Endocrinology

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Author:
ncrook
ID:
208612
Filename:
Endocrinology
Updated:
2013-05-03 02:29:11
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Posterior Pituitary Adrenal Glands
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Posterior Pituitary, Adrenal Glands
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  1. What hormones are released by the posterior pituitary?
    Antidiuretic hormone (ADH) - also known as vasopressin and oxytocin
  2. What is the function of ADH?
    • Controls water homeostasis by affecting the permeability of the collecting tubules of the kidney and enhancing water resorption, making urine more concentrated and the blood more dilute
    • Raises blood pressure by stimulating musculature of arterioles and capillaries
    • Affects uterine contraction
    • Promotes intestinal muscle contraction
  3. What causes an increase level of ADH?
    • Syndrome of inappropriate ADH secretion (SIADH) - no known stimulus for the release
    • Small cell carcinoma of the lung
    • CNS disease
    • Pulmonary disease
    • Side effect of certain drugs
  4. What clinical conditions results in decreased levels of ADH?
    • Polyuria
    • Diabetes insipidus
    • Polydipsia
  5. What is the function of oxytocin?
    • Stimulates uterine contractions during childbirth
    • Causes the ejection of breast milk
  6. Name the 3 layers of the Adrenal cortex
    • Zona glomerulosa (outermost)
    • Zona fasciculata (2nd layer)
    • Zona reticularis (3rd layer)
  7. What does the zona glomerulosa secrete?
    • Mineralocorticoids
    • (Aldosterone is the major one)
  8. What does the zona fasciculata secrete?
    • Glucocorticoids
    • (Cortisol is the major one)
  9. What does the zona reticularis secrete?
    • Sex hormones
    • (principally the androgens)
  10. What is the inner portion of the adrenal gland?
    Adrenal medulla
  11. What does the adrenal medulla produce?
    • Amine hormones
    • (epinephrine and norepinephrine)
  12. What are collectively known as catecholamines?
    • Epinephrine
    • Norepinephrine
  13. What secretes the steroid hormones?
    Adrenal glands
  14. Name the 3 groups of steroid hormones
    • Mineralocorticoids
    • Glucocorticoids
    • Androgens
  15. What regulates salt balance?
    Mineralcorticoids
  16. What assists with carbohydrate metabolism?
    Glucocorticoids
  17. What is required for sexual function?
    Androgens
  18. What controls the retention of Na, Cl, and H2O, the excretion of K and H, and the amount of fluid in the body?
    Aldosterone
  19. What is aldosterone production controlled by?
    Renin-angiotensin system of the kidneys
  20. What is produced when there is a decrease in blood pressure or blood volume?
    Renin
  21. What is a protein that acts on angiotensinogen to produce angiotensin I?
    Renin
  22. What stimulates the secretion of aldosterone and is a potent vasoconstrictor?
    Angiotensin II
  23. What is the function of aldosterone?
    • Increase salt
    • Water conservation
    • Overall effect is vasoconstriction
  24. What is the reference range of aldosterone?
    • Adult supine: 3-16 ng/dL
    • Adult upright: 7-30 ng/dL
    • Levels are higher in the morning
  25. What is the clinical significance of hyperaldosteronism?
    • Primary hyperaldosteronism: adrenal disease (Conn syndrome)
    • Secondary hyperaldosteronism: Renin-angiotensin system disorder, malignant hypertension, or renin-secreting renal tumor
  26. What is the clinical significance of hypoaldosteronism?
    • Atrophy of the adrenal glands
    • Addison disease
    • Congenital deficiency of 21-hydroxylase enzyme
  27. What condition:
    Pigmemtation of the skin
    Muscle weakness
    Weight loss
    Decreased blood pressure
    Nausea
    Diarrhea
    Atrophy of adrenal glands 
    Depressed production of aldosterone and glucocorticoid
    Addison disease
  28. Name the physiological effects of cortisol
    • Anti-insulin effects on carbs that result in increased blood glucose levels
    • Increased gluconeogenesis
    • Increased lipolysis
    • Increased protein catabolism
    • Decreased protein synthesis
    • Decreased antibody formation
    • Suppressed inflammatory response
  29. How is cortisol regulated?
    • Hypothalamus secretes corticotropin-releasing hormone
    • Anterior pituitary secretes adrenocorticotropic hormone
    • Low levels of plasma cortisol promote ACTH release
    • High levels of plasma cortisol inhibit ACTH
  30. What is the reference range of total cortisol?
    • 8 AM: 5-23 micro-gram/dL
    • 4 PM: 3-16 micro-gram/dL
  31. What is the clinical significance of hypercortisolism?
    • Primary hypercortisolism: adrenal adenoma or carcinoma, exogenous administration of cortisol, Cushing syndrome
    • Secondary hypercortisolism: excessive production of ACTH due to pituitary tumor, ectopic production of ACTH by nonendocrine tumor, Cushing disease
  32. What is the clinical significance of hypocortisolism?
    • Primary hypocortisolism: atrophy of adrenal gland, autoimmune disease, tuberculosis, prolonged high-dosage cortisol therapy
    • Secondary hypocortisolism: pituitary hypofunction
  33. Name the inner portion of the adrenal gland
    Adrenal medulla
  34. How are catecholamines synthesized?
    Synthesized from tyrosine by chromaffin cells of the adrenal medulla, brain, and sympathetic neurons
  35. Name the hormones that are included in catecholamines
    • Epinephrine
    • Norepinephrine
    • Dopamine
  36. What hormone mobilizes energy stores by converting glycogen to glucose, which allows the voluntary muscles to have greater work output?
    Epinephrine
  37. What hormone functions as a neurotransmitter affecting the vascular smooth muscle and heart and released primarily by the potganglionic sympathetic nerves?
    Norepinephrine
  38. What hormone functions as a neurotransmitter in the brain affecting the vascular system?
    Dopamine
  39. What are epinephrine and norepinephrine metabolized into and what is the final product?
    • Metabolized into metanephrine and normetanephrine
    • Final end product vanillylmandelic acid (VMA)
  40. What are increased levels of epinephrine and norepinephrine associated with?
    Pheochromocytoma
  41. What is a malignant tumor of the adrenal medulla that occurs in children?
    Neuroblastoma
  42. What does the neuroblastoma tumor produce?
    Produces epinephrine, norepinephrine, and dopamine
  43. What is the end product of dopamine metabolism?
    Homovanillic acid (HVA)
  44. What clinical condition is characterized by:
    Increased HVA urinary excretion
    Increased VMA urinary excretion
    Neuroblastoma

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