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203 Cards in this Set
- Front
- Back
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Describe paracrine action
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A HORMONE DIFFUSES FROM ONE CELL THEN ACTS ON A NEARBY CELL
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Describe endocrine action
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A HORMONE IS RELEASED INTO THE BLOOD THEN ACTS ON DISTANT CELLS
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Describe autocrine action
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A HORMONE ACTS ON THE SAME CELL THAT RELEASED IT
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Exogenous hormone therapy (i.e. synthetic thyroid hormone) is utilized frequently in medical practice. List 2 patient factors that must be taken into account when prescribing exogenous hormone therapy:
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KIDNEY FUNCTION
LIVER FUNCTION |
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What is the solubility characteristic of thyroid hormones and steroid hormones?
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THEY ARE LIPID-SOLUBLE
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How are water-soluble hormones transported in the blood?
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IN THEIR FREE, UNBOUND STATE
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How are lipid-soluble hormones transported in the blood?
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ATTACHED TO A CARRIER PROTEIN
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Briefly explain why receptors for lipid-soluble hormones are located inside target cells
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THESE HORMONES EASILY DIFFUSE THROUGH THE LIPID BI-LAYER OF TARGET CELL MEMBRANES SO THEY ARE ABLE TO REACH INTRACELLULAR RECEPTORS
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Briefly explain why receptors for water-soluble hormones are located within the plasma membrane of target cells:
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WATER-SOLUBLE HORMONES CANNOT EASILY DIFFUSE THROUGH THE PLASMA MEMBRANE OF TARGET CELLS. THE RECEPTOR HAS TO BE EXPOSED ON THE CELL SURFACE IN ORDER FOR THE HORMONE TO BIND TO IT.
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What is the major determinant of the extent/amplitude of hormone action on target cells?
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THE NUMBER (OR CONCENTRATION) OF AVAILABLE RECEPTORS
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The number of hormone receptors on target cells increases when the plasma concentration of a hormone decreases. This is known as
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UP-REGULATION.
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What is a first messenger?
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A WATER-SOLUBLE HORMONE BOUND TO A SURFACE RECEPTOR ON A TARGET CELL
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What is/are the function(s) of second messengers?
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SECOND MESSENGERS ARE CONSIDERED TO BE INTRACELLULAR MEDIATORS OF A HORMONE’S ACTION ON TARGET CELLS
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Which hormone class utilizes second messengers?
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WATER-SOLUBLE
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Name the most common second messenger
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CYCLIC AMP
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Phosphorylated enzymes regulate 4 target cell activities. List them:
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- REGULATE INTRACELLULAR ENZYMES
- REGULATE PROTEIN SYNTHESIS - REGULATE CELL SECRETIONS - REGULATE CELL MEMBRANE PERMEABILITY TO OTHER SUBSTANCES |
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In the negative feedback loop Activating hormones are secreted in response to a HIGH / LOW plasma concentration of a circulating hormone (the circulating hormone exerts effects at target cells).
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LOW
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`
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`
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In the negative feedback loop An increased plasma concentration of a circulating hormone exerts effects on hormone receptors located on the hypothalamus and pituitary gland. What effect does this have on synthesis and secretion of activating hormones?
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DECREASES
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`
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`
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In the negative feedback loop A gradually decreasing plasma concentration of circulating hormone with time (as it is utilized by target cells) eventually increases / decreases secretion of activating hormones by the hypothalamus and pituitary gland.
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INCREASES
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Briefly describe positive feedback
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the response to a secreted hormone (increased concentration in the blood) feeds back to the releasing organ causing continued or increased secretion of the hormone
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List 2 other mechanisms for regulating/controlling hormone secretion:
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NEURAL CONTROL
CHEMICAL CONTROL |
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Name the endocrine organ that is the major link between the nervous system and endocrine system:
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HYPOTHALAMUS
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HYPOTHALAMUS regulates growth, development, metabolism, and overall body homeostasis by working with another endocrine organ. Name it
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PITUITARY GLAND
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List the 5 releasing hormones:
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GHRH:
TRH: PRH: CRH: GnRH: |
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Hypothalamus releasing hormones stimulate synthesis and release of hormones from which endocrine organ
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ANTERIOR PITUITARY GLAND
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List the 2 inhibiting hormones:
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GHIH:
PIH: |
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What is another name for prolactin-inhibiting hormone?
