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1
Q

which areas of the HYPOTHALAMUS influence PARASYMPATHETIC ACTIVITY
ie Salivation, Increased GI Motility, Lowering HR and BP, Sweating

A
  • PRE-OPTIC
  • ANTERIOR
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2
Q

which area of the HYPOTHALAMUS influence ENDOCRINE ACTIVITY - PITUITARY GLAND

A

ANTERIOR NUCLEI

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2
Q

which areas of the HYPOTHALAMUS influence SYMPATHETIC ACTIVITY
ie Increase HR and BP, Vasoconstriction, Shivering, stopping GI Peristalsis

A
  • LATERAL
  • POSTERIOR
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3
Q

development of THYROID GLAND starts as an ENDORDERMAL THICKENING on the TONGUE which burrows through to form ..

A

THYROGLOSSAL DUCT

  • travels down and brings thyroid tissue with it
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4
Q

THYROID covers which TRACHEAL RINGS

A

2ND, 3RD, 4TH

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5
Q

EFFECT of SOMATOSTATIN on GI/PANCREATIC HORMONE release

A

INHIBITS

also inhibits GROWTH HORMONE, TSH

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6
Q

EFFECT of VASOACTIVE INTESTINAL POLYPEPTIDE on INTESTINAL ABSORPTIONS

A

INHIBITS

stops HCL and Pepsinogen release too

But RELAXES LOS for bolus to enter

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7
Q

MINERALCORTICOIDS (ALDOSTERONE) are produced where in ADRENAL GLAND

A

ZONA GLOMERULOSA

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8
Q

SEX HORMONES / ANDROGENS (Androstenedione, Dehyroepiandrosterone) are produced where in ADRENAL GLAND

A

ZONA RETICULARIS

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9
Q

GLUCOCORTICOIDS (CORTISOL) are produced where in ADRENAL GLAND

A

ZONA FASCICULATA

(large middle portion of cortex)

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10
Q

ADRENALINE/NORADRENALINE are produced where in ADRENAL GLAND

A

MEDULLA

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11
Q

which KIDNEY is LOWER

A

RIGHT

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12
Q

SHAPE of RIGHT SUPRENAL GLAND (on right kidney)

A

PYRAMIDAL

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13
Q

SHAPE of LEFT SUPRENAL GLAND (on left kidney)

A

SEMI-LUNAR

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14
Q

HORMONE that KIDNEY SECRETES that ELEVATES BLOOD OXYGEN

A

ERYTHROPOIETIN (EPO)

  • promotes RBC FORMATION by Bone Marrow

so higher circulating RBC and higher blood O2

(can be used to treat aneamia)

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15
Q

what does KIDNEYS RELEASE to INCREASE BLOOD CALCIUM as a result of PARATHYROID HORMONE

A

CALCITRIOL - active VITAMIN D

-> stimulates GUT to absorb calcium

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16
Q

AMINO ACID DERIVED HORMONES (thyroid hormones, catecholamines) are commonly derived from which AMINO ACIDS

A

TYROSINE
TRYPTOPHAN

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17
Q

THYROID HORMONES are … SOLUBLE

A

LIPID

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18
Q

CATECHOLAMINES are … SOLUBLE

A

WATER

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19
Q

what is a SMALL Peptide Hormone

A

TSH

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20
Q

what is a LARGE Peptide Hormone

A

INSULIN

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21
Q

which HORMONE is RELEASED by the HEART in response to HIGH BLOOD PRESSURE and DILATION of ATRIUM

A

ANP - ATRIAL NATRIURETIC PEPTIDE

  • regulates homeostasis of circulatory system
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22
Q

EICOSANOIDS (fatty acid derived) such as PROSTAGLANDIN are synthesised from a 20 carbon AMINO ACID called:

A

ARACHIDONIC ACID

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23
Q

what type of HORMONES bind to INTRACELLULAR RECEPTORS
(which binds gene promoter regions to stimulate/inhibit transcription)

