M2-Cx11-Test 1 --> High Yield Questions

Front 1

ADENOHYPOPHYSIS

What hypothalamic hormones stimulate
==> FSH
==> LH
==> ACTH
==> TSH

==> Beta-LPH
==> Prolactin
==> Growth Hormone

Back 1

- GnRH
- GnRH
- CRH
- TRH

- CRH
- PRH
- GHRH

Front 2

ADENOHYPOPHYSIS

- what 2 adenohypophysis hormones not only have stimulatory, but also Inhibitory hormones from hypothalamus?

Back 2

- Growth Hormone (GH)

- Prolactin

Front 3

ADENOHYPOPHYSIS

- what are the 2 inhibitory hormones?

- what hormones do they inhibit?

Back 3

- GHIH inhibits GH

- PRH inhibits Prolactin

Front 4

ADENOHYPOPHYSIS

- GHIH is also called what?

- PIF is also called what?

Back 4

- Somatostatin

- Dopamine

Front 5

ADENOHYPOPHYSIS

- which hypothalamic hormone is more dominant as the inhibitory rather than its stimulatory counterpart?

Back 5

- PIH (dopamine)

(more dominant than PRH)

Front 6

HORMONE CONTROL LOOPS

- what type of feedback loop is UNSTABLE?

- what type of feedback loop is STABLE?

Back 6

- Positive
(no baseline b/c too much or too little)

- Negative

Front 7

HORMONE CONTROL LOOPS

- in the HPA, what are the 3 types of Negative Feedback loops?

Back 7

- Long loop

- Short loop

- Ultra short loop

Front 8

GROWTH HORMONE

- what are the Metabolic Effects of GH? x4

Back 8

(ASK ' D)

- Anabolic effect

- Sparing of Protein
- Ketogenic effect

- Diabetogenic effect

Front 9

GROWTH HORMONE

- Excessive GH leads to what effect on Fat utilization?

Back 9

- Ketogenic effect

Front 10

GROWTH HORMONE

- how does GH cause a Diabetogenic effect?

Back 10

- GH-induced Insulin resistance

Front 11

GROWTH HORMONE

- excessive GH leading to a GH-induced Insulin Resistance is often associated with which Dz?

Back 11

- Type 2 DM

Front 12

GROWTH HORMONE

- GH effects on skeleton?

Back 12

- stimulates Cartilage growth

- stimulates Bone growth

Front 13

GROWTH HORMONE

- GH requires what 2 things to have an effect?

Back 13

- Carbohydrates

- Insulin

Front 14

GROWTH HORMONE

- GH exerts most of its effect through?

Back 14

- IGFs

(somatomedins)

Front 15

GROWTH HORMONE

- what is the most important Somatomedin?

- what is the most important IGF?

Back 15

somatomedin C

(same as)

IGF - I

Front 16

GROWTH HORMONE

- what are the mechanisms affected by GH in Adipose Tissue? x2

- thus the resulting effect is what?

Back 16

(LG)
- Increased Lipolysis
- Decreased Glucose Uptake

(thus)

- Decreased Adiposity

Front 17

GROWTH HORMONE

- what are the mechanisms affected by GH in the Liver? x4

Back 17

INCREASED: (RPG'S)

- RNA / Protein Synthesis

- Glucose Synthesis / Storage

- Somatomedins

Front 18

GROWTH HORMONE

- what are the Gross effects of Somatomedins (induced by GH) on the body? x3

Back 18

INCREASE
- Linear Growth
- Organ Size
- Organ Function

(organs include Visceral organs, Heart, Lung, Bone, etc)

Front 19

GROWTH HORMONE

- GH effects on Adiposity?
- GH effects on Lean Body Mass?