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DOPAMINE
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List 2 hormones synthesized in the hypothalamus and stored for later release from the posterior pituitary gland:
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ADH: ANTI-DIURETIC HORMONE
OXYTOCIN |
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Supraoptic nuclei synthesize ______hormone, and paraventricular nuclei synthesize______________
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ANTI-DIURETIC
OXYTOCIN |
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What is the stimulus for release of ADH and oxytocin?
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A NEUROENDOCRINE REFLEX
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The pituitary gland is connected to the underside of the hypothalamus by what structure?
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INFUNDIBULUM
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What is another name for the anterior pituitary gland?
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ADENOHYPOPHYSIS
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The 5 hormones synthesized and released by the anterior pituitary gland are known as __________hormones.
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TROPHIC
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Briefly describe how anterior pituitary gland hormones"TROPHIC" enter the general blood circulation
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trophic hormones are released from anterior pituitary cells then they diffuse into the nearby secondary capillary plexus. the blood flow carries the hormones through the anterior hypophyseal veins into the general circulation.
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List the 5 hormones synthesized by the anterior pituitary gland and the specific cell type involved:
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HGH: somatotrophs
Prolactin: lactotrophs ACTH: corticotrophs TSH : thyrotrophs FSH and LH: gonadotrophs |
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Most metabolic effects of human growth hormone (hGH) are mediated by what substance(s)?
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INSULIN-LIKE GROWTH FACTORS (IGFs)
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List locations where INSULIN-LIKE GROWTH FACTORS (IGFs) are produced
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LIVER
BONE MUSCLE CARTILAGE |
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What effect does hGH have on the plasma concentration of proteins?
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INCREASES
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What effect does hGH have on the plasma concentration of glucose?
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INCREASES
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What is the major regulator of hGH secretion?
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THE PLASMA GLUCOSE CONCENTRATION
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When the plasma concentration GLUCOSE is low, what effect does this have on secretion of growth-hormone inhibiting hormone (GHIH) and growth-hormone releasing hormone (GHRH)?
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GHIH: DECREASES
GHRH: INCREASES |
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when GHIH: decreased and GHRH: increases, these effects combine to DECREASE / INCREASE hGH secretion.
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INCREASE
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What effect(s) does stress and strenuous exercise have on hGH secretion?
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IT INCREASES
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What effect do cortisol, insulin, glucagon, and estrogen secretion have on hGH secretion
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IT INCREASES
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What is the most common etiology of pathologic hypersecretion of hGH?
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A BENIGN PITUITARY ADENOMA
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Name the disease caused by hGH hypersecretion in adults:
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ACROMEGALY
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Name the disease caused by hGH hypersecretion in children
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GIANTISM
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Chronically-elevated plasma hGH exerts an adverse effect on pancreatic beta cells. What is this effect? What is the name for this effect?
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BETA CELLS EVENTUALLY CEASE RELEASE OF INSULIN. THIS IS KNOWN AS PITUITARY DIABETES.
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hGH hyposecretion in childhood causes what disorder?
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DWARFISM
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What is/are the primary function(s) of adrenocorticotrophic hormone (ACTH)?
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REGULATES SECRETION OF CORTISOL AND OTHER ADRENOCORTICOIDS FROM THE ADRENAL CORTEX
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What is/are the primary function(s) of prolactin?
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INITIATES MILK SYNTHESIS AND SECRETION
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Name the 2 hormones secreted by the hypothalamus that affect prolactin secretion:
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PRH
PIH (DOPAMINE) |
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Briefly describe how nursing affects dopamine and prolactin secretion:
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DOPAMINE SECRETION DECEASES
PROLACTIN SECRETION INCREASES |
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What is the most common cause of prolactin hypersecretion?
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A BENIGN PITUITARY ADENOMA (COMMONLY KNOWN AS A PROLACTINOMA)
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You should consider a benign pituitary adenoma AKA prolactinoma a diagnosis in what type of patient (specific):
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A NON-PREGNANT, NON-LACTATING FEMALE
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Follicle-stimulating hormone (FSH) and luteinizing hormone (LH) secretion is stimulated by what hormone?
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DECREASED CIRCULATING TESTOSTERONE AND ESTROGEN
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What is another name for the posterior pituitary gland?
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NEUROHYPOPHYSIS
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The posterior pituitary gland is composed primarily of what type of tissue (be specific)?
