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59 Cards in this Set
- Front
- Back
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What is the treatment for hypothyroidism?
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*Levothyroxine Sodium (t4). Effects take 10 days, last 2-3 weeks.
*Liothyronine sodium- (t3)- used for coma rarely-effects take 24hrs, last for 2 days. |
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What are the treatments for hyperthyroidism?
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*Surgery
*Thioureylines- carbamizol (active form = methimazol)-inhibit thyroperoxidase responsible for iodination of tyrosine. (takes 4-6 weeks to show) *Iodidie- inhibits synthesis in high doses *Radioactive iodine (I131), 0.5mm range of radiation. (+thyroid replacement) *B antagonists-propanolol-reduce CVS symptoms. |
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What is the treatment for Adrenal deficiancy (Addisons)?
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Hydrocortisone and fludrocortisone. (can exascerbate diabetes)
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What is the treatment for adrenal excess? (Cushings)
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Metyrapone and tribstane (inhibit synthesis)
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What is the treatment for excess growth hormone, and deficiancy?
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excess- octreotide (activates somatostatin)
Deficiancy- Somatotrophin (GH analogue) |
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What are the effects of parathyroid hormone?
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Released due to hypocalcaemia, requires magnisium...
-reabsorption of Ca in kidney -bones release Ca -Enhanced absorption in intestine (vitamin D also increases serum Ca) |
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What hormone opposes PTH?
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Calcitonin secreted from thyroid parafollicular cells.
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What are the effects of too much and too little PTH?
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*HyperPTH = caliculi, fragile bones, tissue calcification
*HypoPTH = hypocalcaemia, tetany, death |
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What increases the release of Growth hormone?
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Ghrelin from gut and hypothalamus, steroids, stress, excercise
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What decreases the release of Growth hormone?
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Free fatty acids, high protein, somatostatin, IGF1, GH.
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What effects does growth hormone have? (released in surges)
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Lipolysis
Protein anabolism Hepatic gluconeogenesis Insulin resistance Growth (via IGF)- essential for puberty. |
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What disorders of Growth hormone are there?
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Gigantism
Dwarfism Acromegaly (adults) |
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What actions does thyroid hormone have?
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*O2 consumption/metabolism
*cell differentiation-essential for fetal growth *Increase Heart rate and force *Increased adrenal sympathetics *Mood and behaviour *Increase bone breakdown |
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What are the effects of hyper and hypothyroidism?
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*Hypo= delayed puberty, myxoedema, lethargy, slowness, cold sensitivity, retardation
*Hyper= nervous, tremor, tachycardia, palpatations, weight loss, increased apetite. (Graves disease = exopthalmos) |
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Describe the hypothalamopituitary axis.
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*Magnocellular neurones-> posterior pituitary directly
*Parvocellular neurones-> anterior pituitary indirectly via median eminence. |
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What are coticosteroids made from?
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Cholesterol
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Which adrenal cotex cells secrete which hormones?
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GFR
*Zona glomerulosa-Mineralocorticoids (aldosterone) *Zona fasiculata- glucocorticouds *Zona reticularis- gonadocorticoids |
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What does the adrenal medulla synthesise and from what cells?
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Choromaffin cells synthesise catecholamines (NA?A)
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In males, what structure forms the ductus deferens?
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Mesonephric duct (paramesenephric regress)
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What stucture guides the testes descent into the scrotum?
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Gubernaculum
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In females, what structure forms the oviduct, uterus and vagina?
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Paramesonephric duct
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What type of mesoderm are genital ducts, gonads and nephrons derived from?
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Intermediate mesoderm
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In the males what do the leydig cells do?
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produce testosterone and respond to LH
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What are the effects of testosterone?
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Sex differentiation
Puberty (secondary charactaristics) Growth and fusion of long bones Muscle development Spermatogenesis Libido Agression |
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What is Kallman's syndrome?
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No GnRH neurone development (also cannot smell)
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What do sertoli cells do?
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Nutrients
Reabsorbs leftovers for spermatogenesis Secretes semenipherous fluid Blood testes barrier Androgen binding protein Steroid conversion (DHEA) Respond to LH, inhibit by inhibin. |
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What is the mechanism of erection?
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parasympathetic control:
-dilation of arteries -relaxation of smooth muscles -compression of veins -contraction of ischiocavernosus muscle and bulbospongiosus. |
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What are the 2 stages of ejaculation?
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*Emission- contraction of vas and bladder neck and prostate
*Ejaculation- smooth and striated muscle contraction under sympathetic and voluntary semantic control. |
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Which cells of the ovary do LH and FSH target?
