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Endocrinology
Anatomy & Physiology: Endocrine
| Question | Answer |
|---|---|
| 1. Which cells produce T3 and T4. 2. Which cells produce calcitonin. 3. Which cells secrete parathyroid hormone? | 1. Follicular cells of the thyroid 2. Parafollicular (C cells) of the thyroid 3. Chief cells of the parathyroid |
| What are the 3 thyroid binding proteins? | 1. thyroid binding globulin 2. Transthyretin (prealbumin) 3. Albumin |
| Low total T₄ but normal TSH and free T₄ usually signifies... | deficiency in TH-binding proteins |
| Folicular cells secrete __ into the colloid space. Iodine is added to __ amino acid residues. | 1. thyroglobulin 2. tyrosine |
| 1. Enzyme that adds iodine to thyroglobulin 2. Peripheral tissues contain __ that convert T₄ into T₃ by removing iodine from tyrosine residues. | 1. thyroid peroxidase 2. Deiodinases |
| 1. How does estrogen effect thyroid binding globulin? 2. How does this effect bound T₄, free T₄, and total T₄? | 1. estrogen increases TBG synthesis 2. T4 temporarily decreases as more in bound to TBG. TSH levels increase until T₄ returns to equilibrium. Bound T₄ will be elevated above normal as will total T₄ but free T₄ will not be elevated. |
| 1. A preprohormone is synthesized in the __. 2. After cleavage of signal peptides, the prohormone is transported to the __. | 1. rough endoplasmic reticulum 2. golgi |
| 1. Thyroglobulin is released into the colloid space through the process of ___. 2. Iodide is transported into the follicular cell by __. | 1. exocytosis 2. sodium-iodide symporter NIS |
| Function of vitamin D | 1. ↑ gut absorption of dietary Calcium & phosphate 2. ↑ bone resorption of calcium |
| In vitamin D metabolism which metabolite is produced in the liver? Which is produced in the kidney? | 1. 25OH vitamin D in liver 2. 1,25(OH)₂ vitamin D in the kidney |
| Function of calcitonin | ↓ bone resorption of calcium |
| Which endorine hormones act through receptor associated tyrosine kinase (JAK/STAT) pathway? | GH, prolactin |
| Which enzyme is responsible for the second hydroxylation of vitamin D in the kidney? | 1α-hydroxylase |
| 1. What effect do sex steroid hormones have on bone? 2. What effect do glucocorticoids have on bone? | 1. ↓ bone resorption 2. bone resorption |
| 1. GH stimulates the production of IGF1 mainly in the __. 2. What negatively feeds back to inhibit GH release? | 1. liver 2. GH and IGF1 |
| What are the effects of GH on blood sugar in the: 1. acute phase 2. chronic phase | 1. proinsulin - stimulates glucose and amino acid transport 2. anti-insulin - increased blood glucose, insulin resistance |
| What is the effect of the following hormones on growth? 1. thyroid hormone 2. glucocorticoids 3. sex steroids 4. insulin | 1. ↑ growth 2. inhibit growth 3. ↑ growth but closes epiphyseal plate 4. ↑ growth of fetus |
| 1. Primary hypoadrenalism is usually due to.. 2. Secondary hypoadrenalism is due to. | 1. decreased cortisol from autoimmune destruction of the adrenal cortex 2. decreased cortisol from ACTH deficiency |
| What is the cause of hyperpigmentation in primary adrenal insufficiency? | excess MSH and ACTH production from POMC precursor |
| 1. Which endocrine hormones are derivatives of tyrosine? 2. Carrier proteins that transport posterior pituitary hormones in circulation | 1. thyroid hormones 2. neurophysins |
| What part of the adrenal cortex are the following secreted 1. aldosterone 2. cortisol 3. androgens | GFR 1. glomerulosa 2. fasciculata 3. reticularis |
