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59 Cards in this Set

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What is the treatment for hypothyroidism?
*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.
What are the treatments for hyperthyroidism?
*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.
What is the treatment for Adrenal deficiancy (Addisons)?
Hydrocortisone and fludrocortisone. (can exascerbate diabetes)
What is the treatment for adrenal excess? (Cushings)
Metyrapone and tribstane (inhibit synthesis)
What is the treatment for excess growth hormone, and deficiancy?
excess- octreotide (activates somatostatin)
Deficiancy- Somatotrophin (GH analogue)
What are the effects of parathyroid hormone?
Released due to hypocalcaemia, requires magnisium...
-reabsorption of Ca in kidney
-bones release Ca
-Enhanced absorption in intestine
(vitamin D also increases serum Ca)
What hormone opposes PTH?
Calcitonin secreted from thyroid parafollicular cells.
What are the effects of too much and too little PTH?
*HyperPTH = caliculi, fragile bones, tissue calcification
*HypoPTH = hypocalcaemia, tetany, death
What increases the release of Growth hormone?
Ghrelin from gut and hypothalamus, steroids, stress, excercise
What decreases the release of Growth hormone?
Free fatty acids, high protein, somatostatin, IGF1, GH.
What effects does growth hormone have? (released in surges)
Lipolysis
Protein anabolism
Hepatic gluconeogenesis
Insulin resistance
Growth (via IGF)- essential for puberty.
What disorders of Growth hormone are there?
Gigantism
Dwarfism
Acromegaly (adults)
What actions does thyroid hormone have?
*O2 consumption/metabolism
*cell differentiation-essential for fetal growth
*Increase Heart rate and force
*Increased adrenal sympathetics
*Mood and behaviour
*Increase bone breakdown
What are the effects of hyper and hypothyroidism?
*Hypo= delayed puberty, myxoedema, lethargy, slowness, cold sensitivity, retardation
*Hyper= nervous, tremor, tachycardia, palpatations, weight loss, increased apetite. (Graves disease = exopthalmos)
Describe the hypothalamopituitary axis.
*Magnocellular neurones-> posterior pituitary directly
*Parvocellular neurones-> anterior pituitary indirectly via median eminence.
What are coticosteroids made from?
Cholesterol
Which adrenal cotex cells secrete which hormones?
GFR
*Zona glomerulosa-Mineralocorticoids (aldosterone)
*Zona fasiculata- glucocorticouds
*Zona reticularis- gonadocorticoids
What does the adrenal medulla synthesise and from what cells?
Choromaffin cells synthesise catecholamines (NA?A)
In males, what structure forms the ductus deferens?
Mesonephric duct (paramesenephric regress)
What stucture guides the testes descent into the scrotum?
Gubernaculum
In females, what structure forms the oviduct, uterus and vagina?
Paramesonephric duct
What type of mesoderm are genital ducts, gonads and nephrons derived from?
Intermediate mesoderm
In the males what do the leydig cells do?
produce testosterone and respond to LH
What are the effects of testosterone?
Sex differentiation
Puberty (secondary charactaristics)
Growth and fusion of long bones
Muscle development
Spermatogenesis
Libido
Agression
What is Kallman's syndrome?
No GnRH neurone development (also cannot smell)
What do sertoli cells do?
Nutrients
Reabsorbs leftovers for spermatogenesis
Secretes semenipherous fluid
Blood testes barrier
Androgen binding protein
Steroid conversion (DHEA)
Respond to LH, inhibit by inhibin.
What is the mechanism of erection?
parasympathetic control:
-dilation of arteries
-relaxation of smooth muscles
-compression of veins
-contraction of ischiocavernosus muscle and bulbospongiosus.
What are the 2 stages of ejaculation?
*Emission- contraction of vas and bladder neck and prostate
*Ejaculation- smooth and striated muscle contraction

under sympathetic and voluntary semantic control.
