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Questions and Answers
Which gland is NOT mentioned as part of the endocrine evaluation?
Which gland is NOT mentioned as part of the endocrine evaluation?
Stimulation and suppression tests are irrelevant to the evaluation of endocrine disorders.
Stimulation and suppression tests are irrelevant to the evaluation of endocrine disorders.
False
What are the primary hormones produced by the adrenal glands?
What are the primary hormones produced by the adrenal glands?
Cortisol, aldosterone, and adrenaline
The general principles of ______ tests are relevant for specific endocrine disorders.
The general principles of ______ tests are relevant for specific endocrine disorders.
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Match the following endocrine glands with their hormones:
Match the following endocrine glands with their hormones:
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What is a common treatment for patients with acromegaly?
What is a common treatment for patients with acromegaly?
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Growth Hormone Deficiency (GHD) in adults can lead to complete failure of the anterior pituitary gland.
Growth Hormone Deficiency (GHD) in adults can lead to complete failure of the anterior pituitary gland.
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What is the gold standard test for diagnosing Growth Hormone Deficiency?
What is the gold standard test for diagnosing Growth Hormone Deficiency?
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In adults, failure of GH to rise above _____ ng/mL during an insulin tolerance test indicates a deficiency.
In adults, failure of GH to rise above _____ ng/mL during an insulin tolerance test indicates a deficiency.
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Which of the following is not associated with Growth Hormone Deficiency in children?
Which of the following is not associated with Growth Hormone Deficiency in children?
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Match the following hormones with their corresponding abnormal levels in pheochromocytoma:
Match the following hormones with their corresponding abnormal levels in pheochromocytoma:
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The confirmatory test for pheochromocytoma is the _____ test.
The confirmatory test for pheochromocytoma is the _____ test.
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Insulin tolerance test results indicating GH to rise above 10 ng/mL in children suggest Growth Hormone Deficiency.
Insulin tolerance test results indicating GH to rise above 10 ng/mL in children suggest Growth Hormone Deficiency.
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What is the primary function of the endocrine system?
What is the primary function of the endocrine system?
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Endocrine hormones act only on the cells that secrete them.
Endocrine hormones act only on the cells that secrete them.
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What hormone is also known as somatotropin?
What hormone is also known as somatotropin?
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____ is the condition caused by GH hypersecretion after the fusion of the epiphysis.
____ is the condition caused by GH hypersecretion after the fusion of the epiphysis.
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Match the following terms with their definitions:
Match the following terms with their definitions:
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Which of the following stimulates the release of growth hormone?
Which of the following stimulates the release of growth hormone?
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Growth hormone has a detectable level in healthy, non-stressed individuals.
Growth hormone has a detectable level in healthy, non-stressed individuals.
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What is the role of Insulin-like Growth Factor-1 (IGF-1)?
What is the role of Insulin-like Growth Factor-1 (IGF-1)?
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Fasting, major stress, and ____ can stimulate GH secretion.
Fasting, major stress, and ____ can stimulate GH secretion.
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What characterizes gigantism?
What characterizes gigantism?
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Growth hormone promotes hepatic gluconeogenesis.
Growth hormone promotes hepatic gluconeogenesis.
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What testing method is used as a confirmatory test for GH excess?
What testing method is used as a confirmatory test for GH excess?
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____ is the result of bony and soft tissue overgrowth after epiphyseal closure.
____ is the result of bony and soft tissue overgrowth after epiphyseal closure.
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Match the following hormones with their origins:
Match the following hormones with their origins:
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Study Notes
Learning Objectives
- Review the physiology of hormones produced by the pituitary, thyroid, and adrenal glands.
- Learn laboratory tests for diagnosing common endocrine disorders.
- Interpret test results for diagnosis and patient management.
- Understand stimulation and suppression tests for specific endocrine disorders.
- Apply knowledge for rational use of endocrine tests.
Endocrine System Outline
- Introduction to the endocrine system
- Pituitary function
- Thyroid function
- Adrenal function
The Endocrine System
- Endocrine function: secreting hormones into the bloodstream.
- Hormones act at distant sites.
- Autocrine: act on themselves.
- Paracrine: act on adjacent cells.
- Intracrine: act within the cells.
- Control metabolism, growth, reproduction, electrolytes balance, and stress responses.
- Endocrine hormones: released by glands/cells into blood, affecting target cells.
- Neuroendocrine hormones: secreted by neurons into blood and affect target cells.
