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Endocrinology > Normal Growth - AJ > Flashcards

Normal Growth - AJ Flashcards

1
Q

what is unusual about stress in terms of growth?

A

increases GH secretions (anabolic) but also increases cortisol (catabolic)

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2
Q

where is GH released from?

A

anterior pituitary

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3
Q

how is growth (GH secretion) regulated?

A

the balance of GHRH v.s. GHIH release from hypothalamus

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4
Q

other ways growth is regulated?

A 
thyroid hormones
insulin
sex steroids 
availability of nutrients 
stress 
genetics
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5
Q

when do sex steroids have particular significance in terms of growth?

A

during puberty

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6
Q

what is GH aka, and what type of hormone is it?

A

peptide

AKA - somatotropin

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7
Q

what is GHIH?

A

growth hormone inhibiting hormone

AKA - somatostatin

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8
Q

what is GHRH?

A

growth hormone releasing hormone

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9
Q

what are the direct actions of GH?

A

regulation of metabolism

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10
Q

what are the indirect actions of GH?

A

growth and development

by stimulating release of IGF1

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11
Q

how does GH influence metabolism?

A

GH binds to tyrosine kinase receptors which causes phosphorylation

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12
Q

GH’s role in foetal growth?

A

not significant until 8-10months

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13
Q

what determines foetal growth up to 8-10 months?

A

nutritional intake

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14
Q

does GH work independently?

A

no - its sole effects are not significant

it requires thyroid hormones and insulin to promote growth and development

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15
Q

suggest 2 conditions which result in children having normal GH yet stunted growth?

A

poorly controlled diabetes

untreated hypothyroidism

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16
Q

role of GH in adults?

A

maintenance and repair of tissue

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17
Q

how is growth promoted by GH?

A

hyperplasia - cell division

hypertrophy - increased cell size

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18
Q

why is IGF1 similar to insulin?

A

binds to similar receptors

hypoglycaemiac qualities

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19
Q

where is IGF1 secreted?

A

liver

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20
Q

what controls the regulation of GH?

A

IGF1 via -ve feedback

GH itself

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21
Q

role of IGFII?

A

limited to foetus and neonate

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22
Q

how are GH and IGF1 transported?

A

through blood bound to carrier receptors

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23
Q

what are the benefits to transporting GH and IGF1 this way?

A

creates reservoir of GH in blood -
extends half life
smooth out patterns of erratic secretion

24
Q

what is the dominant action of GH secretion?

A

increase in BG

25
result of excess GH secretion?
increase gluconeogenesis, decrease insulin receptor expression - RESULT = hyperinsulinaemia
26
GH and IGF1 effects on bone growth?
GH stimulates prechondrocytes to differentiate into chondrocytes - which become reactive to IGF1 - which stimulates differentiation and cell division of chondrocytes
27
what is produced by differentiated chondrocytes in epiphyseal plates?
cartilage - the foundation for bone growth
28
explain the control of longitudinal growth?
sex steroid hormones cause epiphyseal plates to close during adolescence to stop any further longitudinal growth
29
direct effects of GH?
RELEASING ENERGY STORES TO SUPPORT GROWTH >increases gluconeogenesis >reduces insulin's ability for fat and muscle cells to uptake GLC >fat cells more sensitive to lipolytic stimuli
30
GH as diabetogenic?
it increases BG when present in excess
31
when is majority of GH released and why?
during first 2 hours of sleep - delta sleep | bc energy needed is low therefore can be diverted to growth
32
why is 24hr monitoring of GH important?
to see circadian pattern and get a true picture of hormone status
33
how does IGF1 released over 24hrs compared to that of GH?
it remains relatively constant
34
stimuli that increase GHRH and so GH?
``` >decrease in energy supply to cells >increased amino acids in blood >physical stress >illness >delta sleep >oestrogen and testosterone ```
35
3 factors affecting growth?
hormones nutrition genetics
36
which hormone dominates growth spurt (puberty)?
sex hormones
37
which 2 hormones affect intrauterine growth?
insulin and IGFII
38
thyroid hormones in utero and early childhood?
development of the nervous system
39
effect of undiagnosed hypothyroid child?
hinders brain development
40
congenital hypothyroidism?
mother and child have hypothyroidism - baby doesn't grow properly in uterus and growth is stunted despite GH RESULT = hypothyroid dwarf
41
appearance of hypothyroid dwarf?
short stature for age and is not proportional in size, fat deposits etc.
42
result of hyperglycaemic mother during pregnancy?
large baby
43
genetics?
determines maximum growth
44
2 periods of rapid growth?
infancy and puberty
45
describe puberty rapid growth?
androgens and oestrogen produce spikes in GH - > increases IGF1 - > increases growth
46
GH during puberty?
promotes bone elongation | increased height, weight and body mass
47
hypersecretion of GH?
giantism | acromegaly
48
giantism?
v tall BEFORE plates have closed pituitary giants due to pituitary tumour
49
acromegaly?
enlarged hands and feet due to pituitary tumour AFTER plates have closed - grow in other directions
50
classic sign of acromegaly?
adult's feet growing in size
51
treatment for giantism and acromegaly?
surgery to remove tumour or treat somatostatin analogues
52
hypothalamic origin of dwarfism?
GHRH deficient
53
pituitary origin of dwarfism?
GH secreting cells are defective | decreased GH secreted
54
Laron dwarfism?
end organ is unresponsive to GH increased GH in plasma prevents IGF1 release - therefore GH cannot be inhibited
55
genetic origin of dwarfism?
Pygmies - have mutation so IGF1 isn't produced in response to GH
56
pubertal origin of dwarfism?
precocious puberty stunted growth due to bones fusing to early excess GnHR releases sex hormones
57
thyroid origin of dwarfism?
hypothyroidism bone growth is limited infantile features neurological development stunted

Endocrinology (21 decks)

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