A

HYDROPHOBIC (lipid derived)

eg Mineralcorticoids (aldosterone)
Glucocorticoids (cortisol)
Sex Hormones

and Lipid Soluble - Thyroid hormones

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24
Q

which hormones use G-PROTEIN LINKED RECEPTORS

A

CATECHOLAMINES

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25
Q

which hormone uses ENZYME LINKED RECEPTOR - TYROSINE KINASE Receptor

A

INSULIN

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26
Q

which hormone acts on FAT CELLS to stimulate BREAKDOWN of TRIGLYCERIDES

A

GROWTH HORMONE

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27
Q

hormone from PINEAL GLAND

A

MELATONIN

(response to darkness)

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28
Q

examples of hormones that use cAMP as a SECOND MESSENGER
(G-PROTEIN COUPLED RECEPTOR)

A
  • ADRENALINE / NORADRENALINE
  • GLUCAGON
  • LH, FSH
  • TSH
  • PARATHYROID, CALCITONIN
  • ADH
  • Angiotensin II
  • Histamines
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29
Q

PITUITARY FOSSA / SELLA TURCICA / HYPOPHYSEAL FOSSA is in which bone

A

SPHENOID BONE

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30
Q

ANTERIOR PITUITARY is Derived from..

A

ECTODERM of RATHKE’S POUCH

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31
Q

POSTERIOR PITUITARY is Derived from…

A

NEURAL ECTODERM from Floor of DIENCEPHALON

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32
Q

which hormones STIMULATE and INHIBIT PROLACTIN release from Anterior Pituitary (Lactotrophs)

A

+ : TRH (THYROTROPHIN RELEASING HORMONE)

  • : DOPAMINE
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33
Q

what hormone release is stimulated by STRESS, EXERCISE, HYPOGLYCAEMIA, MALNOURISHMENT, SEPSIS

A

GHRH from Hypothalamus

-> GROWTH HORMONE

(stimulates IGF-1 from Liver)

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34
Q

what hormone release is stimulated by STRESS, EXERCISE, HYPOGLYCAEMIA, MALNOURISHMENT, SEPSIS

A

GHRH from Hypothalamus

-> GROWTH HORMONE

(stimulates IGF-1 from Liver)

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35
Q

what provide NEGATIVE FEEDBACK for GHRH
(Long loop)

A

FREE FATTY ACIDS

(from adipocytes, lipolysis from GH)

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36
Q

which Hormone follows CIRCADIAN RHYTHM where it PEAKS in the MORNING

A

CORTISOL

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37
Q

which hormone release is stimulated during
STRESS, HYPOTENSION, HYPOGLYCAEMIA, SEPSIS, SURGERY

A

CRH
-> ACTH

-> CORTISOL

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38
Q

CORTISOL EFFECT on BONE

A

INHIBIT OSTEOBLASTS

  • Inhibit Bone Formation
39
Q

what is the EFFECT of THYROID HORMONES on BONES

A

INCREASED BONE TURNOVER and RESPORPTION

  • reabsorb and reform
    osteoclasts and osteoblasts
40
Q

which NUCLEI in the HYPOTHALAMUS produce OXYTOCIN & VASOPRESSIN/ADH/AVP that are stored in posterior pituitary

A

PARAVENTRICULAR nucleus
SUPRAOPTIC nucleus

41
Q

Products of GLYCOLYSIS

A

2 ATP (net gain)
2 NADH
2 PYRUVATE

42
Q

Products of the LINK REACTION

A

for 2 GLUCOSE (2 cycles):

2 ACETYL CoA
2 CO2
2 NADH

43
Q

products of the KREBS CYCLE

A

1 cycle:
2 CO2
1 GTP
1 FADH
3 NADH

2 CYCLES (for 1 glucose):

4 CO2
2 GTP
2 FADH
6 NADH

44
Q
  • which Glucose receptor/transporter has the Highest affinity (and lowest Km) and thus is found in the BRAIN? for preferential uptake in HYPOGLYCAEMIA
  • which is INSULIN SENSITIVE?
  • which has the Lowest affinity but is found in Pancreatic Beta cells for Insulin production?
A
  • GLUT3
    (GLUT1 also in brain)
  • GLUT4
  • GLUT2
45
Q

what is Km

A

CONC. of substrate that permits the enzyme to achieve HALF LIFE

46
Q

which hormones stimulate INSULIN secretion (incretins)

