outside the body and into ducts what kind of secretion is this?

A

An EXOCRINE

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19
Q

When a hormone has an action at distant organs/tissues then what kind of secretion is this?

A

Endocrine secretion

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20
Q

Explain the organization of the endocrine system

A

The hypothalamus releases hormones onto the pituitary which will release tropic hormones onto target organs , which will hit up effector hormones which will take action

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21
Q

What all does the anterior pituitary gland secrete?

A

FLAT PIG

F- FSH
L- LH
A- ACTH
T- TSH

P- Prolactin
I - (ignore)
G- GH

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22
Q

What does ACTH (adrenocorticotropic) secrete?

A

Coritosl

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23
Q

What does GH do?

A

insulin-like growth factor

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24
Q

What does TSH do?

A

releases thryoxine

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25
Q

What does FSH do?

A

ovulation and spermatogenesis

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26
Q

What does LH do?

A

releases estrogen, progesterone, and testosterone

aids in ovulation and spermatogenesis

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27
Q

What does prolactin do?

A

helps with lactation in breasts

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28
Q

Are all hormones under direct regulation by the pituitary?

A

no

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29
Q

How do proteins (hydrophillic) hormones travel in the plasma?

A

freely

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30
Q

How do hydrophobic hormones travel through the plasma?

A

Must be bound to a plasma transport protein (globulins)

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31
Q

Why do hydrophobic hormones need to be bound to globulins?

A

protect the hormones from rapid degredation and clearance

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32
Q

What do bound hormones serve as?

A

serve as reserves, ensure easy distribution

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33
Q

Are hydrophobic bound proteins active?

A

no they are inactive, they become active once they become free

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34
Q

What is the relationship between free and bound horomone?

A

dynamic

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35
Q

What are the four hormone binding proteins?

A

coricosteroid binding globulin (CBG)
Thyrotropin binding globulin (TBG)
Sex Hormone binding globulin (SHBG)
Albumin (non specific)

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36
Q

(blank) is bound to TBG (thyrotropin binding globulin) and has a half life of up to 7 days.

A

Thryoxine (T4)

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37
Q

In hypothyroid patients what should they take?

A

thyroxine (T4)

Can take doses to compensate for missed doses

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38
Q

Is PTH protein bound?

What is its halflife?

A

no

2-4 minutes

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39
Q

What can PTH be measured for?

A

It can be measured during surgery to confirm removal of a hyperfunctioning parathyroid gland adenoma.

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40
Q

Explain how hormones act

A
  • Hormones bind to receptor
  • Creates allosteric change w/in receptor
  • allosteric change translates the signal into biologic acitvity
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41
Q

Where are hormone receptors, within the cell or on the cell surface?

A

both

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42
Q

Where are cell surface receptors found?

A

located on target cell membrane

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43
Q

The cell suface receptors are integral proteins that penetrate through the membrane with (blank) domains

A

cytoplasmic effector domains (in cell) and ligand recognition domains (on surface)

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44
Q

When a hormone bonds to recognition domain on a cell surface receptor what happens?

A
  • > hormone binding
  • > initiates an intracellular signaling cascade through 2nd messengers
  • > specific biologic response
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45
Q

What are the three types of cell surface receptors?

A

G protein coupled transmembrane receptor
Receptor tyrosine kinase
ligand gated ion channel

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46
Q

Insulin phosphorylates SHC and IRS protein to do what?

A 
effect:
cell growth
protein synthesis
glycogen synthesis
glucose transport
and stimulate P13 kinase
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47
Q

When insulin phosphorylates IRS protein to stimulate PI3 kinase, what happens?

A

Glut 4 is transported to cell surface to allow glucose to be transported into a cell and begin glucose breakdown

48
Q

What does Insulin do to CBl and CAP?

A

stimulates it to translocate Glut 4 to cell surface

49
Q

In pseudohypoparathyroidism, there is (blank) of PTH receptors to PTH from defect in the G-protein. PTH levels are elevated but patient presents with symptoms of hypoparathyroidism.

A

lack of response

50
Q

How do you determine if someone has pseudohypoparathyrdoidism?

A

Measure cAMP in urine after admin of exogenous PTH (PTH decreases Calcium excretion)

51
Q

What do intracellular (nuclear) receptors do>

A
  • > mediate action of steroid hormones, vit D and thryoid homrone
  • > communicate with surface recept. via 2nd messengers
  • > transcription and gene expression
52
Q

Binding a promoter area or transcription factors (HRE) of nuclear receptor by hormone (or 2nd messenger) result in (blank)

A

transcription and gene expression.

