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Block 3 > Week 6 > Flashcards

Week 6 Flashcards

1
Q

How does thyroid hormones affect GI motility?

A
  • increases
    • appetite adn food intake
    • rates of digestive juices
    • motility
  • Hyper: increases bowl movements
  • Hypo: constipation
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1
Q

How do the adrenal glands maintain homeostasis?

A
  • regulate body’s adaptive response to stress (cortisol)
  • regulate body water, sodium and potassium balance and metabolism (aldosterone)
  • control blood pressure
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1
Q

What is the vaginal fornix?

A
  • recess around cervix
  • has anterior, posterior and lateral parts
    • posterior is the deepest
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2
Q

What are the main functions of glucocorticoids?

A
  • ^ metabolism of proteins, carbs, and fats
    • ^ blood glucose
    • nearly all tissues have glucocorticoid receptors
  • important in resisting stress and inflammation
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3
Q

How does calcitriol work?

A
  • formed from 7-dehydrocholesterol
  • final activation occurs in kidneys
  • Bone: increase Ca2+ and Pi mobilization, stimulates osteoblasts and indirectly osteoclast
  • Kidneys: decrease both phosphate and Ca2+
  • Intestine: increase Ca2+ absorbtion by upregulating calbindin
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3
Q

How does Thyroid hormones effect carbohydrate metabolism?

A
  • increases the rapid uptake of glucose
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3
Q

What are the common causes of primary hyperthyroidism?

A
  • Graves disease
  • hyperfunctioning thyroid nodules
  • therapy induced hyperthyroidism
  • thyroiditis (inflammation)
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3
Q

What is congenital adrenal hyperplasia?

A
  • Cause:
    • autosomal receissive disorder leading to deficient production of cortisol and aldosterone
    • excessive production of sex steroids
  • 95% of cases due to 21-hydroxylase defiency
  • severe deficiency: life treatening vomiting and dehydration in first weeks of life. Ambigious genitalia of gentically female infants
  • moderate: prepubertal virilization
  • mild: infertility in women
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4
Q

How does TSH affect cellular metabolic activity?

A
  • increase
    • number, size, and activity of mito to increase ATP formation
    • Na+/K+ ATPase activity
    • synthesis of metabolic proteins
  • everything increases O2 consumption and BMR
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5
Q

Osteogenesis imperfecta

A
  • bone disorder
  • decreased osteoid
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5
Q

What are the properties of the thyroid hormone receptors?

A
  • TRs have much higher affinity for T3
  • TRs are nuclear receptors
    • ligand activated transcription factors
    • bind to enhance elements on DNA to produce new proteins
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5
Q

What are the structural properties of Vitamin D?

A
  • secosteroid
  • Open B ring
  • 27 carbons
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6
Q

What factors are involved in Thyroid hormone synthesis?

A
  • TSH
  • Thyroglobulin
  • Iodine
  • Membrane transporters
  • Enzymes
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6
Q

What is thyroid hormone metabolism of T3 and T4?

A
  • 40% of secreted T4 are converted to T3
  • T3 is mainly used by tissues
  • Main source of T3 is the deiodination of T4
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8
Q

How is calcium transported in the epithelial cell in the intestine?

A
  • Calcium passive transporter on the lumenal side
    • once in the cell, immediately bound to calbindin
    • Calbindin upregulated by Vit D
  • Ca2+ will disassociate and exit through Na antiporter
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8
Q

What are the 3 types of plasma proteins that thyroid hormones bind to?

A
  • Thyroxine bidning globulin (TBG) 70%
  • Transthyretin (prealbumin) 15%
  • Albumin 15%
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9
Q

What occurs during stage 4 of biosynthesis of thyroid hormones?

A
  • Endocytosis of thyroglobulin
  • Lysosomes fuse wiht pinocytotic vesicles
    • proteases mix with colloid to digest thyroglobulin
  • T3 and T4 released and diffuse into bloodstream and can bind to TBG
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10
Q

What intermediate do all steroid hormones go through?

A
  • Cytochrome p450 makes pregnenolone (C21 intermediate)
    • cleavage of 6 carbons from side chain of cholesterol
  • additional enzymes will make the steroid hormones
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11
Q

What occurs in Graves disease?

A
  • thyroid stimulating immunoglobulins TGIs (antibodies) form against TSH receptor in thyroid gland
  • Stimulates the receptor to release T3/4
  • Develop goiter
  • Low levels of TSH
  • Graves ophthamopathy
  • mexedema
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11
Q

What is the main function of adrenal medullary hormones?