Back 19

- decreases Adiposity

- increases Lean Body Mass

Front 20

GROWTH HORMONE

- what factors would stimulate GH secretion? x10

Back 20

(EGG & FASTED states)

- Estrogen/Testosterone
- GHRH
- Glucose Decrease

- FFA Decrease
- Amino Acid Increase
- Starvation (Fasting)
- Trauma/Excitement/Stress
- Exercise
- Deep Sleep (stage 2 & 4)

Front 21

GROWTH HORMONE

- what factors would inhibit GH secretion? x7

Back 21

(FAG MESS inhibits Growth)

- FFA increase
- Aging
- Glucose increase

- Morbid obesity
- Exogenous GH
- SomatoMedins (IGF)
- SomatoStatins (GHIH)

Front 22

DIETARY REGULATION

PROTEIN effects on :
- GH
- SomatoMedins
- Insulin

Back 22

- increase

- increase

- increase

Front 23

DIETARY REGULATION

CARB intake effects on :
- GH
- SomatoMedins
- Insulin

Back 23

- decrease

- BOTH

- increase

Front 24

DIETARY REGULATION

FASTING effects on :
- GH
- SomatoMedins
- Insulin

Back 24

- increase

- decrease (b/c insulin effects >> GH)

- decrease

Front 25

Back 25

Front 26

Back 26

Front 27

Back 27

Front 28

THYROID PHYSIOLOGY BASICS

- Thyroid gland vascularity is?

Back 28

- rich in supply

Front 29

THYROID PHYSIOLOGY BASICS

- general effects of T3 & T4

- general effects of Calcitonin

Back 29

- Increase metabolic rate

- Decreases Ca2+ levels
(in response to high levels)

Front 30

THYROID PHYSIOLOGY BASICS

- what is Unique about hormones in the Thyroid gland?

Back 30

- only hormones stored in Extracellular compartment

Front 31

THYROID PHYSIOLOGY BASICS

- what molecule is essential for thyroid hormone synthesis?

- how much of this should be taken in by diet?

Back 31

- Iodide

- 1 mg/week

Front 32

THRYOID POOL OF IODIDE

- Na+ I- Co-Transport System is composed of what transport pump?

- Na+ I- Co-transport is dependent on what?

Back 32

- Na+ K+ ATPase

- Energy Dependent

Front 33

THRYOID POOL OF IODIDE

- Na+K+ ATPase involved with the Na+I- COTransport system is located where?

- synthesis of above transporter is stimulated by what?

Back 33

- Cell membrane - basal surface
(G-linked)

- TSH

Front 34

THRYOID POOL OF IODIDE

- the Energy dependent Na+K+ATPase of the Na+ I- COTransport system maintains what Thyroid: Plasma ratio for Iodide?

- what is above ration with TSH stimulation?

Back 34

30 : 1
(thryoid epithelium : plasma ratio)

- up to 250 : 1

Front 35

THRYOID POOL OF IODIDE

- what competitive inhibitors can inhibit the transport system, thus causing rapid iodide discharge? x3

Back 35

(PTT)

- PerChlorate
- PerTechnetate

- ThioCyanate

Front 36

THRYOID HORMONE SYNTHESIS

- T3 & T4 are formed WITHIN what molecule?

- what is an important component of the above molecule?

Back 36

- Thyroglobulin (TG)

- 70 Tyrosine amino acids
(per molecule)

Front 37

THRYOID HORMONE SYNTHESIS

- once iodide is taken in against the concentration gradient, what modifications must be made to it?

- why?

Back 37

- must become Oxidized Iodine

- only Oxidized Iodide can react with the Tyrosine molecules on Thyroglobulin

Front 38

THRYOID HORMONE SYNTHESIS

- If 1 Oxidized Iodine binds with Thyroglobulin, than this forms?

- If 2 Oxidized Iodine binds with Thyroglobulin, than this form?

Back 38

- MIT
(mono-iodo-tyrosine)

- DIT
(di-iodo-tyrosine)

Front 39

THRYOID HORMONE SYNTHESIS

- what 2 reactants form T3?

- what 2 reactants from Reverse T3

- what 2 reactants from T4

Back 39

- DIT + MIT

- DIT + MIT
(with iodide ions at different location)

- DIT + DIT

Front 40

THRYOID HORMONE SYNTHESIS

- which is more potent hormone: T3 or T4?

- potent by how much?

Back 40

T3 is more potent

by a factor of 3 to 4 times more

Front 41

THRYOID HORMONE SYNTHESIS

- when iodide availability is RESTRICTED, the formation of which hormone is Favored?

Back 41

T3

Front 42

THRYOID HORMONE SYNTHESIS

- when the Thyroid Gland is HYPERSTIMULATED, what happens to the T3:T4 ratio?

Back 42

- T3:T4 ratio is increased

(more need for potent T3)

Front 43

THYROID HORMONE RELEASE

- Synthesis of Thyroid hormone occurs where?