53
Q

Explain how a steroid hormone works

A

steroid hormone enters cell, it binds to receptor and induces conformation change. Hormone receptor complex binds to DNA and starts transcription. mRNA are produced and amplify signal.

54
Q

What kind of hormones bind to surface receptors?

A

peptide and amine

55
Q

What kind of hormones bind to nuclear receptors?

A

steroid and thyroid

56
Q

What is this:
Proteins synthesized through gene transcription.
Sythesized as pre-hormones and undergo post-translational processing.

A

peptide hormones

57
Q

What is this:
Stored in secretory granules before release by exocytosis.
Travel free in plasma hence have short half lives (minutes).

A

peptide hormones

58
Q

What is this:
Bind to surface receptor and act through 2nd messengers
Most hormones are in this class.
Examples: Insulin, Glucagon, ACTH, PTH, Glycoproteins(FSH, LH, TSH, HCG)

A

peptide hormones

59
Q

What are amino acid derived hormones?

A

Synthesized from tyrosine

Includes: Catecholamines and thyroid hormones.

60
Q

What is this:
Synthesized from cholesterol in the adrenal cortex, gonads and placenta.
Lipid soluble and require binding to proteins to circulate in plasma to target organs.
Have longer half lives (hours – days).
Able to cross the cell membrane and act inside the cell.
Also includes Vitamin D.

A

steroid hormones

61
Q

Where are steroid hormones synthesized?

A

from cholesterol in adrenal cortex, gonads and placenta

62
Q

What are lipid soluble and require binding to proteins to circulate in plasma to target organs?

A

Steroid hormones

63
Q

What have longer half lives, peptide hormones or steroid hormones?

A

steroid hormones

64
Q

What are able to cross the cell membrane and act inside the cell?

A

steroid hormones

65
Q

Is vit D a steroid hormone or peptide hormone?

A

steroid hormone

66
Q

What are the three patterns of hormone secretion?

A

pulsatile
episodic
diurnal (daily)

67
Q

What is this:

  • > Hormone released in regular pulses varying in amplitude and frequency from minutes to hours.
  • > several pulses= episodic variations (limits reliance on direct measurments of these hormones)
  • > Continuous release can limit hormone action through desensitization.
A

pulsatile pattern

68
Q

In pulsatile pattern
Several pulses results in (blank) variations in hormone level limiting reliance on the direct measurement of these hormones/

A

episodic

69
Q

In pulsatile patterns,(blank) release of hormones can limit hormone action through desensitization.

A

continuos

70
Q

What are some examples of pulsatile pattern?

A

Growth hormone (GH) and Gonadotropin releasing hormone (GnRH)

71
Q

Explain why treatment of gonadotropin deficiency involves pulsatile admin of GnRH (gonadotropin) with a pulsing device.

A

cuz continuous admin would result in suppression of FSH and LH (infertility)

NOTE: remember with pulsatile flow patterns when hormone is continuously released, it will desensitize hormone action

72
Q

Explain diurnal hormone variation

A

hormone secretion is determined by circadian rhythm (sleep-wake cycle) which is set by pacemaker in hypothalamus (SCN)

73
Q

What is the pacemaker for diurnal hormone release?

A

hypothalamus

74
Q

Explain how the levels rise and fall in diurnal hormone variation

A

Follows a 24 hour pattern,
hormones at night
peaks in waking hours
decline as day progresses

75
Q

how will diurnal hormone release be affected?

A

by alterations in the sleep-wake cycle (shift work, jet lag)

76
Q

Why do we wake up in the morning?

A

due to surge in hormones

77
Q

In the dawn phenomenon (surge of hormones in the morning) what do these hormones result in?

A

an increase in blood glucose

78
Q

In the dawn phenomenon, we have an increase in glucose due to a hormone surge, what happens next?

A

you will make a bunch of insulin

79
Q

In diabetes,what can the dawn phenomenon manifest itself as?

A

elevated fasting blood glucose

80
Q

Once hormones are released into circulation what 3 three ways can they go?

A
  • Bind to receptor in target organ
  • transform in liver
  • Undergo urinary excretion
81
Q

What are the three ways you can regulate hormone release?

A

hormonally
nutrient/ion regulation
neurally

82
Q

Hormonally how can you regulate hormone release?

