Hypothalamus & Pituitary S2M1

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lancesadams
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88897
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Hypothalamus & Pituitary S2M1
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2011-08-12 16:23:01
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Ross S2M1
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Physiology
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  1. What are the primary Endocrine organs
    • Pineal
    • Hypothalamus
    • Pituitary
    • Thyroid
    • Parathyroids
    • Adrenals
    • Pancreas
    • Ovaries
    • Testes
  2. What are the secondary endocrine organs
    • Heart
    • Stomach
    • Liver
    • Kidney
    • Adipose
    • Small Intestine
    • Skin
  3. Neurohormone
    • Hormone produced by neurons and secreted
    • Example: Antidiuretic hormone (ADH)
  4. What is the difference in the distribution of hydrophilic and hydrophobic hormone transportation
    • Hydrophilic - transported free in blood
    • Hydrophobic - circulated in blood bound to plasma proteins
  5. What is the job of Binding proteins
    Bind to hormones to deliver them and protect them until they arrive at the target tissue
  6. What hormone has one of the longest half lifes
    T4 (6-7 days)
  7. What are some of the ways that hormones are eliminated
    • Urine
    • Biliary excretion
    • Metabolic degredation
  8. What is the eventual effect of releasing GnRH
    • FSH & LH release causing ovulation, progesterone, and estrogen release in women
    • Spermatogenesis and testosterone release in men
  9. What is the result of releasing GHRH
    • Insulin Growth Factor (IGF) released from liver
    • Increased protein synthesis and metabolism of carbohydrates and lipids
  10. What is the effect of releasing CRH
    Adrenocorticotropic hormone (ACTH) is released to cause the Adrenal cortex to secrete Cortisol stimulating gluconeogenesis
  11. What are the different levels of hormone feedback loops
    • "Ultra short" - Negative feedback from the hormone released from the hypothalamus to the hypothalamus
    • "Short" - Negative feedback from the pituitary to the hypothalamus
    • "Long" - Negative feedback from the target gland hormone to the Anterior pituitary or Hypothalamus
  12. Tropic Hormone
    Hormone released from Pituitary to the target gland
  13. Growth Homone (GH) has what effect on Adipose tissue
    • Decrease Glucose uptake
    • Increases Lipolysis
    • Decrease Adiposity
  14. What effect does GH have on muscle
    • Decrease Glucose uptake
    • Increase amino acid uptake
    • Increase protein synthesis
    • Increase lean body mass
  15. What effects does GH have on the liver
    • Increase in:
    • RNA synthesis
    • Protein synthesis
    • Gluconeogenesis
    • IGFs (insulin growth factor)
  16. GH has what effect on bone, heart, and lung
    • Increase in protein synthesis
    • Incease in RNA synthesis
    • Increase in DNA synthesis
    • Increase in cell size and number
  17. Insulin Growth Factor (IGF) has what metabolic effects
    • Decrease in:
    • Plasma glucose
    • Gluconeogenesis
    • Glycogenolysis
    • Lipolysis
    • Increase in:
    • Insulin sensitivity
    • Glucose uptake
    • Protein synthesis
  18. Under what conditions does GH secretion peak
    Strenuous exercise and sleeping
  19. What happens if GH is in excess before and after closure of the epiphyses
    • Before - Gigantism
    • After - Acromegaly
  20. What are the effects of Somatropin administration
    Increase linear growth of someone with dwarfism
  21. What are some of the side effects of Somatropin
    • Headaches
    • Scoliosis due to rapid growth
    • Diabetes mellitus
    • Edema
    • Arthritis
    • Carpal tunnel
    • "C HEADS"
  22. How is Somatropin administered
    Parenterally
  23. Pegvisomant
    • GH antagonist
    • Used to treat Acromegaly
    • "Peg down the GH"
  24. Mecasermin
    • Recombinant IGF-1
    • Used when there is a lack of response to GH due to disfunctional GH receptor
    • Side effect is hypoglycemia, should be given directly after a snack
    • "The Meca of GH alternatives"
  25. Sermorelin
    • Growth Hormone Releasing Hormone (GHRH)
    • Used for diagnosis purposes

    • There is an orphan of it used for GH deficiency and weight loss caused by AIDS
    • "Give a sermon on GHRH"
  26. Octreotide
    • Somatostatin analog but 45x more potent
    • Administered subcutaneously 3x/day
    • Used for Acromegaly and suppression of ectopic hormone production
    • "Octamom uses this for her Acromegaly"
  27. What are the side effects of Octreotide
    • Gastrointestinal issues
    • Gall stones
    • Vit B12 deficiency
    • Cardiovascular problems
  28. Bromocriptine
    • Dopamine (D2) agonist
    • Prototype drug used to treat hyperprolactinemia
    • Reduces the circulation of prolactin, at higher doses it reduces GH
    • Requires large doses
  29. What are the side effects of Bromocriptine
    • GI issues
    • Nausea and Vomiting
    • Vaginal administration circumvents it
  30. Metoclopramide
    • D2 antagonist
    • Turning on prolactin
    • Antipsychotic that can cause hyperprolactemia and therefore gynecomastia and galactorrhea
    • "Don't medal with D2 antagonists"
  31. What is the role of the posterior pituitary
    • Does not synthesize hormones
    • Stores and releases hormones made by hypothalamus
    • Hormones are transported along the hypothalamo-hypophyseal tract
  32. How are Oxytocin and Vasopressin (ADH) structurally different
    They differ by only 2 amino acids
  33. What are the effects of Oxytocin
    • Uterine contraction
    • Milk Ejection
  34. What are the effects of ADH
    • Increase in water reabsorption and vasoconstriction
    • Increae BP
  35. What happens in ADH deficiency
    Diabetes insipidus
  36. What are the two different types of diabetes insipidus and there effects
    • Central - Tumors, Trauma, Surgery to Pituitary
    • Nephrogenic - Renal disease, ADH-unresponsive kidney, Drugs (lithium)
  37. What is a hallmark of diabetes insipidus
    • Polyuria
    • Polydipsia
    • Dehydration
  38. SIADH
    • Syndrome of Inappropriate ADH secretion
    • ADH excess
    • Often caused by a small cell carcinoma in the lungs, hypothalamus, or pituitary
  39. How is Oxytocin administered, and for what
    • IV
    • Internasal is also available
    • Used for milk let down
  40. What are the different receptors for Vasopressin (ADH)
    • V1 - Constriction of arterioles using IP3/DAG & calcium as second messengers
    • V2 - Antidiuretic effects through cAMP on kidneys
    • Extrarenal V2 - mediate the release of von willebrand factor
  41. What is the function of Vasopressin as a drug
    • Decreases urine production (kidneys return more to blood)
    • Decreases water loss
  42. Desmopressin
    • Synthetic analog of Vasopressin (ADH) selective for V2 receptors
    • Much more powerful then Vasopressin (ADH)
    • Used for Central diabetes insipidus
    • Decreases water loss in kidneys
  43. How is Desmopressin administered
    • Orally
    • Intranasally
    • Parenterally
  44. What are the adverse affects of Desmopressin
    Hyponatremia
  45. What are the additional uses for Desmopressin
    • Von Willebrand disease
    • Nocturnal enuresis (peeing the bed)
  46. Conivaptan
    • Nonpeptide vasopressin antagonist with high affinity for V2
    • Used for SIADH

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