pineal to thyroid Flashcards
pineal gland is — shaped, attached on —
pine coned shape attached on midbrain
pineal gland
it converts serotonin to — which is important for —
MELATONIN
important for: sexual development, sleep/wake cycle
hypothalamus is located at the base of the brain which is the source of what hormones?
hypothalamus controls pituitary gland by?
tropic hromones
neurosecretory and neurostimulation
enumerate the functions of hypothalamus (7)
- blood pressure
- rate & force of heart beat
- digestive tract motility
- rate and depth of breathing
- pleasure, fear, rage
- body temp.
- hunger, satiety, sleep cycle
hypothalamus
enumerate the tropic hormones (6)
tropic hormones are insoluble to the body
- thyrotropin-releasing hormone
- gonadotropin-releasing hormone
- growth hormone-releasing hormone
- corticotropin-releasing hormone
- somatostatin
- dopamine
TRH, GnRH, GHRH, CRH, S, D
hypothalamus
a tripeptide which goes to pituitary gland to TSH and the product is T3T4
Thyrotropin-releasing hormone (TRH)
hypothalamus
GnRH has — amino acids
this is released at —
what is the product of gonadotropin-releasing hormone?
10 amino acids
released at onset of puberty for sexual development
products: ESTROGEN & TESTOSTERONE
amino acids
GHRH:
CRH:
Somatostatin:
GHRH: 44
CRH: 41
Somatostatin: 2 active forms 14 and 28
hypothalamus
product of CRH
acts – cells – anterior lobe of pituitary gland —-
Adenocorticotropic Hormone (ACTH)
hypothalamus
a growth-inhibiting hormone which has 2 active forms and acts on anterior lobe of PG.
this hormone is also produced in —
SOMATOSTATIN
produced in pancreas & intestine
hypothalamus
Somatostatin inhibits the hormone?
TSH and GH
hypothalamus
dopamine is derived from — and inhibits release of — from anterior lobe of PG
derived from tyrosine and inhibits the release of prolactin
pituitary gland (hypophysis) means to —
this gland is generally for — (enumerate)
to spit mucus
pituitary gland is for:
- growth
- metabolism
- milk production
- pregnancy
pituitary gland
enumerate the cells and their associated hormones
- Lactotrophs - PROLACTIN
- somatotrophs - GH
- thyrotrophs - TSH
- corticotrophs - ACTH
- gonadotrophs - FSH, LH
pituitary gland
the extension of forebrain and the storage for — from neurosecreotry cells of hypothalamus
NEUROHYPOPHYSIS
storage for ADH & oxytocin
pituitary gland
intermediate lobe of pars intermedialis is the thin layer of cells that produce what hormone?
melanocyte stimulating hormone
pituitary gland
these produces large hormones and are more complex than hypothalamus
adenohypophysis
pituitary gland
enumerate the hormones produced by adenohypophysis
- somatotropin (GH)
- gonadotropins (FSH, LH)
- prolactin
- thyrotropin (TSH)
- corticotropin (ACTH)
pituitary gland
this is associated with pituitary and parapituitary hypothalamic tumors
hypopituitarism
pituitary gland
this has no pituitary function
panhypopituitaryism
pituitary gland
this is associated with “shock of pregnant girl at time of delivery”
Sheehan’s syndrome
pituitary ischemia
pituitary gland
enumerate the modifiers of adenohypophysis (6)
- excercise, sleep
- arginine
- sex steroids
- alpha-agonist drugs
- beta-blockers
- hypoglycemia
pituitary gland - adenohypophysis
this has 191 amino acids, the most improtant for growth and the most abundant.
it is structurally related to PRL and HPL
growth hormone
pituitary gland - adenohypophysis
growth hormone function
GH is for:
- onset of sleep (2-3 hrs peak)
- calcium retention of bones (mineralization, protein synthesis, lipolysis)
- internal organ development
- function of pancreas & gluconeogenesis
pituitary gland - adenohypophysis
excess GH can lead to?
Acromegaly or Gigantism (Tumor in PG)
pituitary gland - adenohypophysis
the overall metabolic effect of this hormone is the conservation of glucose
inversely related to glucose
growth hormone
pituitary gland - adenohypophysis
gold standard/confirmatory test
complete rest at — before collection
Insulin tolerance test
rest at 30 mins before collection
pituitary gland - adenohypophysis
gonadotropins are inhibited by — which is the 4th marker of down syndrome
if decrease = ?
