Hormones and Their Functions
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Questions and Answers

What type of hormonal effect occurs when hormones act on the same cell that produced them?

  • Autocrine effect (correct)
  • Exocrine effect
  • Endocrine effect
  • Paracrine effect

Which category of hormones includes compounds like norepinephrine and epinephrine?

  • Amines and amino acids (correct)
  • Glycoproteins
  • Peptides and proteins
  • Steroids

What is the primary mechanism of release for protein hormones?

  • Vesicle-mediated synthesis and release (correct)
  • Direct diffusion through the membrane
  • Non-vesicle-mediated transport
  • Simple excretion

Which of the following is NOT derived from cholesterol?

<p>Thyroid hormones (D)</p> Signup and view all the answers

What distinguishes a prohormone from a regular hormone?

<p>Prohormones contain extra amino acids. (C)</p> Signup and view all the answers

What process is used for the synthesis of steroid hormones?

<p>Synthesis upon demand and immediate secretion (A)</p> Signup and view all the answers

Which hormones are classified as glycoproteins?

<p>Follicle-stimulating hormone (FSH) (C)</p> Signup and view all the answers

What is the primary location where hormones are synthesized?

<p>Smooth endoplasmic reticulum (C)</p> Signup and view all the answers

Which hormone serves as a precursor for other hormones such as aldosterone and cortisol?

<p>Progesterone (D)</p> Signup and view all the answers

How do steroid hormones typically circulate in the bloodstream?

<p>As both free and bound molecules (D)</p> Signup and view all the answers

What is the half-life of aldosterone when it is only 15% protein-bound?

<p>25 minutes (C)</p> Signup and view all the answers

What happens when drugs like aspirin compete with hormones for binding to carrier proteins?

<p>They increase free hormone availability (B)</p> Signup and view all the answers

What mechanism is primarily responsible for the degradation of peptide hormones in circulation?

<p>Enzymatic degradation (C)</p> Signup and view all the answers

Why must hormones be continuously inactivated?

<p>To prevent hormone accumulation (A)</p> Signup and view all the answers

Which of the following is true regarding the transport of steroid hormones?

<p>They mostly remain inactive while bound (D)</p> Signup and view all the answers

What role do carrier proteins synthesized in the liver play in hormone regulation?

<p>They affect hormone half-life and cellular uptake (D)</p> Signup and view all the answers

What are the main management strategies for an acute adrenal crisis?

<p>Salt and sugar replacement, and steroid replacement (B)</p> Signup and view all the answers

What condition can cause acute adrenal insufficiency due to adrenal hemorrhage?

<p>Meningococcal septicemia (D)</p> Signup and view all the answers

Which of the following features is NOT a sign of Cushing syndrome?

<p>Skin thickening (B)</p> Signup and view all the answers

How is Cushing syndrome diagnosed?

<p>By measuring 24-hour urinary cortisol (C)</p> Signup and view all the answers

What is a potential treatment for pituitary adenomas in Cushing syndrome?

<p>Transsphenoidal surgery (C)</p> Signup and view all the answers

Which therapeutic drug is commonly used for inoperable tumors in Cushing syndrome?

<p>Mitotane (C)</p> Signup and view all the answers

Which of the following conditions is associated with excessive cortisol production?

<p>Cushing disease (B)</p> Signup and view all the answers

What is the role of ACTH levels in Cushing syndrome diagnosis?

<p>To differentiate between ACTH-dependent and non-ACTH-dependent causes (D)</p> Signup and view all the answers

Which symptom is commonly associated with glucocorticoid excess in Cushing syndrome?

<p>Emotional disturbances (B)</p> Signup and view all the answers

What is the expected clinical feature caused by mineralocorticoid effects in Cushing syndrome?

<p>Hypertension (C)</p> Signup and view all the answers

Which of the following criteria can be used to diagnose Diabetes Mellitus?

<p>HbA1c ≥ 6.5% (A), 2-hour plasma glucose ≥ 200 mg/dL during an OGTT (C)</p> Signup and view all the answers

What differentiates Type 1A Diabetes Mellitus from Type 1B Diabetes Mellitus?

<p>Type 1A is characterized by beta cell destruction due to autoimmune attack (B)</p> Signup and view all the answers

What is a common result of insulin deficiency in Type 1A Diabetes Mellitus?

<p>Unregulated lipolysis leading to ketoacidosis (A)</p> Signup and view all the answers

Which of the following statements is true regarding the prevalence of Type 1 Diabetes Mellitus?