A
  • makes rapid, short term adjustments to actual or threatened changes in external or internal environment
    • fight or flight
  • actions are supported by glucocorticoids
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12
Q

What are the structural properties of the seminal glands?

A
  • Between the fundus of bladder and rectum
    • covered with peritoneum superiorly but seperated from rectum by rectovesical pouch
  • contributes to formation of ejaculatory duct
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12
Q

What are the three parts to the uterine wall?

A
  • permetrium - serosa
  • mymetrium - sm, contains main branches of blood vessels
  • endometrium - inner mucous coat
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12
Q

What two muscles compress the vagina and act as sphincters?

A
  • external utrethral sphincter
  • bulbospongiosus
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13
Q

What is the normal blood concentration of aldosterone and cortisol? Where are they inactivated?

A
  • aldosterone: 6 ng/dl (secretory rate 0.15 mg/day)
  • cortisol: 12 microg/dl (secretory rate 15 mg/day)
  • inactivated mainly in the liver and conjugates excreted mainly in urine
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13
Q

At what level is the rectosigmoidal junction?

A

S3

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14
Q

How is cytochrome P450 important to steroid hormones?

A
  • Used extensively in steroid hormone biosynthesis
  • heme containing membrane bound protein found in the sER of liver and lungs can also be mito
  • broad substrate specificity
  • works with cytochrome P450 reductasen(CPR)
    • e- flow from NADPH to FADH2-CPR to heme in p450
  • C27 to C21
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15
Q

Osteomalacia/Rickets

Calcium? Phosphate? PTH? Alkaline phosphate?

A
  • Calcium: down
  • Phosphate: down
  • PTH: up
  • Alkaline phosphatase: up
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15
Q

What is pheochromocytoma? Symptoms? Diagnosis?

A
  • cause: chromaffin cell tumor
    • over secretion of catecholamines
  • symptoms
    • elevated HR
    • systemic hyertension
    • anxiety
    • pallow and sweating
    • hyperglycemia
  • diagnosed
    • high levels of catecholmines and metabolites in blood in blood and urine
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15
Q

What is benign hypertropy of prostate (BHP)?

A
  • common after middle age in every male
  • median lobe becomes enlarged
    • projects into bladder and obstructs prostratic urethra
  • Symptoms
    • nocturia
    • dysuria
    • urgency
  • treatment: trans-urethral resection of prostate
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16
Q

What occurs during stage 1 of biosynthesis of thyroid hormones?

A
  • Iodide trapping - influenced by TSH
  • movement of iodides from blood into thyroid cells and follicles
  • NaI symporters (NIS)
    • actively pump iodide into cytosol
  • Pendrin
    • counter transporter of iodide into colliod lumen for Cl-
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16
Q

What is the blood supply to the male bladder?

A
  • Internal iliac artery
  • obturator artery
  • inferior gluteal artery
  • inferior vesical artery
  • prostatic venous plexus
  • superior vesical artery
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17
Q

What is the long term regulation of Ca2+ plasma levels?

A
  • PTH
  • Calcitrol (active Vit D)
  • Calcitonin (CT)
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18
Q

How does the Calcium sensing receptor and Vit D help to regulate PTH release?

A
  • in chief cells
  • If there is high plasma Ca2+ levels it inhibits PTH release
  • Vit D directly downregulates PTH synthesis
  • opposite increases PTH release
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19
Q

Where do most steroids bind to their receptor in cell?

A
  • Steroid hormone diffuses straight into nucleus
  • binds to receptor in nucleus
    • results in activated dimer
  • dimer binds to HRE
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20
Q

What is congential hypothyroidism (cretinism)?

A
  • extreme hypothyroidism during fetal life and infancy either from
    • lack of thyroid gland
    • iodine insufficiency
  • symptoms appear a few weeks after birth: sluggish movements, retarded physical and metal development
  • mental growth remains if not treated
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22
Q

How do osteoblasts work?

A
  • synthesize bone
  • cells are signal nuclei but function as a group of connected cells to form a calcium and phosphate mineral base after the matrix has been laid down
  • Release RANK ligand that binds to RANK receptor on stem cells and osteoclast precursors to stimulate the activation of oxteoclasts
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23
Q

What are the secretory products of adrenal medulla?