Inhibin A
decrease = sterility
pituitary gland - adenohypophysis
gonadotropins acts on thecal cells of ovarial follicles to produce — (3)
- androgens
- estrogens
- progesterone
IF DECREASE = STERILITY
pituitary gland - adenohypophysis
enumerate the uses of gonadotropins
evaluate:
- infertility (w/ other hormones)
- functioning gonads
- early/late puberty
- menstrual problems
- menopause
pituitary gland - adenohypophysis (gonadotropin)
a specific hormone for menstrual cycle and ovulation of girls
for boys, it stimulate production of testosterone by leydig cells
Luteinizing hormone
pituitary gland - adenohypophysis (gonadotropin)
Follicle stimulating hormone (FSH) functions in girls and boys
girls: mens and eggs by ovaries
boys: sperm production (constant amount)
pituitary gland - adenohypophysis
prolactin is also called as a — hormone. this is produced by lactotrophs, with single chain and can be stimulated by — or —
prolactin is a direct effector.
STRESS HORMONE
stimulated by TRH/estrogen
pituitary gland - adenohypophysis
prolactin is for — and highest in what time?
production of breast milk
highest in: 4-8 am and 8-10 pm
pituitary gland - adenohypophysis
a glycoprotein that travels to thyroid gland then adds iodine = T3, T4
thyrotropin (TSH)
2 monocovalently subunits:
- a: 92 amino acid sequence same with LH, FSH, HCG
- B: 118 amino acids and specific info to the binding receptors of hormonal activities
pituitary gland - adenohypophysis
ACTH is a single chain polypeptide which is the function is to activate —
if decrease ACTH: ?
if increase ACTH: ?
CORTISOL
decrease: atrophy | increase: Addisons disease & Ectopic tumors
pituitary gland - adenohypophysis
ACTH peaks at — and low at —
specimen should?
peaks: 6-8 am
low: 6-11 pm
NO CONTACT WITH GLASS
T or F: neurohypophysis produces and releases hormones
FALSE
release only does NOT produce
hormones released by neurohypophysis
oxytocin and antidiuretic hormone
neurohypophysis
oxytocin & ADH are nonapeptides which is produced by —
supra optic cells & paraventicular cells of the hypothalamus
pituitary gland - neurohypophysis
oxytocin with corner protein associated is for — (enumerate)
CONTRACTION of:
- uterus
- muscle during delivery and lactation
and has emotional effects
oxytocin has no known disease
pituitary gland - neurohypophysis
contraction of uterus is also known as —
fergussion reflex
pituitary gland - neurohypophysis
oxytocin are produced due to —
- birth canal (stimulate)
- touch receptor of breast (milk flow)
pituitary gland - neurohypophysis
this hormone is associated with a “cry of a hungry baby”
oxytocin
pituitary gland - neurohypophysis
oxytocin have effects on — (4)
- pituitary
- renal
- cardiac
- immune function
pituitary gland - neurohypophysis
ADH is also known as — which conserve body water and constrict in BV. it act on — and — of kidneys to maintain water balance.
arginine vasopressin
act on DCT and CD of kidneys
pituitary gland - neurohypophysis
ADH is stimulated by —
enumerate the 8
- Low BP
- hypovolemia
- fright
- pain
- nicotine
- narcotics
- barbiturates
- increase plasma osmolality
pituitary gland - neurohypophysis
ADH is inhibited by —
- carbonated drinks
- alcohol
- dilantin
- a-agonists
pituitary gland - neurohypophysis
max of ADH
ADH is coupled with — and induce aquaporin-2 insertion in the tubular luminal membrane.
>295 mosm/kg
coupled with adenylate cyclase
pituitary gland - neurohypophysis
diabetes insipidus (>2L/day urine)
this is increase/decrease in what hormone?
decrease ADH
neurogenic - ADH def./hypothalamus
nephrogenic - kidney receptors impaired
pituitary gland - neurohypophysis
increase ADH without stimuli due to brain injury, trauma, tumors, lung cancer
increase water retention, hypo-osmolality, hyponatremia
Syndrome of inappropriate antidiuretic hormone secretion (SIADH)
thyroid gland is a — shaped with 2 lobes separated by — (15-25g)
LARGEST ENDOCRINE GLAND!!
butterfly shaped
separated by Isthmus
thyroid gland straddles the trachea and start to produce hormone at —
enumerate the functions of thyroid gland
11 week gestation
function: produce thyroid hormones, iodine storage
thyroid gland
cells that controls metabolism
follicular epithelium
T3, T4
thyroid gland
cells that is associated with calcitonin
parafollicular cells
thyroid gland
normal thyroid iodide to plasma iodide ratio
this is needed for hormone synthesis
25-40:1
iodine
thyroid gland
iodine intake: <50 ug/day
this indicates?