<p>Type 1A accounts for the majority of Type 1 diabetes cases globally (A)</p> Signup and view all the answers

What role do autoantibodies play in Type 1A Diabetes Mellitus?

<p>They can be detected before hyperglycemia develops (C)</p> Signup and view all the answers

What is the primary issue in Congenital Adrenal Hyperplasia (CAH)?

<p>Defect in cortisol synthesis (B)</p> Signup and view all the answers

Which enzyme deficiency is most commonly associated with a salt-losing form of CAH?

<p>21-Hydroxylase Deficiency (B)</p> Signup and view all the answers

What clinical manifestation may be observed in female infants with CAH?

<p>Enlarged clitoris and fused labia (D)</p> Signup and view all the answers

Which of the following is a common treatment for CAH?

<p>Glucocorticoid replacement therapy (A)</p> Signup and view all the answers

Which type of CAH can lead to hypertension due to overproduction of 11-deoxycorticosterone?

<p>11-β-Hydroxylase Deficiency (B)</p> Signup and view all the answers

What is a common diagnostic method for Congenital Adrenal Hyperplasia (CAH)?

<p>Genetic testing and biochemical evaluations (B)</p> Signup and view all the answers

What long-term effect may occur despite treatment in patients with CAH?

<p>Abnormal secondary sexual characteristics (A)</p> Signup and view all the answers

In which scenario would surgical intervention be necessary for female infants with CAH?

<p>To reconstruct genitalia due to virilization (C)</p> Signup and view all the answers

What characteristic is associated with the simple virilizing form of CAH?

<p>Impaired cortisol synthesis and increased androgen production (A)</p> Signup and view all the answers

What is the genetic inheritance pattern of Congenital Adrenal Hyperplasia (CAH)?

<p>Autosomal recessive (A)</p> Signup and view all the answers

Flashcards

What is the Autocrine Effect?

Hormones act on the same cell that produced them.

What is the Intracrine Effect?

Hormones are synthesized and act within the same cell.

What type of hormones are Amines and Amino Acids?

Hormones derived from a single amino acid, like norepinephrine and epinephrine.

What type of hormones are Peptides and Proteins?

The largest hormone category, ranging from small peptides like TRH to large proteins like GH.

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What are Glycoproteins?

Peptide hormones combined with carbohydrates, like follicle-stimulating hormone (FSH).

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What type of hormones are Steroids?

Hormones derived from cholesterol, like cortisol, estrogen, and testosterone.

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How are hormones synthesized and released?

Synthesis and release of hormones vary based on the hormone's structure.

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How are steroid hormones transported?

Steroid hormones are transported in the bloodstream bound to specific carrier proteins, synthesized by the liver.

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What effect does the carrier protein have on hormone activity?

Carrier proteins influence the rate at which hormones leave the blood and enter cells, impacting the hormone's half-life.

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What is the half-life of a hormone?

The half-life of a hormone represents the time required for its concentration to decrease by half in the bloodstream.

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Why is hormone inactivation necessary?

Hormones are continuously inactivated to prevent their accumulation in the body, maintaining a delicate balance.

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How are peptide hormones and catecholamines inactivated?

Water-soluble peptide hormones and catecholamines circulate freely in the blood. They are degraded by enzymes in the blood or tissues and eliminated by the kidneys and liver.

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What are the mechanisms for degrading peptide hormones?

Peptide hormones typically have a short lifespan in circulation and are degraded through binding to cell-surface receptors or uptake and degradation by enzymes in the cell membrane or inside the cell.

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What is the state of steroid hormones when bound to carrier proteins?

Steroid hormones are transported bound to protein carriers, remaining inactive in this form.

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How can drugs affect hormone action by interfering with carrier proteins?

Certain drugs, like aspirin, can compete with hormones for binding sites on carrier proteins, increasing the availability of free active hormone.

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What is Acute Adrenal Insufficiency?

A life-threatening condition arising from insufficient cortisol and aldosterone production by the adrenal glands.

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What are the symptoms of Acute Adrenal Insufficiency?

Nausea, vomiting, muscle weakness, low blood pressure, dehydration, and potential circulatory collapse.

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What is Congenital Adrenal Hyperplasia (CAH)?

A congenital condition where the adrenal glands don't produce enough cortisol and aldosterone.

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What is Cushing Syndrome?

A condition where the adrenal glands produce excessive cortisol, leading to various health issues.

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What is Cushing Disease?

A type of Cushing syndrome caused by a tumor in the pituitary gland, leading to excessive ACTH production.

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What is Adrenal Tumor Cushing Syndrome?

