Pathophysiology 2 (HSC4558) - Exam 2 Study Guide Review

What are endocrine organs with solely endocrine function?

Pineal gland, Thyroid gland, pituitary gland, Parathyroid glands, adrenal glands

What are some organs with secondary endocrine function?

Hypothalamus, skin, thymus, heart, liver, stomach, pancreas, small intestine, adipose connective tissue, kidneys, and gonads

Chemical messenger that affects target cells anatomically distant from the secreting cells

Hormone

Secretion of hormones into the bloodstream by neurons

Neurocrine

True or False: Endocrine refers to secretion of hormones into the same cells that produced them?

False. Endocrine — secretion of hormones into the bloodstream

Which of the following functions does estrogen have

• Endocrine, Paracrine, Autocrine, or Neurocrine

Endocrine, Paracrine, & Autocrine.

Majority of endocrine hormone are?

Water soluble

Lipid soluble

Water soluble.

True or False: Water soluble hormones interact with target cells via cells surface receptors while lipid soluble hormones interact with their target cells via intra cellular receptors.

True

These types of hormones are carried in circulation by transport proteins

Lipid soluble hormones

True or False: G-protein-linked receptors bind lipid and water-soluble hormones and convey their signal to a secondary intracellular messenger

False. They only bind water soluble hormones

Cell surface receptors that become activated themselves or are associated with cytoplasmic kinases

Protein kinase receptor

Activation of one receptor at the cell surface results in the activation of numerous downstream protein cascades is an example of what?

Amplification

True or False: Steroid and thyroid hormones diffuse easily through the lipid bilayer of cell membranes which results in a larger amplification cascade.

False. They induce a specific gene expression with no amplification cascade.

Very small amounts of hormones are able to produce rapid effects at the cellular and systemic levels. Which term describe this process?

Amplification

Inactive form of Insulin

Proinsulin

These hormones result from series of steps modifying tyrosine molecule

Catecholamines

Dopamine, norepinephrine, and epinephrine are------- ?

Catecholamines

These hormoes are formed on demand from cholesterol that is stored in the cell or retrieved from circulating lipoproteins?

Steroids

True or false: Thyroid hormones synthesis precedes secretion by weeks or months in the thyroid follicle and bound to protein thyroglobulin

True

Body senses a need for the hormone, hormone is released; increase in hormone concentration exerts an inhibitory effect. which feedback is described here?

Negative feedback

True or False: Negative feedbacks are more prevalent than positive feedback mechanisms

True

This term describes the time for a hormone to reach one-half of its original concentration

in the blood.

Half-life

How can target cells are able to regulate their responsiveness to hormones?

By altering the receptor number, affinity, and efficiency of coupling to intracellular responses

When two hormones can bind to the same receptor with the same or different affinities.

This is called------.

Cross-specificity

True or False: If cells are exposed to prolonged high concentrations of hormone; this results in an increase in the number of receptors?

False

This happens in response to chronically low hormone concentrations

Receptor up-regulation

A chemical that binds to a receptor without initiating the typical intracellular changes is called?

Hormone antagonist

A chemical that binds hormone receptors and causes the same intracellular events is called?

Hormone agonist

True or False: Oxytocin and Antidiuretic hormone (ADH) are produced and secreted by the posterior pituitary gland?

False. They are produced by the hypothalamus and stored in the posterior pituitary gland

ADH binding to vasopressin 2 (V2) receptors of distal renal tubule results in what?

This causes pores (aquaporins) to move from the cytoplasm to the tubular cell membranes, allowing free diffusion of water from the tubular fluid into the cell.

Stimulation of the nipple and areola triggers oxytocin release, which binds to myoepithelial cells surrounding the mild ducts, causing them to contract and eject milk during breast feeding.

Is this an example of positive or negative feedback?

Positive feedback

What stimulates the release of antidiuretic hormone (ADH) from the posterior pituitary gland?

Increased serum osmolality or dehydration

All hypothalamic releasing and inhibiting hormones are peptides with the exception of dopamine, which is?

