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Transcript
Endocrine Physiology 1. What is the Endocrine system? 2. What must a cell have to be able to respond to a hormone? 3. What is one thing that a cell will always do in response to a hormone? 4. Name 2 hormones that are synergistic a series of glands that release a hormone into the plasma, where it is dissolved and transported throughout entire body within 60 seconds the cell must have a functional hormone receptor Change its physiology ADH and aldosterone 5. Name two hormones that are antagonists Atrial natriuretic peptide and ADH 6. Name two hormones that are permissive Thyroid hormone is permissive for growth hormone 7. What is a target cell? A cell that has a functional receptor (a protein) for a particular hormone 8. What would happen if there were a gene The receptor becomes faulty, and will not defect in the DNA code for a receptor? respond to the hormone. 9. What would happen if the cell was The hormone receptor will not function exposed to excess salt, heat, or pH? properly 10.What is a receptor? A protein made by a target cell during protein synthesis; it is inserted into the cell membrane. What does the active site on the receptor do? It’s where the hormone is ‘fit’ into the receptor and turns the signal into a response 11.What would happen if there were a gene The receptor would not be made, so the cell defect in the DNA code for a receptor? could not respond to the hormone. 12.What would happen if the receptor The receptor would not work, so it would not (which is a protein) became denatured respond to the hormone. (by heat, abnormal pH, an enzyme, or an attack by a white blood cell)? 13.Where do endocrine glands secrete Blood plasma hormones into? What are the three things that may happen when the hormones are secreted? Hormones can bind to receptor of their target and cause a change Can be destroyed by enzymes in the plasma Go to the kidneys and be filtered out 14.By what mechanism are insulin and glucagon released? 15.By what mechanism are the hypothalamus and pituitary hormones released? 16.What are three neuronal hormones? Humoral mechanism Where are these hormones made? In the neurons How is it transported and where is it stored? Transported by the axon and stored in the synaptic knobs of the neurons What does it get released into? 17.What is a Humoral Trigger? What are some examples The bloodstream Something in the blood is being monitored. When the level of that substance is too low, it stimulates the release of the hormone. Examples; insulin, glucagon, parathyroid hormone The storage form of glucose. When glucose is in excess, it is taken to the liver and converted into glucagon, and stored there. When blood glucose is low 18. What is glucagon? 19.When will glucagon be broken down? 20. What does parathyroid hormone do? 21. Does parathyroid hormone metabolize calcium? 22. What is a Hormonal Trigger? 23.When the hypothalamus (the boss) releases TSH-RH, what happens to the pituitary gland (the manager)? 24.What effect does that have? Hormonal mechanism oxytocin, ADH, and Epinephrine Causes the intestines and kidneys to absorb more calcium, and tells the osteoclasts to degrade bone to increase blood calcium levels. No. This is when one endocrine gland releases a hormone that stimulates another endocrine gland to releases its hormone. Pituitary gland releases TSH (thyroid stimulating hormone) TSH causes the thyroid gland (the worker) to secrete TH (thyroid hormone) 25.What organ is directly affected by hormones secreted by the hypothalamus? The pituitary gland 26.What glands are affected by hormones secreted by the pituitary gland? All endocrine glands in the body 27.What cells are affected by thyroid hormone, and what is the effect? 28.What structure does the hypothalamus directly regulate? Almost all cells in the body have receptors for TH. It causes an increase in metabolism. In the hypothalamus, TH bound onto cell receptors will signal the hypothalamus to stop secreting TSH-RH It regulates the secretion of pituitary hormones. 29.By which two mechanisms is the hypothalamus controlled? 30.Is the hypothalamus controlled by positive or negative feedback loops? 31.How does the negative feedback loop work in relation to the hypothalamus? Neuronal and hormonal mechanisms 32.When the hypothalamus receives a negative feedback signal, what does the hypothalamus do? 33.What do hypothalamus neurotransmitters do that are secreted from axon terminals? 