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Physiology: Exam 2 > Lecture 7: Endocrine Physiology-Cortisol, Thyroid Hormones & Growth Hormone > Flashcards

Lecture 7: Endocrine Physiology-Cortisol, Thyroid Hormones & Growth Hormone Flashcards

1
Q

What does the adrenal cortex secrete?

A

Steroid hormone:
1. aldosterone (sodium potassium balance)
2. Cortisol (stress hormone)
3. DHEA (testosterone)

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2
Q

What is the main glucocoticoud?

A

cortisol

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3
Q

What is the control pathway of secretion

A

Hypothalamic-pituitary-adrenal pathway

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4
Q

What type of secretion is cortisol

A

continuous secretion and diurnal rhythm

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5
Q

CORTISOL

Protective effect against hypoglycemia through _ _

A

permissive effect

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6
Q

What are the metabolic effects of cortisol? (6)

A
  1. Promotes gluconegogenesis
  2. breakdown of skeletal muscle proteins (aa.-> TCA intermediate-> gluconegogensis)
  3. enhance lipolysis (for energy)
  4. suppresses the immune system (inhibits cytokine formation)
  5. Causes negative calcium balance (bone breakdown)
  6. Influences brain function
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7
Q

What are the 3 regions of the adrenal cortex and what do they secrete?

A
  • Zona glomerulosa-> Aldosterone
  • Zona fasciulata-> glucocorticoids
  • Zona reticularis-> sex hormones

SALTY, SWEET, SEXY-> GFR

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8
Q

All steriod hormones are synthezised from what?

A

Cholesterol

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9
Q

What is the pathway cholesterol takes to make aldosterone, cortisol, testosteron and estrone/estraidol?

A
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10
Q

A baby was born with a genetic mutation that results in a deficiency of the enzyme 21-hydroxylase. Based on the role of this enzyme in the pathway, what symptoms might you predict in the baby?

A

increase androgen, decrease aldostorone and decrease in cortisol

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11
Q

What is released at the hypothalmus, anterior pit., and adrental cortex for cortisol? What is the negative feedback loop?

A
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12
Q

What areas does cortisol effects?

A
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13
Q

What type of secretion is cortisol?

A

circadian rhythm

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14
Q

Fill this in for cortisol

A
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15
Q

What ways are Cortisol (ex. Hydrocortisone) used for in clinical use?

A

– Suppresses the immune system
– Inhibits the inflammatory response
– For treating bee stings, poison ivy, & pollen allergies
– Helps prevent rejection of transplanted organs

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16
Q

What can happen when you give cortisol exogenously?

A

Exogenous administration may shut down ACTH production & adrenal cells
– Producing adrenal cells atrophy because exogenous cortisol will decrease ACTH through negative feedback

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17
Q

What are the different ways of causing hypercortisolism?

A
  • Adrenal tumor that autonomously secretes cortisol
  • Pituitary tumor that autonomously secretes ACTH
  • Iatrogenic (physician-caused) hypercortisolism
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18
Q

What is cushing DISEASE
What is cushing SYNDROME

A
  • Diease: Pituitary tumor that autonomously secretes ACTH from ant pit.
  • Syndrome: Iatrogenic (physician-caused) hypercortisolism by taking too much exogenous cortisol
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19
Q

What causes hypocortisolism and what is the disease called?

A

*Hypo-secretion of all adrenal steroid hormones (Aldosterone, DHEA and cortisol)

  • Addison disease
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20
Q

What are some signs of hypersortisolism?

A
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21
Q

Association between stress and immune function appear to be mediated through what?

A

CRH and ACTH

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22
Q

CRH family includes what?

A

CRH & brain neuropeptide urocortin

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23
Q

Effects of CRH? (3)

A
  • Decreases food intake
  • Association with signals that mark the onset of labor
  • Links to several mood disorders, e.g., anxiety, depression
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24
Q

What does POMC (pro-opiomelanocortin) undergo? What does it create?

A

POMC (proopiomelanocortin) undergoes post-translational processing to produce a variety of biologically active peptides

  • ACTH and B-endorphin
  • ⍺-MSH
  • Nonpituitary tissues create MSH (melanocyte-stimulating hormone)
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25
Q

What does ⍺-MSH do?

A

inhibits food intake & acts on melanocytes which contain pigments called melanins

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26
Q

What is melanocortins and how does that relate to addison disease?

A

MSH hormones & ACTH

  • d/t decrease in cortisol there is no negative feedback to ACTH so it causes the tan color in Addision disease (⍺-MSH)
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27
Q

fill this in

A
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28
Q

What effect does thryoid hormones have?

A
  • Have long-term effects on metabolism
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29
Q

What is thyroid hormone essential for?

A

Essential for growth & development in children & infants

  • acts permissively with GH
30
Q

Synthesis of thyroid hormones takes place where?

A

in the thyroid follicles, in the colloid

31
Q

What is the center of the thyroid follicles filled with? What does it hold?

A

filled with colloid and stores T3 and T4

32
Q

What glycoprotein is made in follicular cells? (outside colloid)

A

Thyroglobulin

33
Q

What is concentrated in the colloid? What do we need to keep this concentration

A
  • Iodine concentrated in the colloid with help of transporters NIS & pendrin (Na+/I- symporter to move iodine into the follicle and pendrin to move I into colloid)
34
Q

What is the biosynthesis pathway of thyroid hormone

A

Iodine + tyrosine on thyroglobulin ->
monoiodotyrosine (MIT) THEN I + MIT -> DIT THEN DIT+MIT-> thyroid hormone, triiodothyronine

DIT+DIT= thyroid hormone, tetraiodothyronine (T4, levothyroxine)

35
Q

Where do we release thyroid hormones from

A

thyroglobulin

36
Q

What do thyroid hormones bind to?

