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Endocrinology > Physiology > Flashcards

Physiology Flashcards

1
Q

What is an autocrine signal

A

Chemical signal that acts on the same cell

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2
Q

What is an intracrine signal

A

Chemical signal that acts within the same cell

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3
Q

List the types of hormone receptors

A

G-protein coupled receptors
Receptor Tyrosine Kinase (RTK) Families
Nuclear recpetors - class 1, 2 and hybrid

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4
Q

List the main endocrine organs/glands in the body

A 
Hypothalamus 
Pituitary gland 
4x parathyroid glands
Thyroid gland 
2x adrenal glands 
Pancreas 
2x ovaries 
2x testes
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5
Q

What does the endocrine system consist of

A

Ductless endocrine glands

Secretions occur from individual cells or groups that are organised into glands

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6
Q

How do hormones travel around the body

A

Released into the extracellular fluid which then enter the circulation and travel to target site

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7
Q

How does the endocrine system achieve specificity of signalling

A

Chemically distinct hormones
Specific receptors for each hormone
Distinct distribution of receptors across cells

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8
Q

Endocrine signals are more enduring than nerves - true or false

A

True

They last a lot longer

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9
Q

What are the 4 different chemical classes of hormones

A

Modified amino acids
Steroids
Peptides
Proteins

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10
Q

Give examples of modified amino acid hormones

A

Adrenaline

Thyroid hormone

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11
Q

Where do modified amino acids come from

A

Tyrosine

Tyramine

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12
Q

Where do steroid hormones derive from

A

Cholesterol

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13
Q

Give examples of steroid hormones

A

Cortisol
Progesterone
Testosterone

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14
Q

Where do peptide hormones derive from

A

Larger precursor proteins

Cleaved into smaller units

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15
Q

Give examples of peptide hormones

A

ACTH

ADH

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16
Q

Give examples of protein hormones

A

Insulin

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17
Q

What is a paracrine signal

A

Cell generates signalling molecules that act upon immediately adjacent cells – travels a short distance

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18
Q

What is an endocrine signal

A

signalling molecule is released into extracellular fluid, enters the bloodstream and then travels through the bloodstream to reach it’s target cells

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19
Q

Hormones act at very high concentrations - true or false

A

False
Very low concentrations
Very potent with sensitive receptors

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20
Q

How can the hormone signal be amplified

A

Hormone binds to it’s receptor and triggers secondary pathways - amplifies
Initiates reliable biological response

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21
Q

What causes variation in the length of action of a hormone

A

The different ways that they are inactivated

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22
Q

Describe the complementary action of hormones

A

Several hormones can contribute to complex physiological functions
E.g. adrenaline, cortisol and glucagon all work for short term exercise

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23
Q

Describe the antagonistic action of hormones

A

Some can work in opposing ways but in a balance

e.g. insulin and glucagon

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24
Q

Describe how amine hormones are synthesised and stored etc.

A

Pre-synthesised by enzymes
Stored in vesicles
When Ca enters the cell (response to stimuli) its triggers release by exocytosis

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25
Q

Describe how peptide and protein hormones are synthesised and stored etc.

A

Presynthesised in series of proteolytic steps to mature hormone
Stored in vesicles/granules Released when Ca enters the cell in response to stimuli

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26
Q

Describe how steroid hormones are synthesised and stored etc.

A

Synthesized and secreted on demand

Stimuli increases cell uptake of cholesterol and rate of conversion to intermediate

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27
Q

What is the common intermediate for all steroid hormones

A

pregnenolone

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28
Q

How are steroid hormones transported in the blood

A

Hydrophobic so travel bound to plasma proteins

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29
Q

Describe the functions of carrier proteins

A

Increase amount transported in blood
Provide a reservoir of hormone
Extend half-life of the hormone in the circulation

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30
Q

List 3 important specific carrier proteins

A

Cortisol-binding globulin (CBG) – binds cortisol
Thyroxine-binding globulin (TBG) – binds thyroxine
Sex steroid-binding globulin (SSBG) – binds mainly testosterone and oestradiol

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31
Q

List important general carrier proteins

A

Albumin - binds many steroids and thyroxine

Transthyretin - binds thyroxine and some steroids

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32
Q

How do carrier proteins act as buffers

A

If there is a surge of steroid release the globulins in the plasma mop up the excess by binding
This maintains the equilibrium

