Metabolic & Endocrine: Ch. 10

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Terms in this set (123)
thyroid & adrenalsTwo glands that pituitary communicates withAnterior pituitaryWhere following hormones are produced: ACTH, LH, FSH, TSH, GH, ProlactinThyroid GlandStructure whose function is to concentrate iodine to product T4 & T3 and/or produce calcitonin to suppress bone resorptionBrainThyroid hormone is most important in early embryonic growth for normal maturation of what structure?ThyroidWhere the following hormones are produced: Thyroxine & Triiodythronine, calcitoninParathyroid glandsStructures that help with vitamin D feedback loops (regulate calcium levels)DIOSubstance that lives in placenta & brain; protectiveChoroid PlexusThyroid hormone is critical to development of what part of the brain?Maternal HypothyroidismResults in insufficient transfer of thyroid hormone to fetus, who is dependent upon these hormones during developmentMaternal HypothyroidismMother: High TSH, low T4 & free T4H-P-T axisThis axis is functional by 26wks of gestationTransient hypothyroxinemia of prematurityNeonatal thyroid disease; immature H-P-T axis, results in less surge of TSH after birth compared to term, leads to reduced production of thyroid hormone over first week of lifeTransient Hypothyroxinemia of PrematurityNewborn screen: normal TSH, low T4; Repeat: Normal TSH, low T4, low free T4TBG deficiencyNeonatal Thyroid disease; immature H-P-T axis; X-linked (dominant), affects males > femalesTBG deficiencyNeonatal Thyroid disease; Deficient amount of transport protein leads to normal levels of active (free) T4 but low bound T4 serumTBG deficiencyNewborn screen: Normal TSH, low T4; Repeat: Normal TSH, Normal free T4, low T4, low TBGTBG deficiencyNeonatal thyroid disease; decrease in binding globulin, free unbound T4 levels will increase which inhibits pituitary from secreting more TSHTBG deficiencyNeonatal Thyroid disease; Not enough binding globulins to T4 cant bind to get to target tissuesCongenital HypothyroidismNeonatal Thyroid disease; deficient amount of transport protein leads to normal levels of active (free) T4 but low unbound T4 in serumCongenital HypothyroidismNewborn screen: Normal or high TSH, low T4; repeat: high TSH, low free T4, low T4, normal TBGCalcium Paraythyroid-Vitamin D AxisFeedback loop whose purpose is to normalize the abnormal serum calcium levelsCalcium Parathyroid-vitamin D axisFeedback loop; involves activity in bone, kidneys, GI tract, & thyroidOsteopeniaWhen bone is busted up to release calcium into blood when it's low; can get normal blood levels at expense of bone breakdownCalcitriolActive form of Vitamin D; increases GI absorption of calcium; protects/promotes bone growthCalcitoninHigh calcium causes thyroid production of what?CalcitriolLow calcium causes production of what?CalcitoninActivates osteoblasts; activates formation of bone tissue "bone ossification"; transfer of calcium from bloodstream into bone tissuesHypercalcemiaDevelops when there is increased bone resorption, excess intestinal absorption of calcium, or decreased renal losses of calciumIonized calciumActive calcium not bound to albuminSerum calciumMade up of 60% ionized form & 40% albumin bound formAcidosisAcid/base balance; blocks binding of calcium to albumin (increased ionized levels)AlkalosisAcid/base balance; encourages binding (decreased ionized levels)Proximal TubuleWhere is vitamin D hydroxylated?CalcitriolWhat is vitamin D converted to?PTHHormone; increase calcium release from bones, increase calcium uptake in intestines, increase calcium reabsorption in urine, increase phosphorus excretion in urineCalcitonindecreases calcium deposition in bones; decreases calcium reabsorption in kidneys; Decrease calcium uptake in intestinesPTHHormone that produces vitamin DCalcitoninhormone that reduces calcium blood levelsPancreasWhere insulin & glucagon are secretedHypothalamusAlmond-shaped & sized gland; one of the most powerful control centers within human bodyPituitary glandPea-sized structure, located below hypothalamus at base of skullAdrenal GlandTwo wedge-shaped glands; fight or flight glands; sit within