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FSH=granulosa
LH= Thecal cells->synthesis androgens for release from granulosa cells. NB-LH targets granulosa cells at the LH surge. |
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What does the corpus luteum produce?
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progesterone and oestradiol.
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What are the hormone levels during early follicular stage?(day 1-5)
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*FSH elevated
*Oestradiol, progesterone, inhibin low *Primary follicles rescued *menstruation |
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What are the hormone levels during the late follicular stage? (Day 6-13)
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*FSH falls, LH rising
*Oestradiol and inhibin rise *Progesterone low *Dominant follicle selected |
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What are the hormones during ovulatory phase (day 14)?
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*LH surge.
*Oestradiol and inhibin fall *Progesterone rises *Ovulation |
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What are the hormone levels during the leuteal phase (Day 15-28)
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*FSH/LH are low
*Oestradiol inhibin and progesterone are high *Corpus leuteum present. |
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What does inhibin do?
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Inhibits FSH release
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What happens during the menstrual phase to the endometrium?(day 1-5)
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Spiral arteries coil and constrict so upper layer dies, then dilates so bleeding occurs. prostaglandins cause uterine contractions.
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What happens during the proliferative phase to the endometrium? (day 14-28)
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Proliferation occurs. Glands increase in length, spiral arteries uncoil.
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What happens during the secretory phase to the endometrium ? (day 14-28)
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Glands get distended, and secrete. Stroma becomes oedematus (6-7mm). Decidual cells appear.
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What are the hormonal effects of polycystic ovaries?
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normal oestrogen, no progesterone.
Excess testosterone from thecal cells *Increased LH secretion, but decreased FSH and GnRH. *Increased insulin receptors. (treat with metformin or clomiphine citrate) |
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What are the hormonal effects of hyperprolactinaemia?
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*Excess prolactin
*inhibits GnRH *Decreased FSH/LH *Low oestrogen and no progesterone. treat with dopamine agonist bromocryptine |
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What are the hormonal effects of hypothyroidism?
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*Lowered T4 increases TRH and TSH release. TRH stimulates prolactin release,
*Decreased GnRH *Decreased FSH/Lh *Decreased oestrogens. |
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At what weight is puberty trigged in boys and girls?
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boys- 55kg
girls-47kg thought to be due to leptin signalling. |
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How are fetal and maternal blood supplies seperated?
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By a thin layer of syncytiotrophoblast.
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At what stage does the placenta become endocrine?
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7 weeks
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What is oestrogen formed from in placenta, and what is the main one?
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Oestriol from DHEA, as lacks aromotase enzyme.
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What does human placental lactogen do?
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Growth of mammaries and fetus. (Diverts glucose to fetus).
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How does the fetus efficiently get oxygen?
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*Fetus has more Hb, and Fetal Hb had increased affinity.
*Double Bohr effect-unloads CO2 to mother |
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What are the 4 anatomical shunts present in fetus?
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Placenta
Ductus venosus (liver) Foramen ovale Ductus arteriosus (bypasses lungs) |
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How do sperm get to the egg?
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*Active swimming into cervical mucus
*1/1000 make it through mucus *Active and passive swimming through uterus aided by contractions. *Flow of fluid carries sperm through oviduct to ampulla. |
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What are the stages of fertilisation?
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*Capacitation- more permiable to Ca
*Acrosome reaction- increase in Ca releases hyaluronidase *Penetration of cumulus oophorus *penetration of zona pellucida(zona lysin) *Fusion with vitelline membrane *zona reaction- inhibition of zona lysin *2nd polar body extruded-resumption of meiosis. |
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At what stage does the gamete get implanted?
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Blastocyst stage (5.5days)
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What are the stages of birth?
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*1-cervix dilation (7-14hrs)
*Stage 2- Full dilation, birth, abdominal contractions 1-2 hrs *Stage 3-birth of placenta-half hour |
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What is the role of progesterone during birth?
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hyperpolarises myometrium
Decreases propogation Decreases oxytocin sensitivity Stablises membranes-stops prostaglandin formation |
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What is the role of oestrogen during birth?
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Myometrial growth
Depolarising Increase oxytocin receptors. Causes contractions |
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What is the role of oxytocin during birth?
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Stimulates myometrium in 2nd stage of labour, and liberates prostaglandins.
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What is the role of prostaglandins in labour?
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Cause contractionds (made from arachydonic acid).
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What causes mammary growth?
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Oestradiol and progesterone
(also prolactin and Hpl) |
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What inhibits/stimulates lactation?
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*inhibits=oestradiol and progesterone, dopamine
*stimulates=prolactin |
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What causes milk ejection?
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oxytocin acting on myoepithelium
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