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33
Q

How do steroid hormones cross the capillary wall

A

Can only cross when free in the plasma

There is an equilibrium between free and bound steroid so when some crosses wall, more is released from proteins

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34
Q

What is the primary determinant of plasma concentration

A

Rate of secretion

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35
Q

How is plasma concentration of a hormone maintained

A

Negative feedback mechanisms

Keeps it at a set level

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36
Q

Describe the diurnal (circadian rhythm)

A

Secretion rates of hormones fluctuate throughout the day

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37
Q

How can hormones be excreted

A

Metabolism locally
By the liver
Excretion by the kidney

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38
Q

Which receptors are on the cell surface

A

G-protein coupled

Receptor kinases

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39
Q

Which receptors are intracellular

A

Nuclear receptors

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40
Q

What binds to G protein coupled receptors

A

Amines and some proteins/peptides

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41
Q

What binds to receptor kinases

A

Some proteins/peptides

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42
Q

What binds to class 1 nuclear receptors

A

Many steroids hormones

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43
Q

What binds to class 2 nuclear receptors

A

Mostly lipids

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44
Q

What binds to hybrid nuclear receptors

A

Thyroid hormone

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45
Q

What do Gs proteins and receptors do

A

Increase activity of adenyl cyclase - more cAMP produced

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46
Q

What do Gi proteins and receptors do

A

Decrease activity of adenyl cyclase - less cAMP produced

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47
Q

What do Gq proteins and receptors do

A

Increase activity of phospholipase C

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48
Q

How do receptor kinases work

A

When the hormone binds there is a change in the receptor that allows phosphorylation of receptor itself on tyrosine residues
This allows the secondary pathway to start

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49
Q

How do class 1 nuclear receptors work

A

Hormones enter the cell and bind to intercellular receptor
This causes receptor to dissociate from inhibitory heat shock protein
The steroid:receptor can now enter the nucleus and exert its action
Binds to DNA response elements and results in changes in gene transcription

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50
Q

Describe the structure of the thyroid gland

A

Left and right lobes connected by isthmus

Isthmus may be absent

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51
Q

What does the thyroid gland secrete

A

Thyroxine - T4
Tri-iodothyronine - T3
Calcitonin

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52
Q

Where are the parathyroid glands located

A

2 behind each lobe of the thyroid gland

4 small glands in total

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53
Q

What do the parathyroid glands secrete

A

Parathyroid hormone

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54
Q

What physiological process can cause the thyroid to enlarge

A

Pregnancy

Menstruation

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55
Q

What is the innervation of the thyroid gland

A

Autonomic
Parasympathetic from vagus nerve
Sympathetic from superior, middle and inferior ganglia of sympathetic trunk

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56
Q

What is the arterial supply to the thyroid gland

A

Superior and inferior thyroid arteries - branch from external carotid

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57
Q

What is the venous drainage from the thyroid gland

A

Superior and middle thyroid veins - drain into internal jugular
Inferior thyroid vein - drains into brachiocephalic

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58
Q

Describe the cellular structure of the thyroid gland

A

Made up of follicles which store the hormones
Follicular cells surround a central colloid
Also get occasional parafollicular C cells that produce calcitonin

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59
Q

Drugs to reduce thyroid hormone production have instant effects - true or false

A

FALSE

Takes around 3 weeks to start working due to stores of hormones in the follicles

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60
Q

Which element is required to make thyroid hormones

A

Iodine

Absorbed into follicle via iodine transporters

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61
Q

Describe the synthesis of thyroid hormones

A

Iodine is taken up by follicular cells
Enters the colloid of the follicle where thyroglobulin is stored
Attaches to tyrosine residues on the thyroglobulin’s to produce MIT or DIT
There is coupling of MIT and DIT to form T3 or DIT and DIT to form T4
Stored in colloid until required

62
Q

How do drugs for hyperthyroidism such as carbimazole work

A

Inhibit the attachment of iodine to the thyroglobulin to prevent hormone synthesis