A

GLP-1 (glucagon like peptide 1)
GIP (gastric inhibitory polypeptide)

47
Q

what causes INSULIN RELEASE from Beta cells

A

at rest cell is polarised (K+ efflux)

  1. Glucose intake by GLUT2
  2. GLYCOLYSIS generates ATP
  3. ATP-SENSITIVE K+ CHANNELS CLOSE
  4. CA2+ CHANNELS OPEN (ca2+ influx)
  5. DEPOLARISATION causes Vesicles containing INSULIN to move to surface and RELEASE (exocytosis)

also stimulated by GLP-1 binding

48
Q

INSULIN how many amino acids peptide
GLUCAGON how many amino acids peptide

A

51 (pro-insulin 84 aa)
29

49
Q

how are THYROID HORMONES synthesised

A

THYROGLOBULIN synthesised in FOLLICULAR CELLS and EXOCYTOSED into COLLOID

IODIDE (I-) UPTAKE into FOLLICULAR CELLS, from blood and OXIDISED into IODINE (I). transferred to COLLOID

  • in colloid IODINE attaches to TYROSINE RESIDUES on THYROGLOBULIN to form MONO-IODOTYROSINE (MIT) and DI-IODOTYROSINE (DIT)
  • COUPLING processes to form T4 / THYROXINE (2DIT) and T3 / TRI-IODOTHYRONINE (MIT)
    (mostly T4)
  • released from cell by ENDOCYTOSIS
50
Q

Conversion / Monodeiodination of T4 INTO T3 (4x more potent) in the LIVER and KIDNEY by what

A

TYPE 1,5’ - DEIODINASE

51
Q

thyroid gland weight

A

25g

52
Q

TSH RECEPTORS on FOLLICULAR CELLS (thyroid) are what type

A

G-PROTEIN COUPLED

  • second messenger cAMP
53
Q

which pancreatic hormone uses G-PROTEIN COUPLED RECEPTOR

A

GLUCAGON

54
Q

which Hormone is CALORIGENIC (HEAT PRODUCING)

A

THYROID Hormones

55
Q

HYPOTHYROIDISM symptoms and signs

(increased TSH may indicate)

A
  • FATIGUE, WEAKNESS, LETHARGY
  • COLD INTOLERANCE
  • MENTAL SLOWNESS, Poor memory, concentration, hearing
  • DRY SKIN
  • HOARSE voice
  • CONSTIPATION
  • MUSCLE CRAMPS
  • IRREGULAR PERIODS, INFERTILITY
  • FLUID RETENTION / NON-PITTING EDEMA from fluid build up (swelling)
  • mild WEIGHT GAIN with Poor Appetite
  • Hair Loss
  • SHORTNESS of BREATH
  • SLOW PULSE / BRADYCHARDIA
  • SLOW SPEECH, SLOW MOVEMENTS, DELAYED RELAXATION
  • HYPERTENSION
  • GOITRE - visible Swelling of thyroid (primary)
  • DEPRESSION
  • Face may appear swollen/puffy, puffy eyes
56
Q

ADRENAL GLAND has a very rich blood supply.

where do these branch from?
Superior supra renal artery:
Middle supra renal artery:
Inferior supra renal artery:

A

Superior supra renal artery:
INFERIOR PHRENIC Artery

Middle supra renal artery:
AORTA

Inferior supra renal artery:
RENAL Artery

57
Q

what are the ADRENAL CORTEX and MEDULLA derived from

A

Cortex: LATERAL MESODERM

Medulla: NEUROECTODERM
- NEURAL CREST CELLS

58
Q

which hormones have a CYCLOPENTANOPHENANTHARINE structure

A

ADRENOCORTICO Hormones
(from adrenal cortex)

  • MINERALCORTICOIDS - ALDOSTERONE
  • GLUCOCORTICOIDS - CORTISOL
  • SEX HORMONES & ANDROGENS (androstenedione, dehydroepiandrosterone)
59
Q

