Endocrinology
The endocrine system is part of the body's _________ _____________ ________
extracellular communication system
__________ __________ links the brain to the organs functions which control metabolism, homeostasis, reproduction, growth, and well-being (My Hormones aRe Great Workers)
The endocrine system
The ____ links the immune and endocrine sytems
CNS
The endocrine system has 2 major components, the ______ and ________ system
immune and endocrine
Hormones are ________ _________ produced by glands or cells
chemical messengers
Hormones act through the _________, ________, and ________ sytems
autocrine, paracrine, and endocrine
The hormones of the _________ system affect the same type of cell it was released from (Ex. cytokines)
autocrine
The hormones of the _________ system binds to the receptors of nearby cells of a different type (Ex. neurotransmitters and neurohormones)
paracrine
The endocrine system works through an elaborate network of _________ (Ex. insulin, thyroxine, and cortisol)
hormones
The endocrine system is a series of _______ that release their hormones directly into blood to transport them to their target cells
glands
Hormones act on their target through _________
receptors
Receptors are specific __________ _________ located on the surface of the cell membrane or within the cytosol
binding proteins
The binding of a hormone to a receptor serves as a signal to a cells nucleus to start synthesis of _______________
mRNA messages and new proteins
some hormones require the use of a __________ ______, activated by the hormone binding to a receptor
second messenger
The second messenger system uses ________________ _________ to transmit the message to its target inside the cell
intracellular molecules
Hormones are either ____________, _______, or _________ ________
polypeptide/protein, steroids, or amino acids
If a hormone ends in "one" (aldosterone) it is a ___________
Steroid
_____________
water soluble
requires a secondary messenger
does not require a protein carrier
has a half life ≤ 30 min
ACTH
PTH
Insulin
Growth hormone
(APIG)
Polypeptide/protein
_____________
water insoluble
does not require a secondary messenger
requires a protein carrier
has a half life 30-90 min
Vitamin D
Aldosterone
Cortisol
Sex hormones
(VACS)
Steroid
_____________
water soluble
requires a secondary messenger sometimes
requires a protein carrier
Thyroxine: half life of 7-10 days
Catecholamines: ≤ 1 min (such as epinephrine)
Amino Acids
stimulating/releasing/inhibiting hormones are made in the __________
hypothalamus
Hormones are ______________________
potent, biologically active compounds
______ levels can affect some hormone levels
Protein
The __________ sends stimulating/releasing or inhibiting hormones to the pituitary gland to regulate hormone production
hypothalamus
__________ feedback is trying to acheive a balance in the body using hormones (homeostasis)
Negative
_______ feedback is using hormones for body processes
Positive
the _________ _________ is just a store room
posterior pituitary
The hypothalamus has _________ and ___________ connections to the pituitary glands
neural and anatomical
The hypothalamus stimulates/ inhibits hormone release from the _______________
adenohypophysis
The hypothalamus controls the pituitary through the _______________________ __________ system
hypothalamic-hypophyseal portal
Majority of hypothalamus hormones are _____________
polypeptide/proteins
The hormones synthesized and released from the hypothalamus to the adenohypophysis are the __________________________________
releasing/stimulating/inhibiting hormones, LH, Adrenocorticotropic hormone (ACTH), prolactin, and somatostatin
The hypothalamus releases ADH/AVP and oxytocin to the _________________ for storage
neurohypophysis
PRIF is also called the _____________ ________
neurotransmitter dopamine
_____________ is also called growth hormone inhibiting factor
Somatostatin
The anterior pituitary is also called the _________________
adenohypophysis
The posterior pituitary is also called the _________________
neurohypophysis
The pituitary gland is inside of the __________ _________ (Turkish Saddle)
Sella Turcica