63
Q

Which thyroid hormone is the major biologically active one

A

T3

Other enzymes will convert T4 to T3 by removing an iodine to make it more active

64
Q

Which thyroid hormone is secreted in the greatest amount

A

T4

Makes up 90% of hormone secreted

65
Q

How do thyroid hormones travel in the blood

A

Hydrophobic so most travel bound to plasma proteins

Small amount is unbound – biologically active as available to tissue

66
Q

How do you convert T4 to T3

A

Remove an iodine

This makes it active

67
Q

List the plasma proteins that thyroid hormones can bind to

A

Thyroxine binding globulin - TBG
Thyroxine binding prealbumin - TBPA
Albumin

68
Q

What can cause an increase in TBG

A

Pregnancy
Pill - oestrogen sources
Hepatitis (A & chronic)
Heroin

69
Q

What can cause a decrease in TBG

A 
Androgens 
Large dose of glucocorticoids 
Cushing's 
Severe systemic illness 
Chronic liver disease
70
Q

What are the action of thyroid hormone

A

Target almost every tissue in the body
Can alter gene transcription etc
Has big effect on:
metabolism, growth, reproduction and behaviour

71
Q

What effect do thyroid hormones have on metabolic rate

A

Increase basal metabolic rate
Increase number and size of mitochondria
Increase oxygen use and ATP hydrolysis
Works with GH to control metabolism

72
Q

What effect do thyroid hormones have on thermogenesis

A

Increase it

73
Q

What effect do thyroid hormones have on carb metabolism

A

Increase blood glucose by stimulating glycogenolysis and gluconeogenesis
Increase uptake of glucose

74
Q

What effect do thyroid hormones have on lipid metabolism

A

They mobilise fat from tissue - increase free fatty acids

Increase fatty acid oxidation

75
Q

What effect do thyroid hormones have on protein metabolism

A

Increase protein synthesis

76
Q

What effect do thyroid hormones have on growth

A

Growth hormone releasing hormone needs them to be produced and secreted
GH needs them for activity

77
Q

Are thyroid hormones needed for normal CNS activity

A

YES

The 2 extremes will cause abnormal CNS symptoms

78
Q

How do thyroid hormones affect adrenaline action

A

Increase the response to nor-adrenaline by increasing the number of receptors
This affects force and rate of the heart

79
Q

How is the release of thyroid hormones regulated

A

TRH from hypothalmus is needed to stimulate release of TSH from pituitary
TSH stimulates release of T3 and T4 from thyroid
T3 and T4 exert negative feedback control of TRH and TSH if their levels get too high

80
Q

How can low temperatures affect the release of thyroid hormone

A

In kids, cold temps stimulates TRH release which goes on to cause TSH and then T3/4 release

81
Q

How can stress affect release of thyroid hormones

A

It inhibits TRH and TSH release

82
Q

How does the circadian rhythm affect thyroid hormones

A

thyroid hormones highest late at night, lowest am

83
Q

Which enzymes can convert T4 to T3

A

Deiodinase enzymes
Type 1, 2 & 3
Can remove iodine to activate or inactivate depending on the number and position taken from

84
Q

Where is T1 deiodinase enzyme found

A

Liver and Kidney

safety enzyme – allows you to still produce active T3 hormone in the liver

85
Q

Where is T2 deiodinase enzyme found

A

Heart, skeletal muscle, CNS, fat, Thyroid and pituitary

most important as it activates T4-T3 in most tissues

86
Q

Where is T3 deiodinase enzyme found

A

In foetal tissue and placenta and brain

87
Q

What can lead to deficiency in thyroid hormones

A

Primary failure – may be associated
with enlarged thyroid
Secondary to TRH or TSH (no goitre)
Lack of iodine in diet

88
Q

What are the symptoms of an underactive thyroid

A 
Reduced BMR
Slow pulse rate 
Fatigue, lethargy, slow response times and mental sluggishness
Cold-intolerance
Tendency to put on weight easily
89
Q

What are the symptoms of an overactive thyroid

A 
Increased  BMR
Very fast pulse rate 
Increased nervousness and excessively emotional
insomnia
Sweating and heat intolerance
Tendency to lose weight easily
Frequent bowel movements 
Fine, brittle hair 
Tremor 
Changes in menstrual pattern
90
Q

What is the most common cause of hyperthyroidism

A

Grave’s disease

Autoimmune disease where TSI acts like TSH

91
Q

Describe how G protein coupled receptors work

A

The receptor is made up of a 7 transmembrane domain
When ligand binds there is a conformational change which activates the associated G protein
This goes on to generate secondary messengers by acting on effectors