A
  • epi: norepi 4 to 1
  • adrenal medula sole source of epinephrine
    • chromafin cells are modified postganglionic neurons
  • not esstential for survival as long as sympathetic nervous system is intact
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25
Q

Chronic Renal Failure

Calcium? Phosphate? PTH? Alkaline phosphate?

Treatment?

A
  • Calcium: down
  • Phosphate: up
  • PTH: up
  • Alkaline phosphatase
  • Treatment
    • restore and maintain clacium levels
    • Vit D supplements
    • restrict phosphate
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26
Q

How does Deiodinase Type II work?

A
  • Brain, pituitary, thyroid, skeletal and cardiac muscle
  • T4 to T3
  • rT3 to T2
  • major source for local production of T3 in tissues
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26
Q

How does thyroid hormone affect the CNS?

A
  • maturation of CNS during perinatal period is completely dependent on thyroid hormones
  • cerebral and cellubular growth, myelinization, vascularization, axonal and dendritic density, cell migration and differentiation are all affected
  • generally excitatory effects
    • hyper: nervousness and psychoneurotic tendencies
    • hypo: lack of energy. slowness of speech, dulled mental capacity
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27
Q

What are the measurements of the male and female pelvis?

A
  • male: < 70º
  • female >80º
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29
Q

What are the half lives of T3 and T4

A
  • T3 has a shorter half life than T4
    • T4 is 15 days
  • Binding proteins has a higher affinity for T4 is 10x higher than T3
  • binding thyroid hormones of plasma proteins ensures a circulating reserve and delays their clearance
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30
Q

What are the three parts of the broad ligament?

A
  • mesosalpinx - uterine tube
  • mesovarium - ovary
  • mesometrium - mesentry for the uterus itself
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31
Q

Where does unbound cortisol and aldosterone bind in the cell?

A
  • binds to receptor in cytoplasm
    • cause the release of heat shock protein
    • creates activated dimer
  • dimer translocates into nucleus
  • binds to HRE on DNA
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32
Q

What are the bones in the bony pelvis?

A
  • Ilium
    • Iliac crest 1
    • Anterior superior iliac spine 2
    • Greater siactic notch 3
  • Ischium
    • Ischial spine 4
    • Ischial tuberosity 5
    • Lesser siatic notch
  • Pubis
    • pubic tubercle 7
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33
Q

What are the rapid changes used to change Ca2+ plasma levels?

A
  • Protein bound Ca2+
  • Exchange with bone
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34
Q

How is phosphorus absorbed in the kidneys?

A
  • proximal tubule
    • 80% in transcellular
    • inhibited by PTH
    • Na cotransporter
  • distal tubule
    • 10% transcellular
    • Na cotransporter
  • 10% excreted
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35
Q

When Norepi or Epi bind to alpha-1, what G protein do they use?

A
  • Gq to IP3/DAG/^ [Ca2+]
  • vasoconstriction
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35
Q

What is the blood supply to the prostate gland?

A
  • inferior vesical
  • middle rectal
  • internal pudenal
  • prostatic venous plexus
    • continuous iwth vesical venous plexus
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36
Q

How is calcium stored in the body?

A
  • Bones and teeth 99%
  • Extracellular fluid 0.1% where most of it is free
  • Intracellular fluid 0.9% most bound with a protein
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38
Q

What is the negative feedback of TSH?

A
  • Thyroid hormones inhibit
    • TRH synthesis
    • gene expression for TSH and TRH receptor
    • TSH release
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39
Q

What are the two regions of the pelvis?

A
  • Superior/greater (false) pelvis
  • Inferior/lesser (true) pelvis
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40
Q

What is secreted by the prostate gland?

A
  • 20% of semen volume
  • Slightly acidic
    • zinc - stability of chromatin
    • citric acid - protection
    • acid phosphatase
    • prostate specifc antigen - liquefies semen
    • pro(fibrinolysin) - liquiefies coagulated semen
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41
Q

What are the symptoms of Cushing’s syndrome?

A
  • glucocorticorid excess
    • ^ hyperglycemia
    • ^ fat mobilization from lower body and redistribution to thorax and abdomen (buffalo torso)
    • moon face ( round and puffy)
    • weaknes, osteoporosis, striae on skin
  • androgen excess: acne, excess growth of facial hair in females
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42
Q

What is the cause of Conn’s syndrome and what are the symptoms?