hormone secretion deficiency
thyroid gland
iodine intake: 150 ug/day (1 mg/week)
this indicates?
normal function
thyroid gland
organized by thyroid cells and it absorbs iodine (ring shape)
follicles
thyroid gland
reservoir of materials for hormone production (rich in glycoprotein thyroglobulin) surrounded by follicle
a viscous substance
colloid
colloid is within the follicle.
thyroid gland
major component of colloid which is synthesized and secreted by follicles
additional info: with tyrosyl groups (rich in tyrosine)
thyroglobulin
thyroglobulin is located inside a colloid.
thyroid gland
presence of this in the blood indicate tumor (malignant/benign)
reflected thyroid mass, injury & TSH receptor stimulation
thyroglobulin
thyroid gland
thyroglobulin is increase in?
- graves disease
- thyroiditis
- nodular goiter
thyroid gland
resources will be used for creation of T3 and T4, this refers to —
thyroglobulin
thyroid gland
enumerate the 6 in biosynthesis
biosynthesis is controlled by TSH.
- iodide trapping/uptake (by Na-iodide symporter)
- oxidation
- iodination of tyrosyl residius by TPO
- coupling/condensation reaction
- thyroglobulin is then moved to the colloid for storage
- exocytosis of collod droplets
thyroid gland
this biosynthesis happens at basal membrane of follicular cells. Iodide diffuse into the lumen
lumen iodide to follicular iodide ratio
iodide trapping/uptake
lumen iodide to follicular iodide ratio: 5:1
thyroid gland
conversion of iodide to elemental iodide by thyroid peroxidase enzyme. this refers to what biosynthesis?
oxidation
thyroid gland
iodothyronine formed at optical barrier, follicular cells
monoiodothyronine & diiodothyronine
thyroid gland
DIT + DIT by TPO
T4
thyroid gland
MIT + DIT
T3
thyroid gland
T4 BINDING PROTEINS
plasma protein: __ %
free: ___%
plasma protein: 99.95%
free: 0.05%
thyroid gland
- thyroid binding globulin is ___% of T4
- thyroid binding pre albumin is __% of T4
- thyroid binding albumin is ___% of T4
TBG is measured by?
TBG: 75%
TBPA: 15-20%
TBA: 9%
measured by immunoassay
thyroid gland
T3 BINDING PROTEINS (%)
___ : free
___ : TBG
___ : TBPA
___ : TBA
free: 0.5%
TBG: 99.5%
TBPA: very low
TBA: none
thyroid gland
enumerate the hormone loop (step by step)
- decrease metabolism
- detected by hypothalamus (TRH)
- stimulate anterior pituitary
- target organ (thyroid)
- T3/T4
- target organ
- adrenal medulla
- epinephrine & norepinephrine
- increase metabolism
thyroid gland
enumerate the physiologic actions (8)
- basal metabolic rate
- tissue growth
- CNS development
- ANS
- CV & respiratory systems
- GIT
- Skin
- lactogenesis
thyroid gland
this is for deiodination and has 2 types
iodothyronine 5’ -deiodinase
thyroid gland
most abundant type of iodothyronine 5’ -deiodinase. this is for T3 circulation and found in —
type 1
found in liver and kidney
thyroid gland
type 2 iodothyronine 5’ -deiodinase is found in?
- brain
- maintain T3 levels in CN3
thyroid gland
main serum carrier of T3 & T4
thyroxine-binding globulin (TBG)
thyroid gland
T4:T3 ratio in blood
20:1
thyroid gland
T or F: most of the plasma are T3 derived but the major is T4 which is from direct TG secretion
TRUE
thyroid gland
T4 aacounts 80% of plasma T3, this refers to —
extrathyrodial deiodination
liver/kidney: deiodinate T4 |
peripheral tissue: T4 -> T3
thyroid gland
3rd major circulating thyroid hormone which is the removal or 1 iodine from inner ring of T4
reverse T3 (rT3)
function: more on testing since it is inactivated
thyroid gland
used to assess borderline or conflicting lab results and this is elevated in patients with erythroid sick syndrome
also high in newborns
rT3
difference between T3 is that T3 is active | rT3 inactive
thyroid gland
T or F: T3 is not useful in diagnosing hypothyroidism because levels are not reduced until it becomes severe.
TRUE
thyroid gland
TH is metabolized by?
