Glossary of 1. Endocrinology

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What are the 4 main functions of hormones?
1. Regultn of Growth/Developmnt
2. Homeostatic control
3. Integration of reproduction
4. Behavioral effects
What is the source of hormones?
The endocrine system (cells, glands, and some neurons).
What makes a given cell a TARGET cell for a hormone?
The presence of a specefic receptor on that cell's surface or internal in the cytoplasm or nucleus.
What are the 2 main classes of hormones?
1. Steroids
2. non-steroids
What transports hormones throughout the body?
The blood
What are steroids?
Hormones synthesized from cholesterol in the adrenal cortex, testes, ovaries, and placenta.
What are 4 examples of steroids?
Cortisol, aldosterone, estradiol, testosterone.
What are the 4 chemical classes of non-steroids?
Give 2 examples for each class.
1. Amines (epi/norepi)
2. Peptides (oxytocin/ADH)
3. Proteins (GH, insulin)
4. Glycoproteins (FSH, TSH)
What makes steroids and nonsteroids different?
Their target action mechanisms:
-Steroids: gene activation
-Nonsteroids: 2nd msgr mechanism
How do steroids cause gene activation? (5 steps)
1. Small, lipid soluble.
2. Act on cells w/ cytoplasmic or nuclear receptors
3. If necessary, horm-recptr complex moves into nucleus.
4. Complex binds DNA, stimulating gene transcription and protein synthesis.
5. Hormone effect manifests between minutes to days.
How do non-steroid hormones cause 2nd msgr mechanisms? (5 steps)
1. Don't diffuse into cells.
2. Targets have surface receptor
3. Hormone binds receptor, 2nd msgr released inside cell.
4. 2nd msgr is either: c-AMP or Calcium ion.
5. c-AMP or Ca-Calmodulin complexes activate enzymes for RAPID cascade response (sec to min)
List 4 ways to control hormones:
1. Feedback mechanisms
2. Cyclic secretions
3. Catabolism
4. Protein binding
Pituitary pathologies denote:
Primary = endocrine gland itself
Secndry = controlling gland
Tertiary = master gland
Quatrnry = end organ
Ok... what are the real names?
Endocrine gland
Controlling gland
Master gland
E.g. adrenal gland
sympathetic nerves/muscles
What can cause pituitary deficiency or excess?
Infections, Tumors, Trauma
What is the most common pituitary disease cause?
Prolactin-secreting adenoma
How is Prl-secreting adenoma diagnosed?
Prolactin levels >200 ng/mL
What is the 2nd most common pituitary disease?
Acromegaly - GH secretion causing Gigantism.
What is helpful in diagnosing acromegaly gigantism?
-GH levels in provacative tests
-Insulin-like Growth Factor (IGF-1) esp in borderline cases.
What is the 3rd most common pituitary disease?
Cushing's syndrome with increased cortisol due to increased ACTH.
What are key indicators of cushing's disease?
Glucose inolerance
Dexamethasone Suppression
What dexameth suppression result indicates pituitary cushings?
No suppression of ACTH occurs with high dose dexameth.
What does the Posterior pituitary release?
1. ADH
2. Oxytocin
What does ADH do?
Concentrates urine
what does oxytocin do?
stimulates nonvascular smooth muscle contraction
- myoepithelial cells for milk letdown
-uterine contractions
What 2 main pathologies are associated w/ posterior pit?
1. siADH
2. Diabetes insipidus
How does the posterior pituitary behave in
-Diabetes insipidus
siADH = hypersecretion of ADH
Diabetes insipidus = not enough ADH, undersecretion
What common cancers can cause siADH?
Lung, pancreatic, prostate, hodgkin's lymphoma
Explain the pathology of siADH
1. Increased ADH, retain H2O
2. Volume incr, Decr Na/K
3. Decreased urine/serum osmolality
What are some common causes of central diabetes insipidus?
Head trauma, infections, tumors of hypothalamus
What causes diabetes insipidus to be life-threatening?
Withholding water
What is thyroid hormone responsible for? (6 things)
Sexual maturation
Energy expenditure control
Development and Growth
Protein synthesis, etc.
What can increase thyroid hormones without affecting the thyroid itself? (2 things)
1. Pregnancy
2. Oral contraceptives
What can decrease thyroid hormones without affecting the thyroid itself? (2 things)
1. Malnutrition, protein-wasting
2. Nephrotic syndrome
What are 4 types of Hypothyroidism?
1. Hashimoto's thyroiditis
2. Goiter
3. Cretinism
4. Medications
What causes hashimoto's thyroiditis?
Anti-thyroid antibodies
What is Cretinism?
Congenital hypothyroidism with growth and mental retardation.
What is the treatment for hypothyroidism?
What are symptoms of HYPERthyroidism?
1. Weight loss
2. Menstrual irregularity
3. Fatigue/lethargy
4. Heat intolerance/sweating
5. Tachycardia/ incr. reflexes
What are the classic thyroid panel results in Grave's hyperthyroidism?
Decreased TSH
Increased FT4, T4/T3
What are the classic thyroid panel results in TSH-dependent hyperthyroidism?
Increased TSH
Increased FT4, T4/T3 --> it's because of a pituitary tumor.
What causes Grave's disease?
Anti-TSH receptor Antibodies
What's unique about hashimoto's thyroiditis?
It can cause either hypo or hyperthyroidism.
What is the treatment for hyperthyroidism?
Decrease the production and/or release of T4 by removing the gland, radiation, or medication.
What are the classic thyroid panel values seen in non-thyroid (euthyroid) illness?
Decreased T3, increased rT3.
What lab method is used for measuring TSH?
Sandwich immunoassays for anti-B and anti-a components.
What type of specimens can be used for TSH measurement?
Are there special handling specifications?
Serum or plasma.
Can be frozen - stays stable.

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