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Week 9 Flashcards

1
Q

What are some of the Major Endocrine glands?

A
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2
Q

What are the 3 modes of endocrine secretion?

A
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3
Q

What is the role of Negative feedback in the hypothalamic-pituitary-thyroid axis?

A
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4
Q

What is a Hormone?

A

Chemical messengers that induce a response in the target tissue/organ

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5
Q

What are some hormone examples of Steroids?

A
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6
Q

What are some hormone examples of Peptides?

A
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7
Q

What are some Hormone examples of Proteins?

A
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8
Q

What are some Hormone examples of Glycoproteins?

A
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9
Q

What are some Hormone examples of Amino acid derivatives?

A
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10
Q

What 3 factors control Hormone release from Endocrine glands?

A
  • Humoral
  • Neural
  • Hormonal
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11
Q

What may the patterns of hormone secretion throughout the day look like?

A

A - Diurnal variation
B - Constant value
C - As needed

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12
Q

How do we test for Endocrine disorders?

A
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13
Q

How do we access Pituitary in surgery?

A

Through Sphenoid air sinus (top of nasal cavity)

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14
Q

What are some Neurohormones controlling the release of ant. pituitary hormones?

A
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15
Q

What are some Neurohormones released from the post. pituitary?

A
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16
Q

What hormones are produced in the Paraventricular nuc. in the hypothalamus?

A
  • CRH
  • TRH
  • OXT
  • VP / ADH
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17
Q

What hormones are produced in the Supraorbital nuc. in the hypothalamus?

A
  • OXT
  • VP
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18
Q

What hormones are produced in the Preoptic nuc. in the hypothalamus?

A

GnRH

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19
Q

What hormones are produced in the Arcuate nuc. in the hypothalamus?

A
  • GnRH
  • PIH (dopamine)
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20
Q

What hormones are produced in the Periventricular nuc. in the hypothalamus?

A
  • PIH (dopamine)
  • SS
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21
Q

Describe Diabetes Insipidus

A

Very thirsty
Need to pee often

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22
Q

Describe Oxytocin’s production, binding, and release

A
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23
Q

Describe the hypothalamic control of milk production and ejection

A
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24
Q

What are some of the simplified cascades of Hormones from the ant. pituitary?

A
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25
Q

What are the 3 parts of the Adenohypophysis?

A
  • pars Distalis
  • pars Tuberalis
  • pars Intermedia
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26
Q

What are the 2 parts of the Neurohypophysis?

A
  • pars Nervosa
  • Pituitary Stalk
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27
Q

Describe the Embryonic development of the pituitary gland

A
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28
Q

What may happen if there is residual tissue of pharyngeal hypophysis that becomes neoplastic?

A

Craniopharyngioma
(hormone secreting tumour)

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29
Q

What are the different cell types of the Ant. Pituitary?

A
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30
Q

Label this cross section of the Ant. Pituitary

A
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31
Q

Describe the indepth table of Ant. Pituitary hormones

A
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32
Q

Describe the mechanism controlling Growth Hormone release

A
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33
Q

Describe feedback inhibition of Growth Hormone release

A
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34
Q

What are the levels of Growth hormones throughout the day?

A

Pulsitile and Diurnal

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35
Q

What are the Physiologial actions of Growth Hormone?
(Diagram)

A
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36
Q

What are the Physiological actions of Growth Hormone?
(text)

A
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37
Q

What are some Pathologies associated with Growth Hormone deficiency?

A
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38
Q

What are some Pathologies associated with Growth Hormone excess?

A
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39
Q

What are some physical signs of Acromegaly?

A
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40
Q

How do hormones get from small bodied neurons to ant. pituitary?

A

Release hormones into primary capillary plexuses or median eminence which then carries them to ant. pituitary

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41
Q

How do hormones get from large bodied neurons to post. pituitary?

A

They dirrectly innervate the post. pituitary

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42
Q

What are the Hypothalamic neurohormones’:
- Structure
- Hypothalamic nuclei of origin
- Effect on ant. pituitary

A
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43
Q

In what structure are Oxytocin and Vasopressin synthesised and processed?

A

Secretory Vesicle

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44
Q

What is the function of signal peptides in pre-pro Vasopressin / Oxytocin?