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AXONS AND AXON TERMINALS (NERVE TISSUE)
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The quantity of ADH secreted by the posterior pituitary gland is in response to what two factors involving the blood circulation?
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BLOOD OSMOTIC PRESSURE (PLASMA OSMOLARITY)
BLOOD VOLUME |
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List the 3 tissues that have receptors for ADH and describe the action of ADH at each of these tissues:
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- kidneys: increases water reabsorption by renal tubules
- sweat glands: decreases sweating - vascular smooth muscle: causes vasoconstriction (especially during a significant hemorrhage) |
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Release of atrial natriuretic peptide (ANP) has what effect on ADH secretion?
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IT DECREASES
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Diabetes insipidus is a disease process caused by insufficient ADH action on target tissues. List 2 ways this can occur:
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- INSUFFICIENT RELEASE OF ADH FROM THE POSTERIOR PITUITARY
- ADH RECEPTOR DEFECT AT THE KIDNEY TUBULES |
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What is the most common cause of neurogenic diabetes insipidus?
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HEAD TRAUMA
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What are the 2 primary symptoms associated with diabetes insipidus?
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POLYURIA
POLYDIPSIA |
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List 2 primary functions of oxytocin:
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STIMULATES MILK EJECTION FROM THE BREASTS
STIMULATES UTERINE CONTRACTIONS DURING LABOR |
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Calcitonin (a hormone) is secreted by the thyroid gland. Name the cell type involved
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PARAFOLLICULAR
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Briefly describe the anatomy of thyroid follicles:
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MICROSCOPIC SPHERICAL SACS SURROUNDED BY FOLLICULAR CELLS
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The lumen of thyroid follicles contains what substance?
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COLLOID
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What is the primary protein contained in COLLOID
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THYROGLOBULIN
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List the 2 hormones synthesized by thyroid follicles:
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THYROXINE (T4)
TRIIODOTHYRONINE (T3) |
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Which thyroid hormone is secreted in the greatest quantity?
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T4
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Thyroid hormone synthesis requires an adequate amount of a specific dietary substance in the blood. Name it:
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IODINE
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Name the amino acid within this protein structure that is important in thyroid hormone synthesis
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TYROSINE
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1 iodine + 1 tyrosine =
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MONOIODOTYROSINE (MIT)
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2 iodines + 1 tyrosine =
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DIIODOTYROSINE (DIT)
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Thyroxine =
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NO MIT + 2 DIT
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Triiodothyronine =
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1 MIT + 1 DIT
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Once the 2 thyroid hormones are synthesized they remain attached to what substance within the colloid?
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THYROGLOBULIN
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Name the hormone that stimulates secretion of T3 and T4 from thyroid follicles:
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THYROID-STIMULATING HORMONE (TSH)
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In what state are T3 and T4 released into the blood?
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FREE (UNBOUND)
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More than 99% of the T3 and T4 released into the blood are immediately bound to a carrier/transport protein. Name it:
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THYROXINE-BINDING GLOBULIN
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In the hypothalamic-pituitary-thyroid axis and negative feedback control of thyroid hormone secretion: Name the 2 activating hormones that regulate secretion of T3 and T4 from the thyroid gland:
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Thyrotropin-releasing hormone
Thyroid-stimulating hormone |
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In the hypothalamic-pituitary-thyroid axis and negative feedback control of thyroid hormone secretion: Increased concentration of circulating T3 and T4 affect secretion of the activating hormones. In what way(s)?
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SECRETION OF BOTH TRH AND TSH DECREASES
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`
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In the hypothalamic-pituitary-thyroid axis and negative feedback control of thyroid hormone secretion:A disease process involves the thyroid gland directly (a primary thyroid disorder) and causes insufficient T3 and T4 secretion into the blood circulation. How does this affect TRH and TSH secretion?
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SECRETION OF BOTH TRH AND TSH INCREASES
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`
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`
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Colloid normally contains a thyroid hormone reserve. Approximately how many months worth?
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2-3
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Several endogenous and exogenous factors affect TRH and TSH secretion. List 4 common ones:
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LOW BASAL METABOLIC RATE
HYPOGLYCEMIA EXPOSURE TO A COLD ENVIRONMENT PREGNANCY |
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TSH stimulates release of T3 and T4 from the thyroid gland. What other primary effect does it have on thyroid gland tissue?