A
  • Causes
    • small tumor on the zona glomerulosa that secretes large amounts of aldosterone
    • hyperplastic adrenal cortices secrete aldosterone rather than cortisol
  • Symptoms
    • hypokalemia
    • hypertension
    • low plasma renin
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43
Q

Why doesnt cortisol excert more effects on the kidneys becuase it can bind to minealocorticoid receptors with high affinity?

A
  • renal epithelial cells contain 11beta-HSD2
    • converts cortisol to cortisone
  • Cortisone doenst bind with such high affinity so cortisol doesnt exert significant amounts of mineralcorticoid effects
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45
Q

What does PTH stimulate?

A
  • essential for life
  • Bone: directly stimulates osteoblasts which release cytokines to stimulate osteoclasts
    • bone resorption = increased [Ca2+]
  • Kidney: increase phosphate excretion and Ca2+ reabsorbtion
  • Intestine: Indirectly stimulates Vit D activation which increases absorption of Ca2+ from diet
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46
Q

What are the four parts of the uterine tube?

A
  • infundibulum
  • ampulla
  • isthmus
  • uterine part
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47
Q

Where is the suspensory ligament of ovary?

A
  • superolateral aspect of the ovary
  • contains ovarian vessels, lymphatics, and nerves
    • crosses the pelvic brim
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48
Q

What is pseudohyperaldosteronism?

A
  • genetic deficiency of 11beta-HSD2 so cortisol can have substantial mineralcorticoid effects
  • ingestion of large amounts licorice can block 11beta-HSD2 activity
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48
Q

How does cortisol have anti-inflammatory effects?

A
  • released during body stressful situations
    • rapid mobilization of AA and fats for energy and synthesis of compounds required for maintenance and prouduction of new cells
  • transrepression
    • inhibition of proinflammatory gene
  • transactivation
    • stimulation of anti-inflammatory gene
49
Q

What are the properties of the nuclear steriod hormone receptor?

A
  • contain
    • poorly conserved trans-activation domain
    • highly conserved DNA binding domain
    • ligand binding domain
  • once the hormone binds they have will bind to hormone response elements (HRE) on DNA
  • bind to DNA as homodimers
  • increase or decrease transcription
50
Q

What are the peritoneal relections of the female pelvis?

A
  • Down from anterior abdominal wall to the level of the pubic bone
  • superior surface of bladder
  • isthmus, fundus and body of uterus
    • extends over the fornix of vagina
    • makes the rectouterine pouch before going up to the rectum
  • covers anterior and lateral sides of super rectum
    • lateral sides of middle rectum
  • becomes sigmoid mesocolon at S3
52
Q

Osteogenesis

A
  • Bone disorder
  • decreased mineralization
52
Q

What is Hasimotos disease?

A
  • autoantibodies against thyroglobulin, TPO, TSH receptor
  • autoimmune thyroiditis and progressive deterioration and finally fibrous of gland so no thyroid hormone is produced
  • Low T3/4 but high TSH
54
Q

What is calcium used in the body for?

A
  • Nerve excitability
  • Transmiter release
  • Muscle Contraction
  • Enzyme cofactor
  • Bone
55
Q

What does the vesical venous plexus do and what does it surround?

A
  • Envelops
    • fundus of bladder
    • prostate
    • seminal glands
    • ductus deferens
    • inferior ureter
  • receives blood from deep dorsal vein of penis (drains erectile tissue)
  • mostly drains bladder through inferior vesical veins to internal iliac veins
56
Q

Vitamin D intoxication

Calcium? Phosphate? PTH? 24 hr urine calcium?

A
  • Calcium: up
  • Phosphate: up
  • PTH: down
  • 24 hr urine calcium: up up up
57
Q

How is calcium absorbed in the intestine?

A
  • active absorption in duodenum and jejunum
  • passive absorption in the ileum
58
Q

What is important clinical note about the ureter in the female?

A
  • ureter passes under uterine artery
    • water under the bridge
59
Q

What is the major end product of norepi and epi metabolism?

A
  • Vanillylmandelic acid
    • inactivated products are conjugated with glucuronic acid and sulfates
60
Q

How is phosphorus used in the body?

A
  • phosphoproteins
  • buffering pH
  • DNA, RNA
  • Bone
61
Q

What are the genomic effects of aldosterone?

