ENDOCRINE PHYSIOLOGY

Terms	Definitions
The functions of the endocrine system include what?	1. reproduction 2. growth and development 3. maintenance of the internal environment 4. regulation of energy availability 5. adaptation to stress
Endocrine cells synthesize what and release it where?	Synthesize hormones and release them into the blood
What type of hormones are steroid and thyroid hormones?	lipid-soluble
What type of hormones are catecholamine hormones and the protein hormones?	water-soluble
What are target cells?	cells with specific receptors for given hormones and can therefore, respond directly to those hormones
Target cells are cells with specific receptors for given hormones and can therefore do what?	respond directly to those hormones
Endocrine cells (hormone-secreting cells) are located where?	located scattered among non-endocrine cells or are located in the endocrine glands
What are the classes of hormones?	a. steroid b. amine hormones c. peptide/protein/glycoprotein hormones
What are subcategories of amine hormones?	a. thyroid hormones b. catecholamine hormones
Steroid hormones are synthesized from what?	From cholesterol
True or false: Steroid hormones are stored by the cells that synthesize them.	False: the cells that synthesize steroid hormones do NOT store them
What is the solubility of steroid hormones in water vs. in lipids?	Steroid hormones have a low solubility in water and a high solubility in lipids
How are steroid hormones released?	by diffusion
How do steroid hormones circulate in plasma?	They circulate bound to plasma proteins
The percent of circulating hormone bound to plasma proteins depends upon what?	depends upon the specific steroid hormone
Steroid hormones (excluding vitamin D) can be classified by what?	by the glands that secreted them
The major steroidogenic glands are what?	a. the adrenal cortex b. gonads c. the placenta (during pregnancy)
When is the placenta considered a steroidogenic gland?	during pregnancy
Besides what gland they come from, how else can steroid hormones be classified?	by their MAJOR physiological actions
What is the major physiological action of mineralcorticosteroids (mineralcorticoids)?	Na+ and K+ balance
What is the major physiological action of glucocorticosteroids (glucocorticoids)?	nutrient (including glucose) metabolism
What is the major physiological action of androgens	development and maintenance of male characteristics
What is the major physiological action of estrogens?	development and characteristics of female characteristics
What is the major physiological action of progestins (progestogens)?	pregnancy
What is the major physiological action of 1, 25 dihydroxy vitamin D?	it is the active form of vitamin D involved in calcium balance
Adrenocorticosteroids are synthesized by what?	by cells of the adrenal cortex and include aldosterone, cortisol, and adrenal androgens
What do adrenocorticosteroids include?	aldosterone, cortisol, and adrenal androgens
What type of hormone are aldosterone, cortisol, and andrenal androgens?	steroid hormones: adrenocorticosteroids
What is the major human "mineralcorticosteroid"? What is its function?	Aldosterone: its function is regulating Na+ and K+
What is the major "glucocorticosteroid"? What is it involved in?	cortisol: it is involved in regulating glucose metabolism and has many other functions
What is the major androgen secreted by the testes	testosterone
What is less potent than testosterone?	adrenal androgens
What do the adrenal androgens include?	a. dehydroepiandrosterone (DHEA) and DHEA-sulfate b. androstenedione ("andro")
What are gonadal steroids synthesized by?	synthesized by the gonads
What cells are the major source of testosterone?	the leydig cells in the testes
Testosterone is synthesized and secreted in response to what?	to lutenizing hormone (LH)
What is lutenizing hormone?	aka. "interstitial cell stimulating hormone" a protein hormone secreted by the anterior pituitary gland
Some testosterone is converted to other steroids by what?	enzyme
What does the enzyme aromatase do?	It converts testosterone to estradiol, an estrogen
What are estrogens?	they are "female" sex hormones
How is estradiol made?	it is made when the enzyme, aromatase, converts testosterone
What does the enzyme 5α-reductase do in many target cells?	Converts testosterone to dihydrotestosterone (DHT)
Compare the potency of dihydrotestosterone (DHT) versus that of testosterone?	DHT is generally a more potent androgen than testosterone
What is our major estrogen?	17-β estradiol ("estradiol")
What is our major progestin?	progesterone
What are the major steroid hormones secreted by the ovaries?	17-β estradiol and progesterone
The types and quantities of steroid hormones secreted by the ovary depends on what?	the stage of the ovarian cycle
What is secreted by the follicular phase of the ovarian cycle?	the developing ovarian follicles secrete estrogens, estradiol
What is secreted towards the end of the follicular phase?	the follicle secretes some progesterone in addition to estradiol
What are the major cell types in ovarian follicles?	a. granulosa cells b. theca cells
What are the granulosa cells of the ovarian follicles analogous to?	analogous to Sertoli cells in the testes
What are the theca cells of the ovarian follicles analogous to?	analogous to the Leydig cells of the testes
What does the theca cells of the ovarian follicles synthesize? In response to what?	synthesize androgens in response to luteinizing hormones (LH)
Theca cells synthesize androgens in response to what?	luteinizing hormone (LH)
What do the granulosa cells synthesize?	they synthesize estradiol from the androgens synthesized by the theca cells
What stimulates the synthesis of estradiol from androgens?	stimulated by follicle stimulating hormones (FSH), a protein hormone secreted by the anterior pituitary gland
Ovulation is triggered by what?	by a marked rise in luteinizing hormone (LH) secretion
LH stimulates what?	a. rupture of the follicle releasing the oocyte b. transformation of the remnants of the follicle into the corpus luteum
What two points occur during the luteal phase?	a. the corpus luteum secretes estradiol and also lots of progesterone b. LH maintins the corpus luteum and stimulates secretion of estradiol and progesterone by it
When are placental steroids secreted and include what?	secreted by the placenta during pregnancy and include progesterone and estrogens
steroid hormone synthesis is typically stimulated by what?	other hormones
Describe the other hormones that usually stimulate the synthesis of steroid hormones?	mainly water-soluble messengers that bind to G-protein coupled receptors in the plasma membrane of cells that secrete steroid hormones
What are examples of hormones that stimulate the synthesis of steroid hormones?	a.) angiotensin II = aldosterone synthesis b.) ACTH = cortisol synthesis c.) LH = androgen synthesis by the leydig cells of testes and theca cells of the ovarian follicles d.)FSH = estrogen synthesis by the cells of the corpus luteum e.) LH = progesterone and estrogen synthesis by cells of the corpus luteum
What does angiotensin II stimulate?	an increase in aldosterone synthesis
What does ACTH stimulate?	increased cortisol synthesis
What does LH stimulate?	a.) increased androgen synthesis by the Leydig cells of the testes and by the theca cells of the ovarian follicles b.) increased progesterone and estrogen synthesis by the cells of the corpus luteum
What does FSH stimulate?	increased estrogen synthesis of the granulosa cells of the ovarian follicles
What is the active form of Vitamin D? When is it formed and secreted?	The active form is 1,25 dihydroxy vitamin D and is formed and secreted by the kidneys
Amine hormones are modified what?	modified amino acids
What hormones is the amino acid, tyrosine the precursor for?	it is the precursor for thyroid hormone and the catecholamine hormones (norepinephrine, epinephrine, and dopamine)
What hormone is the amino acid, tryptophan the precursor for?	for melatonin, a hormone secreted by the pineal gland
What gland secretes melatonin?	the pineal gland
The term "thyroid hormone" (TH) refers to what?	1.) Triiodothyronine = T3 and/or 2.) tetraiodothyronine = T4 = thyroxine
What are the characteristics of TH?	1. synthesized from tyrosines 2. stored in colloid as part of thyroglobulin 3. low solubility in water, higher solubility in lipids 4. released by diffusion 5. circulates primarily bound to plasma protein
TH is synthesized from what and stored how?	synthesized from tyrosines and stored in colloid as part of thryoglobulin
Describe the solubility of TH in water vs. lipids	low solubility in water, and high solubility in lipid
How is TH released by?	by diffusion
TH circulates primarily how?	bound to plasma proteins
What is the first endocrine gland to develop in the embryo?	the thyroid gland
What does the thyroid gland contain?	2 hormone-secreting compartments
What are the two hormone-secreting compartments of the thyroid gland?	1. parafollicular cells 2. thyroid follicles
What do the parafollicular cells of the thyroid gland secrete?	secrete the hormone calcitonin
What type of hormone is calcitonin?	peptide hormone
Calcitonin release is stimulated by what?	a rise in plasma [Ca++]
What is a major effect of calcitonin?	to lower plasma [calcium] by decreasing bone reabsorption
What do the thyroid follicles of the thyroid gland secrete?	thyroid hormone
Thyroid hormone synthesis requires what from the diet?	iodide
What is the RDA of iodide required for TH synthesis?	= 150 micrograms/day
How much iodide is used daily to from T3 and T4?	= about 75 micrograms/day
Iodide is recycled via what?	via action of deiodinases which remove iodide from TH
True or False: More T4 is secreted than T3?	True
T4 can be converted to T3 after what?	after release from the thyroid gland by deiodinases
Most actions of TH are attributed to what? Why?	T3, because T3 is considered to be more potent than T4
How many months supply of TH is stored in the thyroid gland (colloid)	about 3 months
Prolonged dietary iodide deficiency results in what?	deficient production of T4 and T3 = hypothyroidism
What is hypothyroidism?	deficient production of T4 and T3 due to prolonged dietary iodide deficiency
Severe untreated infantile hypothyroidism leads to what?	irreversible profound developmental and intellectual disabilities and growth failure
What are the two steps involved in the synthesis of thyroid hormone? Both of which occur where?	Both of which occur in the colloid 1. iodination reactions (organification) 2. condensation reactions
The rate of synthesis and therefore release of thyroid hormone is regulated by what?	thyroid stimulating hormone (TSH aka thyrotropin)
What is another name for thyroid stimulating hormone (TSH)?	thyrotropin
What is TSH and what secretes it?	TSH is a large glycoprotein hormone secreted by the anterior pituitary gland
Virtually all steps in the synthesis of thyroid hormone are stimulated by what?	TSH
What are some catecholamine (CA) hormones?	1. dopamine (DA) 2. norepinephrine (NE) 3. epinephrine (EPI)
What are the major catecholamine hormones?	epinephrine and norepinephrine
What are NE and EPI secreted by?	the chromaffin cells of the adrenal medulla
What catecholamine hormones do the chromaffin cells of the adrenal medulla secrete?	NE and EPI and a little bit of DA is also released
The catecholamines are examples of substrates that serve as what?	both hormones and also as neurotransmitters
NE is the neurotransmitter used by most what?	most postganglionic sympathetic neurons
EPI is a neurotransmitter used by what?	some neurons in the CNS
DA is a neurotransmitter used by what?	some neurons in the CNS
What are catecholamine hormones synthesized from?	tyrosine
what does DOPA stand for?	dihydroxyphenylalanine
Describe the reaction of the synthesis of catecholamines from tyrosine	tyrosine is acted upon by tyrosine hydroxylase and creates DOPA which creates dopamine which creates NE which creates EPI
What enzyme catalyzes the reaction of tryosine to DOPA?	tyrosine hydroxylase
What is the rate limiting step of the synthesis of catecholamines from tyrosine?	the step where tyrosine hydroxylase converts tyrosine to DOPA
What increases the rate limiting step of the conversion of tyrosine to DOPA?	the conversion of tyrosine to DOPA is increased by adrenocorticotropic hormones
True or false: Catecholamine hormones are water-soluble	True
How are catecholamines stored?	stored in secretory vesicles or granules (called "chromaffin granules" in the chromaffin cels of the adrenal medulla)
How are catecholamines released?	by exocytosis
How do catecholamines circulate?	circulate primarily free in plasma
What class do most known hormones belong to?	the protein hormones class
What does the group of "protein hormones" include?	1. peptide hormones (short, a few aa long) 2. protein hormones (larger, may contain more than one polypeptide chain) 3. glycoprotein hormones (proteins associated with carbs)
How are protein hormones synthesized?	by linking amino acids together with peptide bonds
What is the range of size of protein hormones?	they range in size from 3 to hundreds of amino acids long and may contain more than on polypeptide chain
Are protein hormones lipid-soluble or water-soluble?	water-soluble
How are protein hormones stored and released?	stored in secretory vesicles or granules released by exocytosis
How do protein hormones generally circulate?	circulate free in plasma (note: a few circulate bound to plasma proteins)
What are examples of proteins that cells make for export?	protein hormones
The steps in the synthesis of protein hormones are the same as the steps for what?	for other cellular proteins with the modifications of exposed proteins
Typically, the synthesis of the final protein hormone product involves what?	many modifications of the original gene product
What classes of hormones are grouped as lipid-soluble hormones?	steroid hormones thyroid hormones
What classes of hormones are grouped as water-soluble hormones?	catecholamine hormones peptide hormones
Describe the transport of most water-soluble hormones in blood?	circulate free in plasma
What is the major exception to the fact that in terms of transport in blood, most water-soluble hormones circulate free in plasma	major exceptions include: 1. growth hormone 2. insulin-like growth factors I and II
What is the plasma half life of most water-soluble hormones?	have relatively short plasma half-lives, typically second to hours
Describe the transport of lipid-soluble hormones in blood?	circulate primarily bound to plasma proteins
What is the plasma half life of lipid-soluble hormones?	have a relatively long plasma half life, typically hours to even a few days
What contributes to the typically longer half-lives of lipid-soluble hormones compared to that of water soluble?	Binding of lipid-soluble hormones to plasma proteins contributes to their typically longer half lives by: 1.) decreasing renal excretion 2.) providing protection from degradation by enzymes present in plasma
How does binding to plasma proteins help lipid-soluble hormones have a typically longer plasma half-lives?	by: 1) decreasing renal excretion 2.) providing protection form degradation by enzymes present in plasma
Since hormone target cells have specific receptors for given hormones they can therefore what?	they can therefore respond DIRECTLY to those hormones
What type of molecules are hormone receptors?	like the receptors for other messengers like neurotransmitters they are protein molecules
Describe the interactions between most lipid-soluble hormones and their receptors/how to they bind to them/where are the receptors located?	most lipid-soluble hormones are believed to simply diffuse into their target cells and bind to intracellular receptors
Since water-soluble hormones cannot diffuse into cells, target cells for water-soluble hormones have what type of receptors/where are they?	they have receptors that are integral membrane proteins with a hormone-binding site facing the extracellular fluid
How does extracellular calcium stabilize the membrane of excitable cells?	by altering the threshold for initiation of action potentials
What is hypercalcemia and when does it occur? What are the effects?	in the presence of elevated extracellular [Ca], thresholds for action potentials are more positive than normal
What are symptoms of hypercalcemia?	1.) decreased CNS function including: * lethargy * depression * decreased strength of reflexes * muscle weakness * ultimately coma 2.) cardiac arrhythmias 3) prolonged hypercalcemia can cause calcium-containing kidney stones
What is hypocalcemia? When does it occur? What does it cause?	in the presence of lowered extracellular [Ca], thresholds for action potentials are more negative than normal
Symptoms for hypocalcemia include what?	include abnormally increased CNS activity producing: 1. delirium 2. tingling sensations in the skin 3. abnormal contractions of the muscles i the throat impeding breathing 4. abnormal involuntary sustained contractions of other skeletal muslces 5. seizures
What the two most important hormones regulating plasma [calcium]?	1. parathyroid hormone (PTH) 2. 1, 25 (OH)2, vitamin D
What type of hormone is parathyroid hormone and what is it secreted by?	a protein hormone secreted by the parathyroid glands
What type of hormone is 1, 25 dihydroxy vitamin D? What is it secreted by?	a lipid-soluble steroid hormone secreted by the kidneys
PTH secretion increases in response to what?	decreased free plasma [calcium]
PTH acts to effect plasma [calcium] how? By what?	PTH acts to maintain or increase plasma [Ca] by: 1) increased absorption of Ca from bone into blood 2) increased reabsorption of Ca from the kidneys 3) increased synthesis of 1, 25 dihydroxy vitD from 25 OH vit D in the kidneys by increasing the activity of the enzyme 1-hydroxylase
How does PTH act to increase synthesis of 1, 25 dihydroxy vitD from 25 (OH) vit D in the kidneys?	increased synthesis of 1, 25 dihydroxy vitD from 25 OH vit D in the kidneys by increasing the activity of the enzyme 1-hydroxylase
The increased activity of what enzyme increases synthesis of 1,25 dihydroxy vit D from a precursor in the kidneys?	the enzyme 1-hydroxylase
Where does 1, 25 dihydroxy vitamin D mainly act on to maintain or increase plasma [calcium]? What does it do?	acts mainly on the duodenum where it stimulates the absorption of dietary calcium from the GI lumen into the blood
In general, describe initiation time and duration time of the effects of hormones?	generally, these effects: a. take a relatively short time to be initiated b. last for a relatively short time
How does secretion occur for water-soluble hormones? Typically in response to what?	occurs by exocytosis, typically in response to specific signals that elevate intracellular [calcium]
how does secretion occur for lipid-soluble hormones?	secretion occurs by diffuse
Since there is no storage of lipid-soluble hormones, increased secretion requires what?	increased synthesis
Why does increased secretion of lipid-soluble hormones require increased synthesis	since there is no storage of lipid-soluble hormones
Hormone secretion is altered by multiple types of stimuli including what?	1. neuronal activity, 2. nutrients 3. ions 4. pH 5. osmolarity 6. and other hormones
Secretion of most hormones occurs in what?	"pulses" or "bursts" and the secretion of most hormones changes over time
Negative feedback operates to what?	to maintain a variable at a relatively constant value
What is the most common feedback mechanism	negative feedback
What type of feedback is the regulation of insulin secretion by plasma glucose an example of?	negative feedback
What type of feedback is the regulation of parathyroid hormone secretion an example of?	negative feedback
What are positive feedback processes? What do they result in?	positive feedback processes are self-perpetuating and ultimately result in an "explosive" event terminating the process
True or False: Positive feedback regulation of a hormone is common.	False: it is uncommon
What type of feedback is the following an example of: factors stimulating uterine contractions during parturition?	positive feedback
What does the term "permissiveness" refer to?	refers to the actions of one hormone to increase the responsiveness of target cells to another hormone
What do many cases of "permissiveness" involve?	many cases involve one hormone up regulating receptors for another hormone in target cells
What type of tissue cells does thyroid hormone have little effect on?	adipose tissue cells
What is lipolysis?	the breakdown of triglycerides in adipose cells to release fatty acids into the blood
What does epinephrine do when it targets adipose tissue cells?	it causes/stimulates "lipolysis" which is the breakdown of triglycerides in adipose cells to release fatty acids into the blood
When is EPI stimulating "lipolysis" advantageous? Why?	during a "flight or fight" situation because most body cells can use fatty acids for energy
Receptors for EPI in adipose tissues are what kind of receptors?	beta-adrenergic receptors
What is hypothyroidism and what does it do to EPI's effect on fat tissue?	Hypothyroidism = the absence of thyroid hormone it causes EPI's effect on adipose tissue to be minimal
When is EPI's effect on adipose tissue minimal?	during hypothyroidism (the absence of TH)
When TH is present, how is EPI's effect on adipose tissue	When TH is present, EPI's effect on adipose tissue are much greater
When what is present, EPI's effect on adipose tissue are much greater?	When TH is present, the effect is greater
Describe the relationship between thyroid hormone and EPI's effect on adipose tissue.	EPIs effect is dependent on TH when no TH is present, effect is minimal when TH is present, effect is greater
TH "permits" the full effect of EPI on adipose tissue how?	by stimulating adipose tissue to increase their number of beta-receptors
What are "neurohormones"?	some neurons secrete hormones = "neurohormones"
What are the categories of hormones that are water-soluble?	1. most neurotransmitters 2. catecholamine hormones 3. peptide, protein, glycoprotein hormones 4. most growth factorst
What are the selected examples of water-soluble neurotransmitters?	1. acetylcholamine 2. norepinephrine 3. serotonin 4. glutamate 5. dopamine 6. glycine 7. GABA
What are the selected examples of water-soluble catecholamine hormones?	1. dopamine 2. norepinephrine 3. epinephrine
What are the selected examples of water-soluble peptide, protein, and glycoprotein hormones?	1. insulin 2. glucagon 3. luteinizing hormone 4. follicle stimulating hormone 5. angiotensin II 6.antidiuretic hormone 7.atrial natriuretic peptide 8. erythropoietin 9.gastrin 10. secretin 11. CCK