34.In an under-secreting thyroid tumor will TH be high or low? Stop secreting its “releasing” hormones. It may then start secreting its “inhibiting” hormones. They secrete releasing factors to release hormones and can also secrete inhibiting hormones to turn off secretion of hormones. Low It is almost always controlled by negative feedback loops If blood concentration declines below a minimum, more hormones are secreted. If blood concentration exceeds maximum, hormone production is halted. High 35.Will TSH-RH be high or low? High 36.Will TSH level be high or low? 37.In an over-secreting thyroid tumor will TH be high or low? High Low 38.Will TSH-RH be high or low? Low 39.Will TSH levels be high or low? 40.In an under-secreting pituitary tumor will TSH be high or low? Low 41.Will TH be high or low? Low 42.Will TSH-RH be high or low High 43.In an over-secreting pituitary tumor will TSH be high or low? High 44.Will TH be high or low? High 45.Will TSH-RH be high or low? Low 46.In an under-secreting hypothalamic tumor will TSH-RH be high or low? Low 47.Will TSH be high or low? Low 48.Will TH be high or low? Low 49.In an over-secreting hypothalamic tumor High will TSH-RH be high or low? 50.Will TSH be high or low? High 51.Will TH be high or low? 52.What causes a goiter, hyperthyroidism or hypothyroidism? 53.What is the functional unit of the thyroid gland? 54.What secretes colloid? High Either. You have to measure the hormone levels to see what is causing it. The thyroid follicle 55.What is colloid? Water with Thyroglobin proteins 56.What stimulates the follicular cells to make Thyroglobin? 57.Where does thyroglobulin (TG) go when it first leaves the cell? 58.How is TG changed after it leaves the cell, while it is on its way to the thyroid follicle for storage? 59.When iodine is attached to TG, what is this process called? 60.On what amino acid is iodine attached in a thyroglobulin molecule? 61. What is the name of the enzyme that adds the iodine to TG? 62. What drug deactivates peroxidase? TSH Follicular cells It is stored inside the thyroid follicle, in a pink liquid called “Colloid” Iodine is added to it. Iodination Tyrosine peroxidase PTU 63. What drug can be used for people who have Graves’ disease? 64. What would happen to hormone levels in a patient with PTU? 65.What is the most abundant form of TG? 66.What is the active form of TG? 67.What happens to T2? PTU (Propylthiouracil) 68.What effect does TH have on GI motility? 69.What effect does TH have on mental activity? 70.What effect does TH have on endocrine activity? 71.What effect does TH have on growth? Increases GI motility 72.What effect does TH have on brain development? 73.What effect does TH have on fat metabolism? 74.What effect does TH have on the CNS? Promotes brain development 75.What effect does TH have on sleep? Inhibits sleep Iodine cannot be attached to TG, so TH cannot be made, so TSH and TSH-RH increase. T4 is the most abundant form. T3 is the most active form. It is recycled, not released Increases mental activity Increases endocrine activity Promotes growth in children Increases fat metabolism Excites it 76.What occurs after follicular cells receive They take back Thyroglobin (TG) from where the TSH signal from the pituitary gland? it was stored in the follicle (endocytosis), cleave the TG into segments, and secrete the longer segments into blood (exocytosis.) 77.What would happen to TSH-RH, TSH, and TH in the following conditions: 78.Antibodies attacking thyroid gland, destroying the gland -TH low, TSH-RH and TSH high 79.Antibodies binding to the TSH receptor, - TH and TSH high, TSH-RH low stimulating it - TH high, TSH-RH and TSH low. 80.Graves’ Disease 81.Hashimoto’s Thyroiditis - TH low, TSH-RH and TSH high. 82.What is the TS ratio? Iodine in thyroid divided by iodine in serum 83.What is required to bring iodine into cells? Why? 84.What happens when TSH is released? ATP is needed because iodine has to go against its electrical gradient. Follicular cells become larger Metabolism increases Increased O2 consumption, esp. mitochondria Heat is generated Sympathetic neurons in the heart. Increase force of contraction and increase heart rate. 85.What are beta receptors? 86.What do they do? 87.What effect does TSH have on beta receptors? 88.When TH stimulates neurons a person feels what? Stimulates them. 89.Not enough TH? They lose interest, become sluggish, hypoglycemia 90.Too Much TH? 91.When blood sugar is high, what hormone is released by the pancreas and what does it do? 92.What if there is more sugar in the blood than the cells can use? Where does the excess sugar go? 93.When blood glucose is low, what hormone is released by the pancreas and what does it do? They get muscles tremors and hyperglycemia Insulin is released, tells the cells to take in the sugar from the bloodstream. 