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SF3-EXAM 4 (CAMELITA) > Neuro-endocrinology > Flashcards

Neuro-endocrinology Flashcards

1
Q

What are some neuroendocrine structures?

A
  • Neuroendocrine cells of the hypothalamus
  • Pineal gland
  • Adrenal medulla

NOTE: Oxytocin and vasopressin are neurohormones from the posterior pituatary.

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2
Q

Hypothalamic releasing hormones are synthesized in the hypothalamus an secreted from axonal endings at the ______.

A

Median eminence

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3
Q

What is the course of hypothalamic releasing hormones?

A
  1. Hypothalamus
  2. Secreted by axon endings at the median eminence
  3. Enter primary plexus of fenestrated capillaries
  4. Conveyed from the median eminence to a seconday capillary plexus by the hypophyseal protal vessels
  5. Diffuse out of the vasculature and bind to their specific receptors on specific cell types within the anterior pituatary
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4
Q

What is the structure found between the hypothalamus and the anterior pituatary called?

A

Pituatary stalk

NOTE: The pituatary stock is somewhat fragile and can be disrupted by physical trauma, surgery, or hypothalamic disease

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5
Q

Oxytocin and vasopressin are made by the ________.

A

Hypothalamus

REMEMBER: Oxytocin and vasopressin are only stored by the posterior pituatary. The posterior pituatary makes nothing.

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6
Q

If the pituatary stalk is damaged what is one of the first things you will see?

A

Hyperprolatinemia

Polyuria and polydypsia (as a result of blocked ADH release)

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7
Q

Functions of the median eminence

A
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8
Q

What two hormones stimulate the release of prolactin?

A

PRFs and TRH

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9
Q

____________ is the most important regulator of prolactin.

A

Dopamine

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10
Q

_______________ inhibits GH.

A

Somatostatin

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11
Q

What is the ACTH receptor found at the target?

A

MC2R (Gs-linked GPCR)

NOTE: The target endocrine gland are the zona fasciculata and zona reticularis of the adrenal cortex

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12
Q

What is the target of TSH?

A

Thyroid epithelium

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13
Q

What is the receptor for TSH?

A

TSH receptor (Gs-linked GPCR)

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14
Q

What are the receptors for FSH and LH?

A

FSH and LH receptors (Gs-linked GPCRs)

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15
Q

What is the GH receptor?

A

GH receptor (JAK/STAT-LINKED cytokine receptor)

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16
Q

What is the prolatin receptor?

A

PRL receptor (JAK/STAT-linked cytokine receptor)

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17
Q

What are the most common anterior pituaitary disorders?

A

Hyperprolactinemia

Growth Hormone Disorders

Pituatary Adenomas

Hypopituatarism

18
Q

What major factors stimulate prolatin secretion?

A

Pregnancy and nursing

Physiologic stress

Estrogen use

Hypothyroidism

19
Q

How does somatostatin inhibit GH?

A

By inhibiting PKA

20
Q

Stimulators of GH

A

Stress

Exercise

Starvation

Acute hypoglycemia

Aging

Increased amino acids

Decreased fatty acids

Sleep

Ghrelin

NOTE: If you suspect that a child has short stature, you can put the child on an exercise device and growth hormone levels should increase. If the levels don’t increase with exercise you know something is wrong and you can supplement growth hormone.

21
Q

Inhibitors of GH

A

Hyperglycemia

Increased fatty acids

IGF

Glucocorticoids

22
Q

____________ is the transporter for glucose in the muscle and adipose tissue.

A

GLUT-4 (insulin-_dependent)_

NOTE: Growth hormone inhibits glucose uptake inake in muscle and adipose tissue

23
Q

____________ is the glucose tranporter for glucose in the liver.

A

GLUT 2 insulin independent)

24
Q

What affect does GH have on adipose tissue, liver and muscle?

A

Adipose tissue

  • Decrease glucose uptake
  • Increase lipolysis

Liver

  • Increase in RNA synthesis
  • Increase in protein synthesis
  • Increase in gluconeogenesis
  • Increase in IGFBP
  • increase in IGFs

Muscle

  • Decrease in glucose uptake
  • Increase in amino acid uptake
  • Increase in protein synthesis

Muscle

25
Q

IGFs and GH work together to increase the organ size and function of which organs?

A

Kidney

Pancreas

Intestine

Islets

Parathyroids

Skin

Connective tissue

Bone

Heart

Lung

26
Q

GH causes lenthening of bone at the __________.

A

Epipheyseal plates

27
Q

Side effects of too much GH

A

Ketogenesis

Hyperglycemia

Heat issue (like cardiomyopathy

28
Q

What affect does nutrition have on hormone secretion?

A

Eating a balanced meal

  • Proteins stimulate GH, insulin, and glucagon secretion
    • ​GH inturn produces IGF

Eating a high calorie, high carbohydrate, low protein meal

  • Stimulates insulin
  • Inhibit GH and IGF

During fasting

  • ​Increases GH
  • Decreases insulin
29
Q

GH cannot stimulate IGF production in the absence of _________.

A

Insulin

30
Q

Causes of gigantism

A
  • Pituatary GH excess
  • Hypothalamic GHRH excess
  • Ectopic source of GH or GHRH

NOTE: Gigantism is only seen in growing children

31
Q

What tests are used for determining GH hypersecretion

A
  • Serum IGF
  • Oral glucose tolerance test
  • Pituatary MRI
32
Q

What tests can be used to test for GH deficiency?

A

Exercise

Insulin-induced hypoglycemia

Amino acids

33
Q

Which hormones are important for growth?

A

IGFs

GH

T3

Sex steroids

Insulin

34
Q

What are some endocrine causes of growth failure?

A

Hypothyroidism

Cushing syndrome

Growth hormone deficiency

Precocious puberty

35
Q

Common causes of hypopituitarism

A
  • Pituatary adenoma and other types of pituatary masses
  • Pituitary infarction (Sheehan’ssyndrome) or hemorrhage
  • Mutations is genes that encode transcription factors such as PROP-1
36
Q

What affects for hyperprolactinemia have on FSH and LH in females?

A

Causes a decrease in both

37
Q

SIADH

A

Excessive vasopressin release that is defined as less-than-maximally-dilute urine in the presence of plasma hypoosmolality without volume depletion or overload

NOTE: SIADH is one of the many causes of hyponatremia

38
Q

Why is SIADH associated with euvolemia?

A

There should be an increase in volume but when volume is high ANP causes a release in Na+

NOTE: Aldosterone is also supressed, which explains why the K+ levels are normal

39
Q

Treatment of SIADH

A
  • Restrict fluid intake
  • Increase solute intake with urea or a combination of low-dose loop diuretics and oral sodium chloride
  • Treat underlying cause
40
Q

After a desmopressin test, urine osmolality is >300. What type of diabetes is present?

A

Central diabetes insipidus

41
Q

After a desmopressin test, urine osmolality is <300. What type of diabetes is present?

A

Nephrogenic diabetes insipidus

42
Q

After a desmopressin test, urine osmolality is >800. What condition is present?

A

Primary polydipsia

SF3-EXAM 4 (CAMELITA) (23 decks)

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