A

Dirrects pre-pro Vasopressin / Oxytocin into the ER, where the signal protein is then cleaved off

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45
Q

What 2 other structures are present in pre-pro Vasopressin?

A

Neurophysin II
Copeptin

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46
Q

What other structure is present in pre-pro Oxytocin?

A

Neurophysin I

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47
Q

What can Copeptin be used to measure?

A

AVP levels
(produced in same proportion, longer half life)

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48
Q

What is the function of Neurophysin I / II?

A

To protect Oxytocin / Vasopressin as they move through circulation to the target tissue before releasing
Achieves this by binding Oxytocin / Vasopressin

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49
Q

What may cause the release of AVP from the SON & PVN?

A
  • Increase Blood Osmolality (osmoreceptors in lamina terminalis)
  • Decrease Blood Vol (carotid sinus, aortic arch, left atrium)
  • RAAS (angiotensin II)
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50
Q

How does cell differentiation occur in the Ant. Pituitary gland during development?

A

Via the Dorsal gradient (fibroblast growth factor 8 FGF8)
and the Ventral gradient (bone morphogenic protein 2 BMP2)

These oppose each other.
The Ventral diencephalon expresses FGF8
Rathke’s pouch expresses BMP2

Depending where the progenitor cells lie on these gradients, they will differentiate into a specific cell type

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51
Q

What are the 5 cell types of the Ant. Pituitary from Superior to Inferior?

A
  • Corico tropes
  • Somato tropes
  • Lacto tropes
  • Thyro tropes
  • Gonado tropes
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52
Q

What controls Thyroid secretion?

A

Thyroid Stimulating Hormone (TSH)
secreted by ant. pituitary

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53
Q

What is the function of Cuboidal epithelial cells?

A

Secretion of colloid into follicles of thyroid gland

Main component of colloid is thyroglobulin, which contains the thyroid hormones.

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54
Q

What must first happen to thyroid gland secretions before they can function in the body?

A
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55
Q

What cells produce Calcitonin?

A

C cells

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56
Q

What % of metabolically active hormones secreted by the thyroid gland are T4 & 3?

A

93% & 7%

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57
Q

What happens to almost all of T4 eventually?

A

Converted into T3

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58
Q

What’s the difference between T3 & T4?

A

T3 x4 as potent as T4 but is present in the blood in much lower quantities and persists for a shorter time

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59
Q

What is needed to form thyroxine and how much of it is needed?

A

Iodine
50mg/year

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60
Q

What is the link between T3 & 4 and metabolic rate?

A
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61
Q

What does the TG do to Iodide (not iodine)?

A

Sequestered, XS excreted by kidney

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62
Q

Describe Iodide trapping in TG

A
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63
Q

Describe the synthesis and secretion of Thyroglobulin

A

Synthesised and secreted into follicles by ER and Glogi apparatus

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64
Q

Describe Thyroglobulin and its function

A

Large Glycoprotein molecule

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65
Q

What is the function of the enzyme Peroxidase?

66
Q

Describe the Organification of Thyroglobulin

A

The binding of the oxidised iodine to thyroglobulin

67
Q

Describe the production of T3 & 4

68
Q

Describe the storage of T3 & 4 in the TG

69
Q

Describe the Release of T3 & 4 within the epithelial cells in TG

70
Q

Describe the action of Proteases in TG

71
Q

Describe the relationship between T3 & T4 transport in blood and plasma proteins

72
Q

Describe how T3 & 4 bind in their target cells

A

In target cells, T3 & 4 bind with intracellular proteins for storage

T4 more strongly bound

73
Q

Describe the onset and duration of action of T3 & 4

74
Q

What are the major physiological effects of the Thyroid hormones?

A

Mobilisation of Carbohydrate, Fat, and Protein stores (dirrect and indirrect actions)

75
Q

What are the major physiological effects of the Thyroid hormones in relation to BMR and weight?

76
Q

Describe the physiological regulation of T3 & 4

77
Q

Roughly describe the -ve feeback in the regulation of T3 & 4 secretion

78
Q

Describe Hyperthyroidism

79
Q

What are the symptoms of Graves’ Disease?