92
Q

What is the major determinant of hormone concentration

A

rate of secretion

Impacted by feedback loops

93
Q

which hormones should be tested at 9am and why

A

Cortisol
Testosterone
This is when they usually peak during the day

94
Q

What kind of test is required for GH

A

Dynamic testing

It is secreted randomly in pulses throughout the day so you cannot tell if you’ve got an accurate level on random test

95
Q

Where is prolactin secreted from

A

The lactotroph cells of the anterior pituitary

96
Q

Where are most male androgens produced

A

Testes

97
Q

Where are most female androgens produced

A

Adrenal cortex

98
Q

Describe the synthesis of steroid hormone

A

All come from cholesterol
Go through a complex series of enzyme reactions to form final products: testosterone, aldosterone and cortisol
Defects in these enzymes can lead to sex related issues, slat wasting or low cortisol

99
Q

Describe the phases of the menstrual cycle

A

Follicular phase - first 14 days (variable)
Starts with period and then follicles develop and release oestrogen
Ends with ovulation around day 14
Luteal phase also lasts 14 days and progesterone starts to rise (falls if no fertilisation)

100
Q

What hormone is released by the ovum

A

oestrodiol

101
Q

What hormone is released by the corpus luteum

A

progesterone

102
Q

What hormone is released by the placenta

A

hPL - Human Placental Lactogen
Progesterone
Oestrogens

103
Q

What hormone is picked up on pregnancy tests

A

HCG

released after implantation

104
Q

What type of cells make up the anterior pituitary

A

Acidophils - somatotrophs (GH) and mammotrophs (PRL)
Basophils - corticotrophs (ACTH), thyrotrophs (TSH) and gonadotrophs (FSH/LH)
Chromophobes

105
Q

What type of cells make up the posterior pituitary

A

non-myelinated axons of neurosecretory neurons

106
Q

Where are the adrenal glands found

A

Sit superior and medial to upper pole of kidneys

Bilateral

107
Q

What are the adrenal glands composed of

A

An outer cortex and a central medulla

Central medulla made up of neuroendocrine cells

108
Q

Which pituitary hormones have a direct action on organs

A

ADH
Oxytocin
Growth Hormone
Prolactin

109
Q

What is the function of GnRH

A

gonadotrophin releasing hormone

released from the hypothalamus and stimulates the release of LH and RSH from the anterior pituitary

110
Q

What are the functions of LH and FSH

A

Luteinising hormone and follicle stimulating hormone
Released from anterior pituitary
Act on testes/ovaries and cause the release of sex hormones testosterone/oestrogen and progesterone

111
Q

What effect does testosterone have when it is released from the testes

A

increased muscle and bone mass
Increased libido
Increased penile length
Impacts hair follicles - causes growth

112
Q

What effect do oestrogen and progesterone have when they are released from the ovaries

A

Increased bone and fat mass
Develops the vagina
Impacts heart and liver

113
Q

Where is cortisol released from

A

The adrenal glands

114
Q

What is the function of cortisol

A

Most important stress hormone - without it you die
regulates blood sugar - increases plasma glucose
increases fat in the body - increase lipolysis
helps defend against infection
helps us respond to stress
increases responsiveness of adrenoreceptors
Stops us going into shock
Accelerates osteoporosis

115
Q

What is the function of ACTH

A

released from anterior pituitary

Acts on the adrenal glands to stimulate cortisol production

116
Q

What is the function of CRH

A

Corticotropin-releasing hormone

Released from hypothalamus and acts on the anterior pituitary to stimulate ACTH release

117
Q

What is the function of TRH

A

thyrotrophin releasing hormone

Released from hypothalamus and acts on the anterior pituitary to stimulate TSH release

118
Q

What is the function of TSH

A

thyroid stimulating hormone

Released from anterior pituitary and acts on the thyroid gland to stimulate thyroxine release

119
Q

What is the function of GHRH

A

growth hormone releasing hormone
released from hypothalamus
Stimulates the anterior pituitary to release growth hormone

120
Q

What is the function of dopamine

A

Released from the hypothalamus

Inhibits the production of prolactin in the anterior pituitary

121
Q

What is the function of ADH

A

Released from hypothalamus and then stored in the posterior pituitary
Released when needed to act on kidneys to cause water retention

122
Q

What is the function of OXT

A

Oxytocin
Released from hypothalamus and then stored in the posterior pituitary
Released when needed to act on smooth muscle of ductus deferens, prostate or uterine smooth muscle and mammary glands