What are the selected examples of water-soluble growth factors?	1. nerve growth factor 2. interleukins 3. insulin-like growth factors
What categories of hormones are lipid-soluble?	1. steroid hormones and vitamin D 2. thyroid hormone
What are the selected examples of lipid-soluble steroid hormones and vitamin D?	1. cortisol 2. aldosterone 3. testosterone 4. estradiol 5. progesterone 6. 1, 25 dihydroxy-vitamin D
What are the selected examples of lipid-soluble thyroid hormones	1. triiodothyronine (T3) 2. tetraiodothyronine/thyroxine (T4)
What type of hormone is the following an example of: acetylcholine	water-soluble neurotransmitter
What type of hormone is the following an example of: norepinephrine	water-soluble neurotransmitter and catecholamine hormone
What type of hormone is the following an example of: epinephrine	water-soluble neurotransmitter and catecholamine hormone
What type of hormone is the following an example of: dopamine	water-soluble neurotransmitter and catecholamine hormone
What type of hormone is the following an example of: serotonin	water-soluble neurotransmitter
What type of hormone is the following an example of: glutamate	water-soluble neurotransmitter
What type of hormone is the following an example of: glycine	water-soluble neurotransmitter
What type of hormone is the following an example of: GABA	water-soluble neurotransmitter
What type of hormone is the following an example of: insulin	water soluble peptide/protein/glycoprotein hormone
What type of hormone is the following an example of: glucagon	water soluble peptide/protein/glycoprotein hormone
What type of hormone is the following an example of: luteinizing hormone	water soluble peptide/protein/glycoprotein hormone
What type of hormone is the following an example of: follicle stimulating hormone	water soluble peptide/protein/glycoprotein hormone
What type of hormone is the following an example of: angiotensin II	water soluble peptide/protein/glycoprotein hormone
What type of hormone is the following an example of: antidiruetic hormone	water soluble peptide/protein/glycoprotein hormone
What type of hormone is the following an example of: atrial natriuretic peptide	water soluble peptide/protein/glycoprotein hormone
What type of hormone is the following an example of: erythropoietin	water soluble peptide/protein/glycoprotein hormone
What type of hormone is the following an example of: gastrin	water soluble peptide/protein/glycoprotein hormone
What type of hormone is the following an example of: secretin	water soluble peptide/protein/glycoprotein hormone
What type of hormone is the following an example of: CCK	water soluble peptide/protein/glycoprotein hormone
What type of hormone is the following an example of: nerve growth factor	water-soluble growth factor
What type of hormone is the following an example of: interleukins	water-soluble growth factor
What type of hormone is the following an example of: insulin-like growth factor	water-soluble growth factor
What type of hormone is the following an example of cortisol	lipid-soluble steroid hormone
What type of hormone is the following an example of: aldosterone	lipid-soluble steroid hormone
What type of hormone is the following an example of: testosterone	lipid-soluble steroid hormone
What type of hormone is the following an example of: estradiol	lipid-soluble steroid hormone
What type of hormone is the following an example of: progesterone	lipid-soluble steroid hormone
What type of hormone is the following an example of: 1, 25 dihydroxy-vitamin D	lipid-soluble steroid hormone and vitamin D
What type of hormone is the following an example of: triiodothyronine (T3)	lipid-soluble thyroid hormone
What type of hormone is the following an example of tetraiodothyronine/thyroxine (T4)?	lipid-soluble thyroid hormone
What is the cellular location of receptors for water-soluble hormones versus those for lipid-soluble	water sol. = integral membrane proteins lipid sol. = inside the cell
True or False: Both free and bound/stored hormone can freely leave plasma to interact with target cells	False: only free hormones can freely leave the plasma to interact with target cells
What hormones does the GI tract secrete?	1.gastrin (water soluble protein hormone) 2. CCK (water soluble protein hormone) 3. secretin (water soluble protein hormone)
What secretes gastrin and what is the result?	secreted by the stomach = increases H+ secretion
What secretes CCK and what does it do?	secreted by small intestine = increased gall bladder contraction and increased pancreatic enzyme secretion
What secretes secretin and what does it do?	secreted by small intestine = increased bicarbonate secretion
What hormones do the kidneys secrete?	1. EPO (water soluble protein hormone) 2. Vitamin D (lipid soluble) 3. renin
What does the release of EPO from the kidneys result in?	increases red blood cell production
What does the release of vitamin D from the kidneys result in?	vitamin/hormone increases calcium absorption from GI tact
What does the release of renin from the kidneys result in?	enzyme/hormone catalyzes angiotensinogen --> angiotensin II
What hormones does the heart secrete? In response to what? What is the result?	atrial natriuretic peptide (ANP; water soluble peptide hormone) secreted by the atria in response to increased blood volume (stretch) = increased Na+ excretion and vasodilation
What secretes ADH? What does it act on? What is the result?	the posterior pituitary secretes ADH acts on kidneys to increase H20 reabsorption
What secretes insulin? What is the result?	the pancreatic islet cells stimulates cells to take up glucose
What secretes aldosterone? What does it act on? What is the result?	the adrenal cortex acts on kidneys to increase Na reabsorption and K secretion
What secretes epinephrine?	secreted by the adrenal medulla
What secretes norepinephrine?	secreted by the adrenal medulla
What hormones does the adrenal cortex secrete	aldosterone cortisol adrenal androgens
What hormones does the adrenal cortex secrete	EPI NE
How do you get adrenal androgens?	cholesterol --> pregnenolone -> dehydroepiandrosterone + 17hydroxyprogesterone --> androstenedione = adrenal androgens
How do you get glucocorticosteroids	cholesterol --> pregnenolone --> 17-hydroxyprogesterone --> cortisol
How do you get mineralocorticosteroids?	cholesterol --> pregnenolone -> progesterone --> corticosterone --> aldosterone
What steps does the synthesis of adrenal androgens, glucocorticosteroids, and mineralocorticosteroids all share?	the step of cholesterol --> pregnenolone
What increases aldosterone release?	increased angiotensin II and increased [K+]
What does an increase in the release of aldosterone caused by increased angiotensin II and increased [K+] result in?	increased Na+ (and H20) reabsorption and increased K+ secretion-excretion
What causes increased cortisol secretion?	increased adrenocorticotropic hormone (ACTH) from anterior pituitary gland
Compare the importance of adrenal androgens in males and in females	relatively unimportant in males because gonadal androgens are more potent BUT important in females because they are major source of androgens
Describe the steps of synthesis of testosterone.	Cholesterol --> androstenedione --> testosterone, which is then secreted by testes
Describe the steps of synthesis of estradiol	Cholesterol --> androstenedione (2 options) 1. --> estrone converted by enzyme aromatase 2. --> testosterone the estrone --> estradiol and the testosterone + aromatase --> estradiol
What is estradiol secreted by?	by ovaries
What do Leydig cells of testes produce?	testosterone
What occurs in the seminiferous tubules of testes?	sperm production
What hormone targets the leydig cells to produce/secrete testosterone?	Luteinzing hormone (LH)
Testosterone can be acted on by what to enzymes?	1. 5-alpha-reductase 2. aromatase
Testosterone + 5-alpha-reductase = what?	dihydrotestosterone
Testosterone + aromatase = what?	estradiol
So basically LH signals the Leydig cells to make testosterone which is broken down into what?	dihydrotestosterone and estradiol
What stimulates the theca cells of the ovarian follicle? What does this result in the release of?	Luteinizing hormone targets theca cells to release androgens
What stimulates the granulosa cells of the ovarian follicle? What does this result in the release of?	Follicle stimulating hormone targets granulosa cells along with androgens and the cells produce estrogens
What all leads to the synthesis of estrogens?	Luteinizing hormone stimulates the theca cells to produce androgens the androgens then target the granulosa cells along with follicle stimulating hormone and stimulate it to produce estrogens which are then released from the ovarian follicle
During what stage of the ovarian cycle is estrogen produced?	follicular stage
Ovarian steroids = what?	estrogens and progesterone
For most, protein hormones increase the synthesis of what other type of hormones?	protein hormones lead to increased synthesis of steroid hormones
What protein hormone leads to increased aldosterone production?	Angiotensin II targets adrenal cortical cells and leads to increased aldosterone
What protein hormone leads to increased cortisol production?	ACTH targets adrenal cortical cells and leads to increased cortisol
What protein hormone leads to increased testosterone production?	LH targets leydig cells of testes and leads to increased testosterone
What protein hormone leads to increased androgens production?	LH targets theca cells of ovarian follicle and leads to increased androgens
What protein hormone leads to increased estrogens production?	LH targets granulosa cells of ovarian follicle and leads to increased estrogen
What protein hormone leads to increased estrogens & progesterone production?	LH targets luteal cells of ovarian follicle and leads to increased estrogen & progesterone
What class of hormones is 1, 25 dihydroxy-vitamin D a member of?	it is the active form of vitamin D and is part of the steroid class of hormones
What are original sources of vitamin D	1. dietary vitamin D2 or D3 2. sunlight on skin converts 7-dehydrocholesterol into vitamin D3
How does sunlight on the skin result in vitamin D?	The sunlight leads to the conversion of 7-dehydrocholesterol into vitamin D3
Dietary vitamin D2 or D3 and the vitamin D3 produced in the skin circulate in plasma and are taken up where? Where what occurs?	Liver: takes vitamin D and using the enzyme 25-hydroxylase to convert it into 25-OH vitamin D
What occurs to plasma vitamin D in the liver? What enzyme is responsible for this?	in the liver, the enzyme 25-hydroxylase converts vitamin D to 25-OH vitamin D
What is 25-hydroxylase?	an enzyme that converts vitamin D in the liver into 25-OH vitamin D
The 25-OH vitamin D produced in the liver goes where?	to the kidneys
What happens to 25-OH vitamin D in the kidneys?	it is catalyzed by 1-hydroxylase to 1, 25 dihydroxy-vitamin D
What is 1-hydroxylase and what is needed to stimulate its activity?	1-hydroxylase is an enzyme that catalyzes 25-OH vitamin D into 1, 25 dihydroxy-vitamin D in the liver Parathyroid hormone stimulates its activity
What happens once the active form of vitamin D-1, 25 dihydroxy-vitamin D- is created in the kidneys?	It is released into the plasma and circulation and targets the GI tract to increase absorption of calcium (and phosphate) into the blood
What does circulating 1, 25 dihydroxy-vitamin D target and what is it's effect?	it targets the GI tract = increased absorption of calcium (and phosphate) into the blood
Glucocorticosteroids (glucocorticoids are secreted by what? What is their major physiological action? Example?	secreted by: adrenal cortex major physiological action: glucose regulation example: cortisol
Mineralocorticosteroids (mineralcorticoids) are secreted by what? What is their major physiological action? Example?	secreted by: adrenal cortex major physiological action: Na and K regulation example: aldosterone
Androgens are secreted by what? What is their major physiological action? Example?	secreted by: adrenal cortex, gonads major physiological action: male characteristics example: testosterone
Estrogens are secreted by what? What is their major physiological action? Example?	secreted by: ovaries, placenta major physiological action: female characteristics example: estradiol
Progestogens (progestins) are secreted by what? What is their major physiological action? Example?	secreted by: ovaries, placenta major physiological action: progestational example: progesterone
Vitamin D are secreted by what? What is their major physiological action? Example?	secreted by: kidneys major physiological action: Ca++ regulation example: 1, 25 (OH)2 vitamin D
What hormone is secreted in response to increased plasma [calcium]? What is its effect?	Increased plasma [Ca] --> increased calcitonin secretion = decreased bone reabsorption
What percent of world population live in areas of iodide deficiency	38%
What is a solution for helping prevent hypothyroidism in areas where iodide is deficient?	iodized salt and cooking oils
What does the enzyme thryoid peroxidase do?	converts iodide (I-) to iodine (I)
What is the iodination reaction (organification) in the synthesis of thyroid hormones?	Tyrosine + I = monoiodotyrosine (MIT) Tyrosine + I + I = diiodotryosine (DIT)
What does the iodination reaction (organification) of tyrosine result in?	monoiodotryosine (MIT) or diiodotryosine (DIT) depending on how many Iodines are added to the tyronsine
What is the condensation reactions of thyroid hormone synthesis?	MIT + DIT = Triiodothyronine (T3) or DIT + DIT = tetraiodothyroine/ thyroxine (T4)
The tyrosines involved in TH synthesis aren't "free" but rather part of what? and stored where?	part of thryoglobulin (a very large protein synthesized by the follicle cells) and stored in colloid
Synthesis of thyroid hormone is regulated by what?	Thyroid stimulating hormone (TSH)
What is TSH? What is its release stimulated by? what is its function?	a glycoprotein hormone = thyroid stimulating hormone = thyrotropin the anterior pituitary gland signals its release and it regulates the production of thyroid hormones
What do hypothalamic neurons release? What does it do?	release dopamine, a neurohormone that decreases secretion of prolactin
What does dopamine decrease the secretion of?	decreases secretion of prolactin
Where is the pituitary gland located?	at the base of the brain in a bony pocket called the sella turcica sits just below the hypothalamus
What is hypophysectomy?	the removal of the pituitary gland from experimental animals and humans
What is the "master gland" of the body?	the pituitary gland
What is the pituitary gland regulated by?	the hypothalamus
Secretion of hormones by the pituitary gland is under the control of what?	the control of hormones secreted by other glands
What is "hypophysis" another name for?	pituitary gland
What is the posterior pituitary? What is its location?	it is an outgrowth of the hypothalamus and is connected to the hypothalamus by the hypothatlamic-pituitary tract in the hypothalamic-hypophyseal stalk
What is another name for the posterior pituitary?	neurohypophysis
What is an outgrowth of the hypothalamus?	the posterior pituitary
How are the posterior pituitary and hypothalamus connected?	by the hypothalamic-pituitary tract in the hypothalamic-hypophyseal stalk
What's another name for the anterior pituitary?	adenohypophysis
The anterior pituitary is not neuronal but is functionally connected to the hypothalamus by what?	connected to the hypothalamus by a portal system with the portal vessels traveling within the hypothalamic-hypophyseal stalk
Why is the pituitary gland called the "Master Gland" of the body?	because of the widespread effects of hypophysectomy
What does the posterior pituitary gland secrete?	antidiuretic hormone (vasopressin) and oxytocin
What secretes antidiuretic hormone and oxytocin?	the posterior pituitary
Why are ADH and oxytocin called "neurohormones"?	because they are hormones secreted by neurons
The neurons that secrete ADH or oxytocin are called what?	"magnocellular"
The cell bodies of the neurons that secrete ADH or oxytocin are located where?	located in the supraoptic and paraventricular nuclei of the hypothalamus
The cell bodies of the neurons that secrete ADH or oxytocin receive synapses from what?	from neurons with somata in many different CNS regions
What is located in the supraoptic and paraventricular nuclei of the hypothalamus?	the cell bodies of the neurons that secrete ADH and oxytocin
The axons of the neurons that secrete ADH or oxytocin travel from what to where?	travel from the hypothalamus to the posterior pituitary gland forming the hypothalamic-hypophyseal tract
The axons of the of the neurons that secrete ADH or oxytocin travel from the hypothalamus to the posterior pituitary forming what?	the hypothalamic-hypophyseal tract
What do the axons of the neurons that secrete ADH or oxytocin terminate close to?	terminate very close to capillaries
True or false: a given magnocellular neuron can synthesize both ADH and oxytocin.	FALSE: a given neuron can synthesize either ADH or oxytocin...not both
Both ADH and oxytocin are peptides...how many amino acids are the made of? By how many amino acids do they differ?	both are made of 9 amino acids each they differ by only one amino acid
Where are neurohormones stored? How are they released?	like neurotransmitters they are stored in vesicles and released from terminals by exocytosis
How does the frequency of action potentials affect the release of ADH or oxytocin?	Increased frequency of action potentials = increased release of ADH or oxytocin and vice versa
What is the antidiuretic action of antidiuretic hormone (ADH, vasopressin)	conserves body water by stimulating the insertion of aquaporins
What is the "vasopressin" action of antidiuretic hormone (ADH, vasopressin)?	constricts some blood vessels, elevating blood pressure
ADH secretion increases in response to what?	in response to conditions in which conservation of body water is logical: 1) in response to elevated extracellular osmolarity (via hypothalamic osmoreceptors) 2.) in response to decrease in blood volume (via baroreceptors)
ADH secretion increases in response in response to elevated extracellular osmolarity via what type of receptors?	hypothalamic osmoreceptors
ADH secretion increases in response in response to decrease in blood volume via what type of receptors?	baroreceptors
When is ADH secretion decreased?	under conditions in which it is advantageous to eliminate excess body water:
Diabetes insipidus is characterized by what?	by the excretion of very large amounts of urine, resulting in excessive thirst and a high risk of dehydration
Diabetes insipidus excrete very large urine volumes measuring what?	20+ liters/day
What does diabetes insipidus result from?	1. ADH deficiency 2. inability of kidneys to respond to ADH
What is "central" diabetes insipidus?	diabetes insipidus caused by ADH deficiency
What is "nephrogenic" diabetes insipidus?	It is a type of hyporesponsiveness that is caused by inability of kidneys to respond to ADH
The "insipidus" part of diabetes insipidus refers to what?	to the fact that urine is "flat" or "tasteless" because it is very dilute and is not very sweet
Oxytocin stimulates what?	1. uterine contractions during and after childbirth 2. the movement of milk from the lumen of the milk-producing alveoli of the breasts into the ducts ( = milk ejection or milk letdown)
What stimulates uterine contractions during and after childbirth?	oxytocin
What stimulates the movement of milk from the lumen of the milk-producing alveoli of the breasts into the ducts ( = milk ejection or milk letdown)?	oxytocin
Cells of the anterior pituitary gland secrete how many hormones?	at least 6 hormones, all of which are peptides, proteins, or glycoproteins
All hormones secreted by the cells of the anterior pituitary are what type of hormone?	ll of which are peptides, proteins, or glycoproteins
The hormones secreted by the anterior pituitary gland are called what?	they are called "trophic" (nourishing) or "tropic" (acting on or stimulating) hormones
What are the functions of the trophic/tropic hormones released from anterior pituitary gland?	1. stimulate the growth and development of their target cells 2. maintain the size, structure, and function of their target cell 3. stimulate the secretion of hormones by most of their target cells
What is follicle stimulating hormone secreted by? What are abbreviations and common synonyms? What is its target(s)?	secreted by: anterior pituitary gland abbrev/synonyms: FSH target(s): gonads
What is luteinizing hormone secreted by? What are abbreviations and common synonyms? What is its target(s)?	secreted by: anterior pituitary gland abbrev/synonyms: LH target(s): gonads
What is thyroid stimulating hormone secreted by? What are abbreviations and common synonyms? What is its target(s)?	secreted by: anterior pituitary gland abbrev/synonyms: TSH, thyrotropin target(s): thryoid follicles
What is adrenocorticotropic hormone secreted by? What are abbreviations and common synonyms? What is its target(s)?	secreted by: anterior pituitary gland abbrev/synonyms: ACTH, corticotropin target(s): adrenal cortex
What is growth hormone secreted by? What are abbreviations and common synonyms? What is its target(s)?	secreted by: anterior pituitary gland abbrev/synonyms: GH, somatotropin target(s): liver, bone, fat, muscle, other
What is prolactin secreted by? What are abbreviations and common synonyms? What is its target(s)?	secreted by: anterior pituitary gland abbrev/synonyms: none target(s): breasts
What are FSH and LH called?	"gonadotropins"
What is the exception for the fact that most anterior pituitary gland hormones stimulate secretion of a hormone or hormones by their targets?	the exception is prolactin
The secretion of hormones by the anterior pituitary gland is, in part, regulated by what?	by negative feedback exerted by the hormones secreted by the target glands
Secretion of each anterior pituitary gland hormone (except prolactin) is inhibited by what?	by hormones from its target gland
What operates to keep the plasma concentrations of the target gland hormone fairly constant, maintaining homeostasis?	The negative feedback loop between secretion of anterior pituitary hormones and secretion of target cell hormones
The secretion of hormones by the anterior pituitary gland is also regulated by what?	the brain
T/F: While the brain clearly influences the secretion of anterior pituitary gland hormones, there are essentially no nerve terminals in the anterior pituitary gland.	True
If there are no nerve terminals in the anterior pituitary gland, how does the brain influence it?	Parvocellular neurons in the hypothalamus secrete "releasing" or "inhibiting hormones" which effect the secretion of anterior pituitary hormones