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IT STIMULATES FOLLICULAR CELL GROWTH
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How does thyroid hormone increase the basal metabolic rate (BMR
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ITS’ ACTIVITY AT TARGET CELLS INCREASES ATP FORMATION AND UTILIZATION
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Thyroid affects a specific cell membrane transport mechanism. Name it:
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NA+ / K+ PUMPS
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What effect(s) does thyroid hormone have on protein synthesis, cellular uptake of glucose, and lipolysis?
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ALL ARE STIMULATED BY T3 AND T4
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What effect(s) does thyroid hormone have on beta adrenergic receptors on the heart and peripheral nerves?
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THEY ARE UP-REGULATED
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What effect(s) does thyroid hormone have on secretion of human growth hormone?
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IT INCREASES
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List the 2 primary causes of hypothyroidism
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a primary thyroid disorder – usually due to an autoimmune process
inadequate secretion of tsh from the anterior pituitary gland |
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What is myxedema?
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SEVERE HYPOTHYROIDISM SEEN IN ADULTS
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Is hypothyroidism a common cause of obesity?
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NO
ANY WEIGHT GAIN ASSOCIATED WITH HYPOTHYROIDISM IS MODEST (AVG 10-30 LBS) |
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Describe an endemic goiter
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AN ENLARGEMENT OF THE THYROID GLAND THAT MAY BE SYMMETRIC OR ASYMMETRIC
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what causes endemic goiter
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MOST COMMON: DIETARY IODINE DEFICIENCY
INABILITY TO UTILIZE IODIDE TO SYNTHESIZE T3 AND T4 |
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Pathologically increased concentrations of circulating T4 and T3 affect the eyes in some patients with Graves’ disease. How?
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RETRO-ORBITAL EDEMA CAUSES PROTRUSION OF THE EYES. THE EDEMA OCCURS IN THE EXTRA-OCULAR MUSCLES.
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Many symptoms and signs of Graves’ disease are due to thyroid hormone effects on tissues such as the heart and nervous system. What is happening to target tissue receptors for T3 and T4 that cause these signs and symptoms?
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UP-REGULATION OF BETA ADRENERGIC RECEPTORS
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Normal regulation of circulating calcium is important for the proper function of some physiologic processes. List the 3 mentioned in lecture:
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NERVE IMPULSE INITIATION, PROPAGATION, AND SYNAPTIC VESICLE RELEASE
MUSCLE ACTION POTENTIALS BLOOD COAGULATION |
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List the 3 factors that affect bone breakdown and bone formation:
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- ratio of osteoblast to osteoclast activity
- intestinal absorption of calcium and phosphate - urinary excretion of calcium and phosphate |
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List the 3 major hormones involved in calcium homeostasis and the role of each:
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PTH: increases blood calcium and decreases phosphate
calcitonin: decreases blood calcium and phosphate calcitriol: increases blood calcium and phosphate concentration |
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Briefly describe the location of the parathyroid glands:
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THEY ARE IMBEDDED IN THE POSTERIOR ASPECT OF THE THYROID GLAND – 2 IN EACH LOBE
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What cell type within the parathyroid glands is responsible for synthesis of parathyroid hormone (PTH)?
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PRINCIPAL (CHIEF) CELLS
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Where is calcitonin synthesized?
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IN PARAFOLLICULAR “C” CELLS IN THE THYROID GLAND
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List the 3 mechanisms by which PTH increases the plasma calcium concentration:
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- increases osteoclast activity releasing calcium into the blood
- increases renal tubular reabsorption of calcium - stimulates renal synthesis of calcitriol (vitamin d) |
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What is the primary stimulus for secretion of PTH?
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DECREASED PLASMA CALCIUM CONCENTRATION
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List 2 mechanisms by which calcitonin decreases the plasma calcium concentration:
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- inhibits formation and activity of osteoclasts
- decreases renal tubular reabsorption of calcium |
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Is calcitonin an important hormone in the adult? Why or why not? NO
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AFTER SKELETAL MATURITY THERE IS MUCH LESS BONE FORMATION AND REMODELING
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What are 2 other names for 1,25-dihydroxycholecalciferol?
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CALCITRIOL
VITAMIN D |
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List the 3 organs responsible for synthesis of this ( Calcitrol, Vit D) 1,25-dihydroxycholecalciferol.
