Podcast
Questions and Answers
What is the consequence of a deficiency in 21-Hydroxylase?
What is the consequence of a deficiency in 21-Hydroxylase?
- Increased levels of sex hormones (correct)
- Increased aldosterone secretion
- Increased production of cortisol
- Decreased sex hormone levels
Which syndrome is characterized by developmental defects affecting the ability to smell?
Which syndrome is characterized by developmental defects affecting the ability to smell?
- Turner’s syndrome
- Kallmann’s syndrome (correct)
- Sheehan’s syndrome
- Adrenal insufficiency
In the diagnosis of an endocrine condition, what is the first essential question to ask?
In the diagnosis of an endocrine condition, what is the first essential question to ask?
- What symptoms are being experienced?
- What is the treatment required?
- Is there a family history of endocrine disorders?
- Is it a condition of excess or deficiency? (correct)
What is a primary issue in evaluating endocrine disorders?
What is a primary issue in evaluating endocrine disorders?
What hormonal change is typical in adrenal insufficiency during hemodynamic collapse?
What hormonal change is typical in adrenal insufficiency during hemodynamic collapse?
Which nutritional deficiency is commonly associated with endemic goiter?
Which nutritional deficiency is commonly associated with endemic goiter?
Which of the following is NOT an abbreviation related to hormone action mentioned?
Which of the following is NOT an abbreviation related to hormone action mentioned?
Which condition describes hormone resistance problems?
Which condition describes hormone resistance problems?
What is the role of JAKs in cytokine receptor signaling?
What is the role of JAKs in cytokine receptor signaling?
How does ligand binding affect nuclear receptors?
How does ligand binding affect nuclear receptors?
Which of the following is a likely consequence of activated STAT proteins?
Which of the following is a likely consequence of activated STAT proteins?
What mechanism enhances RNA polymerase II-mediated transcription?
What mechanism enhances RNA polymerase II-mediated transcription?
Which receptors are included in cytokine signaling pathways?
Which receptors are included in cytokine signaling pathways?
What is the primary role of hormones in the endocrine system?
What is the primary role of hormones in the endocrine system?
Which of the following glands is NOT classified as an endocrine gland?
Which of the following glands is NOT classified as an endocrine gland?
What might be a treatment approach for excess hormone production due to tumors?
What might be a treatment approach for excess hormone production due to tumors?
Which statement best describes exocrine glands?
Which statement best describes exocrine glands?
How is the definition of endocrinology complicated?
How is the definition of endocrinology complicated?
What role does ACTH play in relation to blood pressure?
What role does ACTH play in relation to blood pressure?
Which hormones are primarily involved in the regulation of the menstrual cycle?
Which hormones are primarily involved in the regulation of the menstrual cycle?
What effect does increasing thyroid hormone levels have on TRH and TSH secretion?
What effect does increasing thyroid hormone levels have on TRH and TSH secretion?
What is the primary feedback mechanism of Inhibin in the menstrual cycle?
What is the primary feedback mechanism of Inhibin in the menstrual cycle?
Which hormone is mainly responsible for the lactation process during pregnancy?
Which hormone is mainly responsible for the lactation process during pregnancy?
What is the primary function of vasopressin in the body?
What is the primary function of vasopressin in the body?
During the early follicular phase of the menstrual cycle, which hormones are secreted in a pulsatile manner?
During the early follicular phase of the menstrual cycle, which hormones are secreted in a pulsatile manner?
What hormonal changes occur at menopause regarding reproductive capability?
What hormonal changes occur at menopause regarding reproductive capability?
What is a significant result of positive feedback mediated by estrogen during the menstrual cycle?
What is a significant result of positive feedback mediated by estrogen during the menstrual cycle?
How does calcium feedback regulate parathyroid hormone (PTH) secretion?
How does calcium feedback regulate parathyroid hormone (PTH) secretion?
What is a primary cause of hormone excess in endocrine dysfunction?
What is a primary cause of hormone excess in endocrine dysfunction?
Which condition can result from an adrenal adenoma?
Which condition can result from an adrenal adenoma?
What characterizes pituitary adenomas?
What characterizes pituitary adenomas?
What mechanism can indicate autonomous function in endocrine tumors?
What mechanism can indicate autonomous function in endocrine tumors?