The pituitary is ~ 1cm or less in height and width and weighs ~ ____ mg
500
The ___________ ________ is called the master endocrine organ due to its role in controlling growth, water and salt homeostasis, development, thyroid function, adrenal function, and gonadal function
pituitary gland
All anterior pituitary hormones are ______________
proteins/polypeptides
The neurohypophysis is mostly composed of _________ __________
neural tissue
ADH/AVP release is regulated mainly by the brains ______________
Osmoreceptors
___________ is caused by deficient ADH
Polyuria
___________ or ___________ is caused from ADH overload
oliguria or anuria
________ promotes contractions, milk ejection, and labor
oxytocin
The primary stimululs for oxytocin is ________
suckling
The adenohypophysis is responsible for secretion of ________ and ________ hormones
trophic and tropic
The hormones released by the adenohypophysis (front of the ship) is ____________________________ (FLAGPT)
FSH, LH, ACTH, GH, PRL, and TSH
Pituitary dysfunction may be from ____________________
genetic disorders, infections, tumors, or head injury (in youth)
Low cortisol suggests ____ _______
Adrenal Deficiency
Some glandular diseases will be classified as ______, ______, or ______ depending on which part of the endocrine system is the cause
primary, secondary, or tertiary
Pituitary diseases are often difficult to diagnose and requires some form of testing through pituitary ___________ and __________
Suppression and stimulation
GH is sythesized by the ___________ cells of the adenohypophysis and is stored within intracellular granules
somatotropic
_______________ is the most abundant hormone produced by the adenohypophysis
GH
GH reaches its peak value during the ______ period of sleep
REM
GH trigger synthesis and release of the polypeptide _________
IGF-1
GH promotes _____, ___, and ______ growth
tissue, bone, and cartilage
GH is a _________ hormone because it influences anabolic and catabolic processes
amphibolic
____________ is the adult form of GH excess
Acromegaly
__________ ___________ is the child version of GH excess
pituitary gigantism
_______ _________ is a reversible GH deficiency caused by stress
Psychosocial dwarfism
____________ are the usual testing method for GH and IGF
Immunoassays
The ________________________ is the most reliable test for GH excess diagnosis
Oral glucose tolerance test
The ________________________ is the most common test for GH deficiency
Insulin Challenge test
________ is a drug used to induce pituitary release of GH
levadopa
For adults with GH deficiency, a ___________________ is exclusively used
Insulin-induced hypoglycemia test
_______ stimulates and sustains lactation
Prolactin
Prolactin is produced by ___________
leukocytes
Prolactin can also affect ______ and _______ reabsorption
salt and water
_________________ is the most common hypothalamic-pituitary disorder
Hyperprolactinemia
_______________ are the most common secretory tumors of the pituitary gland
Prolactinomas
Prolactin is commonly measured using ____________ _____________ methods
automated immunoassay
Thyroid hormones control the ______ _______________
basal metabolic rate
TSH from the hypothalamus regulates __________________(T3 and T4)
thyroid hormone synthesis
Dietary ________ is involved in the synthesis of thyroid hormones
Iodine
__________________ is made up of 2 tyrosine amino acid chains
Thyroglobulin
T3 and T4 are bound to ________________________
TBG, albumin, and transthyretin
T3 is ______ times more potent in biological systems than T4
4-5
The 2 main thyroid gland pathological conditions are ___________ and ______________
Hypothyroidism and Hyperthyroidism
Thyroid hormones and most importantly TSH is monitored to detect __________ ___________
Thyroid disease
Hyperthyroidism is a ______________ condition caused by excessive hormone production
hypermetabolic
________ _________ is the most common cause of hyperthyroidism
Graves disease
Graves disease is caused from IgG antibody development against thyroid _________________
TSH receptors
Hyperthyroidsim can be treated with _______________-
Radioiodine adlation, drugs, or surgery