94.Describe the process of Gluconeogenesis The liver takes fatty acids (leftover from fat metabolism) and joins them to amino acids (from broken down proteins), and makes new glucose molecules that you did not get from eating glucose. These new glucose molecules are then released into the bloodstream to elevate blood glucose levels. Hyperglycemia 95.Blood glucose levels that are too high are called? 96.Low blood glucose is called what? Feels more alert, observing their environment with more interest excess sugar is taken to the liver and converted to glycogen for storage Glucagon tells the liver to take the glycogen and break it back down into glucose and release it into the bloodstream. Hypoglycemia 97.During hyperglycemia, what hormone is released? 98.What gland releases it? 99.What is its effect on the blood sugar levels? 100. During hypoglycemia, what hormone is released? 101. What gland releases it? 102. What is its effect on the blood sugar levels? 103. What two processes raise blood sugar? Insulin 104. What are 2 methods of measuring plasma concentration of hormones? –RIA (radioimmunoassay) –ELISA (enzyme-linked immunosorbent assay) Graves’ Disease 105. Hyperthyroidism is most commonly caused by what disease? 106. What are the signs of Graves’ disease? Pancreas Lowers blood sugar Glucagon Pancreas Raises blood sugar Gluconeogenesis and glycogen breakdown 107. What causes Graves’ disease? Thin person with eyes that stick out like a bug (exophthalmoses). It is an autoimmune disease 108. -What effect does Graves’ disease have on TH levels? On TSH? On TSH-RH? Increased TH Decreased TSH-RH and TSH 109. Over-secreting tumors can be a sign of what? Hyperthyroidism 110. What are two ways to treat hyperthyroidism? 111. What is the problem with having a thyroidectomy? Thyroid oblation or surgical removal (thyroidectomy) The parathyroid glands might become damaged, loss of blood calcium levels, can cause cardiac arrest. Hashimoto’s thyroiditis (autoimmune) Iodine deficiency Thyroid tumor, under-secreting Defective thyroid enzyme(s) Thyromegaly 112. What 4 things can cause hypothyroidism? 113. What is the medical term for a goiter? 114. What does idiopathic mean? 115. What does iatrogenic mean? 116. What is cretinism? Idiopathic = unknown cause Iatrogenic = medical treatment caused the condition A baby with hypothyroidism because the mother had a lack of iodine. 117. What is the mental status of cretinism? Mental retardation 118. If you give a cretinism baby a healthy diet, will it improve? Why? No, because TH was not present during fetal development, when myelination and synaptic formation needed it. 119. What condition is when a baby's thyroid Congenital Hypothyroidism gland is not secreting enough thyroid hormone? This is a problem with the baby, not the 120. Is it a problem with the baby or the mother. mother? 121. Congenital Hypothyroidism babies have Cretinism similar symptoms to what other childhood condition? 122. What other hormone needs to be present TH for GH to work? 123. What is an autoimmune disorder where Hashimoto's thyroiditis antibodies attack and destroy the thyroid gland? 124. In Hashimoto's thyroiditis, what TH goes down while TSH-RH and TSH are happens to the TH, TSH-RH, and TSH elevated levels? 125. In Hashimoto's thyroiditis does the Enlarges healthy remaining thyroid tissue enlarge or get smaller? 126. What type of edema is non-pitting? Myxedema 127. A person who has depressed mental and emotional activity, psychosis, not easily in touch with reality and detached may be signs of what hormonal disorder? Hashimoto's thyroiditis 128. In iodine deficiency, which hormones are elevated, and which are decreased? 129. What type of genetic defect can cause hypothyroidism? 130. A defect in any part of the gene expression of thyroglobulin in follicular cells could lead to the cause of what disorder? TH is decreased, TSH and TSH-RH are increased Genetic defects in the thyroglobulin Hypothyroidism 131. What mechanism does the adrenal gland use to secrete its hormones? 132. What endocrine gland secretes catecholamines (be specific)? 133. What are catecholamines? 134. Name two catecholamines 135. What three things does the adrenal cortex secrete? 136. What happens to blood sugar levels when epinephrine is secreted? 137. How does epinephrine affect the heart, digestion, respiratory system, and blood pressure? Adrenal medulla uses a neuronal mechanism Adrenal cortex uses a hormonal mechanism Adrenal medulla Hormones that are also neurotransmitters in the sympathetic nervous system. They are what trigger fight or flight responses. Epinephrine and norepinephrine Aldosterone Androgens/Estrogen Cortisol It is an antagonist to insulin. It elevates blood sugar by breaking glycogen down in the liver and also increasing gluconeogenesis Heart rate and force increases Digestion slows Respiratory passages open BP goes up from peripheral vasoconstriction Adrenal cortex 138. What endocrine gland secretes nothing but steroids? 