- Storage of Thyroid hormone occurs where?

- Digesion of Thyroid hormone prior to release occurs where?

Back 43

- Colloid center
(TG tho is made in the follicle cell)

- Colloid center

- Follicle cell

Front 44

THYROID HORMONE RELEASE

- prior to release, the follicular vesicles containing the hormone will be fused with?

- as a result, what gets released from the Thyroglobulin moledule?

Back 44

- lysosomes

- MIT
- DIT
- T3
- T4

Front 45

THYROID HORMONE RELEASE

- what happens to the MIT & DIT after being cleaved from Thyroglobulin?

Back 45

- Deiodinase cleaves off the Iodine

Front 46

THYROID HORMONE RELEASE

- Deiodinase is located where?

- what does it do?

- what is its effects on T3 or T4

Back 46

- Follicular cell

- cleaves iodine off of T3 and T4

- does nothing to T3 and T4
(just the iodine for re-use)

Front 47

THYROID HORMONE TURNOVER

- what is the reasons why there is a disproportionate number of T4 in the colloid (extracellular pool) and in the plasma?

Back 47

- T4 has a longer Half life

- T3 has a much higher Metabolic clearance
(reverse T3 is even higher)

- T3 has a much higher Fractional Turnover
(reverse T3 is even higher)

Front 48

THYROID HORMONE TURNOVER

- of the circulating T4, what % is actually FROM the Thyroid?

- of the circulating T3, what % is actually FROM the Thyroid?

- of the circulating Reverse T3, what % is actually FROM the Thyroid?

Back 48

- 100%

- 25%
(rest is converted from T4)

- 5%
(rest is converted from T4)

Front 49

THYROID HORMONE TURNOVER

- the thyroid produces what % of T4?

- of T3?

- of Reverse T3?

Back 49

- 100% for all

Front 50

T3 & T4 TRANSPORT

- list 3 plasma proteins that bind T3 and T4

Back 50

(TAT)

- Thyroxine-Binding Globulin (TBG)

- Albumin

- Thyroxine-Binding PreAlbumin (TBPA)

Front 51

T3 & T4 TRANSPORT

- TBPA is also known as?

Back 51

- TTR

(TransThyRetin)

Front 52

T3 & T4 TRANSPORT

- just by itself (without and T's), which plasma binding protein has the highest plasma concentration?

- T4 has the highest affinity for which?

- T3 has the highest affinity for which?

Back 52

- albumin

- TBG
(T4 affinity = TBG > TBPA > Albumin)

- TBG
(although higher % on albumin, way more albumin in blood)

Front 53

T3 & T4 TRANSPORT

- T3 is almost (1%) nonexistent on which plasma binding protein?

Back 53

- TBPA

Front 54

T3 & T4 TRANSPORT

- which hormone is short acting, with shorter latency and Duration?

Back 54

- T3

Front 55

T3 & T4 TRANSPORT

- what governs T4 distribution btw Free and Bound forms?

Back 55

- T4 & TBG equilibrium

Front 56

CALCIUM HOMEOSTASIS

- Patient with "normal" total serum calcium levels, but with LOW serum Albumin, may actually have?

Back 56

- elevated IONIZED Calcium levels

and be HYPERCALCEMIC

Front 57

CALCIUM HOMEOSTASIS

- Corrected Calcium Formula?

Back 57

= (measured Ca2+) + (0.8) x (4 - Albumin)

(note calcium measured in mg/dL)
(note albumin measured in g/dL)

Front 58

CALCIUM HOMEOSTASIS

- Active Calcium Transport (via GI) is stimulated directly by what compound?

Back 58

1,25 Dihydroxyvitamin D

Front 59

CALCIUM HOMEOSTASIS

- What type of Calcium is Freely Filterable by the Kidney?

- How much of above calcium is freely filtered by the Kidney?

- What percentage is REABSORBED back?

- Thus how much is normally excreted in urine?

Back 59

- Ionized Calcium

- 10 grams

- 98%

- 200 mg
(of urinary calcium +/- 100 mg)

Front 60

CALCIUM HOMEOSTASIS

- what compounds will enhance Bone Resorption (thus increasing Ca2+)?