What role does the MEN1 gene play in tumorigenesis?
What role does the MEN1 gene play in tumorigenesis?
What is indicated by ACTH suppression after high-dose dexamethasone testing?
What is indicated by ACTH suppression after high-dose dexamethasone testing?
Which of the following is a typical characteristic of adenocarcinomas related to endocrine dysfunction?
Which of the following is a typical characteristic of adenocarcinomas related to endocrine dysfunction?
What can result from the loss of function in the normal MEN1 gene?
What can result from the loss of function in the normal MEN1 gene?
What is the significance of a midnight salivary cortisol test in this patient's case?
What is the significance of a midnight salivary cortisol test in this patient's case?
Which condition is the patient most likely experiencing based on her symptoms?
Which condition is the patient most likely experiencing based on her symptoms?
What is the possible consequence of using oral contraceptives in this patient?
What is the possible consequence of using oral contraceptives in this patient?
What does slightly elevated LDL and ALT indicate about the patient's health?
What does slightly elevated LDL and ALT indicate about the patient's health?
Why might the patient be experiencing irregular menses?
Why might the patient be experiencing irregular menses?
What lifestyle factor has contributed to the patient's weight gain?
What lifestyle factor has contributed to the patient's weight gain?
What does the patient's normal electrolyte levels suggest?
What does the patient's normal electrolyte levels suggest?
What can be inferred about the patient's family history?
What can be inferred about the patient's family history?
Flashcards
Endocrine glands
Endocrine glands
Internal secretions that directly enter the bloodstream, influencing cellular responses and regulating physiological processes.
Exocrine glands
Exocrine glands
External secretions that are released into a lumen or duct, like the GI tract, for specific functions.
Hormones
Hormones
Chemical messengers produced by endocrine glands that regulate physiological processes in the body.
Endocrinology
Endocrinology
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Hormone replacement
Hormone replacement
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Hormone Excess (Hyperfunction)
Hormone Excess (Hyperfunction)
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Neoplastic Growth
Neoplastic Growth
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Adenocarcinoma or adrenocortical carcinoma
Adenocarcinoma or adrenocortical carcinoma
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Pituitary Adenoma
Pituitary Adenoma
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Adrenal Adenoma
Adrenal Adenoma
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Cushing Syndrome
Cushing Syndrome
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Impaired Feedback Inhibition
Impaired Feedback Inhibition
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MEN1 Gene
MEN1 Gene
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Endocrine disorders
Endocrine disorders
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Enzyme defects in hormone production
Enzyme defects in hormone production
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21-Hydroxylase deficiency
21-Hydroxylase deficiency
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Kallmann's Syndrome
Kallmann's Syndrome
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Turner's Syndrome
Turner's Syndrome
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Syndrome of Inappropriate Antidiuretic Hormone (SIADH)
Syndrome of Inappropriate Antidiuretic Hormone (SIADH)
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Leptin Resistance
Leptin Resistance
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Endocrine disorders
Endocrine disorders
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Cytokine Receptors
Cytokine Receptors
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Receptor Coactivator Complex
Receptor Coactivator Complex
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STAT (Signal Transducer and Activator of Transcription) Proteins
STAT (Signal Transducer and Activator of Transcription) Proteins
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JAK Kinases (Janus Kinases)
JAK Kinases (Janus Kinases)
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Nuclear Receptor Mutations
Nuclear Receptor Mutations
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Hormonal feedback regulation
Hormonal feedback regulation
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Hypothyroidism feedback loop
Hypothyroidism feedback loop
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Positive feedback in ovulation
Positive feedback in ovulation
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ACTH's role in stress response
ACTH's role in stress response
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Vasopressin's role in blood pressure
Vasopressin's role in blood pressure
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Hypothalamus in stress response
Hypothalamus in stress response
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Hormonal changes in reproduction
Hormonal changes in reproduction
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Ovulation
Ovulation
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Inhibin's role in follicular growth
Inhibin's role in follicular growth
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Growth factors in ovarian development
Growth factors in ovarian development
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What is Cushing's Syndrome?
What is Cushing's Syndrome?
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What is a Midnight Salivary Cortisol Test?
What is a Midnight Salivary Cortisol Test?
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What is Metabolic Syndrome?
What is Metabolic Syndrome?