CONN’S SYNDROME is Excess of…

CUSHING’S SYNDROME (gru) is Excess of…

A

Conn’s: ALDOSTERONE

Cushing’s: CORTISOL

60
Q

ADDISON’S DISEASE is due to

A

ALDOSTERONE & CORTISOL UNDER-PRODUCTION

61
Q

Conversion of Cholesterol into which Hormone is promoted by CA2+ and PROTEIN KINASE C

A

ALDOSTERONE

(cortisol uses cAMP and protein kinase A from ACTH binding)

62
Q

how are CATECHOLAMINES formed

A

by HYDROXYLATION and DECARBOXYLATION of TYROSINE

(Levo-Dopa and Dopamine intermediaries)

63
Q

what is PRECHROMOCYTOMA

A

HYPERSECRETION of CATECHOLAMINES

64
Q

45% of blood CA2+ is bound to..

(1% of body Ca2+ in blood, 99% as hydroxyapatite)

A

ALBUMIN
(not functional)
(pH dependent)

65
Q

Ca2+ normal serum range

A

2.18 - 2.62

66
Q

Ca2+ daily requirements

Infants & children:
Teenagers:
Adults:

A

Infants & children: 350 - 550 mg/day
Teenagers: 800 - 1000 mg/day
Adults: 700 mg/day

67
Q

PHOSPHATE normal blood range:

Adults need how much a day?

A

0.8 - 1.5 mmol/L

550 mg phosphorus / day

68
Q

what can HYPERPHOSPHATAEMIA (high phosphates) cause

A

HYPOCALAEMIA (low ca2+)

  • Calcification of soft tissue, arteries, heart valves
69
Q

CHIEF cells and OXYPHIL cells are found in which gland

A

PARATHYROID Glands

chief cells: PTH

70
Q

PARATHYROID GLANDS are derived from..

A

ENDODERM

  • 3 and 4 PHARYNGEAL POUCHES
71
Q

how many Amino acids in PARATHYROID HORMONE

A

84

pre-pro PTH : 115
pro PTH: 90

72
Q

Effect of PTH on PHOSPHATE LEVELS

A

DECREASES PHOSPHATE REABSORPTION from KIDNEY
due to increased Ca2+ reabsorption

but CALCITRIOL / VIT D INCREASES PHOSPHATE REABSORPTION from the INTESTINES (& Ca2+)

73
Q

clinical features of HYPERPARATHYROIDISM and HYPERCALAEMIA

A
  • NAUSEA, VOMITING
  • BONE PAIN & OSTEOPOROSIS
  • KIDNEY STONES
  • SHORT QT INTERVAL (heart ecg)
  • CONSTIPATION
  • PSYCHOSIS & altered MENTAL status
74
Q

clinical features of HYPOPARATHYROIDISM and HYPOCALAEMIA

A
  • MUSCLE WEAKNESS & CRAMPS
    nerve function:
  • PERORAL (around mouth) NUMBNESS and TINGLING
  • CHVOSTEK’S SIGN, spasm of facial muscles when tap
  • TROUSSEAU’S SIGN, spasm when use BP machine on arm
  • TETANY, involuntary muscle contractions
75
Q

name of GHRELIN RECEPTOR

where is the receptor found?

A

GHS-R
GROWTH HORMONE SECRETAGOGUE RECEPTOR

on NPY / AgRP neurones in the
HYPOTHALAMIC ARCUATE NUCLEUS (key area in hypothalamus for regulation of appetite)

(ghrelin crosses blood-brain barrier)

76
Q

Hormones for SATIETY / DECREASE FOOD INTAKE (Anorexigenic)

A
  • LEPTIN
  • INSULIN
  • GLP-1
  • PYY (peptide YY)
  • CCK (choleocystokinin)
  • PANCREATIC POLYPEPTIDE
77
Q

which hormone activates NEURONS in PVN and AMYGLADA

A

GLP-1

78
Q

where are INSULIN RECEPTORS most highly expressed

A

OLFACTORY BULB & HYPOTHALAMIC ARCUATE NUCLEUS

79
Q

to DECREASE FOOD INTAKE what does LEPTIN and GLP-1 stimulate in Arcuate nucleus

A

POMC (alpha MSH release) CART Neurotensin

(POMC cleaved by PC1/PC2 into MC4)

  • activates MC4 (MELANOCORTIN 4) RECEPTOR and CART RECEPTOR

(alpha-MSH : alpha melanocortin-stimulating hormone)

80
Q

where can you find STROMOVASCULAR CELLS

A

ADIPOSE tissue alongside Adipocytes (20-40%)

contain
- adipocyte precursors
- vascular cells
- immune cells
- nerve cells
- fibroblasts

81
Q

LEPTIN is a small peptide with how many amino acids?

encoded by which gene?