Dopamine is a catecholamine

What are the major hormones of the anterior pituitary gland?

Growth hormone (GH), Prolactin, Gonadotropins ( Follicle stimulating hormone (FSH) and Luteinizing hormone (LH)), Thyroid stimulating hormone, ACTH

Somatotrope cells of the anterior petruitary gland secrete which hormones?

Growth hormone

What are the functions of GH?

GH affects metabolic processes by increasing the rate of protein synthesis, decreasing protein catabolism, slowing carbohydrate utilization, and increasing mobilization of fats and the use of fats for energy (Refer to chart on slide 41)

What can increase in prolactin synthesis and release from the pituitary?

Estrogen production and nipple stimulation

Follicle-stimulating hormone (FSH) and leutenizing hormone LH are produced where?

Gonadotropes of anterior pituitary

True or False: Release of FSH and LH is stimulated by hypothalamic gonadotropin- releasing hormone

True

Thyrotropin-releasing hormone (TRH) induces the secretion of which hormone and from where?

TSH from the anterior pituitary

What is the negative feedback that regulates levels of TSH and TRH?

Levels of T3 and T4 in circulation

This hormone is released by the anterior pituitary gland and binds receptors on adrenal cortex cells to stimulate the production of cortisol and adrenal androgens

ACTH

Thyroxine (T4) and Triiodothyronine (T3) are produced by which organ?

Thyroid gland

Which hormone induces the release of T3 and T4?

TSH

Which form is active T3 or T4

T3 is active. T4 needs to be converted to T3 by plasma enzymes to become active

These hormones are produced from cholesterol by the adrenal cortex and are lipid-soluble.

Steroids

True or False: Steroids are not made on demand; they are premade and stored in the adrenal cortex cells

False. They are made on demand and are not stored in cells

Outer zona glomerulosa produces which hormone in response to which stimulus?

Mineralocorticoid aldosterone in response to stimulation by angiotensin II (AII).

This zone produces the glucocorticoid, cortisol, in response to ACTH.

Middle zona fasciculata

Which zone produces the androgen, DHEAS, in response to ACTH.

Inner zona reticularis is adjacent to the adrenal medulla

Which hormone acts on two different zones of adrenal gland resulting in different hormonal responses?

ACTH produces cortisol from the zona fasciculata and DHEAS from zona reticularis. his zone produces the glucocorticoid, cortisol, in response to ACTH.

What is not true about steroid hormones?

• Travel in circulation bound to proteins: corticosteroid-binding globulin (transcortin) and albumin

• Regulate the "three S's": sugar, salt, and sex.

• Lipid soluble

• Can cause an amplification cascade inside the cell.

Can cause an amplification cascade inside the cell

Only proteinbased hormones can cause an amplification cascade.

How does cortisol oppose the effects of insulin?

By decreasing glucose uptake by many body cells (decreased glycogenesis) and Increasing glucose synthesis in the liver from glycogen and amino acid and glycerol substrates in fat stores (glycogenolysis, gluconeogenesis).

What is not function of cortisol?

• Increases plasma glucose

• Regulates immune and inflammatory reactions

• Inhibits bone and collagen synthesis

• Increase protein storage and muscle fiber build up

Increase protein storage and muscle fiber build up is wrong.

Proteins are released from storage by cortisol stimulus, to be used as energy source therefore leading to decreased muscle mass.

This hormone is released in response to low blood pressure, reduced renal perfusion and a high serum potassium level and is the last hormone activated by the renin angiotensin system?

Aldosterone

Occurs when target tissue fails to respond to a hormone?

Tissue resistance

In this type of endocrine disorder, the gland fails, inadequate hormone is produced, but corresponding trophic hormone levels are high

Primary endocrine disorder

In this type of endocrine disorder, the pituitary gland fails to produce trophic hormone which results in corresponding gland failing to produce their hormones.