Pituitary Gland
- Hypophysis: located in sella turcica, connected to hypothalamus.
- Divided into anterior (adenohypophysis) and posterior (neurohypophysis) lobes.
- Anterior lobe produces trophic hormones:
- Growth hormone (GH): stimulates protein synthesis and growth.
- Thyroid-stimulating hormone (TSH): stimulates thyroid hormone production.
- Adrenocorticotropic hormone (ACTH): stimulates adrenal cortex hormones.
- Prolactin (PRL): stimulates milk production.
- Follicle-stimulating hormone (FSH): affects ovarian follicles/spermatogenesis.
- Luteinizing hormone (LH): stimulates ovulation, testosterone production.
- Posterior lobe stores/releases hormones made in hypothalamus:
- Antidiuretic hormone (ADH): increases water reabsorption, vasoconstriction.
- Oxytocin: stimulates milk ejection, uterine contractions.
Chemical Structure and Synthesis of Hormones
- Proteins/polypeptides: most common, >100 amino acids (proteins) <100 (peptides).
- Steroid hormones: derived from cholesterol, lipid-soluble, rings structure.
- Amine hormones: derived from tyrosine - thyroid and adrenal medullary hormones.
Thyroid Gland
- Located below the larynx, two lobes connected by an isthmus.
- Produces thyroid hormones (T3 and T4) and calcitonin.
- T3 and T4 increase metabolic rate, T3 produced by other tissues.
- Calcitonin regulates calcium homeostasis.
Thyroid Function Tests
- Thyroid-stimulating hormone (TSH): measures thyroid function, most useful.
- Total T3 and T4: measure total serum levels of T3 and T4, useful but free T3/T4 preferred.
- Measure free T4 and free T3.
- Thyroid function tests help diagnose disorders like hypothyroidism, hyperthyroidism, etc.
Regulation of ADH (Antidiuretic Hormone)
- Factors promoting ADH secretion: increased sodium concentration, decreased blood volume/pressure.
- Factors inhibiting ADH secretion: decreased sodium concentration, increased blood volume/pressure, alcohol.
Syndrome of Inappropriate ADH Secretion (SIADH)
- SIADH: high ADH levels causing hyponatremia (low sodium) and hyperosmolar urine.
- Causes: include CNS diseases, tumors, pulmonary infections, and medications.
Diabetes Insipidus (DI)
- DI: inability of the kidneys to concentrate urine; high urine output and elevated blood osmolarity.
- Central DI: insufficient ADH production.
- Nephrogenic DI: kidney resistance to ADH.
- Diagnosed by water deprivation tests.
Pituitary Tumors
- Microadenomas (<1 cm) and macroadenomas (≥1 cm) are classified as functioning or non-functioning.
- Common functioning types: prolactinomas, somatotropinomas (GH).
Adrenal Glands and Function
- Adrenal glands: pyramidal structures above each kidney.
- Medulla (inner), cortex (outer): produce different hormones.
- Cortex (3 zones):
- Zona glomerulosa (mineralocorticoids): aldosterone regulates sodium and water balance.
- Zona fasciculata (glucocorticoids): cortisol for stress response, blood sugar, pressure.
- Zona reticularis (androgens): sex hormones like DHEA.
- Medulla: produces catecholamines (epinephrine/norepinephrine).
Congenital Adrenal Hyperplasia (CAH)
- CAH: arises from errors in steroid hormone synthesis.
- 21-hydroxylase deficiency and other enzyme defects.
- Causes characteristic symptoms, depending on type.
Hypercortisolism (Cushing Syndrome)
- Excess cortisol: can be exogenous (drugs) or endogenous (due to tumors, ACTH excess).
- Clinical symptoms: striae (stretch marks), facial plethora (redness), muscle weakness, obesity.
- Tests for Cushing syndrome: urine free cortisol, overnight dexamethasone suppression test.
Adrenal Medulla
- Adrenal medulla produces catecholamines (epinephrine/norepinephrine).
- Pheochromocytoma: chromaffin tumor, producing excess catecholamines, causing hypertension.
- Diagnosis tests include plasma-free metanephrines, 24 hr urine catecholamines, etc.
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Description
This quiz covers the essential physiology of hormones produced by the pituitary, thyroid, and adrenal glands. It includes laboratory tests for diagnosing common endocrine disorders and the interpretation of test results for effective patient management. Enhance your understanding of stimulation and suppression tests in the context of the endocrine system.