A
  • Purpose is to uptake Na+ and secondarily water
  • binds to receptor complex in the cytoplasm
  • ^ gene transcription of
    • enzymes (Na/K ATPase)
    • membrane transport proteins
  • effects are not immeidate, takes 45-60 mins for protein synthesis
62
Q

What is the secretions from the bulbourethral gland?

A
    • galactose
  • mucus
  • pre-ejactulate
  • phosphate and bicarbonate
64
Q

When TSH binds to thyroid cells, what genes are upregulated?

A
  • Iodide pump
  • Thyroglobulin
  • Enzymes involved in T3 and T4 synthesis
  • NO synthase to increase blood flow
  • local growth factors to increase size and number of thyroid cells
65
Q

Where is the round ligament of uterus?

A
  • anteroinferior to uterotubal junction
  • will go through the deep inguinal ring
  • terminates at the labia majoris
66
Q

What are the three stages epithelial thyroid cells size ?

A
  • Synthesis of thyroglobulin - tall with microvilli
  • Resting - short and flat
  • Breakdown of thyroglobulin - scapploed edges
67
Q

C19 is

A
  • Androgens
    • Testosterone
    • DHEA (dihydroestosterone)
69
Q

How does Deiodinase Type 1 work?

A
  • Liver, Kidney, Thyroid
  • Catalyzes both outer and inner ring deionation
    • T4 to T3
    • T4 to rT3
    • T3 to T2 (inactive)
71
Q

How does osteoprotegetrin work?

A
  • Stops the RANK ligand from activating osteoclast precursors
72
Q

What is the secretion made by the seminal glands?

A
  • 60% of secretions
  • Alkaline fluild containing
    • fructose - nutrition
    • prostaglandins - motility and protection
    • fibrinogen - clotting, keeps semen inside female productive tract
73
Q

What are the degrees of uterine prolapse?

A
  • 1st - cervix still inside vagina
  • 2nd - cervix appears outside vulva
  • 3rd - complete prolapse
74
Q

What are the structural properties of the uterine tube?

A
  • 10 cm long, usually site of fertilization
  • lie in mesosalphix
  • fimbriae ideally arch anterior and superior to ovaries
76
Q

How is phosphorus tansported in the small intestine?

A
  • Sodium/phosphorus co-transporter
  • Unsure how phosphorus gets out
  • Sodium concentration maintained by Na+/K+ antiporter on basolateral side
77
Q

How does Diodinase Type III work?

A
  • Brain, placenta, fetal tissues
    • placental protection of fetus to reduce flow of T3 to fetus
    • Adult Brain: protective mechanism against high thyroid hormone concentrations
  • has only inner ring deiodination activity
  • T3 to rT3
78
Q

What is the blood supply to the rectum?

A
  • rectal arteries
    • Superior - IMA
    • Middle - Anterior division of Internal iliac
    • Inferior - Internal pudendal artery
  • connection between the portal and caval system
79
Q

What are the non-genomic effects of TSH binding to a cell?

A
  • increases cAMP
  • increases proteolysis of thyroglobulin to increase T3 and T4
  • increases iodide pump activity to increase iodide trapping
80
Q

What is the major effect of Vitamin D?

A
  • activated in the kidneys, travels to the intestine
  • stimulates Ca2+ and phosphate from intestinal lumen
  • increases transcription of Ca pump molecules and calbindins
80
Q

How are glucocorticoids released?

A
  • CRH, ACTH, and cortisol secretion are high in the early morning and then steadily decrease throughout the day
  • release is pulsatile
80
Q

What are the parts of the male urethra?

A
  • Preprostatic part
  • prostatic part
  • membranous part
  • spongy part
81
Q

What is secondary hyperthyroidism?

A
  • TSH secreting pituitary adenomas resulting in high TSH, T3/4
82
Q

How are catecholamines released?

A
  • ACh released from preganglionic sympathetic
    • ACh binds to nicotinic receptors
  • Na+ influx into cell
    • Depolarization
  • ^ [Ca2+]
  • exocytosis of neurosecretory granules
83
Q

What is the blood supply to the uterus?

A
  • mostly from uterine arteries
    • anatomoses from the ovarian artery from above
    • will supply placenta
  • uterine veins go with arteries and form venous plexus
    • drains into internal iliac veins
84
Q

How is calcium reabsorbed in the kidneys?

A
  • Proximal tubule
    • 70% mainly paracellular
  • ascending tubule, distal and collecting tubule
    • transcellular
    • influenced by PTH
85
Q

When norepi or epi bind to alpha-2 what g protein use?