retroperitoneal cavity atop kidneys & comprise a larger outer cortex & smaller inner medullaH-P-AAxis comprised of paraventricular nucleus of hypothalamus, anterior pituitary, & adrenal cortexH-P-AAxis that is activated in response to a stressor; systematic, complex cascade of hormonal communications follows, which regulates synthesis & secretion of adrenal hormones in an attempt to restore physiologic equilibriumthyroid glandOne of largest endocrine glands, butterfly-shaped glandthyroid glandGland that is situated inferior to larynx & just below thyroid & cricoid cartilage, attached to ventral floor of pharynx by way of thyroglossal ductH-P-TT4 & T3 are an integral part of this axisH-P-TAxis activated when feedback loop notifies hypothalamus & pituitary of low circulating T4 & T3 levelsH-P-TFeedback loop in which hypothalamus responds to hypothermia with secretion of TRHDopamine, epinephrine, cortisolDopamine, epinephrine, cortisolWhat is the hypothalamus sensitive to with activation of HPT axiscalcium-parathyroid-vitamin DAxis that is responsible for regulating bone resorption, distal renal tubular calcium reabsorption, & 1, 25-(OH)2D-mediated intestinal calcium absorptioncalcium-sensing receptorDuring periods of hypercalcemia, this protein is activated and stimulates CT secretion from thyroid gland, which increases calcium deposition in bones, decreasing intestinal uptake, & decreasing renal calcium reabsorption in distal convoluted tubulecalcium-parathyroid-vitamin DNegative feedback loops that inhibits PTH secretion & increases renal calcium excretionPancreasFlat gland composed of clusters of exocrine cellsPineal Glandsmall, red-gray-colored pinecone shaped organ; located distal to third cerebral ventricle & composed of pineal & neurolglial cellsCalciumMost abundant ion in human bodyionized; bound to albumin & globulins; bound to bicarbonate, phosphate or citrateThree distinct forms total body calcium back be found after birthCalcitoninworks to prevent hypercalcemic states by inhibiting calcium (and phosphorus) release from bone as well as facilitating renal excretion of calciumPTHPromotes calcium resorption in bone & renal system & within intestine by way of facilitating 1,25-(OH)2D-mediated intestinal absorption of calciumVitamin DStimulates absorption of calcium (and phosphorus) from bone, intestine, and kidneyPhosphorusSecond most abundant mineral in the human bodyionized; bound to albumin; bound to sodium, calcium, or magnesiumThree forms in which phosphorus existsMagnesiumAbundant intracellular cation whose serum concentrations influence calcium homeostasisionized; bound to albumin; bound to bicarbonate, phosphate, or citrateThree forms in which magnesium existsGlycogenesisSynthesis of glycogenGlycogenolysisBreakdown of glycogen into glucoseGlycolysisBreakdown of glucose into pyruvateGluconeogenesisSynthesis of non-carbohydrate sources (pyruvate, lactate, amino acids) into glucoseGlycogenesisBiosynthesis of sugar into glycogen storage of later use; occurs immediately after carbohydrate ingestioninsulin, glucagon, epinephrineThree hormones that modulate process of glycogenesis & glycogenolysisGlycogenolysisInvolves breakdown of glycogen stores into glucose-1-phophate (muscle cells) & glucose (hepatocytes)GlycolysisInvolves extraction of energy from glucose; to accomplish this, circulating glucose molecules are oxidized, split into two equal parts, and covered into pyruvateGluconeogenesisMetabolic process that results in synthesis of glucose & glycogen from noncarbohydrate sources, including lactate, glycerol, pyruvate, & amino acidsCalciumMost abundant ion in human bodyParathyroid glandssmall, yellow-brown-colored glands; control calcium levels in body through secretion of PTHTransiet Neonatal HypoglycemiaType of neonatal hypoglycemia whose risk factors include: preterm & IUGR, IDM, GDM, perinatal stressorsPersistent Neonatal HypoglycemiaType of neonatal hypoglycemia whose risk factors include: hyperinsulinism, hormone regulation deficiency, inborn errors of metabolismCarbohydrateInfant's primary source for fuel through breast milk, commercial formulas or comboGlucosePrimary fuel for