| 1. Where is ADH synthesized? 2. Where is oxytocin synthesized? | 1. supraoptic nucleus 2. paraventricular nucleus |
| What increases growth hormone secretion? | 1. sleep 2. stress 3. arginine (high protein meal) 4. hypoglycemia |
| What are the two hormones that decrease growth hormone release? | 1. somatostatin 2. somatomedins (IGF) |
| Where are somatomedins produced? | the somatomedin IGF is produced in the liver after growth hormone binding |
| Which hormone is produced by the following pancreatic cell types: 1. α 2. β 3. δ | 1. insulin 2. glucagon 3. somatostatin |
| Where are the following glucose transporters located: 1. GLUT1 2. GLUT2 3. GLUT4 | 1. RBCs, brain 2. β islet, liver, small intestine 3. (insulin responsive) adipose tissue, muscle, |
| Which enzymes does insulin stimulate for: 1. glycolysis 2. liver synthesis of fatty acids 3. release of fatty acids from VLDL 4. storage of glucose as glycogen | 1. glucokinase, PFK-2, PDH 2. acetyl CoA carboxylase 3. lipoprotein lipase 4. glycogen synthase |
| How does glucose trigger insulin release? | 1. glucose enters liver cells through GLUT-2 transporter and undergoes glycolysis 2. ATP ↑ in cell and K + channels close 3. cell depolarizes and calcium channels open 4. Exocytosis of insulin |
| How does glucagon affect: 1. blood glucose 2. fatty acid level 3. urea production | 1. ↑ glycogenolysis and gluconeogenesis 2. ↑ lipolysis 3. amino acids used for gluconeogenesis and resulting amino groups incorporated into urea |
| 1. Inhibits prolactin release 2. Hormones that increases prolactin release 3. Which hormone does prolactin inhibit | 1. dopamine 2. TRH, estrogen 3. GnRH |
| 1. How does cortisol increase blood pressure? 2. How does PTH effect phosphate? | 1. upregulates α1 receptors on arterioles 2. ↓ kidney reabsorption of phosphate |
| What 3 ways does PTH increase calcium? | 1. ↑ bone resorption 2. ↑ kidney reabsorption 3. ↑ vitamin D production → ↑ GI absorption |
| What is the mechanism of vitamin D activation by PTH? | PTH stimulates kidney 1α-hydroxylase |
| What is the mechanism of bone resorption by PTH? | PTH ↑ production of macrophage colony-stimulating factor and RANK-L in osteoblasts which stimulate osteoclasts |
| 1. How does PTH effect calcium and phosphate 2. How does vitamin D effect calcium and phosphate? | 1. ↑ calcium reabsorption, ↓ phosphate reabsorption 2. ↑ both calcium and phosphate reabsorption |
| Which endocrine hormones act through IP₃ (Gαq)? | GOAT 1. GnRH 2. Oxytocin 3. ADH (V1 receptor) 4. TRH |
| Which hormone binds a nuclear steroid receptor? | T₃/T₄ |
| Which hormones bind cytosolic steroid receptors? | VET CAP 1. vitamin D 2. estrogen 3. testosterone 4. cortisol 5. aldosterone 6. progesterone |
| Hormones that act through cAMP | FLAT CHAMP 1. FSH 2. LH 3. ACTH 4. TSH 5. CRH 6. hCG 7. ADH (V2 receptor) 8. MSH 9. PTH |
| Hormones that act through intrinsic tyrosine kinase (MAP kinase pathway) | insulin, IGF1, PDGF |
| By which mechanism do thyroid hormones effect: 1. cardiac output 2. basal metabolic rate | 1. ↑ β1 receptors in hear 2. ↑ Na+/K+ ATPase activity |
| 1. What is calcitriol? 2. How many phosphate groups are attached to it? | 1. hormonally active vitamin D 2. 3 hydroxyl groups |
| What 3 components compose serum calcium? | 1. albumin bound calcium 2. phosphorus bound calcium 3. free, ionized calcium |
| What is the physiological cause of tetany seen with hypocalcemia? | lower threshold potential of nerve causes partial depolarization |
| How does glucagon effect insulin levels? | 1. glucagon promotes release of somatostatin → ↓ insulin (and glucagon) secretion 2. glucagon binds pancreatic β-cell → ↑cAMP → insulin secretion |
