Monday - Pituitary phys and pharm - Trachte Flashcards

1
Q

What 2 hormones regulate Growth Hormone (somatotropin) release

A

Growth Hormone releaseing Hormone (GHRH)

Growth Hormone Inhibiting Hormone (GHIH) = somatostatin. Uses Gi receptors –> K channels activated

Also, Dopamine inhibits GH

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2
Q

How does GHRH work?

A

G protein S

Adenylyl cyclase –> increase cAMP –> release GH

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3
Q

How is growth hormone transported?

A

bound to GH binding protein, which is a part of the receptor that has been cleaved off. how efficient.

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4
Q

What kind of intracellular signaling does the GH receptor use?

A

tyrosine kinase –> dimerization –> JAK/STAT –> activation of things in nucleus for metabolism, growth, proliferation and differentiation.
(TYRannOSaurus is large (GH))

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5
Q

What hormone has the same effects as GH

A

Insulin-like Growth Factor-1 (IGF-1, somatomedin)

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6
Q
What does GH do to each of these?
Sodium
insulin sensitivity
fat stores
protein synthesis
epiphysial growth
A
Sodium --> retention
insulin sensitivity --> decrease
fat stores --> lipolysis
protein synthesis --> promotes
epiphysial growth --> obviously promotes

also increases IGF-1 production

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7
Q

In what ways to GH and IGF-1 oppose each other?

A

GH - decreases insulin sensitivity, but IGF-1 has insulin activity

GH - lipolysis
IGF-1 –> anti-lipolysis

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8
Q

Why did Barry Bonds need to get a bigger helmet?

A

Because he’s a cheater. (he took growth hormone) better put an asterisk by all his stats, am I right?

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9
Q

What happens to carbohydrate metabolism in response to GH

A

body decreases carb utilization, decreases uptake –> increases level in blood –> secondary release of insulin.
increases fats being used for energy

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10
Q

Laron Syndrome

A

GH receptor insensitive to GH - very short, but resistant to diabetes and cancers

low IGF-1 levels too

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11
Q

Proportional Dwarfism is due to what?

A
decreased GH in kids. 
Can be from Laron syndrome
Turner Syndrome
SHOX mutation
poor nutrition
stress
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12
Q

Symptoms of GH deficiency

A

obesity (reduced muscle mass)
reduced energy, weakness
reduced cardiac output

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13
Q

Why is it not super useful to measure levels of GH

A

it changes to much (pulsate pattern)
increases during sleep

IGF-1 is slightly better at measuring GH

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14
Q

A way to asses the GH activity using blood sugar levels

A

inject insulin –> hypoglycemia

GH should be released after this to increase glucose level in blood

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15
Q

Analog of GHRH called?

A

Sermorelin

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16
Q

Way to measure production of GH

A

collect baseline level of GH and IGF-1
inject Arginine
inject GHRH
measure GH over and hour

17
Q

Side effects of giving GH

A

antibodies to it (its a protein)
Scoliosis
Diabetes

18
Q

Recombinant Human IGF-1 is called?

Use?

A

Mecasermin

If GH receptor is bad (Laron Syndrome), can induce some growth. Fewer side effects than GH

19
Q

Too much secretion of GH leads to:

A

Acromegaly

20
Q

Diagnosis of GH hypersecretion

A

elevated IGF-1

Elevated GH 2 hrs after glucose

21
Q

Treatment for GH hypersecretion

A

Somatostatin (octreotide) and dopamine (specifically the D2 receptor) (Bromocriptide)

22
Q

Growth hormone antagonist used to treat acromegaly

A

Pegvisomant

can have liver tox and antibodies to it

23
Q

Regulation of prolactin

A

Positive

  • Prolactin releasing hormone (trachte doesn’t believe it exists)
  • VIP
  • Thyrotropin releasing hormone (TRH)

inhibitory
- Dopamine

24
Q

How does the prolactin receptor work?

A

prolactin binds to receptor –> dimerizes –> tyrosine Kinase –> Jak/Stat –> trascriptional events

25
Q

Effects of Prolactin

A

Breast development during pregnancy (lobular development)

Milk secretion during lactation (inhibited by progesterone)

26
Q

What does the hypothalamus tonically do to prolactin levels

A

inhibits via dopamine (prolactin inhibitory hormone PIH)
D2 receptor

If infundibulum is severed, prolactin increases. others decrease

Also, no negative feedback when it’s released

27
Q

What would lead to prolactin hypersecretion?

A

Prolactin secreting tumor
Tumor that disrupts inhibition
Dopamine blocking agents
Injury to infundibulum

28
Q

Girl. no period. She’s lactating all over the place. Doesn’t have kids tho.
What’s wrong with her?

A

You may argue, nothing!

But she for sure has prolactin hypersecretion.

29
Q

Treatment of prolactin secreting tumor

A

Dopamine (D2) agonist (bromocriptine. cabergoline has fewer side effects)