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SKIN
LIVER KIDNEYS |
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The KIDNEYS requires another hormone for synthesis of 1,25-dihydroxycholecalciferol. Name the hormone
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PTH
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What is the primary hormonal effect of calcitriol (be specific)?
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INCREASES ABSORPTION CALCIUM FROM THE SMALL INTESTINE
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What is the primary hormonal effect of calcitriol (be specific)?
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INCREASES ABSORPTION CALCIUM FROM THE SMALL INTESTINE
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What effects does hypoparathyroidism have on PTH secretion and plasma calcium concentration?
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- PTH SECRETION DECREASES
- THE PLASMA CALCIUM CONCENTRATION DECREASES |
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Name a dangerous complication of hypoparathyroidism
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MUSCLE TETANY
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Hypocalcemia may be a complication of what surgical procedure(s)?
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- PARATHYROIDECTOMY
- TOTAL THYROIDECTOMY (INADVERTENT REMOVAL OF THE PARATHYROID GLANDS) |
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How is Hypocalcemia treated
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A very small piece of the patient’s preserved parathyroid tissue is implanted under the skin of the forearm. it rapidly begins secreting PTH.
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What effects does hyperparathyroidism have on PTH secretion and plasma calcium concentration?
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PTH SECRETION INCREASES
THE PLASMA CALCIUM CONCENTRATION INCREASES |
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Where is most of the plasma calcium coming from
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THE BONES
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Describe rickets
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DEFORMED BONES OF THE LOWER EXTREMITIES USUALLY SEEN IN CHILDREN CAUSED BY VITAMIN D DEFICIENCY
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In ricket, what specifically, is causing hypertrophy of the parathyroid glands?
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HYPERSECRETION OF PTH
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What is osteomalacia?
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A SOFTENING OF BONE IN ADULTS NOT COMMONLY ASSOCIATED WITH LOW DIETARY VITAMIN D INTAKE
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List 5 common causes for osteoporosis
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-OLD AGE
- MALNUTRITION - DECREASED SECRETION OF ESTROGEN AND TESTOSTERONE - LACK OF EXERCISE/AMBULATION - CUSHING’S SYNDROME |
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Briefly describe the pathophysiology of Paget’s disease of the bone
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ABNORMALLY INCREASED OSTEOCLAST ACTIVITY ON BONE NOT ASSOCIATED WITH PTH HYPERSECRETION
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The adrenal medulla is composed of what cell type?
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CHROMAFFIN
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List the 3 zones of the adrenal cortex and the primary substance produced by each:
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zona glomerulosa: mineralocorticoids
zona fasiculata: glucocorticoids zone reticularis: gonadocorticoids |
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Aldosterone regulates the plasma concentration of 2 electrolytes. Name them:
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SODIUM AND POTASSIUM
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List 2 stimuli for aldosterone secretion:
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Increased formation angiotensin ii (when blood pressure is low)
Increased plasma potassium concentration |
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What is the primary electrolyte abnormality associated with Conn’s disease?
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HYPOKALEMIA (MAY ALSO SEE HYPERNATREMIA)
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List the 3 major glucocorticoids:
Which is secreted in the greatest quantity and has the greatest metabolic activity? |
CORTISOL
CORTISONE CORTICOSTERONE CORTISOL |
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What effect does cortisol have on plasma glucose?
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IT INCREASES
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Cortisol is known as the “stress hormone”. Briefly explain why
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IT INCREASES RESISTANCE TO STRESS BY FACILITATING AN INCREASE IN BLOOD PRESSURE AND BY INCREASING THE PLASMA GLUCOSE CONCENTRATION
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What effect does cortisol have on inflammation
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IT SUPPRESSES INFLAMMATION
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Why are exogenous glucocorticoids prescribed for patients who have received an organ transplant?
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THEY SUPPRESS THE IMMUNE SYSTEM. THIS DECREASES THE RISK OF ORGAN REJECTION.
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How does cortisol affect tissue healing?
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IT SLOWS WOUND HEALING / TISSUE REPAIR
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What effect does cortisol have on bone?
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INCREASED PROTEIN CATABOLISM CAUSES LOSS OF ORGANIC BONE MATRIX
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Normally, cortisol secretion is regulated by negative feedback. Is this true in high stress situations (i.e., trauma, major surgery, acute anxiety)? Why or why not?
