Physiology Endocrine Book Flashcards
Factors promoting GH production
Hypoglycaemia
Deep sleep- circadian pattern
Trauma
Haemorrhage
Fever
Exercise
Pain
GH metabolic functions
Anti insulin
Glycogenolysis
Lipolysis
Metabolic function of cortisol
Gluconeogenesis
Lipolysis
Cortisol effect on immune system
Inhibits complement
Inhibits T cell reproduction
Levels of cortisol throughout the day
Diurnal
Highest in morning
Lowest at midnight
What stimulates cortisol
Stress (trauma, infection, fear, pain)
ANP effect on aldosterone
Inhibits renin and therefore aldosterone
Where aldosterone takes effect and what metabolic effect it causes
DCT
Metabolic alkalosis
Difference in biochem of primary and secondary hyperaldosteronism
1- high aldo low renin
2- high renin
Which organ can freely uptake glucose without inuslin
Brain
Other stimulants of insulin release
Fatty acids
Ketone bodies
Parasympathetic
Gastrin
CCK
Prostaglandin
Insulin effects on metabolism
Protein synthesis
Inhibits protein breakdown
Inhibits lipolysis
Proportion of K that is intracellular
98%
Production of Vit D
7 dehydrocholesterol to cholecalciferol by UV
Converted to 25 in liver and 1,25 in kidney
Where ADH is produced and where it effects
Posterior pituitary
Effects DCT
Physiological effects of GH, prolactin and oxytocin
GH- secretion of ILGF1
Prolactin- milk production and breast development
Oxytocin- uterine contraction and milk secretion
Cushing disease vs syndrome
Disease- pituitary - ACTH high/normal in dex suppression
Syndrome- any cause of high cortisol
Ectopic vs Cushing disease vs adrenal adenoma dex suppression
Ectopic- high ACTH, high cortisol (since produces ACTH that doesn’t have neg feedback)
Disease- normal ACTH, low cortisol only on high dex
Adenoma- low ACTH, high cortisol
Production of ACTH and MSH
POMC cleaved to form MSH and ACTH
Systemic complications of burns
Hypovolaemia
Hyperkalaemia and hypocalcaemia
Hypothermia
SIRS
Gastric ulceration
Coagulopathy
Haemolysis
What electrolyte disturbances are associated with high Mg
Hyperkalaemia and hypercalaemia
Causes of high Mg
CKD
Hypothyroid
Addisons
Tx of High Mg
Calcium gluconate- protects cardiac and neuromuscular (can cause resp depression)
Diuretics
Causes of low Mg
Malnutrition
Diarrhoea
Excessive Alcohol
Loop diuretics
Acute pancreatitis
ECG effects of low Mg
Prolonged PR
Prolonged QT
Broad flat T
Normal range of Mg
0.7- 1
Where is majority of Mg located
Bone
Sx of hyperMg
Bradycardia
Sluggsih tendon reflexes
ECG changes of hyperK
Tented T waves
small p
Wide QRS
ECG changes of low K
Small/intverted T waves
U waves
Prolonged PR ST depression
Serotonin effects
Vasodilation and bronchoconstriction
Insulin relation to injury
Low in ebb phase
Increase in flow phase
Hyperglycaemia due to resistance
CV, neural and endo effects of cortisol
Increase vascular tone with vasopressors
Euphoria
Increase effect of T3- maintain body temp
Effects of histamine
Bronchoconstriction
Blood vessel dilation and permeability increase
Increase gastric acid
Example of stressors that increase cortisol
Prolonged exercise
Prolonged starvation
Cortisol effect on glucose
Increase glucagon
Decrease insulin
Cortisol effect on nitrogen
Increased protein breakdown
Increased excretion
Metabolic effects of catabolic state
Glycogen stores broken
Insulin falls- resistance
Cortisol raised
Increased urinary nitrogen due to protein breakdown
Increase FA oxidation- lipolysis
Composition of Ca in body
99% bone
Of free 40% bound to albumin
60%- importance
Normal levels 2.2-2.6
Which hormone does dopamine effect
Inhibits Prolactin
Water and sodium in hypo, euvolaemic and hyper hyponatraemia and causes
Hypo- lower water but sodium lower- diarrhoea, Addisons
Euv- Water levels increase but sodium remains the same - SIADH, hypothyroid, cushing
Hyper- sodium increases but water increases more- cirrohis, HF, nephrotic
