[09.03] Recognizing Common Adult Endocrine Disorders V2.pdf

Endocrinology

What is the study of glands and the hormones they produce?

To set in motion

What does the Greek root of the word hormone mean?

Hormones

What are the chemical signals secreted into the bloodstream that act on distant tissues in a regulatory function?

Endocrine

Which term was coined by Starling to describe glands that secrete products directly into the bloodstream?

Exocrine

Which type of gland secretes products through a lumen or duct?

Thyroid, parathyroid, pituitary, and adrenal

Name four examples of endocrine glands.

Salivary, liver, mammary, and exocrine pancreas

Name four examples of exocrine glands.

Ducts

What structural feature do exocrine glands have that endocrine glands lack?

Pituitary, thyroid, parathyroid, pancreatic islets, adrenals, and gonads

What are the six classic endocrine glands discussed in the source?

Adenohypophysis

What is the formal name for the anterior pituitary gland?

Neurohypophysis

What is the formal name for the posterior pituitary gland?

Thyroid gland

What is the target organ for TSH?

T4 and T3

Which two hormones are released by thyroid follicular cells in response to TSH?

Tetraiodothyronine

What is the full name for T4?

Adrenal cortex

What is the target organ for ACTH?

Zona fasciculata

Which specific zone of the adrenal cortex is primarily stimulated by ACTH?

Cortisol

What is the primary glucocorticoid secreted in response to ACTH?

Gonadotropins

What general category of hormones includes FSH and LH?

Folliculogenesis and oocyte selection

Name two processes regulated by FSH in the female ovaries.

Testicular development and spermatogenesis

What two processes does FSH mediate in males?

Parathyroid hormone PTH

What hormone is produced by the four small glands located at the back of the thyroid?

Low blood calcium

What is the specific stimulus for the secretion of PTH?

Active Vitamin D or D3

PTH facilitates the synthesis of what substance in the kidneys?

Calcitriol or 1,25-dihydroxycholecalciferol

What are two other names for active Vitamin D3?

Gut, kidneys, and bone

PTH facilitates calcium reabsorption or absorption in which three locations?

Bone

Where is 99 percent of the body's calcium stored?

Neck, on top of the larynx

Where is the thyroid gland located?

Basal metabolic rate

Thyroid hormones T4 and T3 primarily increase what body-wide rate?

Sympathetic nervous system

Thyroid hormones cause overactivity of which part of the nervous system?

Glycogenolysis and gluconeogenesis

Thyroid hormones increase which two processes to raise blood glucose?

Lipolysis

What is the term for the metabolism of fat increased by thyroid hormones?

Heat production

What is the net effect of thyroid hormone on body temperature?

Islets of Langerhans

What is another name for the pancreatic islets?

Alpha, beta, delta, and PP cells

What are the four distinct cell types found in the pancreatic islets?

Beta cells

Which pancreatic islet cell is the most abundant at approximately 75 percent?

Alpha cells

Which pancreatic islet cell produces glucagon?

Increases blood glucose

What is the effect of glucagon on blood sugar?

Insulin

What is the primary hormone produced by beta cells?

Uptake and metabolism of glucose

What is the main function of insulin in relation to glucose?

Anabolic

Is insulin considered a catabolic or anabolic hormone?

Muscle cells

Which cells are prompted by insulin to take up amino acids?

Somatostatin

What hormone is produced by the delta cells?

GH, insulin, and glucagon

Somatostatin is a strong inhibitor of which three hormones?

Appetite

What is the primary role of pancreatic polypeptide produced by PP cells?

Superior surface of the kidney

Where are the adrenal glands located?

Cortex and medulla

What are the two main specific areas of the adrenal gland?

Zona glomerulosa, zona fasciculata, and zona reticularis

Name the three zones of the adrenal cortex from outer to inner.

Mineralocorticoids

What class of hormones is produced in the zona glomerulosa?

Aldosterone

What is the main mineralocorticoid?

Sodium conservation

What is the essential function of aldosterone in the kidneys?