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NO. PATIENTS EXPERIENCING HIGHLY STRESSFUL SITUATIONS WILL INCREASE THEIR SECRETION OF CRH OVERRIDING NEGATIVE FEEDBACK INHIBITION.
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What effect does decreased plasma cortisol have on CRH and ACTH secretion?
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SECRETION OF BOTH INCREASES
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Patients with Addison’s disease hyposecrete 2 hormones. Name them:
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CORTISOL
ALDOSTERONE |
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hat is the most common cause of Addison’s disease?
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an autoimmune process that causes atrophy of the adrenal glands
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What is another name for Addison’s disease
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PRIMARY ADRENOCORTICOID INSUFFICIENCY
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Patients with Addison’s disease exhibit abnormal plasma concentrations of Na+ and K+. Identify which electrolyte is increased and which is decreased:
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POTASSIUM: INCREASED
SODIUM: DECREASED |
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Patients with Addison’s disease hypersecrete 2 hormones from the pituitary gland. Name them:
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ACTH
MSH |
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Briefly describe a common physical sign of Addison’s disease and why this occurs
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DIFFUSE SKIN BRONZING DUE TO THE INCREASED SECRETION OF MSH
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What is the most common cause of pathologic cortisol hypersecretion?
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ACTH HYPERSECRETION BY A PITUITARY TUMOR
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Name another less common cause of pathologic cortisol hypersecretion:
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AN ADRENAL ADENOMA
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Both adrenal adenoma and acth hypersecretion are involveed cortisol hypersecretion. testing the plasma concentration of which hormone will be most helpful in distinguishing which endocrine organ is diseased?
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ACTH
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Patients with either of the disorders above often have an INCREASED / DECREASED plasma glucose concentration.
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INCREASED
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Increased protein catabolism in patients with cortisol hypersecretion affects the muscles. What clinical sign is associated with this?
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MUSCLE ATROPHY (WASTING)
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Dihydroepiandrosterone (DHEA) is known as a ______ androgen.
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WEAK
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Is DHEA a necessary androgen in the adult male? Why or why not?
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NO. THE EFFECTS OF TESTOSTERONE PREDOMINATE.
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What is important about DHEA secretion in the post-menopausal female?
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DHEA IS THE ONLY REMAINING SOURCE OF ESTROGEN
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DHEA and other weak androgens are important in growth and development of children. The effects of DHEA are most prominent in what stage child growth and development?
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PRE-PUBERTY
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List the 3 catecholamines secreted from the adrenal medulla:
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EPINEPHRINE
NOREPINEPHRINE DOPAMINE |
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Why is epinephrine secreted in the greatest quantity from the adrenal medulla?
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during stress, increased cortisol secretion activates an enzyme in chromaffin cells that converts most norepinephrine to epinephrine prior to release into the blood
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Prolonged mass sympathetic discharge (“fight or flight”) may be necessary in some situations. Why is adrenal secretion of epinephrine and norepinephrine important in these situations?
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their hormonal activity lasts 5-10 times longer than the epinephrine and norepinephrine secreted from sympathetic nerve endings
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What effect does epinephrine have on cardiac output and blood pressure?
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THEY BOTH INCREASE
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What effect does norepinephrine have on the systemic vascular system?
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IT CAUSES VASOCONSTRICTION
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Briefly describe a pheochromocytoma
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it is a tumor that forms in chromaffin cells and hypersecretes epinephrine and norepinephrine
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TRUE / FALSE Pheochromocytomas are only found in the adrenal gland
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FALSE
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Patients with a pheochromocytoma often have hypertension. Briefly describe how this secondary cause for hypertension is different than cases of essential hypertension commonly seen in the clinic:
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this type of hypertension is very difficult to control. it is common to see random blood pressure spikes.
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Where is the most common location for a pheochromocytoma outside the adrenal medulla?
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SMALL PARA-AORTIC BODIES
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small para-aortic bodies are known as Organs of
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ZUCKERKANDL
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List the 2 primary cell types that comprise the pancreas:
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ACINAR
ISLETS OF LANGERHANS |
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Which type of pancreas cells secretes endocrine hormones?
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ISLETS OF LANGERHANS
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List the 4 islet cell types and the primary hormone secreted by each:
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ALPHA CELLS: GLUCAGON
BETA CELLS: INSULIN DELTA CELLS: SOMATOSTATIN F CELLS: PANCREATIC POLYPEPTIDE |
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What is the function of glucagon?