139. What is an example of a Aldosterone mineralocorticoid? 140. What is an example of a glucocorticoid? Cortisol 141. What does cortisol do? 142. What layer of the adrenal cortex produces aldosterone? 143. What layer produces the sex hormones? 144. What layer produces cortisol? 145. What classification is aldosterone? 146. What part of the body does aldosterone target, and what is its effect in that organ? 147. What is its effect on blood pressure? 148. What part of the adrenal gland makes aldosterone (be specific)? Stimulates fat and protein catabolism to use for gluconeogenesis Zona glomerulosa produces aldosterone Zona fasciculate and Zona reticularis produce the sex hormones and cortisol Mineralocorticoid Kidney; increases the amount of salt and water absorbed. It increases blood pressure Zona glomerulosa of the adrenal cortex 149. By what mechanism is aldosterone secreted? 150. What triggers aldosterone? 151. Any word that ends in “-ogen” means what? It has a humeral release mechanism High potassium levels and A2 Means they are zymogens (proteins which are released in an inactive form 152. When BP is too low, how does the body compensate? Baroreceptors detect low BP, kidney releases renin, which cuts angiotensinogen into A2, which stimulates adrenal cortex to make aldosterone and stimulates the hypothalamus to release ADH. This raises BP 153. What effect do high levels of A2 have on other hormones? Stimulates the adrenal cortex to make more aldosterone, and also stimulates the hypothalamus to release ADH. 154. What effect do high levels of A2 have on BP? 155. What are Androgens? It raises blood pressure Male sex-hormones (the hormones responsible for male secondary sex characteristics, such as facial hair and low voice). The most well-known androgen is Testosterone. It is a steroid hormone, like all the adrenal cortex hormones. 156. What is the main androgen secreted by the adrenal gland? DHEA 157. What are two of the hormones that DHEA can be converted into? Testosterone or estrogen 158. What does hyper-secretion of androgens No effect cause in males? 159. What is the primary hormone responsible for male characteristics? Testosterone from the testes is the primary hormone responsible for male characteristics 160. What does hyper-secretion of androgens Masculinization – facial hair and low voice cause in females? 161. What effect on female sex characteristics does hyper-secretion of estrogen cause in females? No effect 162. What is the primary hormone responsible for female sex characteristics? Estrogen in the ovaries 163. What does hyper-secretion of estrogen cause in males? Feminization – breast development 164. What are two other names for cortisol? corticosterol; hydrocortisone 165. Which gland in the endocrine system releases cortisol? Adrenal gland, in the adrenal cortex 166. What common situation causes an increased demand for cortisol? Stress 167. If the body cannot keep up with the It will cause androgens to be secreted instead demand for cortisol, what will happen to of cortisol. the excess ACTH? 168. If excess androgens are made, what symptoms result? More masculine characteristics 169. What kinds of stress can cause excess cortisol production? emotional or physical (fighting an infection, fasting, injury) 170. What effect does cortisol have on noninjured, non-stressed tissues? It makes them stop using glucose (except the brain). The cells then have to break down fat to use for energy. 171. What effect does cortisol have on skeletal muscles? Tells them to break down their proteins to release the free amino acids into the blood. 172. After cortisol’s effect on skeletal muscle, what happens to amino acids in the blood? The liver adds them to fatty acids to convert them into new glucose molecules that you did not get by eating food. 173. What is gluconeogenesis? The process by which the liver makes new glucose molecules that you did not get from food. 174. What effect does cortisol have on blood sugar levels? It elevates it because the new glucose made in the liver is released into the bloodstream. This sugar is then used by the cells that are under stress and need extra energy. 175. What two hormones may cause symptoms of diabetes (high blood and urine sugar) in a person who does not have diabetes? Cortisol and prednisone 176. What is the everyday function of cortisol, when the body is not under stress? Helps maintain normally elevated blood glucose levels between meals. 