What are the "releasing" or "inhibiting hormones" that the parvocellular neurons in the hypothalamus secrete also called? Why are they named this for?	These hormones are also called "hypophysiotrophic hormones" they are named for their main effects on the secretion of anterior pituitary hormones
What are the hypothalamic releasing (RHs) & inhibiting hormones (IHs)?	1. GnRH 2. GHRH 3. GHIH 4. TRH 5. dopamine 6. CRH
What is GnRH?	gonadotropin releasing hormone.... a type of hypophysiotrophic hormone = hypothalamic releasing hormone
What is GHRH?	Growth hormone releasing hormone =a type of hypophysiotrophic hormone = hypothalamic releasing hormone
What is GHIH	Growth hormone inhibiting hormone = somatostatin (SS) = type of hypophysiotrophic hormone = hypothalamic inhibiting hormone
What is GHIH also called?	somatostatin (SS)
What is TRH?	Thyrotropin releasing hormone =a type of hypophysiotrophic hormone = hypothalamic releasing hormone
What the main known "prolactin inhibiting hormone"?	dopamine = type of hypophysiotrophic hormone = hypothalamic inhibiting hormone
What is CRH?	corticotropin releasing hormone =a type of hypophysiotrophic hormone = hypothalamic releasing hormone
What type of hormone are all the hypothalamic releasing and inhibiting hormones? What is the exception to this?	they are all peptide/protein hormones except dopamine which is a catecholamine hormone
What is the exception to the fact that all hypothalamic releasing and inhibiting hormones are peptide/protein hormones?	the exception is dopamine, which is a catecholamine hormone
The neurons that secrete the hypothalamic releasing and inhibiting hormones receive synaptic inputs from where?	from many other CNS regions
True/false: f. A given parvocellular hypothalamic neuron typically secretes all of the releasing or inhibiting hormones	False: secretes one of the hormones, not multiple
Where do RHs and IHs go after they are released from the parvocellular hypothalamic neurons?	they enter the capillary bed in the hypothalamus and travel to the anterior pituitary gland in portal veins that end in 2nd capillary bed in the anterior pituitary gland
RHs and IHs travel to the anterior pituitary gland in what? Where does this end?	in portain veins that end in 2nd capillary beds in the anterior pituitary gland
T/F: most of the RHs and IHs have a very short plasma half-lives?	True
Each anterior pituitary hormone (except prolactin) stimulate what? where?	stimulate secretion of hormone(s) by its target gland
What are some examples of target glands of the anterior pituitary hormones?	thryoid, gonads, adrenal cortex, liver
The brain exerts control of secretion of anterior pituitary hormones and therefore has control over what? Via?	control over target glands such as the thyroid gland, the adrenal cortex, and the gonads via the hypothalamic releasing and inhibiting hormone
What is the exception to secretion of hormones by the target gland being regulated by negative feedback loops?	ovulation in cycling women is the result of a positive feedback loop between rising estrogen from the growing follicle and LH secretion
Lipid-soluble hormones diffuse into cells and form hormone-receptor complexes within the cell and then what?	moves into the nucleus and regulates transcription
How does a lipid soluble hormone-receptor complex regulate transcription?	the complex enters the nucleus and causes: Increased (or decreased) transcription of specific genes which leads to... increased (or decreased) synthesis of specific proteins
T/F: It takes time to initiate responses to lipid-soluble hormones, but once started the response lasts a long time?	True
In the hand, carpopedal spasm, which can occur in hypocalcemia, involves what?	involves: adduction of the thumb over the palm, followed by flexion of the metacarpophalangeal joints, extension of the interphalangeal joints (fingers together), adduction of the hyperextended fingers, *flexion of the wrist and elbow joints similar effects can occur in feet
What happens when there is a decrease in plasma calcium	increased parathyroid hormone secretion --> increased plasma [PTH] targets: KIDNEYS to: 1. increase calcium reabsorption which decreases urinary excretion of calcium 2. increases 1, 25 (OH)2 vitamin D formation, which targets the intestines to increase calcium absorption BONE: increase reabsorption from bones to blood --> increased release of calcium into plasma = restoration of plasma calcium toward normal
What are the final effects of PTH that result in restoration of plasma calcium toward normal?	1. decrease urinary excretion of calcium 2. increased calcium absorption from the intestines 3. increased release of calcium from bones to the blood plasma
Water soluble hormones are often called "first messengers" because binding of the hormone to the receptor in the membrane results in what?	binding to the receptor results result of another messenger = an increased intracellular concentrations of a 2nd messenger
Unlike lipid-soluble hormones who cause changes in the synthesis of a protein, a water-soluble hormones changes what?	changes the activity of proteins already present in the target cells (rather than causing changes in transcription/translation)
Compare the release into the blood of lipid-soluble hormones versus water-soluble?	water soluble are released by exocytosis lipid-soluble are released by diffusion
What all can alter rate of hormone secretion from endocrine cells?	1. ions or nutrients 2. neurotransmitters 3. hormones
What are some of the fates of plasma hormones once they are secreted from endocrine cells?	1. excreted 2. inactivated by metabolism 3. activated by metabolism 4. bind to receptors on target cells and produce a cellular response
What are examples of disorders of the endocrine system that are characterized by hyposecretion?	1. hypothyroidism 2. diabetes mellitus, type I 3. central diabetes insipidus
What are examples of disorders of the endocrine system that are characterized by hypersecretion?	1. hyperthyroidism 2. hypercortisolism
What are examples of disorders of the endocrine system that are characterized by abnormalities in responsiveness?	diabetes mellitus, type II 2. nephrogenic diabetes insipidus
What does the hypothalamic-hypophyseal stalk contain?	contains tracts of neurons connecting hypothalamus and posterior pitu. and also contains portal vessels
FSH and LH target the gonads and result in what germ cell development and secretion of what hormones in MALES?	in males FSH and LH = germ cell development: sperm secrete hormones: testosterone
FSH and LH target the gonads and result in what germ cell development and secretion of what hormones in FEMALES??	in females FSH and LH = germ cell development: ovum secrete hormones: estradiol, progesterone
What is the result when growth factor targets the liver and other cells	causes the liver and other cells to secrete IGF-1
What is the result when growth factor targets many organs and tissues	causes protein synthesis, carbohydrate and lipid metabolism
TSH causes the thyroid to what?	secretes thryoxine, triiodothyronine
What occurs when prolactin targets the breasts	causes breast development and milk production
What may prolactin targeting breast tissue in males result in?	in male, prolactin may facilitate reproductive function
What occurs when ACTH targets the adrenal cortex?	the adrenal cortex secretes cortisol
What increases the release of FSH and LH from the anterior pituitary	GnRH from the hypothalamus
What increases release of growth hormone from the anterior pituitary?	GHRH from the hypothalamus
What decreases/inhibits release of growth hormone from the anterior pituitary?	somatostatin from the hypothalamus
What increases release of TSH from the anterior pituitary?	TRH from the hypothalamus
What decreases/inhibits release of prolactin from the anterior pituitary?	DA from the hypothalamus
What increases the release of ACTH from the anterior pituitary?	CRH from the hypothalamus
What all can effect the activity of hypothalamic neurons and thus the release of RHs and IHs?	Thalamus (sensory information) Limbic System (emotional state) *sleep, waking, arousal systems
What is the major glucocorticosteriod in humans and what secretes it?	Cortisol and it is secreted by the adrenal cortex
What is often called our "stress" hormone?	cortisol
Many of the effects of cortisol are what? What are they especially important in?	the effects are metabolic and especially important in our ability to respond physiologically to "stress"
Some effects of cortisol are mediated by what?	mediated by alterations in gene transcription
What hormone is responsible in prenatal development of surfactant and GI enzymes?	cortisol
When do basal levels of secretion of cortisol occur?	non-stressed situations
Most of the effects of basal levels of secretion of cortisol are what?	permissive
What is necessary for sympathetically-induced vasoconstriction?	cortisol
What may occur as the result of cortisol deficiency	Severe hypotension
Cortisol reduces what?	capillary permeability
Cortisol is necessary for the full activity of a variety of enzyme including involved in what in the liver?	those involved in gluconeogenesis, the ability of the liver to produce glucose between meals
Cortisol is necessary for the ability of what hormones? To stimulate what?	for the ability of glucagon and epinephrine to stimulate gluconeogenesis
What are the effects of elevated plasma cortisol during stress?	1.) supplies substrates for cellular energy and glucenogenesis 2) anti-inflammatory, anti-allergy, immunosuppressive 3.) enhanced vascular reactivity 4.) stimulates the activity of phenylethanolamine-N-methytranserase 5.) decreases nonessential functions like reproduction and growth
What is the effect of elevated plasma cortisol during stress on the muscles (and other tissues)?	supplies substrates for cellular energy and gluconeogenesis: = increased proteolysis = increased plasma amino acids
What is the effect of elevated plasma cortisol during stress on the liver?	supplies substrates for cellular energy and gluconeogenesis: = Increased amino acid uptake (for use in gluconeogenesis)
What is the effect of elevated plasma cortisol during stress on the adipose tissue?	supplies substrates for cellular energy and gluconeogenesis: = increased lipolysis = increased plasma fatty acids and glycerol
What is the effect of elevated plasma cortisol during stress on the many body cells?	supplies substrates for cellular energy and gluconeogenesis: = decreased uptake of glucose (anti-insulin action)
What is PMNT and what stimulates it? What is the effect?	PMNT = phenylethanolamine-N-methytransferase it is an enzyme that completes the biosynthesis of epinephrine and increased plasma [cortisol] stimulates its activity
What enzyme is stimulated by increased cortisol and completes the biosynthesis of epinephrine?	PMNT
What regulates the plasma concentration of cortisol?	the hypothalamic, anterior pituitary, and adrenal cortical axis regulates plasma [cortisol]
What is Addison's Disease?	the destruction of the adrenal cortex by autoimmunity, infections such as TB, etc. Results in deficient cortisol, aldosterone, and adrenal androgens
What is hypocortisolism and what are symptoms related to it?	It is a cortisol deficiency 1. anorexia and weight loss 2. malaise, lethargy, fatigue 3. hypoglycemia 4. GI problems 5. hypotension 6. life threatening, poor tolerance to even minor physical stress
What symptoms are related to an aldosterone deficiency?	1.) elevated Na excretion and decreased plasma [Na] 2) elevated plasma K+ 3) polyuria and dehydration 4.) hypotension from decreased plasma volume 5.) can be life-threatening
What is hyperkalemia? What is it a symptom of?	Hyperkalemia is elevated plasma K+ and is a symptom of aldosterone deficiency
What is polyuria and what is it a symptom of?	elevated urine volume and it is a symptom of aldosterone deficiency
What is a symptom related to deficient adrenal androgens?	the thinning or loss of pubic and axillary hair (only seen in women)
True/False: the thinning or loss of pubic and axillary hair related to adrenal androgen deficiency is seen in women and men	False: only seen in women
What are causes of cortisol excess?	1. Hypercortisolism 2. Cushing's disease and syndrome
What are some causes of cortisol excess?	1.) a tumor of the adrenal cortex secreting excessive amount of cortisol 2.) a tumor of the anterior pituitary cells (corticotroph) that secrete ACTH 3.) a tumor, not of the anterior pituitary, that abnormally secretes ACTH 4) a tumor secreting excess CRH 5.) prolonged administration of anti-inflammatory glucocortiocsteroids
What could a tumor on the anterior pituitary gland that causes increased secretion of ACTH cause?	could lead to cortisol excess
What could tumor that abnormally secretes ACTH cause?	could lead to cortisol excess
What could prolonged administration of anti-inflammatory glucocorticosteroids lead to?	could lead to cortisol excess
What are symptoms of hypercortisolism?	1.) hyperglycemia --> diabetes mellitus 2.) changes in fat distribution 3) characteristic round face and fat deposits in upper back 4) thin fragile skin and easy bruising 5) osteoporosis 6.) changes in mood and cognition 7) hypertension 8) immunosupression 9) decreased growth in children
What does the hyperglycemia that is a symptom of hypercortisolism lead to?	can lead to diabetes mellitus
What are the changes in fat distribution that occur as a symptom of hypercortisolism?	* decreased fat in arms and legs * increased fat centrally
Why is think fragile skin and easy bruising a symptom of hypercortisolism?	probably from increased proteolysis
What is associated with/the causes of the osteoporosis that is a symptom of hypercortisolism?	1) decrease ability of osteoblasts to synthesize new bone 2) decrease absorption of calcium from GI tract
True/False: synthetic glucocorticoids are more potent and have longer half-lives than cortisol	true
What are some examples of the synthetic glucocorticoids that are more potent and have longer half-lives than cortisol?	1.) prednisone 2) methylprednisone 3) dexamethasone
What are prednisone, methylprednisone, and dexamethasone examples of?	synthetic glucocorticoids that are more potent and have longer half-lives than cortisol
What properties of synthetic glucocorticoids are they used for?	used for their life-saving anti-inflammatory, anti-allergic, and immunosuppresive properties
Side effects of the use of synthetic glucocorticoids can include symptoms characteristic of what?	symptoms characteristic of hypercortisolism
Secretion of what is markedly inhibited by high doses of steroidal anti-inflammatory drugs?	ACTH secretion
What are the consequences of ACTH secretion being markedly inhibited by high doses of steroidal anti-inflammatory drugs?	1) decreased ACTH causes decreased endogenous synthesis of cortisol 2) decreased ACTH results in atrophy of the adrenal cortex
Decreased ACTH causes decreased what?	decreased endogenous synthesis of cortisol
Decreased ACTH results in atrophy of what?	of the adrenal cortex
What will happen if treatment with high doses of steroidal anti-inflammatory drugs is terminated abruptly?	ACTH secretion rises rapidly, However the adrenal cortices are unable to respond normally because of the atrophy and severe life-threatening cortisol deficiency can arise
Why can severe life-threatening cortisol deficiency arise when treatment with high doses of steroidal anti-inflammatory drugs is terminated abruptly?	because although ACTH secretion rises rapidly, the adrenal cortices are unable to respond normally because of atrophy and this leads to cortisol deficiency
How should you go about ceasing use of high doses of steroidal anti-inflammatory drugs to avoid serious problems?	tapering off these types of drugs can avoid these serious problems
Thyroid hormone circulates primarily how?	primarily bound to plasma proteins
Only what percent of T4 and T3 circulates free in plasma?	only about 0.03% of T4 and about 0.3% of T3
Most effects of thyroid hormone are attributed to what?	T3
Describe thyroid hormone receptors and their location in the body?	They are present in nearly all cells in the body. they are intracellular and binding of the thyroid hormone to its receptors exerts its effects by altering the transcription of specific genes
Binding of thyroid hormone to intracellular receptors exerts its effects by what?	by altering the transcription of specific genes
What are some of the net intracellular effects of thyroid hormone?	1) synthesis of proteins necessary for normal growth and development 2) increased 02 consumption and increased rate of metabolism 3) increased synthesis of beta-adrenergic receptors in certain tissues
What is the increased 02 consumption and increased rate of metabolism that is an intracellular effect of thyroid hormone due to?	1.) increased Na+/K+-ATPase 2) increased mitochondria enzymes 3) increased respiratory enzymes
What are some whole body effects of thyroid hormone?	1.) increased oxygen consumption 2.) increased metabolism 3.) increased beta-adrenergic receptors
What does the increased oxygen consumption that is a whole body effect of thyroid hormone leads to?	1) increased cardiac output 2) increased ventilation 3) increased food intake 4) increased mobilization of carbs, protein, and fat stores for production of energy
What does the increased metabolism that is a whole body effect of thyroid hormone leads to?	1) increased C02 production -> increased ventilation 2) increased heat production -> increased sweating 3) decreased muscle mass and decreased adipose tissue
What does the increased C02 production that is a result of the increased oxygen consumption that is a whole body effect of thyroid hormone lead to?	increased C02 production leads to increased ventilation
What does the increased heat production (thermogenesis) that is a result of the increased oxygen consumption that is a whole body effect of thyroid hormone lead to?	increased heat production (thermogenesis) leads to increased sweating
What does the increased beta-adrenergic receptors that is a whole body effect of thyroid hormone leads to?	increased beta-adrenergic receptors--> to increased heart rate + increased stroke volume-->increased cardiac output and is permissive for epinephrine's ability to stimulate lipolysis
The increased beta-adrenergic receptors that is a whole body effect of thyroid hormone is permissive for what?	permissive for epinephrine's ability to stimulate lipolysis
Increased thyroid hormone has what effect on basal metabolic rate (BMR)?	Increased TH --> increased BMR
What is basal metabolic rate (BMR)?	the basal rate of metabolism determined in the morning, while awake, resting and fasting
BMR can be measured by determining what? What are the units for BMR?	by determining 02 consumption or heat production/unit time. The units for BMR are kilocalories (the calorie of nutrition)
How does epinephrine affect BMR?	Increased EPI, like increased TH, --> Increased BMR transiently
What is hypothyroidism?	abnormally low plasma levels of TH (T3 and T4)
What are all causes of hypothyroidism?	1.) Hashimoto's Disease 2.) Iodide Deficiency 3.) lack of thyroid gland (surgical removal or destruction) 4.) Infantile Hypothyroidism
What happens in Hashimoto's Disease (aka "autoimmune thyroiditis, Type 2A)?	autoantibodies to thyroid follicular cells damage them this leads to impairment of the biosynthesis of thyroid hormone --> decreased secretion of T3 and T4
Why is hypothyroidism a result of Hashimoto's Disease?	autoantibodies to thyroid follicular cells damage them and impair the biosynthesis of thyroid hormone, decreasing its secretion
What percent of the adult population suffers from Hashimoto's Disease?	about 1%
What is the hormone profile in fully-developed Hashimoto's Disease?	1) decreased T3 and T4-->symptoms of hypothyroidism 2.) Increased TSH due to decreased T3/T4 3) Increased TSH--> goiter
What is the decreased T3/T4 in Hashimoto's Disease due to and what does it cause?	It's due to impaired synthesis and leads to symptoms of hypothyroidism
What is the increased TSH in Hashimoto's Disease due to?	due to decreased T3/T4 (decreased negative feedback)
What does the increased TSH in Hashimoto's Disease cause?	leads to a goiter, which is an abnormally enlarged thyroid gland
What is the hormone profile in iodide deficiency?	1) decreased T3 and T4-->symptoms of hypothyroidism 2) Increased TSH due to decreased T3/T4 3) Increased TSH--> goiter
What is the decreased T3/T4 in Iodide Deficiency due to and what does it cause?	It's due to impaired synthesis and leads to symptoms of hypothyroidism
What is the increased TSH in Iodide Deficiency due to?	due to decreased T3/T4 (decreased negative feedback)
What does the increased TSH in Iodide Deficiency cause?	leads to a goiter, which is an abnormally enlarged thyroid gland
What is the hormone profile when there is a lack of a thyroid gland (surgical removal or destruction)?	1) severely decreased T3/T4 --> symptoms of hypothyroidism 2) increased TSH due to decreased T3/T4
What is the most common cause of infantile hypothyroidism?	maternal iodide deficiency
What does severe untreated infantile hypothyroidism lead to?	leads to "cretinism", characterized by profound mental retardation AND somatic (body) growth retardation
What causes cretinism and what is it characterized by?	Untreated severe infantile hypothyroidism leads to cretinism which is characterized by profound mental retardation and body growth retardation
How can many problems of severe infantile hypothyroidism/cretinism be prevented?	if identified at birth and treated very early
What is hyperthyroidism?	abnormally high plasma levels of TH (T3/T4)
What is the most common form of hyperthyroidism?	Grave's Disease
What percent of the adult population has Grave's Disease?	about 1%
How does Grave's Disease lead to hyperthyroidism?	autoantibodies stimulate TSH receptors mimicking the effects of TSH. This leads to 1) increased T3/T4 2) decreased TSH 3) autoantibodies mimicking TSH--> goiter
What is the increased T3/T4 that is a symptom of Grave's Disease due to? what does it result in?	the increased T3/T4 is due to the autoantibodies acting like TSH --> symptoms of hyperthyroidism
What is the decreased TSH that is a symptom of Grave's Disease due to?	due to increased T3/T4 (increased negative feedback)
What do the antibodies mimicking TSH in Grave's Disease result in?	autoantibodies mimicking TSH--> goiter
Where does normal linear bone growth occur?	occurs at the epiphyseal growth plate
Where does normal linear bone growth terminate?	terminates when the epiphyseal growth plates close
Does thyroid hormone promote growth or inhibit growth?	it promotes growth