A
  • Gi inhibits cAMP
  • decreases Norepi release
85
Q

What are the 4 lobes of the prostate?

A
  • Anterior lobe
  • Posterior lobe
  • Lateral (or right and left) - on both sides of the urethra
  • Median lobe
86
Q

What is the transverse cervical (cardinal) ligaments?

A
  • extends from supravaginal part of cervix to lateral walls of pelvis
  • primary support of cervix
87
Q

What is the broad ligament?

A
  • double layer of peritoneum
  • extends from sides of uterus to lateral walls of abdomen to floor of pelvis
  • keeps uterus in position
89
Q

What are the main actions of androgens in the body?

A
  • Normally only weak effects in humans
    • may contribute to early dvelopement of male sex organs
  • Females: growth of pubic and axillary hair in females
  • Males: in testes adrenal androgens converted to testosterone
90
Q

What are the possible causes of hypothyroidism?

A
  • Hasimotos disease
  • Endemic collid goiter
  • Congential hypothyroidism (cretinism)
  • Inherited defects of hormone synthesis
  • Treatments of hyperthyroidsm
  • Thyroid surgery and radiation therapy
91
Q

C18 is

A
  • Estradiol
    • Aromatic A ring points up (receptor recognition)
92
Q

What is the arterial supply in the female bladder?

A
  • superior vesical arteries
    • anterosuperior bladder
  • vaginal arteries
    • fundus and neck
  • obturator
93
Q

What are the affects of cortisol on protein metabolism?

A
  • decreases protein stores in all body cells (except liver)
    • decreases protein synthesis
    • ^ protein catabolism
  • ^ liver and plasma proteins
    • ^ liver enzymes for protein synthesis that will be used for protein catabolism
  • ^ blood AA
    • ^ available AA for the liver to turn into glucose
94
Q
A
95
Q

What is the blood supply to the ureter?

A
  • it receives branches from
    • renal arteries
    • aorta
    • gonadal vessels
    • common iliac artery
    • super and inferior vesical arteries
      • note: vaginal artery instead of inferior vesical artery in females
  • venous drainage mostly parallels
96
Q

When norepi and epi bind to Beta 1 and 2 what G protein?

A
  • Gs increase cAMP
  • increases contractility, conduction, velocity
  • sm vasodilation
97
Q

What occurs during stage 5 of biosynthesis of thyroid hormones?

A
  • 75% of iodinated tyrosine in thyroglobulin never becomes T3 or T4
    • digested MIT and DIT are freed into cytosol of the thyroid cell
  • Iodine is cleaved from MIT and DIT by deiodinase enzyme and recycled
98
Q

Osteoporosis

A
  • Bone disorder
  • decreased osteoid and mineral
100
Q

What drugs stimulate osteoblasts?

A
  • Denosumab (increases RANK ligand)
  • Teriparatide (mimics PTH)
102
Q

What is the biosynthesis and storage of catecholamines?

A
  • Catecholamines are synthesized in chromaffin cells
    • synthesized from tyrosine
  • Stored in electron dense chromaffin granules at very high concentrations
  • Granules contain ATP and ADP and severl neuropeptides
103
Q

What are the causes of uterine prolapse?

A
  • weakness of pelvic floor muscles and/or ligaments
  • more common with multiple vaginal births
  • other causes
    • normal aging
    • lack of estrogen after menopause
    • anything thats puts pressure on pelvic msucles
    • retroversion
104
Q

What mineralocorticoid has the most activity?

A
  • aldosterone
    • very potent 90% of all mineralcorticoid activity
  • coritsol has slight mineralocorticoid activity and is not as potent as aldosterone but has 2000x higher plasma concetration
106
Q

How much calcium is excreted from the urine?

A
  • 150 mg/day
108
Q

How does thyroid hormones effect the heart?

A
  • Increases SV
    • because of up metabolism and O2 consumption
    • increased contractility
  • increases HR
    • T3 increases expression of beta adrenergic receptors
109
Q

What is the cause of adrenogenital syndrome and what are the symptoms?

A
  • Cause
    • adrenocortical tumor secreting excessive quantities of androgens
  • Symptoms
    • Females - masculinization of hair, voice, growth of clitoris, masculine appearance in skin and muscle
    • Males - repid development of sexual organs in prepubertal males
  • Diagnosis
    • levels of 17-ketosteroids in urine
111
Q

What abnormalities could lead to colloid goiter?