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INCREASES BLOOD GLUCOSE WHEN IT IS TOO LOW
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Name 2 physiologic processes of glucagon catabalism
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GLYCOGENOLYSIS
GLUCONEOGENESIS |
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Glucagon action can increase the plasma concentration of non-glucose energy sources for tissue cells. Name 2 physiologic process that occur:
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LIPOLYSIS
KETOGENESIS |
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Why is adequate glucagon secretion important for the brain?
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GLUCOSE IS THE DESIRED ENERGY SOURCE FOR THE BRAIN
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The circulating concentration what hormone regulates glucagon secretion?
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INSULIN
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Name another stimulus for glucagon secretion
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INCREASED SYMPATHETIC NERVOUS SYSTEM ACTIVITY
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What is the function of insulin?
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DECREASES BLOOD GLUCOSE WHEN IT IS TOO HIGH
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What effect does insulin have on glycogenolysis and gluconeogenesis?
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BOTH PROCESSES ARE INHIBITED
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The circulating concentration of a hormone regulates insulin secretion. Name it
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GLUCAGON
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List 2 other major stimuli for insulin secretion:
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parasympathetic vagal stimulation of the pancreas
secretion of glucose-dependent insulinotropic peptide (GIP) |
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List the “3 P’s” of diabetes mellitus:
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POLYURIA
POLYDIPSIA POLYPHAGIA (TYPE I) |
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What is the pathophysiology of type I diabetes mellitus?
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PANCREATIC BETA CELLS DEGENERATE AND DO NOT SECRETE INSULIN
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What treatment is required for patients with type I diabetes mellitus?
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INSULIN REPLACEMENT THERAPY
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What is the pathophysiology of type II diabetes mellitus?
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INSULIN RECEPTOR INSENSITIVITY TO INSULIN AT TARGET CELLS
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Patients in the early phase of type II diabetes mellitus have an increased plasma concentration of which pancreatic hormone?
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INSULIN
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Do patients with type II diabetes mellitus require insulin replacement therapy?
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SOME PATIENTS DO EVENTUALLY REQUIRE INSULIN REPLACEMENT (APPROX 50%)
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Obese patients are more likely to develop type II diabetes mellitus. Why?
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research indicates that there are fewer insulin receptors in obese persons. add this to insulin receptor insensitivity to insulin and it is obvious that the risk of developing type ii dm increases.
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Diabetic patients who inject too much insulin can develop hypoglycemia. List some common signs and symptoms that diabetic patients who inject insulin must be aware of:
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WEAKNESS
TREMORS SWEATING DISORIENTATION (NOTED BY OTHERS) |
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All diabetic patients who inject insulin should have a readily available source of injectable
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GLUCAGON.
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Briefly describe an insulinoma:
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AN ADENOMA THAT DEVELOPS IN AN ISLET OF LANGERHANS THAT HYPERSECRETES INSULIN.
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In what type of patient should PAs consider insulinoma?
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A HEALTHY PATIENT WHO HAS REPEATED EPISODES OF HYPOGLYCEMIA
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What is the primary cause of diabetic ketoacidosis (DKA)?
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insulin deficiency – either endogenous insulin hypersecretion or failure to administer exogenous insulin if a diabetic
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Increased formation of plasma ketones in patients with DKA is often noticeable. In what way?
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PATIENTS OFTEN HAVE A SWEET BREATH ODOR
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Patients with DKA have what type of acidosis?
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METABOLIC
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What is the compensatory response to this acid-base imbalance that is often observed in patients with DKA?
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INCREASED RATE AND DEPTH OF BREATHING
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Where is the pineal gland located?
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IT IS PART OF THE EPITHALAMUS
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Name the hormone synthesized by the pineal gland
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MELATONIN
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What effect does MELATONIN have on sleep?
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IT PROMOTES SLEEP
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Describe the location for the thymus
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WITHIN THE MEDIASTINUM ANTERIOR TO THE AORTA AND POSTERIOR TO THE MANUBRIUM
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List the 4 thymic hormones:
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THYMOSIN
THYMOPOETIN I AND II THYMIC HUMORAL FACTOR THYMIC FACTOR |
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Activity of all thymic hormones stimulates
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T CELL DIFFERENTIATION INTO KILLER, HELPER, OR SUPPRESSOR CELLS
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The thymus produces what type of cells involved in cell-mediated immunity?
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T CELLS
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