Thyroid hormones is necessary for normal growth of what?	necessary for: 1) normal development of the nervous system 2) normal linear bone growth
Does insulin promote growth or inhibit growth?	it promotes growth
Normal amounts of insulin are necessary for what having to do with growth?	are necessary for normal growth
Do some anterior pituitary hormones promote or inhibit growth of their target glands?	they promote the growth of target glands
During puberty estrogen and testosterone have what affect on growth?	they stimulate linear bone growth
Estrogen and progesterone ultimately do what to linear bone growth?	ultimately cause closure of the epiphyseal growth plates terminating long bone growth
What type of effects does testosterone exert on skeletal muscles?	Testosterone exerts anabolic effects on skeletal muscles
Does cortisol promote growth or inhibit growth?	inhibits growth
What can excess cortisol secretion from prolonged severe stress or treatment with glucocorticosteroids do in children?	in children it can slow growth and development
True/False: in children who's growth has been slowed by an excess in cortisol secretion from prolonged severe stress or treatment with glucocorticosteroids, catch-up growth can usually occur	True
1, 25(OH)2 vitamin D is necessary for normal growth of what?	for normal bone growth
How can "gigantism" occur?	if excess growth hormone secretion begins before the epiphyseal growth plates have closed due to anterior pituitary tumors
When can "acromegaly" occur?	If excess growth hormone begins after the epiphyseal growth plates have closed or continues after they close
What are characteristics/symptoms of acromegaly?	1) no further increase in height 2) thickening of bones of the hands, feet, and head 3) enlargement of internal organs 4) hyperglycemia
What is the height in dwarfism?	adult height of 4 ft 10 in
What are some causes of dwarfism associated with the GH/IGF axis?	1) deficiency in the secretion of GH 2) abnormalities in the responses of target tissues to GH 3) insensitivity to IGF-1
What are abnormalities in the response of target tissue to GH that can become a cause of Dwarfism?	1) Laron Syndrome Type 1 (genetic defect in GH receptors and GH fails to bind to them) 2) Laron Syndrome Type 2 (genetic defect in signaling pathways initiated by GH-receptor binding)
What is Laron Syndrom Type 1?	genetic defect in GH receptors GH fails to bind to them can cause dwarfism
What is Laron Syndrome Type 2?	genetic defect in signaling pathways initiated by GH-receptor binding can cause dwarfism
Most of the known effects of prolactin are related to its effects on what?	on the mammary glands in women
During puberty, breast development is stimulated by what?	by estrogen, progesterone, prolactin, and other hormones
During pregnancy breast ducts and alveoli develop further in response to what?	in response to high estrogen, progesterone, prolactin, and a protein hormone secreted by the placenta called "placental lactogen"
What blocks milk synthesis during pregnancy?	high placental estrogen and progesterone
After delivery the loss of what allows prolactin do to what?	after delivery the loss of placental estrogen and progesterone allows prolactin to begin stimulating the synthesis and secretion of milk
During lactation, nursing stimulates what?	stimulates prolactin secretion which maintains milk synthesis
What all leads to milk synthesis	Baby nurses and this stimulates tactile receptors and this info is conveyed via somatosensory system to the hypothalamus --> anterior pituitary --> prolactin = milk synthesis
What all leads to milk let down	Baby nurses and this stimulates tactile receptors and this info is conveyed via somatosensory system to the hypothalamus --> anterior pituitary --> oxytocin = milk let-down
What regulates development of the gametes and secretion of gonadal hormones in the adult male and the adult cycling female?	the hypothalamic-pituitary-gonadal axes
What is inhibin in males secreted by? In response to what?	inhibin (protein) is secreted by the Sertoli cells in response to FSH
What does inhibin in males do?	selectively inhibits the secretion of FSH and probably has other roles as well
What is testosterone in males secreted by and in response to what?	testosterone (steroid) is secreted by the Leydig cells in response to LH
What is the main testicular steroid hormone?	testosterone
How is dihydrotestosterone (DHT) formed?	DHT is formed from testosterone by the action of 5-alpha-reductase, an enzyme found in many target tissues
What is 5-alpha-reductase?	an enzyme found in many target tissue that converts testosterone into DHT
How is estradiol (E2) formed?	from testosterone by the action of the enzyme aromatase, also found in many target tissues
What is aromatase?	an enzyme found in many target tissues that converts testosterone into estradiol
Many of the actions of testosterone are actually the result of what?	result of DHT or E2 formed in the target cells
What are the gonadal hormones in males?	1) inhibin 2) testosterone --> DHT --> Estradiol
What are the gonadal hormones in females?	1. inhibin 2. estrogen 3. progesterone
What secretes inhibin in females? In response to what?	secreted by the granulosa cells and the corpus luteum in response to FSH
What does inhibin in females do?	selectively inhibits the secretion of FSH and probably has other roles as well
During the follicular phase of the cycle, estrogen is secreted by what? in response to what?	secreted by the granulosa cells in response to FSH
During the luteal phase of the cycle, estrogen and progesterone secretion is stimulated mainly by what?	by LH
Progesterone is secreted mainly by what? In response to what? During what phase of the cycle?	secreted mainly by the corpus luteum in response to LH during the luteal phase of the cycle
The nervous system has a near-absolute requirement for what?	for glucose
The absorptive (fed) metabolic state is characterized by what?	1) glucose uptake by most cells 2) widespread glucose utilization for energy 3) net anabolism: glycogen synthesis, lipogenesis, protein synthesis
The postabsorptive (fasting) state is characterized by what?	1) net catabolism 2) gluconeogenesis 3) decreased uptake of glucose by skeletal muscle and adipose tissue 4) utilization of fatty acids for energy by almost all cells except those of the nervous system which continue to use glucose for energy = glucose sparing 5) ketogenesis
What does net anabolism in the absorptive state includes?	glycogen synthesis, lipogenesis, protein synthesis
What does net catabolism in the postabsorptive (fasting) state include?	glycogenolysis, lipoglysis, proteolysis
What is gluconeogenesis? It occurs where?	synthesis of glucose from substances such as pyruvate, lactate, glycerol, and amino acids primarily in the liver
What is glucose sparing? When does it occur?	increased utilization of fatty acids for energy by almost all cells except those of the nervous system Occurs in the postabsorptive (fasting) state
What is ketogenesis?	the formation of "ketone bodies" by the liver from acetyl CoA produced during beta-oxidation of fatty acids
What are ketone bodies? What can they be used for?	= acetoacetic acid, beta hydroxybutryic acid, acetone they are produced by the liver from acetyl CoA they can be used for energy
What happens to the concentration of ketone bodies during starvation?	during starvation, the concentration of ketone bodies in plasma increases sufficiently to serve some of the nervous system's energy needs
What happens when ketone bodies are present in excess?	Since they are weak acids, if present in excess, they can produce metabolic acidosis
Cells in the Islets of Langerhans secrete hormones that regulate what?	regulate metabolism
What type of hormone is insulin and what secretes it?	a peptide hormone secreted by the beta cells in the Islets of Langerhan of the liver
Insulin secretion is increased by factors associated with eating a meal including what?	1) Increased plasma glucose 2) Increased parasympathetic activty 3) increased plasma amino acids 4) increased plasma GIP (glucose dependent insulinotropic hormone)
Insulin secretion is decreased by what?	by Increased sympathetic efferent activity and EPI
What are major target tissues for insulin?	liver striated muscle adipose tissue
What are the major cellular actions of insulin?	1) increased cellular uptake of glucose into major glucose-consuming tissue 2) increased cellular uptake of amino acids 3) increased activity of enzymes involved in fuel storage 4) decreased activity of enzymes involved in fuel breakdown 5) decreases plasma [glucose]
Insulin stimulates the insertion of what into the plasma membrane of what tissues?	stimulates the insertion of GLUT-4s into the plasma membrane of skeletal muscle, cardiac muscle, and adipose tissue
Insulin stimulates the insertion of GLUT-4s into the plasma membrane of skeletal muscle, cardiac muscle, and adipose tissue thereby increasing what?	increasing glucose transport from plasma into those tissues
What are the two major families of hexose transporters?	1. Sodium-glucose cotransporters (SGLTs) 2. Facilitated diffusion transporters (GLUTs)
What are SGLTs? How do they transport glucose? Where are they primarily located?	Sodium-glucose cotransporters Na-linked secondary active transporters they transport glucose UPHILL and are present primarily in the intestine and kidney
SGLTs are present where in the membrane of epithelial cells?	these transporters are present in the luminal (apical) membrane of epithelial cells
In the GI tract, these epithelial cells accumulate how much glucose?	they accumulate nearly all glucose present in the GI lumen from the breakdown of dietary carbs, even if the intracellular concentration of glucose becomes very high
Why are active, uphill mechanisms needed for glucose transport in the kidneys	In the kidneys, normally, the epithelial cells with SGLTs must recover all the filtered glucose, even if the intracellular concentration becomes high. Therefore, active, uphill mechanisms are needed
Which way do facilitated diffusion transporters for glucose or "GLUTs" transport glucose?	move glucose across membranes downhill
Where are GLUT-1 located?	high in brain, RBCs, and endothelial cells
What are GLUT-2 and where are they located?	they are low-affinity transporters, present in kidney, small intestines, and liver
What are GLUT-5? Where are they present?	They have a very low affinity for glucose; actually a fructose-transporter Present in small intestine, sperm, kidney, brain, adipose tissue, and muscle
What is the affinity of GLUT-5 for glucose? What type of transporter are they?	have a low affinity for glucose anda re actually fructose transporters
What type of affinity do GLUT-3s have and where are they located?	High affinity neurons and placenta
What are GLUT-4s responsive to? Where are they concentrated the most?	insulin-responsive glucose transporters highest concentration in skeletal muscles, cardiac muscle, and adipose cells
What type of GLUTs are in the brain?	GLUT-1 (high affinity) GLUT-5 also present (very low affinity for glucose)
What type of GLUT is present in the RBCs?	GLUT-1 (high affinity)
What type of GLUT is present in endothelial cells?	GLUT-1 (high affinity)
What type of GLUT is present in the kidney?	GLUT-2 (low affinity) GLUT-5 (very low affinity)
What type of GLUT is present in the small intestine?	GLUT-2 (low affinity) GLUT-5 (very low)
What type of GLUT is present in the liver?	GLUT-2 (low affinity)
What type of GLUT is present in the neurons?	GLUT-3 (high affinity)
What type of GLUT is present in the placenta?	GLUT-3 (high affinity)
What type of GLUT is present in the sperm?	GLUT-5 (very low affinity; fructose transporter)
What type of GLUT is present in the adipose tissue?	GLUT-5 (very low affinity; fructose transporter) GLUT-4 (insulin-responsive glucose transporter)
What type of GLUT is present in the muscle?	GLUT-5 (very low affinity; fructose transporter)
What type of GLUT is present in the skeletal muscle	GLUT-4 (insulin-responsive glucose transporter)
What type of GLUT is present in the cardiac muscle?	GLUT-4 (insulin-responsive glucose transporter)
The brain can normally use only what for energy?	normally can use only glucose
Glucose uptake in the brain is via what?	GLUT-1 GLUT-3 GLUT-5
What is the most important GLUT in the brain for glucose uptake	GLUT-3 (high-affinity)
T/F: GLUT-3s are insulin sensitive receptors?	FALSE: they are NOT insulin sensitive
What is the result/effect of GLUT-3s in the brain not being insulin sensitive on glucose uptake?	since they aren't insulin sensitive, uptake of glucose by the brain is NOT dependent upon insulin
Tissues in which insulin stimulates the insertion of GLUT-4s also have other GLUTs....therefore what?	therefore, insulin acts to INCREASE glucose uptake
By increasing the cellular uptake of glucose into skeletla muscle, cardiac muscles, and adipose tissue, insulin does what?	a) promotes the use of glucose for energy b) promotes the storage of glucose as glycogen c) decreases plasma [glucose]
Insulin causes stimulation of events of the absorptive state while inhibiting what?	inhibiting events of the postabsorptive state
What are sume of the major net effects of insulin?	1) increase glucose utilization 2) Increase net anabolism --> Increase glycogen synthesis --> increase lipogenesis --> increase protein synthesis 3.) decrease gluconeogenesis 4) Inhibition of net catabolism --> decrease glycogenolysis --> decrease lipolysis & decrease ketogenesis --> decrease protein breakdown 5.) decreases plasma glucose and amino acids
What is our most "anabolic" hormone? What does it do?	insulin It increases net anabolism 1) increases glycogen synthesis 2) increase lipogenesis 3) increase protein synthesis
What type of hormone is glucagon and what secretes it?	it is a peptide hormone secreted by the alpha cells of the Islet of Langerhan in the liver
Glucagon secretion is stimulated by decreased what?	by decreased plasma glucose
Glucagon secretion is stimulated by increased what?	by increased sympathetic activity and EPI
Major effects of glucagon are exerted on what?	on the liver
What does glucagon to/in the liver?	a) increases glycogenolysis --> increased plasma [glucose] b) increases gluconeogenesis --> increased plasma [glucose] c) increased ketogenesis--> increased plasma [ketone bodies]
How does glucagon increase plasma [glucose]?	glucagon targets the liver and increases glycogenolysis and increases gluconeogenesis, both of which increase plasma glucose
How does glucagon increase plasma [ketone bodies]?	it targets the liver and increases ketogenesis, which increases plasma [ketone bodies]
What does glucagon do in adipose tissue?	it causes an increase in lipolysis, which increases plasma fatty acids
How does glucagon increase plasma fatty acids?	It targets the adipose tissue and causes an increase in plasma fatty acids
When do ketones become a significant energy source for the nervous system?	only during prolonged fasting
What do plasma fatty acids serve as energy for?	energy for tissues other than the nervous system
In the normal individual, what is far more serious than abnormally high plasma [glucose]?	an acute episode of abnormally low plasma glucose (hypoglycemia)
Which is more serious: an acute episode of hypoglycemia or hyperglycemia?	an acute episode of abnormally low plasma glucose is more serious
In hypoglycemia what can occur if the nervous system's need for glucose is not met?	hypoglycemia may lead to coma and death if the nervous system's need for glucose s not met
What is extremely effective in lowering plasma [glucose]?	insulin
What is the only hormone that directly lowers plasma [glucose]?	insulin
What are "counterregulatory hormones"?	hormones that oppose the actions of insulin
When are counterregulatory hormones typically released?	during "stress" including hypoglycemia
What do counterregulatory hormones act to do?	they act to increase plasma concentrations of glucose and/or fatty acids
What are some counterregulatory hormones?	a. glucagon b. epinephrine/norepinephrine c. cortisol d. growth hormone
Epinephrine from the adrenal medulla and NE from increased sympathetic activity acts as a counterregulatory hormone how?	by: a) increasing glycogenolysis --> increased plasma glucose b) increase gluconeogenesis --> plasma glucose c) increased lipolysis --> increased fatty acids
How does EPI/NE increase plasma glucose and therefore opposes the action of insulin?	It increases glycogenolysis and increases gluconeogenesis, both of which increase plasma glucose
How does EPI/NE increase fatty acids and therefore opposes the action of insulin?	it increases lipolysis and therefore increases fatty acids
Basal concentrations of cortisol are permissive for what?	for stimulation of gluconeogenesis by EPI and glucagon
Elevated cortisol (as occurs during stress) results in what that opposes the action of insulin?	a) increased protein breakdown --> increased plasma amino acids b) increased gluconeogenesis -> increased plasma glucose c) increased lipolysis--> increased plasma fatty acids d) decreased uptake of glucose by muscles and fat-> less glucose used
What does diabetes mellitus arise from?	a) the beta cells cant secrete insulin and/or b) failure of target cells to respond to insulin
What are two major types of diabetes mellitus?	Diabetes Mellitus Type 1 and Diabetes Mellitus Type 2
What are synonyms for Diabetes Mellitus Type 1?	a. type I diabetes mellitus b. insulin-dependent diabetes mellitus (IDDM) c. juvenille-onset diabetes
Diabetes Mellitus Type 1 accounts for how much of all diabetes mellitus cases?	about 5-10% of all cases
Diabetes Mellitus Type 1 is due to what?	due to total or near-total destruction of the beta cells of the pancreas resulting in near or total absence of insulin
What are synonyms for Diabetes Mellitus Type 2?	a.) Type II diabetes mellitus b) non-insulin dependent diabetes mellitus (NIDDM) c.) adult onset diabetes mellitus
Diabetes Mellitus Type 2 accounts for how much of all diabetes mellitus cases?	for about 90-95% of all diabetes mellitus cases
What are major characteristics/associates of Diabetes Mellitus Type 2?	a.) usually associated with obestiy b) insulin secretion may be normal, elevated (hyperinsulinemia) c) deficient during development of type 2
The insulin resistance in Diabetes Mellitus Type 2 is an example of what?	example of hyporesponsiveness
Describe Gestational Diabetes and compare it to Diabetes Mellitus Type II?	It is diabetes during pregnancy it is like type 2 but normally can be reversed after delivery. However, women who have gestational diabetes may be at higher risk for later development of type 2
Symptoms in diabetes mellitus are directly or indirectly related to what?	related to insulin deficiency or inability of target cells to respond to insulin
What are some major symptoms in untreated both types of diabetes mellitus?	1) weight loss from wasting of muscles and fat 2) plasma [glucose] 3) glucose in urine 4) excessive volumes of urine arises 5) excessive thrist
What is a major symptom of untreated diabetes mellitus type 1 on top of symptoms shared by type 1 and 2?	increased plasma [ketone bodies]
The excessive volume of urine that arises as a major symptom of both types (1 and 2) of diabetes mellitus arises form what?	a) failure to reabsorb all the filtered glucose increases the osmolarity of the tubular fluid b) elevated tubular fluid osmolarity decreases the reabsorption of water, increasing water excretion
Failure to reabsorb all the filtered glucose in diabetes mellitus results in what that leads to excessive volume of urine?	increases the osmolarity of the tubular fluid
Increasing the osmolarity of the tubular fluid by failure to reabsorb all the filtered glucose in diabetes does what that leads to excessive volume of urine?	elevated tubular fluid osmolarity decreases the reabsorption of water, increasing water excretion
Acute life-threatening consequences are most common when in cases of diabetes mellitus? Which type?	acute life-threatening consequences are most commonly seen in severe untreated type I diabetes mellitus
The complications that arise over time in diabetes mellitus are mainly from what?	mainly from chronically elevated plasma [glucose]
What are complications that arise over time in both Type 1 and 2 diabetes mellitus?	a) increased risk for heart disease and stroke b) vascular diseases c) renal diseases d) diabetic neuropathy e) sensory loss, vascular problems, difficulty hearing d) periodontal (gum) and skin problems f) retinopathy
What percent of end-stage renal diseases requiring dialysis or transplant is caused by diabetes?	about 40%
What/where is diabetic neuropathy that occurs in both type 1 and 2 diabetes mellitus?	= damage to peripheral nerves 1) somatic motor 2) sensory 3) autonomic
Why are amputations common in type 1 and 2 diabetes mellitus?	sensory loss, vascular problems, and difficulty hearing increase the risk of injury and infection
What is retinopathy? What is it a complication of?	damage to the retina complication of both type 1/2 diabetes mellitus
What is a major cause of blindness?	retinopathy that is a consequence of both types of diabetes mellitus
What is the cause of diabetes mellitus type 1?	most cases of type 2 are the result of autoimmune destruction of the beta cells of the pancreas
What is the treatment at present for Type I Diabetes Mellitus?	the only common treatment for type is is replacement of insulin by: a) injection b) infusion pump c) inhalation
What is the only inhalable insulin? Who launched it? Is it available still?	Exubera it was released by Pfizer in Sept 2006 and as of Jan 2008 it is no longer available apparently because of lack of sale
What does Diabetes Mellitus Type I often cause failure of?	often causes kidney failure
In some select type I diabetic patients receiving kidney transplants, what do they also receive? How does this affect their diabetes?	Some also receive pancreas transplants to cure the diabetes
Instead of replacing the whole pancreas, what type of transplant in currently in clinical trials to improve/cure Diabetes mellitus Type 1?	beta cell transplants
Which type of diabetes mellitus is called "metabolic syndrome"	Diabetes Mellitus Type II
What is a characteristic of the metabolic syndrome, Diabetes Mellitus Type II?	insulin resistance
How many americans are estimated to have diabetes mellitus type II?	50 million
What factors can all contribute to insulin resistance and therefore diabetes mellitus type II?	a) genetics b) obesity c) excessive abdominal fat d) advancing age e) lack of physical activity
What factors contribute to failure of beta cells in diabetes type 2?	a) genetics b) glucose toxicity c) elevated fatty acids d) other?