Which cells of the ovary do LH and FSH target?
FSH=granulosa
LH= Thecal cells->synthesis androgens for release from granulosa cells.
NB-LH targets granulosa cells at the LH surge.
What does the corpus luteum produce?
progesterone and oestradiol.
What are the hormone levels during early follicular stage?(day 1-5)
*FSH elevated
*Oestradiol, progesterone, inhibin low
*Primary follicles rescued
*menstruation
What are the hormone levels during the late follicular stage? (Day 6-13)
*FSH falls, LH rising
*Oestradiol and inhibin rise
*Progesterone low
*Dominant follicle selected
What are the hormones during ovulatory phase (day 14)?
*LH surge.
*Oestradiol and inhibin fall
*Progesterone rises
*Ovulation
What are the hormone levels during the leuteal phase (Day 15-28)
*FSH/LH are low
*Oestradiol inhibin and progesterone are high
*Corpus leuteum present.
What does inhibin do?
Inhibits FSH release
What happens during the menstrual phase to the endometrium?(day 1-5)
Spiral arteries coil and constrict so upper layer dies, then dilates so bleeding occurs. prostaglandins cause uterine contractions.
What happens during the proliferative phase to the endometrium? (day 14-28)
Proliferation occurs. Glands increase in length, spiral arteries uncoil.
What happens during the secretory phase to the endometrium ? (day 14-28)
Glands get distended, and secrete. Stroma becomes oedematus (6-7mm). Decidual cells appear.
What are the hormonal effects of polycystic ovaries?
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)
What are the hormonal effects of hyperprolactinaemia?
*Excess prolactin
*inhibits GnRH
*Decreased FSH/LH
*Low oestrogen and no progesterone.
treat with dopamine agonist bromocryptine
What are the hormonal effects of hypothyroidism?
*Lowered T4 increases TRH and TSH release. TRH stimulates prolactin release,
*Decreased GnRH
*Decreased FSH/Lh
*Decreased oestrogens.
At what weight is puberty trigged in boys and girls?
boys- 55kg
girls-47kg
thought to be due to leptin signalling.
How are fetal and maternal blood supplies seperated?
By a thin layer of syncytiotrophoblast.
At what stage does the placenta become endocrine?
7 weeks
What is oestrogen formed from in placenta, and what is the main one?
Oestriol from DHEA, as lacks aromotase enzyme.
What does human placental lactogen do?
Growth of mammaries and fetus. (Diverts glucose to fetus).
How does the fetus efficiently get oxygen?
*Fetus has more Hb, and Fetal Hb had increased affinity.
*Double Bohr effect-unloads CO2 to mother
What are the 4 anatomical shunts present in fetus?
Placenta
Ductus venosus (liver)
Foramen ovale
Ductus arteriosus (bypasses lungs)
How do sperm get to the egg?
*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.
What are the stages of fertilisation?
*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.
At what stage does the gamete get implanted?
Blastocyst stage (5.5days)
What are the stages of birth?
*1-cervix dilation (7-14hrs)
*Stage 2- Full dilation, birth, abdominal contractions 1-2 hrs
*Stage 3-birth of placenta-half hour
What is the role of progesterone during birth?
hyperpolarises myometrium
Decreases propogation
Decreases oxytocin sensitivity
Stablises membranes-stops prostaglandin formation
What is the role of oestrogen during birth?
Myometrial growth
Depolarising
Increase oxytocin receptors.
Causes contractions
What is the role of oxytocin during birth?
Stimulates myometrium in 2nd stage of labour, and liberates prostaglandins.
What is the role of prostaglandins in labour?
Cause contractionds (made from arachydonic acid).
What causes mammary growth?
Oestradiol and progesterone
(also prolactin and Hpl)
What inhibits/stimulates lactation?
*inhibits=oestradiol and progesterone, dopamine
*stimulates=prolactin
What causes milk ejection?
oxytocin acting on myoepithelium