- what compound will inhibit bone resorption (thus decreasing Ca2+)

Back 60

1,25 DihydroxyVitamin D
PTH

Calcitonin

Front 61

PARATHYROID (PTH) SECRETION

- Calcium-Sensing Receptor has the Biological Effect of INCREASING what? x2

- Calcium-Sensing Receptor has the Biological Effect of DECREASING what? x2

Back 61

(INCREASES)
- Calcitonin hormone Secretion
- Urine Ca2+ Excretion

(DECREASES)
- PTH Secretion
- Reabsorption of Ca2+ AND Mg2+

Front 62

PARATHYROID (PTH) SECRETION

- PTH secretion is inversely related to what?

Back 62

- concentration of Serum Calcium

(so low serum calcium = high PTH secretion)

Front 63

PARATHYROID (PTH) SECRETION

- activation of the Calcium Sensing Receptor will have the Biologic effect of DECREASING the REABSORPTION of? x2

- above decrease in reabsorption occurs where?

Back 63

- Calcium
- Magnesium

- THICK Ascending Limb of Henle

Front 64

PARATHYROID (PTH) SECRETION

- activation of the Calcium Sensing Receptor will have the Biologic effect of DECREASING the REABSORPTION of? x2

- above decrease in reabsorption occurs where?

Back 64

- Calcium
- Magnesium

- THICK Ascending Limb of Henle

Front 65

PARATHYROID (PTH) SECRETION

- INACTIVATING mutations of the Calcium Sensing Receptor can lead to what Dz?

- what lab changes would be associated? x3

Back 65

- Familial HYPOCalciuric HYPERCalcemia

- Increased PTH secretion
- Hypercalcemia
- Hypocalciuria

Front 66

PARATHYROID (PTH) SECRETION

- PTH binding to receptors on the KIDNEY will cause what biological effect INCREASES? x3

- PTH binding to Kidney receptors will cause what biological effect DECREASES?

Back 66

(INCREASES URA)
- Urinary Excretion of cAMP
- Resorption of Ca2+ @ distal tubules
- Activity of Vit. D1 alpha Hydroxylase

(DECREASES)
- Resorption of PO4- @ the tubules

Front 67

PARATHYROID (PTH) SECRETION

- PTH binding to receptors on the BONE will cause what biological effect?

Back 67

- Increased Bone resorption of CALCIUM
- Increased Bone resorption of PHOSPHATE

(into the ECF)

Front 68

PARATHYROID (PTH) SECRETION

- PTH binding to the receptors in the GI tract will cause what biological effect?

- is this GI effect by PTH an INDIRECT or DIRECT effect?

- explain why

Back 68

- Increases ABSORPTION of CALCIUM
- Increases ABSORPTION of PHOSPORUS

- INDIRECT

- via the effects on RENAL Vit. D1 alpha Hydroxylase

(thus increasing 1,25 dihydroxyvitamin D levels)

Front 69

DIURETICS & CALCIUM

- what is the effect of LOOP Diuretics (such as Fursemide) on calcium?

- Loop diuretics can also do the same effect on what other electrolyte?

- what other diuretics can have an OPPOSITE effect to those done by Loop diuretics?

Back 69

(LICER - Loop diuretics Increase Calcium Excretion Renaly)

- INCREASES Excretion of Calcium

- Sodium

(TACER - Thiazides Abates Calcium Excretion Renaly)
- Thiazide diuretics
(have the opposite effect of decreasing calcium excretion)

Front 70

PARATHYROID (PTH) SECRETION

- activation of Calcium-Sensing-Receptors (w/ Ca2+) effects renal reabsorption of what electrolytes and how?

- where does this occur renaly?

Back 70

INCREASES
- Calcium
- Magnesium

- Thick Ascending Loop of Henle

Front 71

PARATHYROID (PTH) SECRETION

- activation of PTH Receptors (w/ PTH) effect renal reabsorption of what electrolytes and how?

- where does this occur renally?

Back 71

INCREASED
- Calcium
- Phosphorus (PO4-)

- Distal Tubules

Front 72

PARATHYROID (PTH) SECRETION

- activation of PTH Receptors (w/ PTH) effects the GI absorption of what electrolytes and how?

- describe the INDIRECT mechanism involved

Back 72

INCREASED
- Calcium
- Phosphorus (PO4-)

Increases the RENAL activity of Vitamin D1 alpha Hydroxylase,
thus, increasing the levels of
1,25 Dihydroxyvitamin D