What are the "steps" in developing diabetes mellitus type II?	1) excessive abdominal fat --> 2) insulin resistance --> 3) elevated insulin secretion --> 4) hyperinsulinemia --> 5) compensation for insulin resistance with normal glucose tolerance and normal fasting glucose --> 6) impaired glucose tolerance and impaired fasting glucose ("pre diabetes") --> 7) diabetes type 2 --> 8) failure of beta cells 9) insulin dependence
What are treatments for diabetes mellitus type 2?	1) lifestyle changes (weight reduction, exericse, diet changes) 2) medications to: a) stimulate insulin release b) inhibit digestion of carbs c) reduce insulin resistance d) inhibit glucose output by the liver 3) insulin
What lifestyle changes are treatments for diabetes mellitus type 2?	weight reduction, exercise, diet changes
To treat diabetes mellitus type 2 you can use medications to what?	medications to a) stimulate insulin release b) inhibit digestion of carbs c) reduce insulin resistance d) inhibit glucose output by the liver
What all does decreased parasympathetic activity in response to stress leads to?	a) decreased GI activities b) increased heart rate c) decreased insulin secretion among other effects
What are our physiological responses to stress?	a) decreased parasympathetic activity b) increased sympathetic activity c) elevated cortisol secretion d) elevated growth hormone secretion e) elevated glucagon secretion (via increased sympathetic activity) f) secretion of other hormones
Why are the effects of the sympathetic more widespread then those of parasympathetic division of ANS?	because the sympathetic division can discharge as a whole ("mass discharge")
The effects of increased sympathetic activity in stress include what?	a) pupil dilation b) airways dilate c) increased heart rate and strength of contraction d) increased arterial blood pressure e) increased blood flow to skeletal muscle f) decreased blood flow to GI tract g) increased sweating h) piloerection i) decreased insulin secretion j) increased EPI secretion
What are some metabolic effects on increased sympathetic activity and EPI?	1) increased glycogenolysis and gluconeogenesis -> increased plasma glucose 2) increased lipolysis -> increased plasma fatty acids
Elevated cortisol secretion in stress increases secretion of what?	increases secretion of: a) corticotrophin releasing hormone (CRH) b) adrenocorticotrophic hormone (ACTH)
Elevated cortisol secretion in stress increases secretion of CRH and ACTH which has what effect?	1) increases tyrosine hydroxylase activity, increasing catecholamine synthesis by the adrenal medulla 2) increased phenylethanolamin-N-methyltransferase activity, increasing EPI synthesis by the adrenal medulla 3) increased secretion of cortisol
Elevated cortisol secretion in stress increases secretion of CRH AND ACTH which increases tyrosine hydroxylase activity which does what?	increased tyrosine hydroxylase activity increases catecholamine synthesis by the adrenal medulla
Elevated cortisol secretion in stress increases secretion of CRH AND ACTH which increases phenylethanolamine-N-methyltransferase activity which does what?	increase PNM activity increases EPI synthesis by the adrenal medulla
Elevated cortisol secretion during stress causes increased secretion of cortisol which has what effects?	a) increased PNM activity increases EPI synthesis by the adrenal medulla b) increased gluconeogenesis --> increased fatty acids c) increased lipolysis --> increased plasma fatty acids d) increased vascular tone e) possible other effects
What are the possible other effects (generally considered "pharmacological" but may occur physiologically in severe or chronic stress) that occur because of increased secretion of cortisol?	a) anti-inflammation b) anti-allergy c) immunosuppression d) inhibition of growth
Elevated growth hormone secretion during stress increases secretion of what?	increase secretion of: a) growth hormone releasing hormone (GHRH) b) growth hormone (GH)
Elevated growth hormone secretion in times of stress leads to what?	1) increased gluconeogenesis --> increased plasma glucose 2) increased lipolysis --> increased plasma fatty acids
During stress glucagon secretion is elevated via what?	via increased sympathetic activity
Elevated glucagon secretion during stress leads to what?	1) increased glycogenolysis and gluconeogenesis -> increased plasma glucose 2) increased lipolysis -> increased plasma fatty acids
Secretion of what other hormones may or not be altered in a "flight or fight" situation?	a) increased antidiuretic hormone = increased ACTH = increased cortisol b) increased angiotensin II c) increased aldosterone d) decreased GnRH = decreased LH and FSH = decreased gonadal steroids
In the flight or fight situation, an increase in antidiuretic hormone secretion can lead to what?	leads to conservation of body water AND increased secretion of adrenocorticotrophic hormone (ACTH) = increased cortisol secretion
In the flight or fight situation, an increase in angiotensin II secretion can lead to what?	leads to increased arterial blood pressure and increased aldosterone secretion
In the flight or fight situation, an increase in aldosterone secretion can lead to what?	conservation of body Na+ --> conservation fo body water
During stress what increased hormones are secondary to increased sympathetic activity?	during stress increased angiotensin II and therefore increased aldosterone secretion are secondary to increased sympathetic activity
In the flight or fight situation, a decrease in gonadotropin releasing hormone (GnRH) secretion can lead to what?	leads to decreased luteinizing hormone (LH) and decreased follicle stimulating hormone (FSH) --> decreased gonadal steroids
All the changes in ANS activity and hormone secretion are advantageous when?	advantageous for our adaptations to an acute stress such as a flight or fight situation
Mounting even parts of the stress responses (ANS, endocrine) chronically may be a cause of many of our current diseases and conditions such as?	a) muscle wastage b) weakness c) increased risk of type II diabetes d) hypertension e) GI problems such as ulcers and colitis f) "stress dwarfism" g) reproductive problems h) infections i) possibly impaired memory
How can the stress response being chronically active possibly impair memory?	from injury to the hippocampus by elevated cortisol
What is a measurement of obesity?	Body Mass index (BMI)
How do you calculate BMI?	body weight (kg) / height (meters^2)
What is an underweight BMI?	below 18.5
What is a normal BMI?	18.5-24.9
What is an overweight BMI?	25-29.9
What is a clinically obese BMI?	30-39.9
What is a morbidly obese BMI?	40 and above
What are the shortcomings of BMI/why may BMI statistics be misleading?	1) it corrects for the height of the individual only 2) no correction for very muscular or very fit (muscle is heavier than fat) 3) does not correct for age (as we age, we gain about 10lbs/decade of life until about the age of 60) 4) Not corrected for gender (women tend to have more body fat. Women also have a longer lifespan)
What type of statistic is BMI value for obesity?	BMI value for obesity is a "threshold statistic"
What does it mean that the BMI value for obesity is a "threshold statistic"?	Relatively small changes in a value such as weight gain can move an individual into the category of obesity. The shorter the individual is, the less weight is required to move them into the obese category
Our nation's population has gained on average how much since 1990.	Since 1990 the nation's population has gained on average 7 to 10 lbs
Why is reducing obesity in our country a great public health importance?	because obesity is associated with increased risk for Type II diabetes, hypertension, coronary heart disease, congestive heart failure, and fatty liver disease
Obesity is associated with increased risk for what?	a) type II diabetes b) hypertension c) coronary heart disease d) congestive heart failure e) fatty liver disease
What are the Syndrome X or Metabolic syndromes?	the health problems/diseases associated with obesity and are the leading known causes of morbidity and mortality in the western world: a) type II diabetes b) hypertension c) coronary heart disease d) congestive heart failure e) fatty liver disease
What are Apple body types? Describe their risk for what diseases?	individuals who carry their excess weight above the waist (apples) = intraabdominal fat This fat distribution increases an individual's risk for Type II diabetes and cardiovascular disease
The apple body type weight distribution correlates with the distribution of what type of fat?	distribution of visceral fat (the fat surrounding the internal organs)
What is the pear body type? Describe their risk for what diseases?	have their fat distributed below the waist in their buttocks and thighs Does not correlate with increased risk for Type II diabetes and cardiovascular risk
The pear body fat distribution correlates with what type of fat? located where?	correlates with subcutaneous fat (the fat beneath the skin). Subcutaneous fat is not associated with health risks
Is the pear body type or the apple body type associated with an increased risk for type II diabetes and increased cardiovascular risk?	The apple body type
Compare visceral fat versus subcutaneous fat	Visceral fat correlates with increased resistance to insulin ( a precursor to Type II diabetes) and subcutaneous fat does not
True/FalseL subcutaneous fat loss through liposuction correlates with health benefits	FALSE: it does NOT correlate with any health benefits
What is the goal waist circumference for a man if your BMI is greater than or equal to 25kg/m^2?	40 inches or less
What is the goal waist circumference for a woman if your BMI is greater than or equal to 25kg/m^2?	35 inches or less
Obesity occurs when there is a long term imbalance between what?	energy intake and energy expenditure
Extra energy ingested is stored how?	as fat
The basis of the long term imbalance between energy intake and energy expenditure that can lead to obesity can be due to what?	can be due to: a) lack of willpower b) lifestyle c) genetics
How should an individual be able to lose weight?	by simply reducing caloric intake and exercising more
What percent of all diets fail within 1-2 years?	70% to 95%
How many calories do we consume per year	about one million calories
We balance the energy intake versus energy expenditure equation with about what percent accuracy?	about 99.6% accuracy
Food labels are not accurate. Errors in these values range from what to what?	from 2 to 85%
Populations with what type of ancestor tend toward obesity in modern society?	populations whose ancestry included a hunter-gatherer lifestyle (where food was in short supply and a significant amount of caloric intake was expended on obtaining food), will tend toward obesity in modern society
What appear to play a dominant role in the phenotypic differences?	genes
Is there greater variability in body weight in dyzygotic twins or monozygotic twins?	greater variability in body weight in dyzygotic twins
What is an example of strong support for genetics over environment playing a dominant role in body weights?	adoptees raised by adoptive parents have body weights that correlate most closely with their biological parents rather than their adoptive parents
Body weight is controlled by many factors and therefore what?	many genes
Factors that control body weight come from where?	fat, brain, and the GI tract
What is leptin?	a hormone produced by fat
What is ghrelin?	a hormone from the stomach
What releases leptin and what does it act upon?	released by fat and acts on the hypothalamus of the brain to inhibit feeding
Leptin acts on the hypothalamus of the brain to do what?	to inhibit feeding
What feedback does leptin provide to the organism?	provides feedback that there is sufficient fat and that food intake can be reduced
What does leptin inhibit in the hypothalamus?	it inhibits Neuropeptide Y cells (NPY)
What are Neuropeptide Y cells (NPY)?	they are cells in the hypothalamus that stimulate feeding
What inhibits NPY cells and therefore stops feeding?	insulin
Leptin stimulates what type of cells which also inhibits feeding?	Leptin stimulates alpha MSH producing cells, which inhibits feeding
What are alphaMSH producing cells? What stimulates them and what is the result of stimulation?	they are cells that leptin stimulates to inhibit feeding
What is the two-pronged manner in which leptin inhibits feeding?	1) inhibits NPY cells in hypothalamus from stimulating feeding 2) stimulates alpha MSH producing cells which inhibits feeding
What does the rare lectin deficiency result in?	lectin deficiency results in morbid obesity in childhood and related alterations in growth and increased insulin levels
In individuals with leptin deficiency, what can be used as treatment?	injection with leptin daily can return such individuals to the normal range in body weight, height, and insulin levels
Compare the leptin levels of most obese individuals versus normal weight individuals?	Obese individuals tend to have a higher level of circulating leptin, compared with normal weight individuals
Since most obese people don't suffer from leptin deficiency, rather higher than normal levels, what may be the problem?	its as though these individuals have developed a resistance at the receptor level for leptin
Injections of what will help about 30% of obese individuals with resistance at the receptor level for leptin lose some weight?	injections of extra leptin for obese individuals will help about 30% of that population to lose some weight
The fact that 30% of obese individuals lose weight when they receive injections of extra leptin suggest what?	that there are multiple factors mediating obesity in most individuals
T/F: Leptin deficiency is extremely rare	TRUE
What leads to increase in leptin secretion and what results as a consequence of increased leptin?	When energy intake is > than energy expenditure, there is an increase in fat deposition in adipose tissue this increases leptin secretion --> increased plasma [lectin] targets the hypothalamus and alters activity of integrating centers --> decreased energy intake and increased metabolic rate which serves as negative feedback to restore balance of intake and expenditure which stops excess fat storage and decreases lectin secretion
In successful dieting, what happens if energy expenditure exceeds energy intake?	the fat stores decrease
In successful dieting, what happens if energy expenditure exceeds energy intake and the fat stores decrease, what happens to leptin?	Leptin secretion decreases and the experience of "satiety" decreases
What is the leptin-dieting paradox?	In sucessful dieting, expenditure exceeds intake and fat stores decrease and you lose weight BUT, a decrease in fat stores decreases leptin secretion and this results in the experience of "satiety" decreasing --> leads to an individual eating more cause they are not "full" and this changes the balance and makes intake greater than expenditure --> increased fat storage and the individual gains weight
What may be a reason may be one of the reasons diets "dont work" in the long-term?	because of the leptin-dieting paradox
What releases ghrelin? What stimulates this release?	it is a hormone released by gastric cells when nutrients are absent from the stomach. It is stimulated by fasting and a low calorie diet
Secretion of what is stimulated by fasting and a low calorie diet?	ghrelin
when do ghrelin levels rise? What does increased ghrelin result in?	when the stomach is empty and induces hunger
What cells does ghrelin stimulate? What does this stimulation result in?	stimulates cells in the arcuate nucleus of the hypothalamus to release NPY to stimulate feeding
How does gastric by-pass surgery affect ghrelin levels?	ghrelin levels alter their circadian rhythmicity of its release
What may correlate with the success of gastric by pass surgeries to result in long-term weight reduction?	ghrelin levels altering their circadian rhythmicity of its release
What study on monkeys gave support for combining exercise with dieting to lose weight?	When adult, ovariectomized female monkeys were placed on a 30% calorically reduced diet they didn't lose weight because they reduced activity levels to compensate for lost calories But when the monkeys were trained to run a tread mill at 80% max for 1hour/day, 5days/week with the same restricted diet, they did lose weight
Why should you combine exercise with dieting to lose weight?	because exercising with dieting counteracts the compensatory decrease in physical activity associated with a decreased caloric diets (shown by monkey study)
What is resveratrol?	a substance found in red grapes
In a study on obese mice, what happened when they were given high doses of resveratrol?	the mice did not develop the health-related problems associated with excess weight
While obese mice given high doses of resveratrol didn't develop the health related problems associated with excess weight, why may this not work in humans?	because the doses that the mice were given of resveratrol in order to create those results are equal to 750 to 1500 bottles of wine a day!