177. What is the function of glucocorticoids? Stimulates the smooth muscles in the walls of blood vessels to cause vasoconstriction, which will get the blood pressure up when it is too low. 178. What naturally occurring hormone may be used in high doses as a medicine for asthma? How does it work? Prednisone. In high doses, it does the opposite of what it normally does: In high doses, it suppresses smooth muscle constriction in the walls of blood vessels, so their bronchioles cannot close up. 179. Will people with asthma have high or low levels of prednisone in their body? High 180. What are the side effects of taking prednisone? Prednisone can make you hungry and make it hard to sleep because brain is stimulated. 181. If a person abruptly stops taking prednisone what will happen? They will get low blood pressure and low blood sugar 182. What disorder has the same symptoms as a person who abruptly stops taking prednisone? Addison’s Disease 183. What are two ways to prescribe prednisone? High dose, short duration (okay to stop abruptly) 184. Which of these ways is okay to stop abruptly? Low dose, long duration (must taper off) 185. What are the two classifications of adrenal gland deficiencies? Primary and secondary adrenal insufficiency 186. Which one is Addison’s disease? 187. What two things can cause Addison’s disease? Addison’s is primary adrenal insufficiency entire adrenal gland is destroyed due to atrophy or autoimmune disorder Tuberculosis –disease attacks adrenal gland 188. What is the difference in hormone levels between primary and secondary adrenal insufficiency? 189. What causes secondary adrenal insufficiency? Primary has increased ACTH Secondary has decreased ACTH 190. What are the signs/symptoms of Adrenal gland deficiencies? Water/salt imbalance plasma volume depletion (low BP) low blood glucose pigmentation Addisonian crisis Low blood pressure and low blood glucose, to the point where it is a medical emergency Hands, fingers, and gums 191. What is Addisonian crisis? 192. What parts of the body are affected by Addison’s disease? Rapid withdrawal of pharmacologic doses of cortisol 193. In Addison’s disease, what are the levels Cortisol is low of cortisol? ACTH and ACTH-RH are high 194. What are the levels of ACTH? 195. What are the levels of ACTH-RH? 196. Why do you get skin pigmentation from excess ACTH? ACTH is a peptide (protein) hormone, synthesized from a larger protein called POMC. When it is cut into two segments, one becomes ACTH and the other becomes melanocyte stimulating hormone (MSH). When a lot of ACTH is made, a lot of MSH is made, and skin gets darker. 197. Where is the problem in secondary adrenal insufficiency? Pituitary is the problem, not secreting enough ACTH 198. In secondary adrenal insufficiency, what Cortisol is low are the levels of cortisol? ACTH-RH is high 199. What are the levels of ACTH-RH? 200. What are the symptoms of Cushing’s disease and Cushing’s syndrome? Buffalo hump, moon face, muscle loss, thin striated skin, hyperglycemia, immune suppression. Females get masculinization features (facial hair, thicker jaw and skull) 201. What is CAH? Congenital adrenal hyperplasia. In a female fetus causes the clitoris to enlarge and the labia major fuse into a scrotal sac. 202. What causes CAH? Genetic problem, missing the enzyme to convert cholesterol into anything except androgens. 203. Are boys affected by CAH? Boys are not affected 204. What treatment is there for girls with CAH? Girls need surgery and cortisol for life 205. What is growth hormone also known as? Somatotropin 206. What does GH do? GH stimulates all cells to increase protein synthesis, fat utilization, and gluconeogenesis. 207. What is the result of excess GH during pre-puberty? Gigantism 208. What is the result of excess GH after growth plates closed? acromegaly 209. What hormones are antagonistic to insulin? GH, Cortisol, Epinephrine 210. Which gland is most responsible for raising blood calcium levels? 211. Which hormone stimulates osteoclasts to chew away bone, releasing the bones calcium into the bloodstream? Parathyroid Glands 212. What hormone has an action that is antagonistic (opposite action) to parathyroid hormone, and where is this antagonist produced? Calcitonin; produced in thyroid gland Parathyroid Hormone 213. Parathyroid levels are released by what? Hormonal Mechanism 214. What are the 3 ways that the Parathyroid glands raise blood calcium levels? 215. PTH and Vit D have an effect on what three body parts? 216. What is the effect at each of these locations? a. Stimulates osteoclasts to move bone calcium into bloodstream. b. Stimulates the intestines to absorb more calcium from diet. c. Stimulates the kidneys to stop excreting calcium. Bone: increases bone resorption by osteoclast activity Kidney: increases calcium reabsorption Intestine: increases calcium absorption