Endocrine Physiology Midwestern

Front 1

Hypertension Renal Parenchymal Disease

Back 1

Kidney can't secrete enough Na and water so volume increases along with CO and MAP

Front 2

Renal Artery Stenosis (RAS)

Back 2

Reduced blood flow to kidneys triggers RAAS which leads to hypertension

Front 3

Coarctation of the aorta

Back 3

Narrowing of aorta increases pressure to head and arms and decreases pressure to kidneys triggering RAAS, also reduced baroreceptor sensitivity in aorta.

Front 4

Pheochromocytoma

Back 4

Catecholamine (epi/norepi) secreting tumor that increases CO and HR and arterial pressure

Front 5

Hyperaldosteronism (Conn ' s syndrome)

Back 5

Aldosterone secreting adenoma resulting in increased Na and water reabsorption, alkalosis, and hypokalemia. (Glycyrrhetinic acid from licorice inhibits 11BHSD from converting cortisol to cortisone which also results in aldosterone excess)

Front 6

Cushing ' s syndrome

Back 6

Increased cortisol that: 1) stimulates hepatic angiotensinogen for RAAS, 2) activates mineralcorticoid receptors for similar results, 3) increases reactivity to catecholamines for more vasoconstriction.

Front 7

Acromegaly

Back 7

Excess GH and IGF-1 that prevents Na excretion due to increased insulin levels and sympathetic tone

Front 8

Hypothyroidism

Back 8

T3 deficiency results in vasoconstriction, a-1 receptor density increases and B-1 decreases also resulting in vasoconstriction. High ADH and low ANP is common.

Front 9

Estrogen Hypertension

Back 9

Stimulates hepatic angiotensinogen (RAAS)

Front 10

Hyperinsulinemia Hypertension

Back 10

Increases SNS

Front 11

Obesity Hypertension

Back 11

Adipocytes release angiotensinogen (RAAS)

Front 12

Leptin Hypertension

Back 12

Increases renal tone through SNS to retain Na and water. Also acts on hypothalamus to increase BP

Front 13

RAAS

Back 13

1) insulin resistance

2) dyslipidemia

3) Na and water reabsorption

4) vasoconstriction

Front 14

PTSD

Back 14

Increased SNS leads to increased HR and MAP

Front 15

Hypothalamus location that inhibits appetite

Back 15

Ventromedial nucleus (arcuate nucleus)

Front 16

Hypothalamus location that is feeding center

Back 16

Lateral Hypothalamic Area (LHA) in arcuate nucleus

Front 17

What is the Arcuate Nucleus?

Back 17

Hypothalamus area where ghrelin and leptin act to affect energy expenditure and feeding behavior

Front 18

What is the mTOR pathway?

Back 18

After a meal, insulin uses the mTOR pathway to increase leptin synthesis. Leucine and glucose also activate the mTORC1 pathway to increase leptin synthesis. During fasting the SNS catecholamines decrease mTORC1 which decreases leptin synthesis.

Front 19

How does obestatin work?

Back 19

Decreases food intake and weight gain by decreasing gastric emptying and decreasing GI contractions. Vagus induces satiety.

Front 20

Where are glucagon and GLP1 -2 made?

Back 20

Glucagon is made in the pancreas by PC2. GLP1-2 are made in the intestine by PC1/3. (PC= prohormone convertase)

Front 21

How does uroguanylin work?

Back 21

Prouroguanylin is secreted after eating then becomes uroguanylin in CNS which activates GUCY2C to satiate you.

Front 22

Prader-Willi Syndrome

Back 22

Part of brain responsible for fullness and hunger doesn't work.

Front 23

Vasoactive Intestinal Peptide (VIP)

Back 23

Binds to VPAC-R which activates AC which generates cAMP which activates PKA to increase HR and inotropy and vasodilation. Can also bind NPC-R which is coupled to GInhibitory proteins to decrease HR and inotropy but still vasodilate.

Front 24

PHI and PHM

Back 24

Same effect as VIP on heart, but less potent.

Front 25

What effect does ghrelin have on the heart?

Back 25

Decreases MAP by increasing NO bioavailability. Also inhibits ROS formation and inflammation. Decreases TPR so SV is increased. Suppresses SNS tone and plasma norepi. Maintains heart structure by preventing LV remodeling. (Lots of Good stuff!)

