Endocrine - 02,03,04 - Neuroendocrinology

Front 1

neurotransmitters important for hypothalamic peptidergic secretory cells

Back 1

dopamine

norepinephrine

serotonin

Front 2

paraventricular nucleus

supraoptic nucleus

Back 2

secretory neurons to posterior pituitary

Front 3

genes necessary for formation of rathke's pouch and early pituitary development

Back 3

PITX2, HESX1, LHX4

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LHX3 gene

Back 4

needed for differentiation of gondadotropes, thyrotropes, lactotrope, somatrotrope

all pituitary cell types EXCEPT corticotrope (ACTH)

Front 5

what genes are needed for development of corticotroph specifically

Back 5

TPIT, NEURO D1

Front 6

mutation in SF1 would stop development of which type of pituitary cell

Back 6

gonadotroph

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PROP1 and PITI genes

Back 7

needed for differentiation into thyrotrophs (also need GATA2), lactotroph (also need ER), somatotroph

Front 8

acidotrophs make

Back 8

GH or Prolactin

Front 9

pro-opiomelanocortin is processed into what in the anterior pituitary

Back 9

N- terminal fragment

ACTH

Beta-LPH

____

ACTH can be converted further in the intermediate lobe to MSH + CLIP

Beta-LPH converted in the intermediate lobe to gamma-LPH, beta-endorphins, gamma-MSH, Met-Enk

Front 10

CRH is released due to

Back 10

STRESS (emotional, physical, chemical, etc)

Time - higher in the morning before waking

hypoglycema

VASOPRESSIN*

Front 11

why does high ACTH cause hyperpigmentation

Back 11

conversion to MSH in intermediate lobe -> stimulates melanocytes

Front 12

plasma ACTH is pulsitile or non-pusitile

Back 12

pulsitile

increased pulses -> more ACTH

Front 13

if lack corticotrophs, why is surgery dangerous

Back 13

any trauma is dangerous if dont have high enough cortisol

Front 14

how to check pituitary function test with insulin

Back 14

give insulin

blood glucose will drop

cortisol, GH should increase

Front 15

mutation of HESX-1 would cause

Back 15

panhypopituitarism

Front 16

tumor compressing stalk of piuititary would do what to the hormone release

Back 16

all hormones would decrease except prolactin which would increase (due to decreased dopamine from hypothalamus)

Front 17

patient with poor growth could have what levels of thyorid, GH, and cortisol?

Back 17

low Thyroid hormone

low growth hormone

high cortisol

Front 18

addisons disease

Back 18

chronic primary adrenal insufficiency

ACTH excess due to unresponsive adrenals

fatigue
anorexia
weight loss
salt carving (low aldosterone)
hyperpigmentation (due to high ACTH)

Front 19

nelson's syndrome

Back 19

removal of both adrenal glands -> low cortisol -> lack neg feedback on any pituitary adenoma -> overgrowth of pituitary adenoma

--> mass effect, increased hyperpigmentation due to increased ACTH

Front 20

which hormones share the same alpha subunit

Back 20

TSH, FSH, LH, beta-HCG

beta unit is specific

Front 21

important of thyroid hormone in development

Back 21

CNS maturation

Front 22

GNAS1

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Gs alpha membrane associated protein

mutation can cause constitutive activation

Front 23

T/F continuous GnRH infusion will increase LH

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False - continuous infusion will decrease LH

pulses of GnRH will increase LH

Front 24

early stage of puberty and LH

Back 24

see increase in GnRH and LH pulse at night only - elevated during sleep

in the morning see high testosterone

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turner's syndrome

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only one X chromosome - XO

not enough SHOX gene - resistance to growth

see high FSH

see short stature, short 4th and 5th metacarpals,pigmented nevi

complications - primary ovarian failure, coarctation of aorta, renal abnormalities (horseshoe kidney)

Front 26

T/F if you find one problem in pituitary then you should evaluate all

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true

Front 27

which pituitary hormones use cytokine receptors (JAK/STAT)

Back 27

GH, prolactin

Front 28

IGF-1

Back 28

secreted from liver in response to GH

important for bone and tissue growth

Front 29

factors that increase GH secretion

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hypoglycemia

GHRH

alpha-adrenergic agonist

beta-adrenergic antagonist

ghrelin

sleep

exercise

stress

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factors that decrease GH secretion

Back 30

postrandial hyperglycemia

elevated fatty acid

somatostatin

Front 31

ghrelin

Back 31

emptys stomach

causes GH secretion

makes you hungry (via neuropeptide Y and agouti related protein from hypothalamus)

stops fat utilizaiton in adipose cell

secreted from stomach mostly

Front 32

most important regulator of prolactin secretion

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dopamine NEGATIVELY affects prolactin secretion

more dopamine means less prolactin

levadopa, bromocrtiptine, pergolide, carbergoline = dopamine agonist -> supress prolactin

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factors that affect prolectin secretion

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increased by:

pregnancy
breast feeding
exercise
stress
sleep
TRH
Estrogen
Dopamine angatonist
monoamine oxidase inhibitor
H2 angatonist
opiods

Front 34

which releasing factor from the hypothalamus increases prolactin

Back 34

TRH

Front 35

drugs that increase prolactin secretion

Back 35

dopamine antagonist:
phenoothiazine
haloperidol
metoclopramide

H2 antagonist:
cimetidine

MAO inhibitors

Front 36

KALLMANN syndrome

Back 36

hypogonadotropin hypogonadism

KAL gene mutation - abnormal migration of GnRH secreting neurons in the hypothalamus (also for olfactory nerve)

symptoms:
anosmia (lack of sense of smell)
delayed puberty
lack of strength

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most common cause of hyperprolactinemia

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pregnancy

Front 38

symptoms of hyperprolactinemia

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amenorrhea

infertility due to anovulation - inhibits GnRH

glactorrhea

hypogonadism

Front 39

cabergoline

Back 39

dopamine agonist - shrinks prolacinomas

can cause cardiac valve problems - by increasing quiescent valve cells

Front 40

excess growth hormone consqeunces

Back 40

gigantism - in children before epiphyseal closure - tall, large hands and feet, fast linear growth

acromegally - after epiphyseal closure

look:
acral enlargement, coarse facial features, prominent supraorbital ridges, porgnathism (enlarged jaw)

clinically: acanthosis, hyperinsulinemia, cardiovascular problems

90% due to pituitary adenoma

Front 41

treatment of acromegaly

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somatostatin analog - octreotide

GH receptor antagonist - pegvisomant - prevents dimerization of cytokine receptor

Dopamine agonist - cabergoline

Front 42

maccune albright syndrome

Back 42

mutation in GNAS1 gene on Chr. 20 -> lack GPTase activity - causing constitutive activation of G-protein

means dont need TSH, GH, TRH to be acctive

see increased thyroid hormone, incresaed growth hormone

goiter, cafe au lait mark, fibrous dysplasia of bones,