- deiodination
- deamination
- cojugation (by glucoronic acid)
conjugated -> bile duct -> intestine -> excreted
thyroid gland
a thyroid hormone with most hormonal activity. this is measured by competitive assay
75-80% is from tissue deiodination of T4 (outer ring)
Trioodothyronine
3, 5, 3 Trilodothyronine
thyroid gland
Trioodothyronine is for diagnosing —
increase T3 is first seen in ____
for diagnosing T3 thyrotoxicosis
first seen in hyperthyrodism
thyroid gland
a hormone indicator of recovery and recurrence of hyperthyroidism (low in cord blood)
what is the physiologically active form of this hormone?
Trioodothyronine (T3)
FT3 - physiologically active and is readily available
thyroid gland
principal secretory product and the major fraction of organic iodine
prohormone of T3
Tetraiodothyronine (T4)
3, 5, 3’, 5’ tetraiodothyronine | thyroxine
thyroid gland
indicator of thyroid secretory rate
physiologically active form of T4?
increase T4 indicates?
Serum T4
active form: FT4
increase T4 = no TSH
thyroid gland
enumerate the methods used for thyroglobulin tests
- ELISA
- RIA
- IRMA
- Immunochemiluminescent assay
thyroid gland
increase thyroglobulin tests indicates?
thyroid cancer nodular goiter, hyperthyroidism
thyroid gland
decrease thyroglobulin test indicates?
goitorous hypothyroidism and thyrotoxicosis factitia
associated diseases
- inc T3 & T4
- dec TAG level
enumerate the signs and symptoms
hyperthyroidism
- heat intolerance (incr sweating)
- emotionally labile
- tachycardia
- unexplained weight loss
- tremors, restlessness, hyperkinesis, anxiety, irritability
- diarrhea and increase appetite
associated diseases
primary hyperthyrodism
enumerate the inc and dec
increase: T3, T4, FT4, rT3
decrease: TSH
normal TBG
associated diseases
secondary hyperthyroidism
enumerate the inc and dec
increase T3, T4, TSH
“pituitary problems”
associated diseases - hyper
most common and autoimmune
diffuse toxic goiter due to circulating antibodies to TSH receptor
test?
with exophthalmos & pritibial myxedema
Grave’s disease
test: TSH receptor antibody test
associated diseases
thyroid is woody/stony hard mass
Riedel’s thyroiditis
associated diseases
enumerate the diseases in hyperthyroidism
- Grave’s disease
- Reidel’s thyroiditis
- subclinical hyperthyroidism
- subacute granulomatous/subacute non-suppurative thyroiditis / De Quervain’s
associated diseases
painful thyroiditis
TPO antibody is absent
increase thyroglobulin and ESR
subacute granulomatous/subacute non-suppurative thyroiditis / De Quervain’s
associated diseases
low TSH, normal FT3 & FT4 and without symptoms
subclinical hyperthyrodism
associated disease
after fertility
increase FT4 and T3
low TSH
associated disease
decrease T3, T4
increase TAG
enumerate the sign and symptoms
HYPOTHYROIDISM
- cold intolerance
- bradycardia, fatigue
- dryness of skin
- unexplained weight gain, dyspnea, hair loss
- mental dullness, muscle weakness, constipation
- yellow discoloration of skin
- decrease Na+ incrase CK
associated disease
associated with severe hypothyroidism
- pleural and peritoneal effusions
- irregular mens
- periorbital edema
- myopathy
- anemia
associated disease
inc TSH
dec T3 T4 rT3 FT4
normal TBG
primary hypothyroidism
normal or increase: aTPO, ATG, TBII
normal to decrease: Tg
associated disease
dec T3 T4 FT4 TSH
secondary hypothyroidism
associated disease
normal T3 T4 FT4
slightly inc TSH
no signs and symptoms
subclinical hypothyroid…
enumerate the associated diseases in hypothyroidism
- hashimoto’s disease
- myxedema
- congenital hypothyroidism
associated disease
common cause of primary hypothyroidism
with goiter, thyroid is replaced by nest of lymphoid tissue
Hashimoto’s disease
Chronic autoimmune thyroiditis
also known as chronic lymphocytic thyroiditis
associated disease
test for hashimoto’s disease and its results
TPO antibody test
increase TSH
TPO Ab = tissue destructive disease
associated disease
peculiar nonpitting swelling of skin
- “puffy face” (moon face)
- weight gain, slow speech
- thin eyebrows, dry yellow skin
myxedema
myxedema coma is due to severe hypothyroidism
associated disease
development/functional defect of gland
retarded child
congenital hypothyroidism
“cretinism”