BP, plasma sodium, and plasma potassium

Aldosterone plays a role in the homeostatic regulation of which three factors?

Glucocorticoids

What class of hormones is produced in the zona fasciculata?

Suppresses the immune system

What is the immunological effect of cortisol?

Osteoporosis

Chronic high doses of glucocorticoids can lead to what bone condition?

Androgens

What class of hormones is produced in the zona reticularis?

DHEA

What is the primary androgen produced by the adrenal cortex?

Adrenarche

DHEA is responsible for which phase of prepubertal development?

Axillary hair, body odor, and acne

Name three physical changes associated with adrenarche.

Catecholamines

What class of substances is produced in the adrenal medulla?

Norepinephrine and epinephrine

Name the two specific catecholamines produced in the adrenal medulla.

Stress

In response to what do catecholamines release?

Fight or flight

What classic survival response is triggered by the adrenal medulla?

Estrogen and progesterone

What are the two most important hormones produced by the ovaries?

Secondary sexual characteristics

Estrogen is responsible for the appearance of what in females at puberty?

Uterus and mammary glands

Progesterone prepares which two organs for pregnancy and lactation?

Testosterone

Which hormone is produced by the Leydig cells of the testis?

Leydig cells

Which specific cells in the testis produce testosterone?

Spermatogenesis

Besides secondary sexual characteristics, testosterone is involved in what reproductive process?

Negative feedback loop

What process maintains hormone levels within a relatively narrow range?

Negative feedback

What is touted as the hallmark of endocrine regulation?

TRH and TSH

A reduction in thyroid hormone triggers a rapid increase in which two hormones?

Hypothalamus

Which brain structure releases CRH and TRH?

SRIF or somatostatin

Which hypothalamic hormone is inhibitory to TSH?

Dopamine

Which hypothalamic hormone is inhibitory to prolactin?

Inorganic ion or metabolite

Besides hormones, what else can act as a negative regulator, such as calcium for PTH?

Positive feedback loop

What type of loop is the menstrual cycle an example of?

LH surge

In the menstrual cycle, what does the estrogen surge induce?

Ovulation

What event is heralded by the LH surge?

Pituitary gland

Which gland is often called the master gland?

False

True or False: The posterior pituitary gland synthesizes its own hormone products.

Hormone resistance

What is the term for a condition where hormones are present but tissues are not responding?

Local compressive symptoms

How do non-functional glandular tumors cause disease?

Benign neoplastic growth

What is the most common cause of hormone overproduction in endocrine glands?

Pituitary adenomas

What is a common benign cause of ACTH or GH overproduction?

Struma ovarii

What is the term for thyroid tissue found in the ovary that leads to hormone excess?

Graves disease

Name an autoimmune cause of T4 and T3 overproduction.

Iatrogenic

What term describes hormone excess caused by medical treatment, such as taking too much exogenous steroid?

Subacute thyroiditis

Which inflammatory condition causes an enhanced release of stored T4 and T3?

Hashimoto thyroiditis

Which autoimmune condition leads to a gradual deficiency of T4 and T3?

Type 1 Diabetes

Which autoimmune disease involves the destruction of beta cells leading to insulin deficiency?

Turner syndrome

Which developmental defect in females results in reduced estrogen?

Klinefelter syndrome

Which developmental defect in males results in reduced testosterone?

21 hydroxylase deficiency

Which enzyme defect results in a lack of cortisol and aldosterone?

Sheehan syndrome

Which condition involves pituitary hormone deficiency due to hemorrhage or infarction?

Androgen receptor resistance

Name a cause of hormone resistance due to receptor mutations.

Albright hereditary osteodystrophy

Which rare condition involves signaling pathway mutations leading to PTH resistance?

Type 2 Diabetes

What is the classic example of post-receptor hormone resistance?

Direct examination of palpable glands

Since most glands are inaccessible, PE focuses on hormone manifestations and what else?

Central fat and abdominal striae

Name two physical findings of Cushing's syndrome related to fat and skin.

Proximal muscle weakness

What type of muscle weakness is seen in Cushing's syndrome?