Secondary endocrine disorder

This hormone is released by the pituitary gland and is inhibited by hypothalamic somatostatin

Growth hormone

True or false: Defective IGF-1 (somatomedin) generation can cause GH deficiency

True

What is not a sign a GH deficiency in adults

a) Hypocholesterolemia

b) Hypercholesterolemia

c) Decreased bone density

d) Increased bone density

a) Hypocholesterolemia

d) Increased bone density

What is the most common cause of excess GH

Benign somatotropic tumor of the pituitary (adenoma)

Why is GH called a diabetogenic hormone?

Because excess GH causes persistent hyperglycemia and increased insulin production

True or False: Acromegaly occurs in childhood before the skeletal epiphyses

False. Pituitary gigantism occurs in childhood.

True or False: Acromegaly is associated High IGF-1 and an elevated GH level that is suppressed by administration of oral glucose

False. Acromegaly is associated High IGF-1 and an elevated GH level that is NOT suppressed by administration of oral glucose

Synthetic somatostatin could be used as a treatment for what?

Excess GH in adults (Acromegaly)

Hypothyroidism can result from all except

• Intrinsic thyroid gland dysfunction

• Pituitary gland dysfunction

• Iodine deficiency

• Thyroid gland dysgenesis

None! All are valid.

Type of edema that occurs in severe or prolonged hypothyroidism

Myxedema

This type of hypothyroidism is associated with elevated TSH and low T3 and T4

Primary. Issue with thyroid gland

This type of hypothyroidism is associated with low TSH and low T3 and T4

Secondary. Issue with Pituitary gland

This disorder is associated with increased T3 and T4 release by autoantibodies-stimulated TSH receptors activation.

Graves disease

Adrenocortical insufficiency resulting from dysfunctional adrenal gland

Addison disease

Inadequate secretion of ACTH from ----- will cause----

Anterior pituitary/cortisol insufficiency

Primary adrenal insufficiency is associated with -----cortisol levels and ------ACTH levels?

Decreased cortisol/increased ACTH

Secondary adrenal insufficiency is associated with -----cortisol levels and ------ACTH levels?

Decreased Cortisol and ACTH

Tertiary adrenal insufficiency is associated with decreased -----------

Decreased CRH, ACTH and Cortisol

Congenital adrenal hyperplasia will cause what?

Defects in the biosynthesis of cortisol (Cortisol insufficiency)

Medical crisis resulting from drastic decrease in levels of glucocorticoids and mineralocorticoids, leading to cardiac collapse.

Addisonian crisis/acute adrenal insufficiency

In congenital adrenal insufficiency, increased---------secretion causes adrenal------------- and overproduction of -----------

In congenital adrenal insufficiency, increased ACTH secretion causes adrenal hypertrophy and overproduction of androgens

Hypercortisolism resulting from over stimulation from anterior pituitary gland is called?

Cushing disease

True or False: A non-pituitary tumor resulting in ectopic ACTH production is an example of Cushing syndrome etiology.

True

This syndrome is caused by aldosterone-secreting tumors.

Conn syndrome

True or False: Secondary hyperaldosteronism results from an over expression of Renin from the anterior pituitary

False. It results from an over expression of Renin from the kidneys

Hypertension, hypervolemia, hypokalemia are clinical manifestations of----

Hyperaldosteronism

True or False: Pheochromocytoma is an Adrenal medulla aggressive (malign) tumor resulting in excessive production and release of catecholamines

False - benign tumor

Decrease in calcium causes PTH release which causes ------

Bone resorption to release calcium, its absorption in the GI and reabsorption in the kidneys.

Molecule secreted by the thyroid gland that increases bone formation by osteoblasts and inhibits bone breakdown by osteoclasts.

Calcitonin

Hyperplasia of parathyroid glands will cause------

Hyperparathyroidism

True or False: Congenital lack of parathyroid tissue will cause hypoparathyroidism

True

What is untrue about this statement. Diabetes insipidus results from anomaly in ADH production leading to diabetes-like symptoms?

Diabetes insipidus has nothing to do with diabetes. It causes excessive water loss in

urine.

Excessive ADH from ectopic production from tumors is called------?

Syndrome of Inappropriate ADH (SIADH)