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33 Cards in this Set
- Front
- Back
Name the three classes of hormones.
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Peptides/proteins,
Amines (tyrosine derivatives) Steroids (cholesterol derivatives) |
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What is the amino acid cutoff between peptide and protein hormones?
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3-100 = peptides (TRH, IGF-1, insulin)
>100 = proteins (GH, prolactin) |
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How are protein/peptide hormones stored and circulated?
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Stored in secretory vesicles. Most circulate free because they are water soluble. Small peptides may have carrier proteins.
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Which hormones are tyrosine derivatives?
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Thyroxine, norepinephrine, epinephrine (catecholamines)
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How are T4/T3 hormones stored and circulated?
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T4/T3 stored in follicles with thyroglobulin (TG), 99% circulated with thyroid binding globulin (TBG)
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How are catecholamines stored and circulated?
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E/NE (4:1) stored in secretory vesicles, circulate 50% free (water soluble) and 50% loosely with albumin
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How are steroids stored and circulated?
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Cholesterol ester precursors are stored in adrenal cortex, gonads, and placenta, >90% circulate bound (binding acts as storage depot)
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Where are steroid receptors found?
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Usually unbound in the cytoplasm and nucleus
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Where are T4/T3 receptors found?
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In the nucleus bound to DNA with co-repressors. Activation causes binding to hormone response elements.
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Where are peptide/protein hormone receptors found?
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On the cell surface, as G-protein coupled receptors, receptor kinases, receptor-linked kinases or ligand gated ion channels
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Adrenotoxic used in non-resectable cushing's disease
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Mitotane - cousin of DDT
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Synthetic cortisol used to test for Cushing's
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Dexamethasone
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Converts Cortisol to cortisone (inactivates)
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11β-hydroxysteroid dehydrogenase D2
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Converts cortisone to Cortisol (activates)
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11β-hydroxysteroid dehydrogenase D1
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Describe Paget's disease
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Overactive osteoclasts = enlarged skull, pelvis, blindness, hearing loss, hyperparathyroidism, CN palsies
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Cause of familial hypocalciuric hypercalcimia
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CaSR defect. Important because not resectable
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Sulfonylurea MOA and AEs
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Glyburide
binds to Katp pump, causes Ca influx and insulin release from Beta cells. May cause hypoglycemia and weight gain Chlorpropamide causes SIADH and disulfiram like rx |
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Short acting secretagogues MOA and AEs
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Repaglinide (different than SU), and netaglinide
bind to Katp pump, causes insulin release from Beta cells Hypoglycemia and wt gain |
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Vascular diabetes complication causes
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Polyol - sugar > sorbitol, absorbed by vascular cells makes them swell and damage - leaky vessels
AGE / ROS / PKC - sugar > metabolites like PKC, ROSs and AGEs, AGE receptors in kidney produce harmful cytokines - kidney failure. PKC - vasodilation |
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ADH receptor types
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V1 - direct vasoconstriction. Agonists used in septic shock
V2 - renal DCT increases permeability, allows H20 to be reabsorbed |
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PRLoma tx
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DA agonists:
bromocriptine cabergoline |
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What causes tan in Addison's?
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Excess ACTH converted to alpha MSH melanocyte stim horm. ONLY in primary Addison's. 2o = no ACTH
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Waterhouse-Friedrichson syndrome
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Adrenal insufficiency caused by an adrenal hemorrhage in meningococcal sepsis
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Pituitary apoplexy
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bleeding into an undx pit adenoma that causes 2o Addison's
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Cosyntropin
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synthetic ACTH. Used to dx Addison's. Administer, then measure cortisol 30 min later - should peak, unless long term Addison's and adrenal's are dormant.
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Metapyrone
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blocks cortisol synthesis. Used to dx 2o Addison's - should cause ACTH to rise.
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Dx primary aldosteronism
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salt-loading with fludrocortisone causes salt retention and normally supresses aldosterone production, but not in disease
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Tx of aldosteronism
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surgery in adenoma
Rx aldosterone receptor antagonist: spironolactone - causes hyperkal and gynecomast eplerenone - Hyperkalemia amiloride - inhibits Na retention, hyperkalemia |
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Distinguish salt-wasting CAH from simple-virilizing
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simple-virilizing has normal aldosterone, so no salt-wasting crises
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Hypogonadotrophic hypogonadism types
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Kallmann's (men and women),
Fertile Eunuch (LH deficiency) FSH deficiency |
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What hormone is hCG similar to?
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LH
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Hypergonadotrophic hypogonadism types
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Mumps orchitis
Sertoli-only syndrome Klinefelter's Idiopathic |
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What is the difference between T3 and T4?
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T3 is active, more actively taken up.
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