A new gene "adipose" has been discovered to regulate the deposition of fat. Increased gene activity leads to what in a mice study?	increased gene activity leads to decreased fat deposition, and leaner, healthier mice
A new gene "adipose" has been discovered to regulate the deposition of fat. Decreased gene activity leads to what in a mice study?	Decreased gene activity leads to fatter, less lively mice with an increased risk of diabetes
Compare the death rates of overweight people versus underweight vs normal vs obese individuals for a range of diseases that a CDC study indicated?	the study indicated that overweight people have a lower death rates than underweight, normal, and obese individuals for a range of diseases
The lower death rate for a range of diseases that overweight people compared to all other size people is not off-set by what?	not off set by the increased risk for cardiovascular diseases or diabetes related risk
The physiological problem of obesity is not likely due to a single genetic component gone wrong, but rather is?	rather is a result of a complex system involving many genes and their interplay with a modern lifestyle
What effect does increased cortisol have on muscles	increases proteolysis = increased amino acids
What effect does increased cortisol have on the liver?	increased amino acid uptake for gluconeogenesis
What effect does increased cortisol have on adipose tissue?	increased lipolysis = increased fatty acids and glycerol
What effect does increased cortisol have on many body cells?	decreases glucose uptake (opposes insulin)
What effects of increased plasma cortisol are anti-inflammatory, anti-allergy, and immunosuppressive	a) increases vascular reactivity to sympathetic b) stimulates PMNT (thus EPI synthesis) c) decreases reproduction, growth
What president had Addison's Disease?	John F Kennedy
Compare exocrine gland secretion to endocrine gland excretion	EXOCRINE: enters ducts from where their secretions either exit the body or connectt the lumen of a structure such as the intestines or to the surface of the skin ENDOCRINE: secrete hormones that enter the interstitial fluid and diffuse into the blood, from where they can reach distant target cells
What are the messengers of the endocrine system?	hormones
Compare the target cells of hormones versus the paracrine and autocrine substances released by local cells	Hormones target cells in one or more distant places in the body while substances released by local cells target cells in close proximity to site of release
What hormones does adipose tissue produce?	leptin
what is the major function of leptin?	control of appetite; metabolic rate; reproduction
What hormones does the adrenal cortex secrete?	cortisol androgens *aldosterone
what is the major function of cortisol?	secreted by adrenal cortex control of organic metabolism; response to stress; immune system; development
what is the major function of adrenal androgens?	secreted by adrenal cortex control of sex drive in women
what is the major function of aldosterone?	secreted by adrenal cortex control of Na and K excretion by kidneys; extracellular water balance
What hormones does the adrenal medulla secrete?	EPI and NE
What is the major function of epinephrine and norepinephrine?	secreted by adrenal medulla control of organic metabolism; cardiovascular function; response to stress (flight or fight)
What hormones do the ovaries secrete?	* estrogen (estradiol in humans) * progesterone * inhibin
What is the function of estrogen in females?	secreted by ovaries control of reproductive system; secondary sex characteristics; growth and development; development of ovarian follicle
What is the function of progesterone in females?	secreted by ovaries control of endometrium and pregnancy
What is the function of inhibin in females?	secreted by ovaries control of follicle stimulating hormone (FSH) secretion
What hormones do the testes secrete?	* testosterone * inhibin
What is the function of testosterone in males?	secreted by testes control of reproductive system; secondary sex characteristics; growth and development; sex drive; gamete development
What is the function of inhibin in males?	secreted by testes control FSH secretion
What hormones does the heart secrete?	Atrial natriuretic peptide (ANP)
What is the function of atrial natriuretic peptide (ANP)?	secreted by heart control of Na+ excretion by kidneys; blood pressure
What are the hormones released by the hypothalamus?	Corticotropin releasing hormone (CRH) Thyrotropin releasing hormone (TRH) Growth hormone releasing hormone (GHRH) Somatostatin (SS) Gonadotropin releasing hormone (GnRH) dopamine (DA)
What is the function of Corticotropin releasing hormone (CRH)?	released by hypothalamus control of: secretion of adrenocorticotropic hormone (ACTH)
What is the function of Thyrotropin releasing hormone (TRH)?	released by hypothalamus control of: secretion of thyroid stimulating hormone (TSH)
What is the function of Growth hormone releasing hormone (GHRH)	released by hypothalamus control of: secretion of growth hormone (GH)
What is the function of Somatostatin (SS)	released by hypothalamus control of: secretion of growth hormone
What is the function of Gonadotropin releasing hormone (GnRH)	released by hypothalamus control of: secretion of luteinizing hormone (LH) and follicle stimulating hormone (FSH)
What is the function of dopamine (DA)	released by hypothalamus control of: secretion of prolactin
What hormones does the kidney secrete?	Erythropoietin (EPO) 1, 25 dihydroxy vitamin D
What is the function of erythropoietin (EPO)?	secreted by the kidneys control of: erythrocyte production in bone marrow
What is the function of 1, 25 dihydroxy vitamin D?	secreted by the kidneys control of: Ca++ absorption in GI tract
What hormone does the liver secrete?	insulin-like growth factor 1
What is the function of insulin-like growth factor 1?	secreted by kidneys control of: cell division and growth of bone and other tissues
What hormone does the parathyroid release?	parathyroid hormone (PTH)
What is the function of parathyroid hormone (PTH)?	released by parathyroid control of: plasma [calcium] and phosphate ion; synthesis of 1, 25 dihydroxy vitamin D
What hormones does the anterior pituitary secrete?	growth hormone thyroid stimulating hormone (TSH) * adrenocorticotropic hormone (ACTH) * prolactin * follicle stimulating hormone (FSH) * luteinizing hormone (LH)
What is the function of growth hormone?	secreted by anterior pituitary control of: growth; mainly via local production of IGF-1; protein; carbohydrate and lipid metabolism
What is the function of thyroid stimulating hormone (TSH)?	secreted by anterior pituitary control of: thyroid gland activity and growth
What is the function of adrenocorticotropic hormone (ACTH)?	secreted by anterior pituitary control of: adrenal cortex activity and growth
What is the function of prolactin?	secreted by anterior pituitary control of: milk production in breast
What is the function of follicle stimulating hormone (FSH) in MALES?	secreted by anterior pituitary control of: gamete production
What is the function of luteinizing hormone (LH) in MALES?	secreted by anterior pituitary control of: testicular production of testosterone
What is the function of follicle stimulating hormone (FSH) in FEMALES?	secreted by anterior pituitary control of: ovarian follicle growth
What is the function of luteinizing hormone (LH) in FEMALES?	secreted by anterior pituitary control of: ovarian production of estradiol; ovulation
What hormones does the posterior pituitary gland secrete?	* oxytocin * antidiuretic hormone (ADH); vasopressin
What is the function of oxytocin	secreted by posterior pituitary control of: milk secretion; uterine motility
What is the function of antidiuretic hormone (ADH); vasopressin	secreted by posterior pituitary control of: blood pressure; water excretion by the kidneys
What hormones does the placenta secrete?	estrogens progesterone *placental lactogen
What is the function of estrogens released by placenta	secreted by placenta control of: same function as estrogen secreted by ovaries: reproductive system; secondary sex characteristics; growth and development; development of ovarian follicle
What is the function of progesterone released by the placenta	secreted by placenta control of:same function as progesterone secreted by ovaries: control of endometrium and pregnancy
What is the function of placental lactogens	secreted by placenta control of: breast development; organic metabolism
What hormones does the thyroid secrete?	thyroxine (T4) and triiodothryonine (T3) * calcitonin
What is the function of thyroxine (T4) and *triiodothryonine (T3)?	secreted by thyroid control of: metabolic rate; growth; brain development and function
What is the function of calcitonin	secreted by thyroid control of: plasma calcium in some vertebraes (unclear in humans)
True/False: both the ovaries and the testes have high concentrations of the enzyme aromatase required to produce the estrogens estrone and estradiol	False: only the ovaries have high enough concentrations of aromatase
What are the Sertoli cells? Where are they located?	a cell type that is a component of the wall of the seminiferous tubules, the site of sperm production
What stimulates Sertoli cells and what is the result of stimulation?	The sertoli cells are stimulated by FSH to increase spermatogenesis and produce inhibin (which controls FSH secretion)
Where are Leydig cells located? What stimulates them? What do they do once stimulated?	Leydig cells are located in the interstitial space that separates seminiferous tubules in the testes. They are stimulated by LH to produce testosterone
What is the major androgen secreted by the theca cells?	androstenedione
Androgen diffusing from theca to granulosa cells passes through what part of the membrane?	the basement membrane
Describe FSH and LH levels at the beginning of the follicular stage. Why are they like this?	FSH and LH secretion increase because plasma estrogen concentration is low and exerting little negative feedback
Around day 10 of the menstrual cycle, towards the end of the follicular stage, what happens to FSH secretion and plasma FSH levels?	FSH secretion and plasma FSH decrease, causing atresia of nondominant follicles
FSH secretion and plasma FSH concentrations start to decrease towards the end of the follicular stage, but what does increasing plasma estrogen do to these levels?	Increasing plasma estrogen exerts a "positive" feedback on gonadotropin secretion triggering an LH surge
Describe the levels of plasma estrogen and progesterone during pregnancy?	plasma concentrations of estrogen and progesterones continually increase until it reaches till the moment of delivery. At delivery estrogen and progesterone levels drop down to zero very rapidly/instantly
What does estrogen do throughout the pregnancy?	stimulates the growth of the uterine muscle mass, which will eventually supply the contractile force needed to deliver the fetus
what does progesterone do throughout the pregnancy?	inhibits uterine contractility so that they fetus is not expelled prematurely
What are the steps for synthesis of proteins destined for export?	1) proteins destined to be secreted from a cell or to become integral membrane proteins are recognized during the early stages of protein synthesis...for such proteins, the first 15-20 amino acids that emerge from the surface of the ribosome act as a recognition signal, known as the signal sequence or signal peptide 2) The signal sequence binds to a complex of proteins known as a signal recognition particle, which temporarily inhibits further growth of the polypeptide chain on the ribosome 3) The signal recognition particle then binds to a specific membrane protein on the surface of the rough ER 4) this binding restarts the process of protein assembly, the growing polypeptide chain is fed through a protein complex in the ER membrane into the lumen of the ER 5.) upon completion of protein assembly, proteins that are to be secreted end up in the lumen of the rough ER 6) within the lumen, enzymes remove the signal sequence from most proteins, so its not present in final protein as well as other modifications 7) following modifications, portions of the reticulum membrane bud off, forming vesicles that contain the newly synthesized proteins 8) these vesicles migrate to the Golgi apparatus and fuse with membrane 9) within the golgi apparatus, the protein may undergo further modification 10) proteins are then sorted out based on their final destination. This sorting involves binding of regions of a particular protein to specific proteins in the golgi membrane that are destined to form vesicles targeted for specific destinations 11) Following modification and sorting, the proteins are packaged into vesicles that bud off the surface of the Golgi membrane 12) Some of the vesicles travel to the plasma membrane where they fuse with the membrane and release their contents to the extracellular fluid, a process known as exocytosis
The autonomic nervous system controls hormone secretion by what?	by the adrenal medulla and many other endocrine glands
The autonomic nervous system inhibits activity or promotes activity of the adrenal medulla?	promotes activity
Do autonomic nervous system nerves with ganglion in the posterior pituitary and postganglionic axons ending at endocrine gland cells inhibit the activity of endocrine gland cells or does it promote activity?	Autonomic nerves with ganglion in posterior pituitary and postganglionic axons terminating near endocrine gland cells inhibits or promotes activity of the gland
Does secretion of hypothalamic hormones inhibit or promote activity of the posterior pituitary gland?	both...it inhibits and promotes
What is an example of how the direct control of a hormone secretion by the plasma concentration of a substance results in negative feedback control of the substance's plasma concentration aka negative feedback?	Increased plasma [glucose] --> causes insulin secreting cells to increase insulin secretion --> increased plasma insulin concentration --> insulin targets cells and causes increases actions of insulin (transport of glucose from extracellular to intracellular fluid) this lowers plasma glucose concentrations "turning off/lowering" insulin secretion back to normal
What happens if implantation of a developing conceptus does not occur and hCG does not appear in blood? How does this effect progesterone and estrogen levels?	If implantation doesn't occur and hCG does not appear, the corpus luteum dies and progesterone and estrogen levels decrease
What happens because of estrogen and progesterone decreasing a a result of corpus luteum death due to implantation not occurring and lack of hCG?	when the corpus luteum dies, progesterone and estrogen levels decrease...this causes menstruation to occur and the next menstrual cycle to occur
What all occurs to inhibit FSH and LH during luteal phase?	During the luteal phase, the corpus luteum of the ovary secrets inhibin and progesterone/estrogen * The inhibin targets the anterior pituitary and inhibits the secretion of FSH and LH (mainly FSH) * The progesterone and estrogen also target the anterior pituitary to suppress FSH an LH. It also targets the hypothalamus and suppresses secretion of GnRH. The decrease in GnRH, which normally targets the anterior pituitary leads to a decrease in FSH an LH secretion
How does thyroid hormone "permit" EPI-induced release of fatty acids from adipose tissue cells?	by causing an increased number of EPI receptors on the cell
Why is the ability of TH to permit EPI-induced release of fatty acids from adipose by increasing EPI receptors so beneficial?	Because TH alone only releases little to no fatty acids and EPI alone only releases small amounts, but together EPI + TH = large amount of fatty acids released
What are the net cellular effects of thyroid hormone?	a) increase Na/K-ATPases b) increase mitochondria c) increase respiratory enzymes d) increase proteins necessary for growth and development c) increase beta adrenergic receptors (for EPI)
What does the increase in beta adrenergic receptors by thyroid hormone lead to?	leads to: increased HR & increased SV which leads to Increased cardiac output
What is the net whole body effect is the result of an increase in respiratory enzymes by thyroid hormone?	increased o2 consumption
What are net whole body effects of thyroid hormone?	a.) increased cardiac output b) increased ventilation c) increased food intake d) increased mobilization of energy stores
What famous couple both are diagnosed with Grave's Disease?	former president George Bush and Barbara Bush...the odds of both spouses haveing the same autoimmune disease are 1 in 10,000...the chance of this occuring within two years drops to 1 in 3,000,000
What all can cause dwarfism?	deficiency in GH secretion abnormalities in responsiveness to GH (Laron syndrome type 1 and 2) *insensitivity to IGF-1
Most antipsychotic medications block dopamine receptors in lactotrophs (cells that secrete prolactin) What is an undesirable side effect in males related to this axis on this medication?	prolactin targets breasts and causes them to grow and develop and increases milk synthesis dopamine inhibits prolactin secretion from the anterior pituitary gland *so if those dopamine receptors are blocked, then dopamine can't inhibit prolactin and it will continuously signal breasts to develop and create milk...an unwanted side effect in males
what are effects of testosterone in the male?	a) required for initiation and maintenance of spermatogenesis b) decreases GnRH secretion via an action on the hypothalamus c) inhibits LH secretion via a direct action on anterior pituitary d) induces differentiation of male accessory reproductive organs and maintains their function e) induces male secondary sex characteristics, opposes action of estrogen on breast growth f) stimulates protein anabolims, bone growth, and cessation of bone growth g)required for sex drive and may enhance aggressive behavior h) stimulates EPO secretion by kidneys, resulting in higher hematocrit in males
How does testosterone decrease GnRH secretion?	via an action on the hypothalamus
How does testosterone inhibit LH secretion?	via a direct action on anterior pituitary
Spermatogenesis requires what?	both LH via testosterone and FSH
How would a proposed male contraceptive agent work?	possibly block actions of FSH or LH
What is the result of high doses of anabolic steroids?	it has an increased negative feedback on GnRH, LH, and FSH which leads to decreased gonadal hormones, inhibits gamete development, and decreasing size and function of testes
Assume you have no endocrine disorder and you have not eaten anything since noon, yesterday. Right now you are not in a coma due to hypoglycemia because?	gluconeogenesis is occurring in the liver
How long can glucose supply derived from the breakdown of glycogen during fasting state last?	the breakdown of glucagon in the liver can supply glucose for only a few hours
T/F: the nervous system uses glucose for energy during the normal absorptive state only, not the postabsorptive states	FALSE: the nervous system uses glucose for energy during both the normal absorptive and postabsorptive states
T/F: the pancreas is both an exocrine organ and endocrine?	TRUE: exocrine = enzymes and bicarbonate endocrine = insulin, glucagon, and somatostatin
What all targets pancreatic islet beta cells to increase insulin secretion?	a) increased plasma glucose b) increased plasma amino acids c) incretins d) increased parasympathetic activity
What is incretins?	= GIP and glucagon-like peptide-1 target pancreatic islet beta cells to increase insulin secretion
How does insulin increase cellular glucose uptake?	By increasing insertion of GLUT4s in the membrane of heart, liver, adipose tissue, and skeletal muscles increased insertion of GLUT4s --> increased glucose transport from plasma into those tissues
Does insulin increases the rate of glucose transport into skeletal muscle cells require synthesis of new protein or does it use proteins already synthesized?	uses proteins already synthesized
Does histamine increasing H+ secretion into the stomach's lumen require synthesis of new protein or does it use proteins already synthesized?	uses proteins already synthesized
Does 1, 25 dihydroxy vitamin D increasing calcium absorption by intestinal epithelial cells require synthesis of new protein or does it use proteins already synthesized?	requires the synthesis of new protein
Does ADH increasing water resabsorption by renal epithelial cells require synthesis of new protein or does it use proteins already synthesized?	uses proteins already synthesized
Does aldosterone increasing sodium reabsorption by renal epithelial cells require synthesis of new protein or does it use proteins already synthesized?	requires the synthesis of new protein
Does gastrin increasing H+secretion into the stomach's lumen require synthesis of new protein or does it use proteins already synthesized?	uses proteins already synthesized
Does ACh increasing H+ secretion into the stomach's lumen require synthesis of new protein or does it use proteins already synthesized?	uses proteins already synthesized
What situations stimulate the alpha cells of the islet of langerhans to increase glucagon secretion?	a) stress and increased sympathetic activity b) decreased plasma [glucose]
What inhibits the alpha cells of the islet of langerhan from secreting glucagon secretion?	increased plasma glucose
When there is a decrease in plasma glucose how does the pancreas respond? What is the result?	the pancreas islet alpha cells increase glucagon secretion --> increased plasma [glucagon] targets the liver to: increase gluconeogenesis increases glycogenolysis increases ketone synthesis --> increased plasma [glucose] increased plasma [ketones]
Basal concentrations of cortisol are permissive to stimulation of what?	of gluconeogenesis and lipolysis in the postabsorptive state
Increased plasma [cortisol] causes what?	a) increased protein catabolism b) increased gluconeogenesis c) decreased glucose uptake by muscle cels and adipose-tissue cells d) increased triglyceride breakdown
What is the net result of increased cortisol	increased plasma concentration of amino acid, glucose, and free fatty acids
what is syndrome X aka metabolic syndrome	having three or more of the following conditions: a) obesity b) type II diabetes c) elevated triglycerides d) reduced HDLs e) hypertension f) coronary heart disease g) congestive heart failure
Almost the entire blood supply to the anterior pituitary gland come via what?	via the hypothalmo-pituitary portal vessels, which originate in the median eminence