Front 26

What effect does adrenomedullin (AM) have on the heart?

Back 26

It is a potent vasodilator, increases CO and inotropy. Suppresses RAAS and increases urine and Na excretion.

Front 27

What effect does Intermedin have on the heart?

Back 27

Potent vasodilator that also exerts chronotropic and inotropic effects.

Front 28

What effect does oxytocin have on the heart?

Back 28

Stimulates ANP/BNP which decreases RAAS which increases Na excretion in urine and reduces volume. OT Decreases HR and inotropy and induces vasodilation.

Front 29

What effect does Irisin have on the heart?

Back 29

Increases muscle endurance, decreases insulin resistance and browns adipose tissue. May protect hippocampus against Alzheimer disease. Exercise, NEFAs, and norepi can increase Irisin release.

Front 30

What results from hyperleptinemia?

Back 30

Increased BP, Na reabsorption, SNS vascular tone, HR, inflammation, lipotoxicity, thrombogenesis, ROS (lots of bad things because you are fat and have too much leptin)

Front 31

Adiponectin

Back 31

Positive metabolism effects like increase glucose uptake and insulin sensitivity, increased B ox, decreased gluconeogenesis, anti inflammatory

Front 32

Resistin

Back 32

A peptide produced by WAT that causes insulin resistance

Front 33

Visfatin

Back 33

An insulin mimic - er that binds to insulin receptors but at a separate site so there is no competition

Front 34

Apelin

Back 34

Peptide created by WAT that causes vasodilation, Na excretion, and increased inotropy

Front 35

Omentin

Back 35

Enhances glucose uptake in fat cells through GLUT 4 (inversely correlated with BMI)

Front 36

Adipsin

Back 36

Improves B cell function so it can treat diabetes

Front 37

What makes up the female athlete triad?

Back 37

Osteoporosis, disordered eating, and amenorrhea

Front 38

Low BMD is linked in part to...

Back 38

Estrogen deficiency, hyperthyroidism, hypercortisolism, poor nutrition. (Hyperleptinemia can have opposit effect increasing BMD)

Front 39

Matt

Back 39

You are a mega poopy head. A mega ultra pooperific poopy head. Sometimes you like to eat poop, but other times you only just smell like it. Poop poop poop poop!

Front 40

Conversion of testosterone to DHT is by the enzyme...

Back 40

5a reductase

Front 41

Conversion of testosterone to estradiol is by the enzyme...

Back 41

Aromatase

Front 42

Purpose of seminal vesicle secretion

Back 42

Is to provide nourishment and dilution to semen (vit c, prostaglandins, fibrinogen, fructose)

Front 43

Purpose of prostate secretion

Back 43

Alkalinization of the acidic female tract (PO4, citric acid, acid phosphatase, clotting enzymes)

Front 44

Purpose of bulbourethral gland secretion

Back 44

Mucus like lubrication and urine neutralization

Front 45

How do phosphodiesterase inhibitors work to fix ED?

Back 45

They inhibit the conversion of cGMP to GMP. cGMP causes relaxation, so the PSNS would be active for longer allowing for a more effective erection

Front 46

Graafian follicle

Back 46

The follicle that is the most mature and receives signals (estrogen causes LH surge which signals for completion of meiosis 1 and enzymes to break wall of follicle) to prepare for ovulation

Front 47

Theca cells can make _____ after stimulation by _____

Back 47

Androsteredione from cholesterol with cholesterol desmolase after LH stimulation, but lacks aromatase so it can't turn it into estradiol

Can make progesterone after becoming a lutheal cell

Front 48

Granulosa cells can make _____ after stimulation by _____

Back 48

Estradiol from testosterone with aromatase after being stimulated by FSH

Can make progesterone after becoming a lutheal cell

Front 49

What is the function of inhibin?

Back 49

To inhibit the release of FSH from anterior pituitary while not affecting the release of LH

Front 50

Effects of LH surge

Back 50

1) meiosis resumed

2) conversion of antral follicle to Graafian follice

3) proteolytic enzyme production for digestion of follicle wall

4) increases prostaglandins

5) differentiation of follicle to corpus luteum