80
Q

Describe Hypothyroidism

81
Q

What are the symptoms of Hypothyroidism?

82
Q

How do T3 & 4 effect cellular transcription of genes?

A
  • T4 is converted into T3 via de-iodination
  • T3 interacts with the thyroid hormone receptor
  • Leads to increases or decreases in transcription of genes that lead to the formation of proteins
83
Q

Describe the Non-genomic cellular effects of T3 & 4

A

Some responses seen are too fast for the gene transcription to be responsible

Presumed to work through activation of intracellular 2nd messangers e.g. cAMP and protein kinase signalling cascades

84
Q

What are the Major physiological effects of the Thyroid Hormones?

85
Q

What happens during pharmacological regulation of T3 & 4 secretion by iodides?

86
Q

What is a Goitre?

A

Swollen thyroid gland

87
Q

What factors make you more likely to get a Goitre?

A

Female
Young adulthood

88
Q

What is the difference between Toxic and Non-toxic Goitre?

A

Toxic is Thyrotoxic and shows signs of thyrotoxicosis

89
Q

What diet issue may lead to Goitre?

A

Iodine insufficiency

90
Q

What are the two catagories of Goitre?

A

Euthyroid
- Diffuse - younger people
- Multinodular - older

Hypothyroid
- Iodine deficiency - endemic
- Goitrogens (drugs: lithium, amiodarone - diet: cabbage, turnips)

91
Q

What is the pathogenesis of Goitre?

A
  • Reactive
  • Iodine block
  • Genetic
92
Q

How would you establish if a Solitary thyroid nodule is in fact solitary?

A

Ultrasound

93
Q

What are some signs and symptoms of Solitary thyroid nodules?

A

Benign masses
- Usually moveable
- Soft
- Non-tender

Malignancy
- Hard nodule
- Fixation to surrounding tissue
- Regional lymphadenopathy

94
Q

What signs and symtoms may a patient present regarding thyroid hormone levels in the case of a Solitary thyroid nodule?

A

Most are asymptomatic however some show signs of:

Hyperthyroidism
- Nervousness
- Heat intolerance
- Diarrhoea
- Muscle weakness
- Loss of weight + appetite

Hypothyroidism
- Cold intolerance
- Constipation
- Fatigue
- Weight gain

95
Q

What local issues may occur due to Solitary thyroid nodule?

A

Dysphagia and hoarseness due to potential impact on recurrant laryngeal n.

96
Q

What may be used for Diagnosing Thyroid issues?

97
Q

What imaging studies may be done to help diagnose a thyroid disorder?

98
Q

Give some exaples of causes of diseases of the Thyroid

99
Q

What are the most common types of Hyperthyroidism?

A
  • Graves disease
    (may present as diffuse toxic goitre)
  • Functional Goitre
  • Toxic Adenoma
100
Q

What are the most common causes of Hypothyroidism?

A
  • Congenital
  • Autoimmune

Defective TH production
Loss of parenchyma
Deficient TSH

101
Q

Describe Graves Disease

102
Q

Describe Hashiomoto Thyroidism

A

Chronic autoimmune
Increased risk of lymphoma

103
Q

Describe the Neoplasms of Thyroid gland

104
Q

Describe thyroid Follicular Adenoma

105
Q

Describe thyroid Papillary Carcinoma

A

Travels through LYMPH NODES

106
Q

Describe thyroid Follicular Carcinoma

A

Travels through BLOOD, may end up in bones

107
Q

Name and describe the 3 types of Hyperparathyroidism

108
Q

What structures in the pancreas are responsible for Exocrine and Endocrine functions?

109
Q

Name the cells of the Endocrine Pancreas

110
Q

What are the hormones produced by each cell type in Endocrine Pancreas

111
Q

What is the main function of Endocrine hormones from the pancreas?

A

Control of blood glucose in absorptive and post-absorptive states (insulin & glucagon)
Stimulate or inhibit digestive enzymes and HCO3- secretion in GI tract

112
Q

Roghly outline the synthesis and processing of Insulin

113
Q

Describe the microvasculture & innervation of the Endocrine Pancreas

114
Q

Roughly describe the factors regulating insulin secretion

115
Q

Roughly describe the physiological actions of Insulin

116
Q

Roughly outline the factors regulating Glucagon release

117
Q

Roughly describe the physiological actions of Glucagon

118
Q

What is the overall prevalence of Autoimmune disorders in most western populations?