_____________ causes increased leakage of stored hormones into the gland itself
Thyroiditis
__________ is a severe form of hypothyroidism with mucopolysaccharide buildup
Myxedemia
___________(Congenital Hypothyroidism) is severe hypothyroidism in newborns
Cretinism
_________ ______________ is impaired T3 and T4 synthesis, which triggers hypersecretion of TRH and TSH
Primary hypothyroidism
TSH is a _______ hormone
trophic
A enlarged thyroid is called a _________
goiter
________ _______ is the most frequent cause of primary hypothyroidism
Hashimoto Thyroidism
Hashimoto Thyroidism leads to destruction of the thyroid _________ _____
follicular cells
__________ _______________ ______________ is loss or atrophy of thyroid tissue, resulting in less hormone production
Primary nongoitrous thyroidism
Goitrous Thyroidism is commonly caused by ________ __________, causing TSH hypersecretion
iodine deficiency
________ ____________ _________ is a result of pituitary or hypothalamic diseases that result in TSH and/or TRH deficiency
Central thyroid disease
Thyroid test use ____ or _______ __________ methods
kit or automated immunoassay
Hyperthyroidism usualls consists of a low ____ and high ____
TSH; FT4
TRH tests may diagnose _______ _________ ________
central thyroid disease
The average person has _ parathyroid glands
4
Parathyroid glands are comnposed of _____ and _______ cells
chief and oxyphil
The chief cells of the parathyroid gland synthesize, store, and secrete _____
PTH
PTH regulates ______ levels in the blood stream
calcium
Calcium is the 5th most common element in the body and the most prevalent _____ in the body
cation
In the body, ___% of calcium is free ionized, ___% is bound to plasma proteins, and ___% complexes with small anions
50; 40; 10
_____ is the only source of calcium
Diet
The ______ stores 99% of the bodys calcium
skeleton
Bones are mineralized _________ ________
connective tissue
_________ break down bone
Osteoclasts
__________ rebuild bone
Osteoblasts
______, __________, and __________ influence bone growth
calcium, phosphate, and magnesium
PTH and 1,25 D3 regulates ________________ concentration
calcium-plasma
Free calcium and PTH have a _____ _______ relationship
inverse sigmoidal
______ influences calcium and phosphate homeostasis directly through its actions on bone
PTH
____________ is produced from both sunlight exposure and from food
Vitamin D
Vitamin D deficiency may cause _________ (kids) or __________ (adults)
rickets or osteomalacia
25 (OH) D has a ____ week half life
2-3
1, 25 (OH)2 D has a ____ hour half life
4-6
Calcium metabolism disorders are seperated into those causing __________ and ______________
hypercalcemia and hypocalcemia
________ ___________ is the most common cause of hypercalcemia in OUTPATIENTS
Primary Hyperthyroidism
________ is the most common cause of hypercalcemia in HOSPITALIZED patients
Malignancy
Symptoms of hypercalcemia are of the ___________ _____
neuromuscular system
Hypercalcemia may induce mild nephrogenic _________ _________
diabetes insipidus
Chronic hypercalcemia with hypercalciuria can lead to the formation of calcium-containing _________ _________
kidney stones
___________ is commonly encountered in the clinical practice and results when a influx of calcium entering into ECF is greater than the efflux
Hypercalcemia
Hypocalcemia may be caused by _________________________________
Hypoalbuminuria, chronic renal failure, Mg+ deficiency, Hypoparathyroidism, Osteomalacia, rickets, and possibly from Psuedohypoparathyroidism
Hypocalcemia symptoms are of __________ __________
neuromuscular hyperexcitability
Calcium is measured mainly in serum and ___________ _______
heparinized plasma
Urine samples for calcium tersting should be preserved by adding ______ to the specimen
HCl
Serum or ______ ______ are preferred for PTH testing
EDTA Plasma
Vitamin D is usually measured in _________
serum
_____ or _______ calcium are the most requested calcium tests
free or total
Calcium specimen are usually measured using ______________ or ____
spectrophotometry or ISE
_____ testing is important for hypocalcemia and hypercalcemia diagnosis
PTH
___________ ___________ measure intact PTH
Sandwich immunoassays