A

bind to plasma proteins such as thyroid-binding globulin (TBG)-> becasue hydrophobic BUT also becasue made in advance and stored

37
Q

What is used to make T4 into T3

A

target cells use deiodinases to remove iodine from T4 to make active T3

38
Q

What controls the thyroid gland

A

Thyroid-stimulating hormone(TSH) controls the thyroid gland

39
Q

What does thyroid hormones promote? What is it needed for?

A

Thyroid hormones promote oxidative metabolism, Necessary for full expression of growth hormone in children

40
Q

What specifically in the first few years after birth needs T3/4

A

myelin and synapse formation

41
Q

fill in and explain

A
42
Q
A
43
Q

What is released at the hypothothalamus, ant pit, thyroid gland for thyroid hormone

A

Hypo: TRH
Ant pit: TSH
Thyroid: T4/3

44
Q

Where can we get iodine?

A

SHELLFISH, salty

45
Q

What can physical appear with too much TSH stimulation of thyroid gland?

A

goiters

46
Q

What happens with hyperthroidism?

A
  • Increases oxygen consumption & metabolic heat production (increase metabolism)
  • Increase protein catabolism & may cause muscle weakness (inrease breakdown)
  • Hyperexcitable reflexes & psychological disturbances
  • Influence b-adrenergic receptors in the heart->permissble effect with NE and tachycardia
47
Q

What are two things that can cause hyperthyroidism

A
  • Thyroid-stimulating immunoglobulins (TSI) mimic TSH in Graves disease (increase stimulation of T3)
  • Pituitary tumors secreting TSH
48
Q

What is the treatment of hyperthroidism?

A
  • – Surgical removal of gland
  • Destroy with radioactive iodine (increase iodine in colloid-> bursting tumor)
  • Block biosynthesis of hormone
49
Q

Besides the goiter, what other physical sign do we see with hyperthroid states?

A
50
Q

What happens to our TSI, TSH, TRH and T3/4 levels in hyperthyroidism due to graves diease

A
51
Q

What are the side effects for hypothroidism?

A

– Slows metabolic rate & oxygen consumption

– Decreases protein synthesis

– Myxedema: puffy appearance
↳TSH = A GAG deposition(hyaluronic acids retains H2O in ECM

– Nervous system changes in adults include slowed reflexes, slow speech & thought processes, & feelings of fatigue
* Cretinism in infancy (dec growth), ↓ mental capacity

– Bradycardia

52
Q

What is myxedema?

A
53
Q

What is the cause of primary hypothyroidism? Txt?

A
  • Due to lack of iodine in the diet
  • Treatment for hypothyroid disorder, PO thyroid hormone (levothuroaine (T4))
54
Q

What does the levels of TRH, TSH and T3/4 look like in hypothyroid?

A
55
Q

What does normal growth depend on?

A
  1. GH and other homrones
  2. An adequate diet: Essential AA from diet
  3. absence of chronic stress: catabolic cortisol
  4. Genetics
56
Q

When is peak GH released?

A
  • Peak GH release during teenage years
57
Q

GH is anabolic or catabolic?

A

anabolic

58
Q

What are the two hypothalamic neuropeptides released for GH

A

GHRH and Somatostatin (inhibitory)

Be careful with somatostatin and somatotropic!

59
Q

What is an unclear role that GH may have

A

Unclear role in sleep cycles
* GHRH may have sleep-inducing properties

60
Q

What does GH bind to?

A
  • Binds to growth hormone–binding protein in blood to increase half life
61
Q

What may play a role in detemining adult height?

A

GHBP: growth hormone–binding protein

62
Q

What does GH do in our bodies?

A
  • Stimulates secretion of insulin-like growth factors ↳liver
    – Stimulate bone & soft tissue growth with GH
    – Stimulate cartilage growth
  • Promotes protein synthesis
  • Increases plasma fatty acid & glucose (similar to cortisol but diff purpose)
63
Q
  • Explain what is released at hypothalmus, ant pit and liver+other tissues for GH
  • What does GH cause?
A
64
Q
A
65
Q

What does GH deficiency in childhood lead to

A

dwarfism

66
Q

What does oversecretion of GH in childhood lead to?

A

gigantism?

67
Q

What happens with adults that have excessive secreation of GH?

A

acromegaly-> everything grows (hands, feet, face) except you

68
Q

What are SE of genetically engineered GH?

A

glucose intolerance and panceatitis

69
Q

What are two ways that adults can have growth hormone deficincy?

A
  • Continuation of child onset growth hormone deficiency
  • Adult onset: Trauma, Surgery, or Radiation to head (damage to the pituitary)
70
Q

What does adult growth homrone deficiency cause? What is TXT

A
  • Metabolic dysfunction, ↓ physical strength & activity, altered lipid metabolism, ↑ body fat
  • Treatment with Somatropin (Zomacton®, rDNA) > Also used to treat growth failure in pediatric patients
71
Q

Which of the following is secreted by the adrenal medulla?
A) Testosterone
B) Cortisol
C) Aldosterone
D) Epinephrine

A

Epinephrine

72
Q

What is the pathway cholesterol takes to make aldosterone, cortisol, testosteron and estrone/estraidol?

A

Physiology: Exam 2 (9 decks)

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