brainPhenylketonuriaAutosomal recessive genetic disorder; enzyme deficiency caused by mutations in hepatic enzyme phenylalinine hydroxylase (PAH)PhenylalanineEssential amino acid normally metabolized by PAH enzyme within liver to tyrosineTyrosineEssential amino acid, instrumental in production of hormones, including thyroid hormones, epinephrine, norepinephrineGalactosemiaAutosomal recessive disorder; caused by mutations in GALT, GALK1, GALE genesGalactosemiaAbnormally elevated levels of galactose; results from deficiency of enzymes needed to metabolize simple sugar, galactoseGalactoseFound within lactose, a milk carbohydrateLactoseNormally broken down into galactose & glucose by way of lactase enzymeMaple syrup urine diseaseAutosomal recessive; error of branched-chain amino acid catabolism, caused by mutations in BCKDHA, BCKDHB & DBT genesThyroid dysgenesisMost common type of congenital hypothyroidism; involves absence, hypoplastic development, or abnormal positioning of glandCushing syndromeMaternal adrenal abnormality; Hypercortisolemia: weight gain, fatigue, glucose intolerance, hypertensionConn SyndromeMaternal adrenal abnormality; Hypokalemia, hypertension, proteinuria, placental abruption, preterm deliveryadrenal insufficiencyMaternal adrenal disorder; N&V, weight loss, hyperpigmentation, weakness, hyponatremia, hypoglycemiaCongenital adrenal hyperplasiaMaternal adrenal disorder; Virilization, salt wasting, adult hirsutism, menstrual irregularity, subfertility, PIH, GDMPheochromocytomaMaternal adrenal disorder; Hypertension, placental insufficiency, placental abruptionHyperparathyroidismMaternal Parathyroid disorder; causing Hypertension, preeclampsia, maternal mortality secondary to pancreatitis, maternal & fetal mortality secondary to hypercalcemic crisisProlactinomaMaternal pituitary disorder; causing reduced GRH, infertility; maternal visual diturbancesAcromegalyMaternal pituitary disorder; causing PIH, GDMPituitary insufficiencyMaternal pituitary disorder; causing miscarriage, GDMLymphocytic hypophysitisMaternal pituitary disorder; causing ACTH deficiencyDiabetes insipidusMaternal pituitary disorder; causing worsening symptoms secondary to increased placental production of vasopressinHypothyroidismMaternal thyroid disorder; causing lethargy, weight gain, constipation, cold intolerance, bradycardia, amenorrhea, infertility, miscarriage, anemia, preeclamspia, LBW infantHyperthyroidismMaternal thyroid disorder; Causing infertility, miscarriage, preterm delivery, fetal growth restriction, fetal hyperthyroidism, goiterSIADHMost frequent cause of hyponatremia; involves inappropriate secretion of ADH in presence of euvolemiaADHAlso known as vasopressin; polypeptide hormone produced by hypothalamus & stored in & released from posterior pituitary glandadrenal insufficiencyCan be an inherited steroidogenesis defect (congenital adrenal hyperplasia or congenital adrenal hypoplasia); result of an injury to hypothalamus or pituitary gland during fetal development (central adrenal insufficiency aka ACTH or CRH deficiency); result of a hemorrhage within adrenal gland, hypothalamus, or pituitary; or acquired insufficiencyOsteopenia of prematurityAcquired metabolic bone disease characterized by deficient bone mineralization & subsequent loss of bone massHypothalamusIt's endocrine function is to secrete hormones that either "turn on" or "turn off" feedback loops; these stimulating or inhibiting hormones get to pituitary through hypothalamic-hypophyseal portal venous systemHypothalamusThe non endocrine functions of this structure are thermoregulation & autonomic functionPituitary GlandStructure that receives stimulating or inhibiting hormones secreted by hypothalamusPituitary glandif stimulating hormone Is received, this structure secretes its own stimulating hormone, to advance the feedback loopPituitary glandIf inhibiting hormone is received, this structure stops secreting a stimulating hormone, which slows and then stops feedback loopRelative adrenal insufficiencyInadequate production of glucocorticoids in response to stress (infection or surgery)ACTH stimulation testTest used to confirm adrenal insufficiency