Describe the typical sequential pattern by which a hypophysiotropic hormone controls the secretion of an anterior pituitary gland hormone, which in turn controls the secretion of a hormone by a third endocrine gland	1) stimulus 2) targets hypothalamus to increase secretion of hypophysiotropic hormone (hormone 1) 2) this causes an increase of that hormone 1 in the hypothalamo-pituitary portal vessel 3) targets the anterior pituitary to increase secretion of a hormone (hormone 2) 4) this increases plasma [hormone2] 5) targets third endocrine gland and increases that glands hormone secretion (hormone 3) 6) leads to an increase in plasma [hormone 3] 7) the hormone 3 then targets a cell and causes it to respond
What are the steps for corticotropin releasing hormone(CRH) -adrenocorticotropic hormone (ACTH) - cortisol sequence?	Begins with a neural input which targets the hypothalamus to increase CRH secretion 2) causes an increase in plasma [CRH] in hypothalamo-pituitary portal vessels 3) this targets the anterior pituitary gland to increase ACTH secretion 4) increase in plasma [ACTH] levels 5) targets adrenal cortex to increase cortisol secretion 6) causes increase in plasma [cortisol[ 7) the cortisol targets cells and causes them to respond to the cortisol *at the same time that the increased plasma cortisol is causing target cells to respond the increasing concentration sends negative feedback to the hypothalamus and the anterior pituitary which steps CRH and ACTH secretion and ultimately cortisol secretion decreases
Cortisol exerts a negative feedback control over the CRH-ACTH-cortisol sequence by acting on what?	by acting on: 1) the hypothalamus to inhibit CRH synthesis and secretion 2) the anterior pituitary to inhibit ACTH synthesis and secretion
Neural inputs for the CRH-ACTH-cortisol sequence include what?	those related to stressful stimuli and non-stress inputs such as circadian rhythms
What are the steps in the thyrotropin-releasing hormone (TRH) -thyroid stimulating hormone (TSH) - thyroid hormone (TH) sequence?	1) begins with neural inputs that target the hypothalamus to increase TRH secretion 2) this increases plasma [TRH] within the hypothalamo-pituitary portal vessels 3) targets the anterior pituitary to increase TSH secretion 4) increases plasma [TSH] 5) targets the thyroid to increases thyroid hormone (T3 and T4) secretion 6) this increases plasma [TH] levels 7) targets cells for TH. T4 is converted to T3 and the cells respond to the increased T3 ** at the same time that the increased plasma [TH] levels are stimulating target cells to respond, it is also sending negative feedback to the hypothalamus and the anterior pituitary, ceasing secretion of TRH and TSH and ultimately stoping TH secretion bring plasma [TH] back to normal
How do T4 and T3 exert negative feedback control over the TRH-TSH-TH hormone sequence system?	by targeting 1) the hypothalamus to inhibit TRH secretion 2) the anterior pituitary to inhibit TSH secretion
Various stimuli can increase growth hormone (GH) and insulin like growth factor 1 (IGF-1) levels how?	by: INCREASING GHRH secretion and DECREASING somatostatin levels
Describe the steps leading to secretion of growth hormone (GH) and insulin-like growth factor 1 (IGF-1)?	1) begins with stimuli (exercise, stress, fasting, low plasma glucose, sleep) which targets the hypothalamus to INCREASE GHRH secretion and DECREASE SS secretion 2) this leads to an increase in plasma GHRH and a decrease in plasma SS levels in the hypothalamo-pituitary portal vessels 3) targets the anterior pituitary to increase GH secretion 4) increases plasma [GH] 5) targets liver and other cells to increase secretion of IGF-1 6) increases plasma [IGF-1]
Feedback control of GH and IGF-1 secretion is accomplished how?	Both GH and IGF-1 stimulate SS release which inhibits the anterior pituitary from releasing GH IGF-1 inhibits GH and GHRH which lowers the levels of GH and IGF-1 further
Several hormones, like thyroid hormone, not in the sequence for secretion of GH and IGF-1 influence growth hormone secretion via effects on what?	effects on the hypothalamus and/or pituitary gland
What are the overall effects of increased plasma cortisol concentration during stress?	1) effects organic metabolism 2) enhanced vascular reactivity 3) unidentified protective effects against the damaging influences of stress 4) inhibition of inflammation and specific immune responses 5) inhibition of nonessential function (ie: reproduction and growth)
What are the effects on organic metabolism that increased plasma [cortisol] during stress has?	1) stimulation of protein catabolism in bone, lymph, muscle, and elsewhere (releasing amino acids into blood) 2) stimulation of liver uptake of amino acids and their conversion to glucose (gluconeogenesis) 3) maintenance of plasma glucose levels 4) stimulation of triglyceride catabolism in adipose tissues to release glycerol and fatty acids into the blood
What does it mean that increased plasma cortisol during stress causes enhanced vascular reactivity?	enhanced vascular reactivity means increased ability to maintain vasoconstriction in response to norepinephrine and other stimuli which try to decrease blood pressure
Bone growth is nearly complete by what age? Whereas maximal bone lengthening and reproductive organ size are not reached till what age?	bone growth completion= age 5 bone lengthening completion and reproduction organ size = late teens
What are the actions of the sympathetic nervous system, (including epinephrine secreted by the adrenal medulla) during stress	1) increased hepatic and muscle glycogenolysis (provides quick source of glucose) 2) increased breakdown of adipose tissue TGs (supplies glycerol for gluconeogenesis and fatty acids for energy through oxidation) 3) increased cardiac function 4) diversion of blood from viscera to skeletal muscles by means of vasodilation in skeletal muscles and vasoconstriction in viscera beds 5) increased lung ventilation by stimulating deep breathing centers and dilating airways
How does the sympathetic nervous system diverte blood from viscera to skeletal muscles during stress?	by vasoconstriction of capillary beds in viscera and vasodilation in those in skeletal muscles
What secretes GH? What are the principal actions of growth hormone that influence growth?	secreted by the anterior pituitary principal actions: a) major stimulus of postnatal growth: induces precursor cells to differentiate and secrete IGF-1, which stimulates cell division b) stimulates liver to secrete IGF-1 c) stimulates protein synthesis
How is GH a major stimulus of postnatal growth?	it induces precursor cells to differentiate and secrete IGF-1, which stimulates cell division
What secretes insulin and what are its principal actions that influence growth?	secreted by beta cells of the islets of langheran in the pancreas principal actions: a) stimulates fetal growth b) stimulates postnatal growth by stimulating secretion of IGF-1 c) stimulates protein synthesis
What are the major hormones influencing growth? Do they stimulate growth or inhibit it?	a) growth hormone-stimulate b) insulin-stimulate c) thyroid hormones- stimulate d) testosterone- stimulate e) estrogen)- stimulate f) cortisol - inhibit
What secretes thyroid hormone and what are its principal actions that influence growth?	the thyroid principal actions: a) permissive for growth hormone's secretion and action b) permissive for development of central nervous system
What secretes testosterone and what are its principal actions that influence growth?	secreted by leydig cells of testes principal actions: a) stimulates growth at puberty, in large part by stimulating the secretion of growth hormone b) causes eventual closure of epiphyseal growth plate c) stimulates protein synthesis in males
What secretes estrogen and what are its principal actions that influence growth?	secreted by theca cells of ovaries principal actions: a) stimulates the secretion of growth hormone during puberty b) causes eventual epiphyseal closure
What secretes cortisol and what are its principal actions that influence growth?	secreted by adrenal cortex principal actions: a) inhibits growth b) stimulates protein catabolism
What are major controls of the secretion of prolactin and oxytocin during nursing?	starts with suckling of the infant which stimulates nipple mechanoreceptor stimulation and sends neural input to HYPOTHALAMUS and POSTERIOR PITUITARY * Hypothalamus 1) decrease in dopamine secretion and increase in prolactin-releasing factor 2) this leads to a decrease in plasma [dopamine] and increase in [PRF] in hypothalamo-pituitary portal vessels 3) this targets the anterior pituitary to increase prolactin secretion 4) this leads to an increase in plasma [prolactin] 5) targets the breasts and stimulates gland cells to increase milk synthesis *Posterior Pituitary 1) nipple stimulation targets posterior pituitary to increase oxytocin secretion 2) leads to increase in plasma [oxytocin] 3) targets the breast and causes contraction of myoepithelial cells 4) contraction of said cells leads to milk ejection
How does GnRH, like all other hypothalamic-hypophysiotropic hormones, reach the posterior pituitary?	via the hypothalamo-pituitary portal vessels
What are the steps for general pattern of production control in both males and females/release of sex hormones and response?	1) the hypothalamus secretes gonadotropin-releasing hormone (GnRH) 2) increases plasma [GnRH] in the hypothalamo-pituitary portal vessels 3) targets anterior pituitary to secrete FHS and LH 4) leads to an increase in plasma [FSH] and [LH] 5) targets the gonads to secrete sex hormones (some of which are paracrine/act locally in gametogenesis) 6) causes increase of [sex hormone] 7) targets productive tract and other organs and causes response
Sex hormones normally exhibit negative feedback on the hypothalamus and anterior pituitary to stop GnRH and FSH/LH secretion and ultimately lower sex hormone leves. What situation is this not true in?	sex hormones do not exhibit negative feedback on the anterior pituitary in the middle of menstrual cycles in females, rather a positive feedback which maintains and/or increases secretion of FSH and LH, both of which are essential in the cycle
What local positive feedback occurs within the ovaries?	estrogen increases granulosa cell function, increasing the conversion of androgens to estrogen
How does increased plasma [estrogen] exert negative feedback on the hormonal control of ovarian function during early and middle follicular phase?	1) targets hypothalamus to inhibit/decrease secretion of GnRh 2) targets anterior pituitary to decrease/inhibit secretion of FSH and LH
How does inhibin released by granulosa cells exert negative feedback on the hormonal control of ovarian function in early to middle follicular phase?	targets the anterior pituitary to decrease/inhibit secretion of FSH and LH (mainly secretion of FSH)
What does the dominant follicle secrete large amounts of during the late follicular phase? What does this result in?	secretes large amounts of estrogen, which act on the anterior pituitary gland and possibly the hypothalamus to cause an LH surge
What does the increased plasma [LH] that results from the LH surge in the late follicular phase trigger?	the LH surge triggers both ovulation and formation of corpus luteum
the actions of LH, for example the LH surge, are mediated by what?	granulosa cells
What are the steps that occur to cause the LH surge that occurs in late follicular phase?	1) Begins with the dominant follicle secreting large amount of estrogen, increasing plasma [estrogen] 2) which sends positive feedback to the hypothalamus to increase GnRH secretion and anterior pituitary to increase LH secretion 3) the increase in GnRH stimulates the anterior pituitary to release even more and this coupled with the stimulus from the postive feedback cause a very large amount of LH to be secreted 4) causes a surge of LH in the plasma 5) triggers ovulation and the formation of the corpus luteum, ending the follicular phase and starting the luteul phase 6) the corpus luteum then begins to secrete progesterone and estrogen
What happens to FSH and LH levels if implantation occurs and hCG appears in blood? Why?	if implantation and hCG appear, the corpus luteum continues to live and secretes progesterone and estrogen and inhibin, all three which send negative feedback to the hypothalamus and anterior pituitary to inhibit secretion of FSH and LH
What happens to FSH and LH levels if implantation doesnt occur and hCG doesn't appear in the blood?	the corpus luteum will die and will no longer secrete progesterone, estrogen, and inhibin so LH and FSH levels will increase as a result from being released from the inhibition that negative feedback that was occuring, causes the woman to menstruate and the cycle starts all over again
Describe nutrient metabolism during the absorptive (fed) period.	1) energy is provided primarily by absorbed carbs in a typical meal 2) there is a net uptake of glucose by the liver 3) some carbs are stored as glycogen in liver and muscles, but most carbs and fats in excess of that are stored as triglycerides (fat) in adipose tissue 4) there is some synthesis of body protein, but some of the amino acids in dietary protein are used for energy or converted to fat
Describe nutrient metabolism during the postabsorptive (fasting) period.	1) glycogen, fat, and protein synthesis are curtailed and net breakdown occurs 2) glucose is formed in the liver both from the glycogen stored there and by gluconeogenesis from blood-borne lactate, pyruvate, glycerol, and amino acids. Kidneys also perform gluconeogenesis during prolonged fasting 3) the glucose produced in the liver (and kidneys) is released into the blood, but it's utilization for energy is greatly reduced in muscle and other nonneuronal tissue 4) lipolysis releases adipose-tissue fatty acids into the blood and those and ketones produced in liver serve most of the body's energy supply 5) the brain continues to use up glucose but also starts using ketones as they build up in blood
How does sympathetic activity (plasma EPI) affect insulin?	plasma EPI targets the pancreatic islet beta cells to inhibit insulin secretion
How does insulin decrease the plasma levels of glucose?	insulin binds to its receptor on the plasma membrane and via a signal transduction pathway it stimulates vesicles in the intracellular fluid to fuse with plasma membrane and insert glucose transporters into the membrane. As long as insulin levels are elevated, there will be high numbers of transporters in the membrane bringing glucose in by facilitated diffusion
How are the insulin-stimulated glucose transporters constantly recycled?	by endocytosis from the plasma membrane back through endosomes into vesicles and then the vesicles re-insert them in to the membrae
What happens to the number of glucose transporters if insulin levels decrease?	there will be no signal transduction pathway promoting vesicles to fuse with cell wall, so there will be less transporters inserted into the membrane, and less glucose brought into the cell
What is the effect of increased plasma [insulin] on muscles?	a) increased glucose uptake and utilization b) net glycogen synthesis c) net amino acid uptake d) net protein synthesis
What is the effect of increased plasma [insulin] on adipocytes	a) increased glucose uptake and utilization b) net triglyceride synthesis
What is the effect of increased plasma [insulin] on liver	a) increased glucose uptake b) net glycogen synthesis c) net triglyceride synthesis d) NO ketone synthesis
What is the effect of decreased plasma [insulin] on muscles?	a) decreased glucose uptake and utilization b) net glycogen catabolism c) net protein catabolism d) net amino acid release e) fatty acid uptake and utilization
What is the effect of decreased plasma [insulin] on adipocytes	a) decreased glucose uptake and utilization b) net TG catabolism and release of glycerol and fatty acids
What is the effect of decreased plasma [insulin] on liver	a) increased glucose release due to net glycogen catabolism and gluconeogenesis b) increased ketone synthesis and release
What stimulates glycogenolysis?	a) glucagon b) EPI
What stimulates gluconeogenesis?	a) glucagon b) EPI c) cortisol d) growth hormone
What stimulates lipolysis?	a) EPI b) cortisol c) growth hormone
What inhibits glucose uptake by muscle cells and adipose cells?	a) cortisol b) growth hormone
Where can EPI stimulate glycogenolysis compared to where glucagon can?	EPI can stimulate in both liver and skeletal muscle wheras glucagon only does in the liver
What does the sympathetic nervous system do in response to low plasma glucose concentration (hypoglycemia)?	decreased plasma glucose causes a reflex via glucose receptors in the central nervous system to increase activity of sympathetic nerves to liver and adipose tissue increased sympathetic activity couples with the increased adrenal medulla secretion of EPI = increased sympathetic activity + increased EPI * targets liver to: a) increase glycogenolysis b) increase gluconeogenesis *targets adipose tissue to: a) increase lipolysis + EPI targets skeletal muscles to increase glycogenolysis ALL = increased plasma glucose, fatty acids, glycerol
What does the increased sympathetic nervous activity during low plasma glucose inhibit that further contributes to it increasing plasma glucose, fatty acids, and glycerol?	increased sympathetic activity when plasma glucose is low also helps increase plasma glucose, fatty acids, and glycerol by: inhibiting insulin and stimulating glucagon release, which further contributes to increasing plasma energy sources
What are the effects of cortisol on organic metabolism? What is the net effect?	BASAL CONCENTRATIONS are permissive for stimulation of: a) gluconeogeneis b) lipolysis in the postabsorptive state INCREASED CONCENTRATIONS cause: a) increased protein catabolism b) increased gluconeogenesis c) decreased glucose uptake by muscles and adipose cells d) increased TG breakdown, releasing fatty acids and glycerol NET RESULT: increased plasma concentration of amino acids, fatty acids, and glucose
What all contributes to plasma cholesterol (in lipoproteins)?	1) dietary cholesterol --> GI tract--> plasma cholesterol 2) liver, GI tract and other cells synthesize cholesterol--> plasma cholesterol
Where is plasma cholesterol (in lipoproteins) delivered to?	LIVER: a) secretion into bile b) catabolism into bile salts (stored in gall bladder) and sent back to GI tract VARIOUS CELLS: incorporation into membranes, steroid hormones, etc
Cholesterol synthesis by the liver is up-regulated when?	when dietary cholesterol is reduced and vice versa
What are the steps by which decreased plasma volume leads, via the renin-angiotensin-aldosterone system, to increased Na+ reabsorption by the cortical collecting ducts and hence to decreased Na+ excretion?	1) decreased plasma volume leads to: a) increased activity of renal sympathetic nerves b) decreased arterial pressure (direct effect of less stretch) c) decrease in GFR, which cause decrease in flow to macula densae = decreased NaCl delivery to macula densa 2) all of which target the renal juxtaglomerular cells to increase renin secretion 3) which leads to an increase in plasma [renin] 4) increased renin leads to increased conversion of angiotensinogen to angiotensin II which leads to increased plasma [angiotensin II] 5) angiotensin II targets the adrenal cortex to increase aldosterone secretion 6) increase in plasma [aldosterone] 7) targets cortical collecting ducts and increase Na+ and H20 reabsorption 8) decreases Na+ and H20 excretion 9) increase in plasma volume back towards normal
What is an example of more than one gene being subject to control by a single lipid-hormone receptor?	cortisol, a glucocorticoid hormone, acts via one type of intracellular receptor to activate number genes involved in cellular metabolism and energy balance
What is an example of a binding of a lipid-soluble hormone to its receptor decreasing transcription of gene(s) rather than increasing them?	cortisol inhibits transcription of several genes whose protein products mediate inflammatory responses that occur following injury or infection
What are types of receptors for water-soluble hormones?	receptors that are: a) ligand-gated ion channels b) that function as enzymes, such as receptor tyrosine kinases c) bound to and activate cytoplasmic janus kinases d) G-protein-coupled receptors that activate G proteins, which in turn act upon effector proteins
When a receptor may itself be an enzyme, the enzyme activity is that of a protein kinase, usually tyrosine kinases, What is the one exception to this?	the exception is the receptor that functions as a guanylyl cyclase to generate cyclic GMP
Describe synthesis of catecholamines dopamine, NE, and EPI)	begins with uptake of tyrosine by the cell it is converted to another precursor, L-DOPA by the rate-limiting enzyme in the pathway, tyrosine hydroxylase * depending on the enzyme present in the cell, any one of the three catecholamines will ultimately be made: DOPA + dopa decarboxylase = dopamine dopamine+dopamine beta-hydoxylase = norepinephrine * NE+phenylethanolamine N-methyltransferase = EPI
Catecholamines are broken down in both extracellular fluid and axon terminals by what enzymes?	by enzymes known as monamine oxidase (MAO)
Drugs known as MAO inhibitors do what to the amount of NE and dopamine in a synapse? How?	MAO inhibitors increase the amount of NE and DA in a synapse by slowing down their metabolic degradation
Within the CNS, the cell bodies of catecholamine-releasing neurons lie where?	in the brainstem and hypothalamus
What are the two major classes of receptors for NE and EPI	1) alpha-adrenergic receptors 2) beta-adrenergic receptors
Since catecholamines are water-soluble binding to their receptor uses what to cause response?	binding to receptor leads to use of second messenger to transfer a signal from the surface of cell to cytoplasm
What second messengers to beta-adrenergic receptors use? What is the result?	they use stimulatory G proteins to increase cAMP
What are the two subclasses of alpha-adrenergic receptors? What are their functions?	1) alpha-2: act presynaptically to inhibit NE release 2) alpha-1: act postsynaptically to either stimulate or inhibit activity at different types of K+ channels
What are the most common CNS catecholamines?	dopamine and NE
Where do sympathetic fibers leave the CNS vs. where parasympathetic fibers leave?	SYMPATHETIC: leave from the thoracic and lumbar region of the spinal cord PARA: from the brainstem and sacral portion of spinal cord
In both the parasympathetic and sympathetic division what is the neurotransmitter released between pre- and postgangionic neurons in autonomic ganglia? What type of receptor do postganglionic cells predominantly have?	neurotransmitter = ACh receptor = nicotinic ACh receptor
What is the neurotransmitter normally used between postganglionic neurons and effector cells in the parasympathetic division	ACh