25 (OH) D is usually measured to determine ___________ concentration
Vitamin D
Adrenal glands weighs ~__g and is small in size; they weigh the same and are the same size in EVERY person
4
Each adrenal gland consist of a yellow _______ and a gray _______
cortex; medulla
The outer-inner parts of the adrenal glands are labeled the __________________________________
zona glomerulosa, zona fasciculata, and finally the zona reticularis
The zona glomerulosa produce mainly mineralocorticoid steroids, primarily ___________
Aldosterone
The zona fasciculate produces mainly glucocorticoid steroids, primarily ___________
Cortisol
The zona reticularis produces mainly androgen steroids, primarily ___________
DHEA and Androstenedione
The medulla produces mainly Catecholamines (amino acids), primarily ___________ (NED)
Epinephrine, Norepinephrine, and Dopamine
Circulating adrenocortical steroid hormones are ____% bound to carrier proteins
90-98%
The adrenal cortex controls _________, _________, and ______ _______
aldosterone, cortisol, and adrenal androgens
CBG binds and transports _______
cortisol
Cortisol affects metabolism of _______, ________, and ________
carbs, protein, and lipids
___________ and _________________ have more function in women
DHEA and Androstrenedione
______________________ provide fight or flight function
Catecholamines
Steroid hormones are synthesized primarily from _____________ in the adrenal glands
cholesterol
______ triggers cortisol synthesis and release
ACTH
Cortisol provides _________ feedback to the hypothalamus and pituitary
negative
___________ _________________ are two conditions used to describe elevated cortisol
Cushing syndrome/disease
Cushings _________ is when the pituitary is directly responsible for cortisol hypersecretion
disease
Cushings _________ is when the pituitary is not directly responsible for cortisol hypersecretion
syndrome
In ______ ______ ________ (Addison Disease), loss of cortical cells take place
primary adrenal insufficiency
Mineralocorticoid deficiency leads to _______________
dehydration
Cortisol deficiency may either by _________, __________, or __________
primary, secondary, or tertiary
Steroid hormones can be measured with ___________________ (PUSSH)
urine, serum, plasma, saliva, and hair
If urine is tested for cortisol, the 24-hour urine sample should be paired with ______ ______
boric acid
Cushings disease/syndrome is measured in ________
urine
A lack of cortisol suppression after a overnight ________________ suppresion test suggests pituitary tumors
dexamethasone
Morning cortisol testing is useful for _________ _____________ testing
adrenal insufficiency
The __________________ tests how well the adrenale glands respond to ACTH
ACTH stimulation test
The Corticotropin Releasing Hormone stimulation test is a direct and selective test of _______________________
anterior pituitary function
_____, ______, and _____ are crucial for reproductive function
GnRH, LH, and FSH
____________ is the principle androgen for males
testosterone
The function of the ___________ is to synthesize sperm and androgen with the help of Steroli and Leydig cells
testes
____ _____ in the testes play a role in sperm maturation and inhibin secretion
Steroli Cells
_________ inhibits FSH secretion
Inhibin
________ _____ are the primary site of testosterone production
Leydig cells
GnRH is synthesized in the hypothalamus, transported to the anterior pituitary, and then stimulates ________ and _______ release
FSH and LH
_____ is inhibited by testosterone
LH
____________ is the loss of circulating testosterone in males
Andropause
The female ovaries produce ____ and secrete the steroids ___________ and __________
ova; estrogen and progesterone
_________ regulates the menstrual cycle, maintains pregnancy, and is responsible for feminine characteristics
Estrogen
Estrogen are _________
proteins
Estrogen has 3 forms, ______ _______ and _______
Estriol, Estradiol, and Estrone
____________ maintains pregnancy and is converted to testosterone in males
Progesterone
In non pregnant women, _________ and ___________ is mainly secreted
Estradiol and progesterone
In pregnant women, ___________ is mainly secreted
estriol