A
  • tropic hormones (hormones that target other endocrine glands)
  • feedback loops
83
Q

HOw do you regulate hormone release via nutrients/ions?

A

glucose and calcium

84
Q

How do you regulate hormone release neurally?

A

via adrenal medulla releasing epinephrine

85
Q

What is the purpose of feedback?
Is feedback usually postive or negative?
What does feedback require?

A

to maintain a steady state
negative
requires a closed loop system (product, effect and sensor)

86
Q

What is this:

reduction of an initial stimulus by the product of stimulation

A

negative feedback

87
Q

What is the most common control of hormone release and protects against excess hormone production?

A

negative feedback

88
Q

What is this:

original stimulus results in an increased stimulation for hormone release.

A

positive feedback

89
Q

What is an important positive feedback mechanism for childbirth and lactation?

A

oxytocin

regulated by the presence or absence of the stimulation (fetal head, sucking

90
Q

What is an open loop?

A

it means there is no feedback

therefore closed loop means there is feedback

91
Q

An open mainly refers to control of hormone secretion by (blank)

A

CNS stimulation

92
Q

An (blank) is regulated by depletion of hormone in absence of further CNS stimulation.
What is an example of this?

A

Open loop

epinephrine

93
Q

In primary hypothyroidism, there is a failure of the thryoid gland to make (blank)

A

thyroxine

94
Q

During treatment of hypothyroidism we rely on the (blank) level to determine the correct replacement dose of levothyroxine.

A

TSH

95
Q

In a healthy pituitary what does TSH do?

A

it makes T4/T3

96
Q

What does LT4 do?

A

Levothyroxine (LT4) is a synthetic version of T4/T3 and inhibits TSH via negative feedback loop

97
Q

What is this:
Important in determining physiologic and pathologic function of endocrine organs.
Techniques involve direct measure of hormone level in plasma.

A

hormone measurment

98
Q

If you cant measure hormones what can you measure as a surrogate?

A

products of hormone action :)

99
Q

Can you test stimulation or suppression of hormone levels?

A

yes

100
Q

Explain the ACTH stimulation test

A

Give exogenous ACTH-» stimulate cortisol production-»measure serum cortisol

101
Q

What is the evaluation for cushings disease (excess cortisol)?

A

dexamethasone suppression test

102
Q

How does the dexamethasone suppression test work?

A

give exogenous steroid (to suppress cortisol production), and measure serum cortisol
(i.e inhibit pituitary gland and check cortisol levels)

103
Q

What does radioimmunoassay do?

A

uses immunoenicity to determine hormone levels in a solution (serum).

104
Q

How does radioimmunoassy (RIA) work?

A

> > mix known amount of radio-labeled antigen (hormone) w/ antibody (they bind)
add patients serum containing hormone to compete with bound, radio labeled hormone
precipitate
measure
calculate (scatchard plot)

105
Q

What is ELISA?

A

> > mix known antigen/hormone w/ antibody
add patients serum containing hormone to compete with bound, radio labeled hormone
precipitate
measure color change (bound to enzyme)

106
Q

What is the problem with ELISA?

A

cross-reactivity of hormones binding to same antibody can result in errors (FSH, LH, HCG, TSH)

107
Q

What is the hook effect?

A

Patient with very high hormone levels w/ clinical manifestation but assay shows normal or mildly elevated hormone levels.

108
Q

What is the hook effect caused by?

How do you fix this?

A

overwhelming of the antibody by very high levels of antigen preventing detection of actual concentration.
Dilute the sample

109
Q

How are hormone levels interpreted?

A

based on populations and demographics, assumes normal distribution

110
Q

2 SDs=(blank) percent of all numbers

A

95%

111
Q

How should you interpret hormone levels?

A

Look at age and gender
remember patterns of hormone release, illness, nutrition
look at regulatory factors
interpret with clinical context

112
Q

What are the three main categories of endocrine disorders?

A

Hormone deficiency
Hormone Resistance
Hormone excess

113
Q 
What kind of endocrine disorder is this:
Autoimmune destruction (Type 1 DM)
Deficiency of precursor (Iodine/hypothyroidism)
A

Hormone deficiency

114
Q 
What kind of endocrine disorder is this:
Receptor mutations (Psuedohypoparathyroidism)
Functional (Type 2 DM)
A

Hormone Resistance

115
Q 
What kind of endocrine disorder is this:
Tumors/mutations (Acromegaly)
Autoimmune activation (Grave’s disease)
A

Hormone excess

Block 3 Week 5 (7 decks)

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