What is the neurotransmitter normally used between postganglionic neurons and effector cells in the sympathetic division	NE
Postganglionic neurons that are recognized as nonadrenergic and noncholinergic use what neurotransmitters? to do what?	use nitric oxide and other neurotransmitters to mediate some form of blood vessel dilation and to regulate various GI, respiratory, urinary, and reproductive functions
A great number of ACh receptors in the autonomic ganglia are what type?	nicotinic receptors
The ACh receptors on smooth muscle, cardiac muscle, and gland cells are what type?	muscarinic
The ACh (cholinergic) receptors on skeletal muscle fibers are not innervated by autonomic neurons but rather what? What type of ACh receptor are they?	they are nicotinic receptors innervated by somatic motor neurons
EPI causes vasodilation of skeletal muscle arterials by binding to what type of receptor?	beta2 adrenergic
EPI causes vasoconstriction of skeletal muscle arterioles when it binds to what type of receptor?	alpha adrenergic
What does angiotensin II do to arterioles?	constricts
What does aldosterone do to arterioles	constricts
What does atrial natriuretic peptide hormone do to arterioles?	it is a potent vasodilator and influence blood pressure by regulating sodium balance and blood volume
What is erythropoietin? What is its function?	a hormone released by the kidneys it is the direct control of RBC production *acts on bone marrow to stimulate proliferation and differentiation of precursors into RBCs
When is EPO secretion increased? When can this occur?	when there is decreased oxygen delivery to kidneys can occur: insufficient pumping of blood by heart lung disease anemia prolonged exercise *exposure to high altitudes
What hormone stimulates the release of EPO and is the reason that males have a higher hematocrit?	testosterone
What is the major factor determining the rate of tubular sodium reabsorption?	the hormone aldosterone
what secretes renin?	juxtaglomerular cells of kidneys
What are the most important effects of angiotensin II?	stimulate the secretion of aldosterone and the constriction of arterioles
What is the rate-limiting factor in angiotensin II formation?	the plasma [renin]
What are the mechanisms through when sodium depletion causes an increase in renin secretion?	1) increase activity of renal sympathetic nerves (reflexively activated via baroreceptors when [sodium] and therefore plasma volume decreases and decrease BP) 2) intrarenal baroreceptors= juxtaglomerular cells are stretched less when BP drops and causes increase in renin secretion 3) macula densa: sense Na concentration in tubular fluid. Decreased [sod.] releases paracrine hormones which target the JG cels and activate them
What causes atrial natriuretic peptide to be released and what steps does it take to increase Na+ excretion?	1) increase in plasma volume 2) causes increased distension in the cardiac artria, which as a result increases secretion of ANP 3) this increases plasma [ADH] which lowers the plasma [adolsterone] 4) the increased AND and decreased aldosterone targets the kidneys to cause the afferent arterioles to dilate and the efferent to constrict, increasing GFR. Also targets the tubules to decrease sodium reabsorption 5) together, the increased GFR and the decreased Na+ reaborption, increases Na+ and H20 secretion, thus lowering plasma volume
What happens when you ingest too much water?	1) increase in H20 leads to decreased body fluid osmolarity (increased H20 concentration) 2) this causes decreased firing of hypothalamic osmoreceptors 3) the decreased firing signals the posterior pituitary to decrease vasopressin secretion 4) decrease in plasma [vasopressin] 5) This targets the collecting ducts of the kidneys and decreases tubular permeability to h20 which decreases water reabsorption 6) increase in water excretion
Regulation of body fluid osmolarity requires separation of water excretion from secretion of what? How is this done?	sodium done by osmoreceptors and vasopressin-dependent water reabsorption without Na+reabsorption
What hormones are involved in response to severe sweating? What do they do?	Aldosterone: increased secretion to decrease sodium excretion to replace salt lost in sweat Vasopressin: increased to decrease water excretion in order to replace water lost
What causes the feeling of thirst? What hormones does this involve?	feel of thirst is stimulated by an increase in plasma osmolarity and a decrease in extracellular fluid volume = vasopressin and angiotensinII/adolsterone
What hormone is involved when increased potassium intake increases plasma [K]?	the increased plasma K stimulates the adrenal cortex to increase aldosterone secretion which targets the cortical collecting ducts to increase K secretion --> increased K excretion in urine lowering plasma K levels
What two situations result in increased aldosterone secretion? What is it's effect?	* decreased plasma volume --> decreased Na+ excretion AND *increased plasma K --> increased K excretion
What type of drug can block the action of aldosterone?	potassium sparing diuretics ie: spironlactone and eplereone
What part of the adrenal gland secretes amine hormones?	adrenal medulla
What part of the adrenal gland secretes steroid hormones?	adrenal cortex
The adrenal medulla is really a modified what?	modified sympathetic ganglion whose cell bodies do not have axons. Instead, they release their secretions into blood which makes it an endocrine gland
Why does the adrenal medulla secrete approx 4x more EPI than NE?	because the adrenal medulla expresses high amounts of an enzyme called phenyl-N-methyltransferase (PNMT) which catalyses the step that converts NE to EPI
Describe the synthesis and secretion of peptide hormones?	1)initially synthesized on the ribosomes of endocrine cells as larger molecules known as prehormones 2) the prehormone is cleaved by proteolytic enzymes into prohormone 3) the prohormone is packed into secretory vesicles by the Golgi. In this process the prohormone is cleaved to yield the active hormone and other peptide chains found in the prohormone
What is the general process for steroid hormone synthesis?	1) The cells are stimulated by the binding of an anterior pituitary gland hormone to it's receptor 2) these receptors are linked to Gs proteins, which activate adenyly cyclase and therefore cAMP production 3) the subsequent activation of protein kinase A results in phosphorylation of numerous cytosolic and membrane proteins 4) the protein kinase A activates the enzyme cholesterol esterase to release free cholesterol rom lipid droplet 5) carrier proteins then transport the free cholesterol to mitochondria 6) once in mitochondria the cholesterol must be transported across the outer membrane to the inner = rate limiting step 7) cytochrome P450 enzymes modify cholesterol and forms intermediates which must be further modified before the final steroid hormone is produced- these modifications occur in both mitochondria and the smooth ER, so intermediates are shuttled back and forth 8) the final product depends upon cell type and the types and amount of the enzymes it expresses 9) the steroid hormone cannot be stored in the cell so they diffuse out into interstitial fluid and from there into circulation as they are synthesized
Briefly production of aldosterone is under the control of what circulating hormones? Binding of it results in the activation of what pathway (which is different from more common cAMP-mediated synthesis of steroid hormones?	under control of angiotensin II which activates inositiol triphosphate second messenger pathway
What are the three zones of the adrenal cortex and what do each secrete?	Top) Zona glomrulosa = aldosterone Middle) Zona fasciculata - cortisol and small amounts of androgens bottom) Zona reticularis = androgens and small amounts of cortisol
What diseases could cause increase in androgen secretion? How would this effect a woman?	If there is an absence of the enzyme that forms cortisol, the cortisol precursors will be made into androgens resulting in increased production * In a woman one result of increased androgen production is masculinization, characterized by excessive body and facial hair, muscle development, deepened voice, other changes
Besides pregnancy, what are some functions that progesterone has been implicated to have?	water and ion balance, regulation of synaptic activity associated with mood, memory, and other brain activities and in immune function
The total concentration in plasma of a hormone is the sum of the free and bound hormones, but what is more biologically important then the concentration of total hormone? Why?	the concentration of free hormone is more biologically important than total concentration. This is because only free hormone can diffuse out of capillaries and encounter its target cell
Why does removal of circulating steroid and thyroid hormones generally take longer than that of water-soluble hormones?	because they circulate bound to a binding protein. This protects the hormone from excretion and metabolism by enzymes as long as they remain bound the to protein
What is an example of a secreted hormone that is relatively inactive until metabolism activates it?	1) testosterone, which is converted to either estradiol or dihydrotestosterone in certain target cells. It is these molecules, rather than testosterone itself, that bind to receptors and elicit response 2) Thryoxine (T4), one of the major thyroid hormones is converted to the more active T3 form upon entering target tissues
In the context of hormones, what is up-regulation versus down regulation?	UP: increase in the number of a hormone's receptors in a cell often resulting from prolonged exposure to a low concentration of the hormone DOWN: a decrease in receptor number often from exposures to high concentrations of that hormone
What is permissiveness?	When one hormone A may induce an increase in the number of receptors for a second hormone B that hormone A must be present (low concentrations) for the full strength of hormone B's effect
What is one reason that thyroid hormone is permissive to EPI causing the release of fatty acids from adipose tissue?	TH stimulates the synthesis of beta-adrenergic receptors for EPI on adipose tissue, resulting in the tissue being much more sensitive to EPI
How can peptide and catecholamine hormones exert both rapid (nongenomic) and delayed (gene transcriptionn) actions on the same target cell?	1) after binding, the change in enzyme activity is usually very rapid and produces changes in the activity of various cellular proteins 2) in some cases, the signal transduction pathway also leads to activation or inhibition of a particular gene(s) causing a changes in the synthesis of that protein
For what steroid hormone do some target cells have, in addition to intracellular receptors, plasma membrane receptors that initiated rapid, nongenomic cell response?	progesterone and estradiol
What is the most common example of a drug whose pharmacological effects are really important?	a very potent synthetic form of cortisol, called prednisone, which is administerd to suppress allergic and inflamm. reactions but has a host of unwanted effects
How is growth hormone linked to sleep?	the secretion of GH increases during the early period of sleep and decreases during the rest of the night and day
What division of the nervous system stimulates secretion of insulin and the gastrointestinal hormones? What division inhibits secretion?	stimulated by parasympathetic and inhibited by sympathetic
What is primary hyposecretion? What are some examples	when an endocrine gland may be secreting too little of a hormone because the gland cannot function normally EX: 1) partial destruction of a gland leading to decreased hormone secretion 2) an enzyme deficiency resulting in decreased synthesis 3) dietary deficiency of iodide, leading to decreased secretion of THs 4) many other causes such as infections and exposure to toxic chemicals
What is secondary hyposecretion?	The endocrine gland is not damaged initially, but is receiving too little of its tropic hormone
How would you diagnose primary hyposecretion by administering the tropic hormone?	the target gland for the tropic hormone is damaged and thus doesn't respond to the administered tropic hormone
How would you diagnose secondary hyposecretion by administering the tropic hormone?	in secondary, the target gland was initally normal, but it atrophied due to lack of tropic hormone stimulation, so it may respond to administered hormone but not normally. This can be fixed with normalization of tropic input
How do you distinguish between primary and secondary hyposecretion?	by measuring plasma levels of the tropic hormone If elevated = primary if lower = secondary
What is one fo the most common causes of primary or secondary hypersecretion?	the presence of a homrone-secreting endocrine-cell tumor. These tumors tend to produce hormones at higher rates, even in the absence of stimulation or in the presence of negative feedback attempting to turn it off
How do you diagnosis primary vs secondary hypersecretion?	you measure the concentration of hormone and of the tropic hormone Both are elevated = secondary decreased concentration of tropic = primary (because of negative feedback from the high concentration of hypersecreted hormone)
What are causes for hyporesponsiveness	1) deficiency of receptors or abnormal receptor 2) an event that occurs after binding may be defective 3) deficiency of enzymes that catalyze the activation of hormones that are inactive till metabolized
What is an example of a hyporesponsiveness that effects males caused by absence of receptor?	some individuals who are genetically male have a defect manifested by the absence of receptors for androgens. The result is a lack of development of male characteristics
What enzyme converts T4 to T3 at target cells?	deiodinases
What is the enzyme responsible for oxidizing iodides and attaching them to thyroglobulin in the colloid?	thyroid peroxidase
What characteristic of the thyroid gland makes it unique among endocrine glands?	its storing capacity: the fact that there is sufficient iodinated thyroglobulin stored within follicles of the thyroid to provide thyroid hormone for several weeks even in absence of dietary iodide
why is it not surprising that the symptom of excress TH concentration closely resembles some of the symptoms of excess EPI or NE (sympathetic nervous system activity?	because many of the actions of TH are attributed to their permissive effects on catecholamines...TH up regulates beta-adrenergic receptors in many tissues, notably the heart and nervous system and this potentiates the effects of the catecholamines even though they are within normal levels
Because of the potentiating effect on catecholamines that TH have, people with hyperthyroidism are often treated with drugs that do what?	block beta adrenergic receptors to alleviate the anxiety, nervousness, and "racing heart" associated with excessive sympathetic activity
What are the roles of T3/T4 in fetal development?	growth development of nervous system (including formation of axon terminals, production of synapse, growth of dendrites and dendritic extensions, formation of myelin)
What is cogenital hypothyroidism (cretinism)?	absence of T3/T4 during fetal life characterized by poor developed nervous system and severely compromised intellectual functions
Why can a sypmtom of hypothyroidism be decreased mental function/concentration?	hypothesized to have to do with decreased cererbral blood flow due to decrease in pumping activity in heart..remember that TH is permissive to catecholamine function and it is these hormones that are responsible in part for maintaing cardiovascular function
What is myxedema?	in severe untreated hypothyroidism, certain hydrophilic polymers called glycosaminoglycans can accumulte in interstitial space in scattered regions of the body and water tends to be trapped within them, this results in characteristic puffiness of face and other regions = myxedema
what is the most common form of hyperthryroidism?	Grave's disease- an autoimmune disease which is characterized by overstimulation of the growth and activity of the thyroid gland
What are symptoms of hyperthyroidism?	1) heat intolerance 2) weight loss, 3) increased appetite 4) signs of increased sympathetic activity like anxiety, tremors, jumpiness, increased HR
What are symptoms of hypothyroidism/	a) cold intolerance b) weight gain c) fatigue d) change in skin tone, hair, appetite, GI function, and mental function e) goiter
What can a low plasma [calcium] do to you vs. the effects of high plasma [calcium?	LOW:increases the excitability of neuronal and muscle plasma membranes HIGH: causes cardiac arrhythmias and depresses neuromuscular activity via its effects on membrane potential
What hormones favor bone formation and increased bone mass?	a) insulin b) growth hormone c) IGF-1 d) estrogen e) testosterone f) calcitonin
What hormones favor bone resorption and decreased bone mass?	a) parathyroid hormone b) cortisol c) thyroid hormones
Describe resabsorption in the kidneys when plasma [calcium] increases? When it decreases?	reabsorption decreases when plasma levels of calcium increase and it increases when plasma levels decrease
The hormonal controllers of calcium levels also regulate the balance of what ion?	phosphate
What are the two major controllers of calcium concentrations?	a) parathyroid hormone b) 1, 25 dihydroxyvitamin D
How all does parathyroid hormone increase extracellular calcium concentrations?	1) directly increases the resorption of bone by osteoclasts,w hich causes calcium (and phosphate) ions to move from bone to blood 2) directly stimulates formation of 1, 25dihydroxyvitamin D, which then increases intestinal absorption of calcium (and phosphate) ions. Thus the effect of PTH on the GI tract is indirect 3) directly increases calcium reabsorption in kidneys (decreasing excretion in urine) 4) directly reduces the reabsorption of phosphate ions, thereby raising its urinary excretion
WHat is the major event of vitamin D deficiency?	decreased dietary calcium absorption and thus decreased plasma concentrations
What stimulates calcitonin secretion? How does calcitonin decrease plasma calcium?	stimulated by increased plasma [Ca] by inhibiting osteoclasts, thereby reducing bone resorption
What is rickets and osteomalacia? what does it result from?	conditions in whcih the mineralization of bone matrix is deficient causing bones to be soft and easily fractured major cause is vitamin D deficiency
What is osteoporosis? When does it occur?	both matrix and minerals are lost as a result of an imbalance between bone resorption and bone formation. Results in decrease of bone strength and mass Occurs in people: a) who are immobilized b) who have excessive plasma concentrations of a hormone that favors bone resorption (PTH, cortisol, THs) c) who have deficient plasma concentrations of hormones favoring bone formation (insulin, GH, IGF-1, estrogen, testosterone, calcitonin)
What can lead to osteoporosis in menopausal women?	loss/decrease of estrogen production (a hormone that favors bone formation)
What substances can be used as therapy for osteoporosis?	a) drugs called bisphosphonates, that interfere with the resorption of bones by osteoclasts b) calcitonin c) selective estrogen receptor modulators (SERMs) act by interacting with estrogen receptors, thereby compensating for the low estrogen after menopause
what drug is used to treat osteoporosis in menopausal women	selective estrogen receptor modulators (SERMs) act by interacting with estrogen receptors, thereby compensating for the low estrogen after menopause
What is a common cause of hypercalcemia	primary hyperparathyroidism
what causes primary hyperparathyroidism?	bengin tumor (adenoma) of one of the 4 glands. these tumors are composed fo abnormal cells that arent adequately suppressed by extracelluar Ca and they secrete PTH in excess, leading to increase in Ca resorption from bone, increased kidney resorption, and increased production of 1, 25(oh)2 vit. D
What is humoral hypercalcemia of malignancy?	caused by certain types of cancer (ie breast cancer) the release of a molecule that is chemically similar to PTH called PTHrp, and causes similar effects of PTH however, authentic PTH release is decreased due to the hypercalcemia caused by PTHrp
What can cause hypercalcemia without raising PTH levels?	excessive ingestion of vitamin D
What are symptoms of hypercalcemia	primarily from its effect on excitable tissues= tiredness, lethargy with muscle weakness, nausea and vomiting
What can cause hypocalcemia?	a) primary hypoparathyroidism b) pseudohypoparathyroidism c) secondary parathyroidism
What causes primary hypoparathyroidism	1) removal of parathryoid, many times on accident because PTH is low, 1 25 (OH)2 vit D is also decreased = decrease in bone resorption, kidney, and GI tract absorption
what causes secondary parathryoidism	failure to absorb vitamin D decreased kidney 1, 25(OH)2 vit D production
what causes pseudoparathyroidism?	resistance to the effects of PTH in tissues even though PTH levels tend to be elevated
symptoms of hypoglycemia?	*increases excitability of nerves and muscles, which leads to CNS effects (seizures), muscle spasms (hypocalcemia tetany), and nueronal excitability
What does long term treatment of hypothryoidism involve?	a) calcium salts and calcitriol b) poor absorption is treated with supplemental dietary calcium and high does of vitamin D c) injections of vitamin D
In an experiment, the sympathetic preganglionic fibers to the adrenal medulla are cut. What happens to the to the plasma concentration of EPI at resut and during stress?	sympathetic innervation is the only innervation/major control to the adrenal medulla, so if fibers are cut, stimulation wont occur This causes EPI, at rest, to fall to very low levels and fail to rise during stress
What is the advantage of packaging peptide hormones in secretory vesicles?	storage of large amounts of hormone allows for an increase in plasma levels of that hormone within seconds of stimulation packaging also protects from intracellular degradation * modifications occur in to the hormone during packaging, cleaving it into the active protein and also peptide fragments. So when the vesicle is released both the hormone and the fragments are released and allows one cell to possibly have multiple effects
Why are steroid hormones not packaged in vesicles like peptide hormones?	because they have a lipophilic nature which allows them to diffuse across the lipid bilayer without the aide of vesicle exocytosis. Once it is synthesized it immediately leaves the cell

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ENDOCRINE PHYSIOLOGY

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