The _________ ________ is first responsible for progesterone production until the placenta takes over
corpus luteum
_______________ influences the menstrual cycle
GnRH, FSH, LH, Estradiol, and Progesterone
A normal menstrual cycle consist of a ___________ and a _________ phase
follicular and a luteal
Throughout the follicular phase, _________ is released from growing follicles
estrogen
____________ occurs around day 14 of the mentrual cycle
Ovulation
Ovulation ends the follicular phase and begins the _________ phase
luteal
During the luteal phase, ____ develops ruptured follicular cells into the corpus luteum, producing progesterone and estrogen, suppressing FSH and LH
LH
__________ reaches a peak about 8 days post ovulation
Progesterone
A developing embryo produces _____
hCG
hCG triggers the corpus luteum to increase _________ and _______, preventing menstruation and protecting pregnancy
progesterone and estrogen
___________ is the complete ceasing of menstration that occurs around age 50 in women
Menopause
______________ is the hormonal changes years before actual menopause
perimenopause
After ovulation the fertilized ovum becomes a _________
zygote
The placenta and _______________ link fetus to mother
umbilical cord
During pregnancy women undergo changes in __________________
metabolism, physiology, protein production, and hormone levels
Progesterone prevents _________ and allows pregnancy to continue
menses
The placenta produces significant amounts of _________ throughout pregnancy
estrogens
____________ CG tests are used for pregnancy confirmation
Qualitative
___________ serum CG tests are helpful in discovering problems in early pregnancy
Quantitative
CG concentration rises significantly in the first ___ weeks of pregnancy
8
CG concentrations ⪰ ___ IU/L are consistent with pregnancy
5
Peak CG concentrations are reached in ______ weeks of pregnancy
8-10
hCG testing can screen for _____ ________
down syndrome
An ______ _________ is when the fertilized egg implants in a location other than the uterus
Ectopic Pregnancy
A ________ ______ can help identify an ectopic pregnancy
Ultrasound exam
Serum or heparinized plasma is used to measure _________, which is best collected in the morning
Testosterone
_____________ ______________ and _____ _______________ are widely used for testosterone testing
Enzymatic immunoassays and mass spectrometry
_________ or __________ can be used for estrogen measurement
EDTA or Heparin
__________ and __________ methods are used for estrogen blood measurement
Instrumental and immunoassay
EDTA or heparinized plasma or serum is most reliable for ________________ testing
Progesterone
________________ are used for progesterone testing
Immunoassays
Serum is the preferred specimen for _________________ measurement
gonadotropin
LH, FSH, GH, hCG, and TSH all have a similarly structured __________
a-subunit
hCG is measured in serum and tested using ___________ and __________ ______________
qualitative and quantitative immunoassays
T4 and T3 are transported through the blood by the proteins ____________________
TBG, TBPA, and Albumin
The oral glucose tolerance test administers ___ g of glucose
75
glucose and GH has a ________ relationship
inverse
Iodide is transported inside the follicles to become ___________
Iodine
_______is mostly used for T3 backup
T4
Hyperthyroidism symptoms are _______________________
weight loss, sweating, heat intolerence, eyelid retraction, Tachycardia, and high BP
Hypothyroidism symptoms are _______________________
Lethargy, fatigue, cold intolerence, Bradycardia, and low BP
Intracellular calcium has a role in _________________
Contraction, hormone secretion, glycogen metabolism, and cell division
Extracellular calcium is used for __________________________ (BOB)
Bone mineralization, blood coagulation, and other functions
_________ wants calcium in the blood
PTH
________ wants calcium in the bones
1,25
______ and 1,25 D influence PTH synthesis and release
Mg+
PTH doesnt want ___________ in the blood
phosphate
Vitamin D acts on ____________________________
Bones, Intestines, kidneys, and parathyroid glands
LC-MS-MS is the preferred method for ____ _________ testing
free cortisol