119
Q

What are two examples of a single gene mutation causing an Autoimmune disease?

120
Q

Describe both Deletional and Regulatory Tolerance

A

Deletional (recessive)
- Self-reactive T cells are deleted in the thymus. Occasionally, self-reactive T cells may escape deletion and cause tissue damage in the periphery

Regulatory (dominant)
- T cell specific for self antigen becomes a regulatory T cell (T reg). Cytokines produced by T reg inhibit other self-reactive T cells

121
Q

What are some mechanisms thought to be involved in the breakdown of tolerance?

122
Q

Describe what happens in Rheumatic fever

A
  • Group A Steptococcus infection
  • Antibodies against strep carbohydrate
  • These antibodies cross react on cardiac myosin
  • T cells produced
  • Heart valve damage
123
Q

What are some common signs of Systemic Lupus Erythematosus (SLE)?

A
  • Butterfly rash
  • Raised red patches on skin
  • Light sensitivity
  • Mouth ulcers
  • Heart / lung inflammation
  • Seizures
  • Proteinuria
124
Q

What are some treatments for SLE?

A
  • Systemic corticosteroids
  • Monoclonal antibodies
125
Q

Describe Grave’s disease
AND
How it’s treated

126
Q

Describe Hashimoto’s thyroiditis
AND
How it’s treated

127
Q

Describe Myasthenia Gravis
AND
How it’s treated

128
Q

Describe Autoimmune Pernicious Anemia
AND
How it’s treated

129
Q

Describe Autoimmune Hemolytic Anemia
AND
How it’s treated
AND
Its side effects

130
Q

Describe MS
AND
How it’s treated

131
Q

What is Rheumatoid Arthritis?

132
Q

What is the Epidemiology of Rheumatoid Arthritis?

133
Q

Joints affected by RA?

134
Q

What are some of the effects of RA on different organs?

135
Q

How is RA diagnosed?

136
Q

For the treatment of RA name some:
- Symptomatic meds
- Disease modifying drugs
- Bological modifiers

137
Q

Describe Coeliac disease

138
Q

When should we perform Thyroid Function Tests?

139
Q

Describe Hypothyroidism

140
Q

Describe Subclinical Hypothyroidism

141
Q

What are the Symptoms of Hypothyroidism

142
Q

What are some causes of Hypothyroidism?

143
Q

Describe Hashimoto’s

144
Q

What are some causes of Congenital Hypothyroidism?

145
Q

Describe the relationship between Amiodarone and the Thyroid

146
Q

What is the treatment for subclinical hypothyroidism

147
Q

How do you differentiate between thyrotoxicosis WITH hyperthyroidism (grave’s) and Thyrotoxicosis WITHOUT hyperthyroidism (transient thyroiditis)

A

Measure TSH receptor antibodies to confirm Grave’s disease

148
Q

What is used to treat Transient Thyrotoxicosis without hyperthyroidism?

A

β-blockers

149
Q

What are the symptoms of hyperthyroidism?

150
Q

What are some examples of potential causes of Hyperthyroidism?

151
Q

What are some clinical features of Grave’s disease?

152
Q

Describe Toxic Multinodular Goitre

153
Q

What are the treatment options for Hyperthyroidism?

154
Q

How does Radioactive Iodine work to help with Hyperthyroidism?

155
Q

When shouldn’t radioactive Iodine be used as 1st line treatment for Grave’s disease?

156
Q

What are two examples of Thioureylenes
AND
What is their action?

A
  • Propylthiouracil
  • Carbimazole
157
Q

Describe Carbimazole

158
Q

What are the main side effects of Carbimazole?

A
  • Neutropenia & agranulocytosis
  • Pancreatitis
  • Skin rashes
159
Q

State both the usual dosage
AND
the side-effects of Propylthiouracil

160
Q

How do you monitor Antithyroid medications?

161
Q

What are the 3 types of Thyroidectomy?

162
Q

What are some potential complications of thyroid surgery?

Neuro (14 decks)

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