| How does insulin effect glucagon levels? | insulin directly inhibits glucagon release |
| Why is insulin levels higher after oral glucose than IV glucose? | incretins (e.g. GLP-1) are released from the intestines following oral glucose and they stimulate β-cell insulin secretion |
| How does insulin deficiency lead to an increase in ketones? | without insulin, lipolysis is increased producing increased ketoacids |
| Why does growth hormone excess lead to hyperglycemia? | Growth hormone actions: 1. ↑ gluconeogenesis 2. ↓ glucose uptake into insulin sensitive tissues |
| 1. The activity of which adrenal enzyme is increased by ACTH? 2. The activity of which adrenal enzyme is increased by angiotensin II? | 1. Desmolase (converts cholesterol to pregnenolone) 2. Aldosterone synthase |
| Why does ↑ GH lead to gigantism while ↑ adrenal androgens do not when both promote bone growth? | androgens aromatized to estrogens which lead to premature epiphyseal plate closure leading to short stature while GH → ↑ IGF which does not |
| How do anabolic steroids effect total T4, free T4 and TSH levels? | anabolic steroids divert poteins (plasma proteins) into building muscle. thyroid binding globulin is low 1. ↓ total T4 2. normal free T4 3. normal TSH |
| Drainage of the: 1. Left adrenal 2. Right adrenal | 1. left adrenal → left adrenal vein → left renal vein → IVC 2. right adrenal → right adrenal vein → IVC |
| Embryologic origin of: 1. adrenal cortex 2. adrenal medulla 3. posterior pituitary 4. anterior pituitary | 1. mesoderm 2. neural crest 3. neuroectoderm 4. oral ectoderm (Rathke's pouch) |
| Which hormones share a common α subunit to LH? | TSH, LH, FSH, hCG |
| 1. What causes somatostatin secretion from the hypothalamus? 2. Common cause of death from acromegaly or gigantism? | 1. somatomedin (IGF) from liver as a feedback mechanism for Growth Hormone regulation 2. cardiomegaly; GH causes IGF release from liver, IGF increases organ size |
| How does pulsative GnRH vs non-pulsatile GnRH effect pituitary secretion of LH and FSH? | 1. pulsatile stimulates pituitary secretion 2. nonpulsatile inhibits secretions |
| Which hormone: 1. ↑ breast milk production 2. ejection of milk from breast | 1. prolactin 2. oxytocin |
| T4 vs T3 1. longer half life 2. created in peripheral tissues 3. negative feedback on TRH | 1. T4 2. T3 3. T3 |
| 1. Number one cause of cushing syndrome 2. What is cushing's disease 3. What is the most likely cause of ectopic ACTH secretion? | 1. exogeneous steroids 2. ACTH secreting pituitary adenoma 3. small-cell lung cancer |
| How is epinephrine level effected by cortisol? | cortisol sytimulates the enzyme PNMT which converts norepinephrine to epinephrine leading to increase epi levels |
| How do thyroid hormones effect: 1. protein synthesis 2. lipid store levels 3. cholesterol levels 4. plasma glucose levels | 1. ↑ 2. ↓ through lipolysis 3. ↓ through lipolysis 4. ↑ through gluconeogenesis and glycogenolysis |
| 1. How do sleep, stress and glucose levels effect GH secretion? 2. Which amino acid increased GH secretion? | 1. sleep, stress and hypoglycemia ↑ GH secretion 2. Arginine |
| How does cortisol effect: 1. Blood pressure 2. Bone 3. immune function 4. Glucose levels | 1. maintains blood pressure 2. ↓ bone formation 3. ↓ immune function 4. ↑ gluconeogenesis and lipolysis |
| PTH vs vitamin D in calcium increase: 1. acts on gut 2. acts on bone 3. acts on kidney | 1. vitamin D 2. PTH 3. PTH |
Created by:
amichael87
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