Receptor?

A

167 aa

LEP / Ob gene

ObRb receptor in hypothalamus (arc)

82
Q

hormone released from Adipose that INCREASES INSULIN SENSITIVITY (decreases insulin resistance)

what stimulates secretion of it

A

ADIPONECTIN

  • excretion/secretion diminished in obesity
    (high adipose tissue means less adiponectin)

THIAZOLIDINEDIONES stimulate

83
Q

WHITE ADIPOSE TISSUE for:

BROWN ADIPOSE TISSUE for:

WAT structure:
BAT structure:

A

WAT: STORES ENERGY (lipids)
& secretes signalling factors that regulate appetite and energy - LEPTIN, ADIPONECTIN

BAT: GENERATES BODY HEAT

WAT: SINGLE, LARGE Fat Droplet
BAT: SMALL Fat Droplets with IRON-RICH MITOCHONDRIA (brown appearance)

84
Q

name of MC4 AGONIST to reduce body weight in MC4 Deficiency

name of GLP-1 AGONIST to reduce body weight in obesity

A

SETMELANOTIDE

SEMOGLUTIDE

85
Q

most of the enzymes in STEROIDOGENESIS pathway are part of the CYP450 enzyme family.
name of the Cholesterol Side-Chain Cleavage enzyme that cleaves Cholesterol side chain to form Pregnenolone

(most enzymes in SER)

A

CYP11A

86
Q

which enzyme converts Dehydroepiandrosterone (DHEA) into Androstenedione

A

3-BETA HSD

(also converts pregnenolone to progesterone)

87
Q

TESTOSTERONE is converted into its more Potent form DIYDROTESTOSTERONE by which enzyme

A

5-ALPHA REDUCTASE

88
Q

3 estrogens: Estrone, Estradiol, Estriol

TESTOSTERONE (A Ring) is aromatised by AROMATASE enzyme into which form of ESTROGEN?

Androstenedione can directly be aromatised into which Estrogen type?

A

Testosterone -> ESTRADIOL (main type)
(-> Estriol)

Androstenedione -> Estrone
(-> Estriol)

89
Q

which Testicular cell secretes Inhibin for negative feedback of FSH

A

Sertoli Cells (nurse cells)

90
Q

which Ovarian cell secretes Inhibin and Activin for negative and positive feedback of FSH

A

GRANULOSA cells

91
Q

LH and FSH.

which one produces TESTOSTERONE (Androgens) and where does it act on?

which one produces ESTROGENS and where?

A

Testosterone: LH
- Leydig cells (males)
- Theca Interna cells (female)

Estrogens: FSH
- Granulosa cells (females)
- sertoli cells (males)
(also secreted from corpus luteum & placenta)

92
Q

how long are the FOLLICULAR and LUTEAL phases of the MENSTRUAL cycle

which hormones dominate each phase

A

Follicular: 14-21 days varies
(menses first 4-5 days)

ovulation (around day 14)

Luteal: fixed 14 days

Follicular: Oestrogen
(FSH causes oestrogen peak -> LH surge)
Luteal: Progesterone (oestrogen increase from CL, flat LH, FSH)

93
Q

AROMATASE
where is it present?

deficiency caused by Mutation of which gene (causing overproduction of testosterone and estrogen deficiency)

A
  • SKIN, BONE, BRAIN, ADIPOSE TISSUE, VASCULAR ENDOTHELIUM, ENDOMETRIUM, GONADS, PLACENTA
  • CYP19A1
94
Q

Right ADRENAL Vein drains into:

Left ADRENAL Vein drains into:

A

right: IVC

left: LEFT RENAL VEIN

ENDOCRINOLOGY (11 decks)

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