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What are Proton Pump Inhibitors?
What are Proton Pump Inhibitors?
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What are Prokinetics?
What are Prokinetics?
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What is Gonadotropin-releasing Hormone (GnRH)?
What is Gonadotropin-releasing Hormone (GnRH)?
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What is an ACTH Stimulation Test?
What is an ACTH Stimulation Test?
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What is Adrenal Insufficiency?
What is Adrenal Insufficiency?
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Study Notes
Endocrine System Approach
- Endocrine system evaluated by measuring hormone levels
- Hormone synthesis and replacement are common
- Diagnosing deficiency vs excess is key
- Hormone deficiency diagnosed by stimulating hormone
- Hormone excess diagnosed by suppressing hormone
- Treatment involves physiological hormone replacement for deficiency, and medical or surgical for excess
- Many endocrine disorders treatable once diagnosis confirmed
Endocrine Glands
- Endocrine glands difficult to define anatomically
- Interdigitation with other physiologic processes is common (e.g., blood pressure, intravascular volume)
- Thyroid gland can be part of ENT
- Examples of organs with interdigitation functions:
- Cardiovascular system (hormone roles in vascular tone and natriuresis)
- Kidneys (involved with erythropoiesis and Renin-Angiotensin Axis)
Endocrine Disorders - Causes
- Hyperfunction (Excess):
- Neoplastic: Benign and malignant growths (e.g., pituitary adenoma, adrenal adenoma)
- Ectopic: Hormone production from non-endocrine tissues (e.g., ectopic ACTH)
- Autoimmune: Immune system attacks the gland (e.g., Graves' disease)
- latrogenic: Iatrogenic: Treatment-induced (e.g., excess steroid administration)
- Infectious/inflammatory: (e.g., subacute thyroiditis)
- Activating receptor mutations: Receptor defects leading to constant activation (e.g., activating LH receptor mutations)
- Hypofunction (Deficiency):
- Surgery (most common):
- Thyroidectomy
- Infection:
- Adrenal insufficiency secondary to tuberculosis
- Inflammation:
- Infarction:
- Pituitary or adrenal damage
- Tumors:
- Advanced sarcoma
- Autoimmune: (e.g., Hashimoto's thyroiditis)
- latrogenic: (e.g., radiation-induced hypopituitarism)
- Surgery (most common):
Endocrine Disorders - Pathologic mechanisms
- Enzyme defects
- Developmental defects
- Hormone resistance:
- Result of inherited defects in membrane receptors, nuclear receptors.
- Example: Type 2 diabetes.
- Hormone mutations:
- Nutritional/vitamin deficiency
- Hemorrhage/Infarction
- Iatrogenic factors/exposure
- Activating mutations
Endocrine Testing
- Specializations differ, but labs confirm the diagnosis
- Endocrinology: Diagnosis made primarily from labs, not physical examination
- Physical exams focus on hormone excess or deficiency
- Imaging to confirm anatomic abnormalities
Hormone Measurements
- Measuring hormone levels is done with immunoassays
- Detects hormones in picomolar or nanomolar ranges using specific antibodies
- 24-hour urine collection gives integrated assessment of hormone production/metabolites
Dynamic Testing
- Suppression Tests: Used in suspected hormone excess (e.g., Cushing's syndrome).
- Stimulation Tests: Used in suspected hormone deficiency (e.g., ACTH stimulation test).
- Used when baseline tests are inconclusive, and hormone levels overlap with pathologic ranges.
Hormone Secretion and Transport
- Circulating hormone levels depend on secretion rate and half-life
- Longer half-life means longer stimulating action
- Peptides have short half-lives, because of enzymatic degradation
- Proteins are stored in vesicles, while steroids are not
- Protein hormones secreted as soon as they are synthesized.
- Steroid hormones are proportional to the synthesis rate.
Hormone Action mechanisms
- Hormones divided into membrane receptors and nuclear receptors
- Membrane Receptors:
- Bind peptide hormones and catecholamines.
- Divided into categories:
- Seven transmembrane GPCRs
- Tyrosine kinase receptors
- Cytokine receptors
- Serine kinase receptors
- Nuclear Receptors:
- Bind small molecules (steroids & vitamin D).
- 100 members:
- Ligand-receptor complex directly sends the signal
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