A
  • deficient
    • iodide trapping mechanism
    • TPO
    • coupling of iodinated tyrosines
    • deiodinase enzyme
112
Q

What are the parts of the uterus?

A
  • Body
    • fundus most superior part
    • isthmus is where is uterus becomes narrow before forming the cervix
  • Cervix
    • supravaginal (btwn isthmus and vagina)
    • vaginal (part protrudes into vagina)
    • external ox is mostly fibrous
114
Q

How are adrenal medullary hormones transported?

A
  • most circulate in blood bound to albumin
  • T1/2 of circulating catecholamines is very short (10 sec to 1.7 mins)
115
Q

What is cushing’s syndrome? What are the possible causes?

A
  • signs and symptoms related to prolonged exposure to inappropriately high levels of cortisol
  • causes
    • Hypersecretion of CRH or ACTH - Cushing’s disease
    • adrenal cortex adenomas
    • ectopic secretion of ACTH
117
Q

What are the effects of excess aldosterone?

A
  • loss of K+ from ECF into urine = hypokalemia
    • muscle weakness and cramping
  • ^ tubular H+ secretion = metabolic alkalosis
119
Q

What drugs block osteoclasts?

A
  • Bisphosphates
  • calcitonin
  • Estrogen
120
Q

What is the role of the parathyroid hormone (PTH)?

A
  • role is to regulate the concentration of Ca2+ in the extracellular fluid
  • PTH is stimulated when [Ca2+] is low
    • stored in the parathyroid gland
121
Q

Besides the kidneys, where else does aldosterone target?

A
  • sweat glands
    • conserves body salts in hot environments
  • Salivary glands
    • conserves salt when excesive quantities of saliva are lost
  • intestinal epithelial glands
    • prevents loss of Na in stool
122
Q

How does Thyroid hormone affect lipid metabolism?

A
  • lipids are quickly mobilized from fat tissue adn decreases fat stores
  • Decreases plasma cholesterol by increasing LDL receptors on liver
123
Q

What is prostatic carcinoma?

A
  • most common cancer among men
  • usually in posterior lobe
  • prostatic venous plexus anatomoses with vertebral venous plexus
  • symptoms
    • blood in urine
    • back pain
    • numbness
124
Q

What is the normal position of the uterus?

A
  • normally
    • anteverted (90º with respect to vagina)
    • anteflexed 170º with respect to cervix
125
Q

What is the metabolism of adrenal medullary hormones?

A
  • 3 possible fates
    • Reuptake by extraneuronal sites
    • Degradation at target cells by COMT or MAO
    • Direct filtration into urine
126
Q

What supports the bladder?

A
  • puboprostatic (male) pubovesical (female) ligaments
  • pubic bones
  • perineal membrane and associated muscles
  • levator ani
127
Q

What are the anti-inflammatory effects of high levels of cortisol?

A
  • stabilizes lysosomal membranes - keeps proteolytic enzymes inside lysosomes
  • decrease permeability of capillaries
  • decrease migration of WBC
    • prevents phagocytosis of damaged cells to decrease formation of prostaglandins adn leukotrienes
  • suppresses immune system - decreases production of T lymphocytes
  • decrease fever
128
Q

How is phosphorus stored in the body?

A
  • Bones and teeth 86%
  • Extracellular 0.08%
  • Intracellular 14%
129
Q

Primary Hyperparathyroidism

Calcium? Phosphate? PTH? 24 hour urine calcium?

A

in most cases people have a benign tumor called adenoma

  • Calcium: up
  • phosphate: down
  • PTH: up
  • 24 hr urine calcium: up

Treatment - remove tumor

129
Q

Why is there an increased vitamin requirement for thyroid hormones?

A
  • thyroid hormone increases the amount of enzymes which require a number of vitamins
  • can have a vitamin defiency with hyperthyrtoidism
131
Q

What is the route of sperm?

A
  • made in testis goes into epididymis and ductus deferens to be stored
  • during emissionsperm up ductus deferens to ampulla
    • join with secretions from seminal gland in ejaculatory duct
    • more secretions from prostate and bulbourethral glands
  • sperm ejactuated by urethra
132
Q

Pseudohypoparathyroidism

Calcium? Phosphate? PTH? Alkaline phosphate?

