Reading...
Play button
Play button
Use LEFT and RIGHT arrow keys to navigate between flashcards;
Use UP and DOWN arrow keys to flip the card;
H to show hint;
A reads text to speech;
17 Cards in this Set
- Front
- Back
|
What are some things can can cause variations in hormonal patterns?
|
cicadian, seasonal, episodic pulses of release (stressors, meals, exercise, menstrual cycle, varies with age), positional changes
|
|
|
Is protein-bound hormone biologically active? What does "total" give you?
What types of proteins can bind hormones? |
no. Just the free is active.
Total = protein bound + free albumin, prealbumin (transthyretin), and specific carrier proteins (cortisol binding globulin, thyroid binding globulin, IGF b/ protein) |
|
|
List the anterior pituitary hormones. Then, list the cells responsible, the releasing hormones, the inhibiting factors (if any), the target gland, and the function.
|
- ACTH: Corticotropes; Corticotropin RH (CRH), AVP; <N/A>; adrenal; stimulation of corticoS and adrenal Androgens.
- GH: Somatotropes; GHRH; Somatotropin rel. inhib. fc. (SRIF); Perip. tiss & liver; direct and indirect (IGF-1) growth stim. - PRL; lacto; TRH; PIF; Mammary, stim of lactation - TSH; Thyro; TRH; SRIF, PIF; Thyroid; stim of thyroid hormone release - LH; Gonado; GnRH; <N/A>; Ovary/testis; stim of E and T - FSH; gonado; GnRH; <N/A>; "..." |
|
|
What is another name for GnRH?
SRIF? What is the main PIF? |
LHRH
somatostatin or GHIH (GHIF) DA is the main one. |
|
|
What non-hypothalamic peptide has recently been found to play a role in GH regulation by directly inducing secretion of both GHRH and GH?
|
Ghrelin
|
|
|
What sets the baseline for GH? What controls the spikes?
- additional secretory control? |
inhibitory (SRIF)
GH-RH does the pulsatile activity - ghrelin |
|
|
What initiates the synth of IGF-1 by the liver?
- what effects does IGF-1 have on tissues? |
GH.
- bunch of insulin like effects, as well as promoting the growth of cartilage. |
|
|
Is GH release pulsatile? Episodic?
Under what conditions should we strive to measure GH lvls in pts? |
both
fasting, at rest for 30min, but NOT asleep. |
|
|
On GH stimulation test, 70% of normal people will show what? The other 30%?
- what does this mean re: dx of GH def? - what types of stimulations are used for a "GH stim" test? |
increase in GH of 7-10 ng/mL or 3 times over baseline
- won't show a "normal" increase - sometimes two abnormal stim tests are thus required before a dx of GH def. is made. - 20-30 min of exercise; arginine; Glucagon; L-DOPA; Clonidine |
|
|
Is a low IGF-1 specific for GH def?
|
no, you have to rule out poor nutrition, renal dz, hypothyroidism, psychological dz, etc.
|
|
|
What is a test that is done for GH excess?
What is seen in this test for pts with GH excess? |
oral glucose challenge
- then measure serial GH lvls. - you'd expect a suppression Pts either (1) don't show suppression or (2) show a paradoxical increase in GH lvls (~20% of pts) |
|
|
Regulation of PRL is stimulatory or inhibitory? What is the main factor? What are the factors for the opposite function?
|
primarily inhibitory
Main PIF = DA TRF, Vasoactive intestinal peptide, Estrogen. |
|
|
What is the most common hypothalamic-pituitary disorder investigated?
- most common etiology for lvls >150ng/mL? Does the converse have any clinical importance? |
hyperprolactinemia
- PRL > 150 usually means a PRL secreting tumor. - no, PRL deficiency has no recognized clinical importance. |
|
|
When Anterior Pituitary fx is lost due to destruction or compression, what is the order of hormone actv loss? What might happen to PRL lvls?
|
GH --> LH/FSH --> TSH --> ACTH
they might be high because their reg is primarily inhibitory. |
|
|
What three conditions lead to polyuria?
|
HDI (CDI), NDI, psychogenic polydipsia
|
|
|
Walk through the assessment of a pt that presents with polyuria.
When do you look for non-ADH-related causes? Next step if we decided it *is* related to ADH? |
- 24hr urine collection
- urine glucose - Serum osmolality, serum Na, and fasting glucose + if osm > 295 or serum Na >145, look for non-DI causes. Water deprivation test --<duration>--> once urine osmol's are constant, admin AVP! One of 3 things will happen: - Normal/psychogenic etiology: only 3-5% drop in BW during water dep test; serum osmol & Na WNL; urine osm no change. - HDI: ^serum Na or osm; AVP --> u osm ^^ ... NDI: " "; but w/ no change in u osm on AVP - partial HDI/NDI: u osm > 300.... *measure ADH lvls on earlier samples to see if appropiate to Na and osm |
|
|
Pt's lab values:
- low serum Na, osm, urea N, uric acid - urine osm (>300) > serum osm - high ADH - low renin actv (--> low aldosterone) Dx? |
SIADH: autonomous, sustained production of ADH in the absence of known stimuli
- this is presuming you can rule out cardiac, hepatic, renal, thyroid, adrenal, and drug related causes. |