123
Q

Which hormone does GH stimulate the release of

A

IGF-1

insulin-like growth factor 1

124
Q

What hormones are secreted from the zona reticularis of the adrenal gland

A

Androgens

DHEA

125
Q

What hormones are secreted from the zona fasciculata of the adrenal gland

A

Cortisol
Cortisone
Corticosterone

126
Q

What hormones are secreted from the medulla of the adrenal gland

A

Adrenaline

Nor-adrenaline

127
Q

when are steroid hormones synthesized

A

When the cells producing them respond to a stimuli

They aren’t stored within cells

128
Q

What is the function of aldosterone

A

Release is stimulated by angiotensin II
It increase NaCl retention and reabsorption in the kidney
This also leads to water retention due to osmosis - increased blood volume and pressure
Helps regulate extracellular volume

129
Q

What impact does cortisol have on CO

A

By increasing responsiveness of adrenoreceptors it increases CO
This also increases BP

130
Q

What hormones are secreted from the glomerulosa of the adrenal gland

A

Mineralocorticoids - aldosterone

131
Q

What are the sources of androgens

A

In females the only source is the adrenal glands

In males the majority is produced in the testes but also some from adrenal glands

132
Q

How is are the production of cortisol and androgens regulated

A

regulated by hormones produced by hypothalamus and anterior pituitary gland

133
Q

How is the production of aldosterone regulated

A

The renin-angiotensin system and plasma potassium levels

134
Q

What are the 6 classes of steroid receptor

A 
Glucocorticoid
Mineralocorticoid
Progestin
Oestrogen
Androgen
Vitamin D
135
Q

Where are mineralocorticoid receptors found

A

Kidneys - majority
Salivary glands
Gut
Sweat glands

136
Q

Which mineral adds strength to bone

A

Calcium phosphate

137
Q

What is the function of parathyroid hormone

A

Sense calcium levels within the body via calcium sensing receptors
Regulates serum calcium and serum phosphate
Activates vitamin D

138
Q

Where is secreted from calcitonin

A

It is a polypeptide secreted from parafollicular cells within the parafollicular C cells in the thyroid gland

139
Q

How is vitamin D activated in the body

A

Taken in via diet and sunlight
Activated by enzymes in the liver and kidneys - hydroxylated in both
The version released from the kidneys is the active one

140
Q

List functions of calcium in the body

A

Bone strength
Excitability of smooth and cardiac muscle
Secretion of peptide and hormones
Excitability of neuromuscular junctions in skeletal muscle
Role in blood clotting

141
Q

What stimulates parathyroid hormone release

A

Hypocalcaemia

142
Q

Describe the action of parathyroid hormone

A

Increases osteoclastic activity - resorption of bone allows calcium in it to be released
In the kidney and gut it increases calcium reabsorption and increases excretion of phosphate
Have role in production and activation of vitamin D

143
Q

What is the role of calcitonin

A

Secreted in extreme cases of hypercalcaemia
It acts to decrease serum calcium
Opposite to PTH

144
Q

How does calcitonin work

A

It inhibits osteoclasts - decreases bone reabsorption

Decreases absorption in the intestine and the kidneys

145
Q

what is the difference between endocrine and exocrine

A

endocrine glands secrete hormones directly into the blood

exocrine glands secrete hormones into a network of ducts

146
Q

Which hypothalamic hormones are classed as releasing ones

A 
Growth hormone releasing hormone 
Prolactin releasing hormone 
Thyrotropin releasing hormone 
Corticotrophin releasing hormone 
Gonadotrophin releasing hormone
147
Q

Which hypothalamic hormones are classed as inhibiting ones

A

Somatostatin - inhibits release of GH

Dopamine - inhibits release of prolactin

148
Q

Which hypothalamic hormones are peptides

A

All except dopamine which is an amine

149
Q

Describe the action of GH

A

Increases gluconeogenesis - increased blood glucose
Releases more insulin growth factors
Decreases glucose uptake in the muscle cells and increased it in the brain
Increases rate of lipolysis
Increases protein synthesis

150
Q

What is meant by negative feedback in relation to hormones

A

Product hormones often feedback on the endocrine organs further up the pathway to suppress production
Keeps the levels at normal levels

151
Q

How does magnesium affect PTH function

A

Magnesium helps PTH work - allows it to be released and act effectively
Therefore you should always check Mg as well as calcium

Endocrinology (13 decks)

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