A
  • Calcium: down
  • Phosphate: up
  • PTH: up
  • Alkaline phosphatase: no change
133
Q

What is the non-genomic effect of aldosterone?

A
  • activation of second messenger system
    • ^ H+ secretion and bicarbonate retention
  • faster
135
Q

How does cortisol effect carbohydrate metabolism?

A
  • stimulates gluconeogenesis
    • ^ enzymes required to breakdown AA into glucose
  • decreases glucose utilization by cells
    • ^ storage of glucose as glycogen in liver cells
  • elevates blood glucose concentration
    • stimulates insulin
136
Q

How does thyroid hormone affect the skeletal system?

A
  • thyroid hormone is required fro attainment of normal stature and bone maturation
  • necessary for normal growth in children
137
Q

How are adrenocortical hormones transported?

A
  • Bound to plasma proteins and free form
    • binds to corticosteroid binding globulin (CBG) and albumin
  • 90-95% of cortisol is bound T1/2 = 60-90 min
  • 60% of aldosterone is bound T1/2 20 min
138
Q

What is peritonitis?

A
  • an inflammation of the peritoneum
  • may result from build up of fluid or infection
  • left untreated, sepsis
139
Q

What are the measurements of the pelvis?

A
140
Q

C21 is

A
  • Progesterone
  • Aldosterone
  • Cortisol
141
Q

What occurs during stage 2 of biosynthesis of thyroid hormones?

A
  • Formation and secretion of thyroglobulin
  • ER and golgi synthesize and secrete thyroglobulin into follicular colloid
  • each thyroglobulin molecule is glycosylated and has 140 tyrosine AA, some combine with iodine
  • thyroid hormone forms within the thyroglobulin molecule
143
Q

Osteopetrosis

A
  • bone disorder
  • increased osteoid and mineral
144
Q

What is the pathway activated by the hormone to activate steroid hormone synthesis?

A
  • hormone > adenylate cyclase > cAMP > PKA > ^cholesterol easterase to cholesterol > transported to the mito through StAR protein
  • in mito
    • side chain cleavd off cholesterol > pregnenotone > synthetic pathway in cytosol > sent back into mito for modification > steriod hormone diffuses out of cell
145
Q

Hypoparathyroidism

Calcium? Phosphate? PTH? Alkaline phosphate?

A
  • Calcium: down
  • Phosphate: up
  • PTH: down
  • Alkaline phosphatase: no change
146
Q

Where is the Pouch of Douglas and what can happen to it? How is it treated?

A
  • lies behind posterior fornix of vagina
  • susceptible to injury (illegal abortion) or collection of fluids
  • culdocentesis extraction of fluid from pouch of douglas via posterior fornix of vagina
147
Q

How to osteoclasts work?

A
  • resorbs bone tissue
    • critical for maintenance, repair, and remodeling of bones
  • form from macrophage precursors
    • stimulated by the RANK ligand secreted by osteoblasts
148
Q

What are the effects of cortisol on fat metabolism?

A
  • promotes mobilization of FA from adipose tissue
    • ^ FFA to be used for energy
  • enhances beta oxidation of FA in cells
    • important factor for long term conservation of body glucose and glycogen
149
Q

What ducts open into the urethra?

A
  • prostatic ducts
  • seminal colliculus
  • prostatic utricle
  • opening of ejaculatory duct
  • opening of bulbourethral duct
150
Q

What occurs during stage 3 during biosynthesis of thyroid hormones?

A
  • Oxidation of iodide and coupling of iodine with tyroglobulin
  • thyroperoxidase (TPO)
    • oxidizes iodine
    • adding iodine to tyrosine
    • coupling of iodothyrosine residues
  • thyroglobulin in colloid acts as a storage form of thyroid hormones
151
Q

What anterior pituitary hormones regulate steroid hormone production? What second messenger do they use?

A
  • FSH - cAMP
  • LH - cAMP
  • TSH - cAMP
  • ACTH
    • Cortisol - cAMP, phosphoinositol
    • Aldosterone - phosphoinositol
152
Q

What are the structural differences of the male pelvis?

A
  • iliac wings less flattened
  • smaller tranverse diameter of pelvic inlet
  • Ischial tuberosities are inverted
  • taller pubic symphysis
  • narrower pubic arch
  • heart shaped inlet (female - oval)
  • more curved sacrum
  • narrower interpubic disc

Block 3 (8 decks)

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