A type of Cushing syndrome caused by a tumor in the adrenal glands.

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What is Ectopic Cushing Syndrome?

Cushing syndrome caused by a non-pituitary tumor producing ACTH.

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What is Iatrogenic Cushing Syndrome?

Cushing syndrome due to long-term use of glucocorticoid medications.

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What are the clinical manifestations of Cushing Syndrome?

Moon face, buffalo hump, abdominal obesity, muscle weakness, thin skin, purple striae, osteoporosis, hypertension, hypokalemia, increased susceptibility to infections.

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How is Cushing Syndrome diagnosed?

Testing cortisol levels, measuring 24-hour urinary cortisol, performing dexamethasone suppression test.

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What is the primary issue in CAH?

In CAH, the primary issue is a defect in cortisol synthesis, which stimulates the adrenal glands to produce more androgens, leading to adrenal hyperplasia.

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How does CAH affect female infants?

Excess androgen production in CAH can cause ambiguous genitalia in female infants, including an enlarged clitoris, fused labia, and a urogenital sinus.

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What is 21-hydroxylase deficiency?

In 21-hydroxylase deficiency, the most common type of CAH, cortisol synthesis is impaired, and steroid synthesis shifts to androgen production.

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What is salt-losing CAH?

Salt-losing CAH, a severe form of 21-hydroxylase deficiency, causes deficient aldosterone production, leading to fluid and electrolyte imbalances like hyponatremia and dehydration.

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What is 11-β-hydroxylase deficiency?

11-β-hydroxylase deficiency is a rarer type of CAH characterized by excessive androgen production and impairment of corticosterone synthesis, causing hypertension due to the mineralocorticoid activity of 11-deoxycorticosterone.

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How is CAH diagnosed?

Diagnosis of CAH involves biochemical evaluation of cortisol pathway metabolites and genetic testing, although the correlation between phenotype and genotype can be complex.

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What is the treatment for CAH?

Treatment for CAH typically involves glucocorticoid replacement to regulate cortisol levels, while fludrocortisone acetate may be given for salt-losing cases.

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When is surgery needed for CAH?

Surgical intervention may be necessary in the first two years of life to reconstruct genitalia in female infants with virilization caused by CAH.

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What is Adrenal Insufficiency?

Adrenal insufficiency, a condition of insufficient cortisol production, can be either primary (Addison's disease) or secondary (due to dysfunction in the HPA axis).

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What is Type 1 Diabetes Mellitus (DM)?

A condition characterized by the destruction of pancreatic beta cells, leading to insufficient insulin production. It can be categorized into two subtypes: Type 1A (immune-mediated) and Type 1B (idiopathic).

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What is Type 1A Diabetes Mellitus?

An autoimmune disorder where the body's immune system mistakenly attacks and destroys insulin-producing beta cells in the pancreas. This subtype is more prevalent in individuals with a family history of diabetes.

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What is Type 1B Diabetes Mellitus?

A less common form of Type 1 diabetes that lacks an autoimmune component. The cause of this subtype is unknown, and it occurs without any clear trigger.

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What is Type 2 Diabetes Mellitus?

The most common form of diabetes, accounting for the majority of cases. It is characterized by insulin resistance, where the body either doesn't produce enough insulin or the body's cells resist insulin's effects.

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What is HbA1c?

A blood test that measures the average blood sugar level over the past 2-3 months. It is a crucial test for diagnosing diabetes and monitoring its management.

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Study Notes

Endocrine System

  • The endocrine system plays a critical role in integrating essential life functions, including growth, sex differentiation, metabolism, and adaptation to changing environmental conditions
  • This system uses hormones to regulate and coordinate body functions
  • It is closely associated with the nervous and immune systems
  • The endocrine system utilizes chemical messengers called hormones to regulate and integrate various bodily processes
  • Hormones are chemical messengers transported through body fluids
  • Specialized organic molecules produced by endocrine organs to act on specific target cells
  • Hormones do not start reactions but modulate cellular and systemic responses
  • Hormones are released from several sites, including the endocrine glands, the brain, and other organs such as the heart, liver, and adipose tissue.

Hormones

  • Definition: Chemical messengers transported through body fluids
  • Specialized organic molecules: Produced by endocrine organs to act on specific target cells
  • Do not start reactions: Modulate cellular and systemic responses

Hormone Effects and Actions

  • Endocrine Effect: Hormones are released into the bloodstream and act on distant target cells
  • Paracrine Effect: Hormones act locally on nearby cells without entering the bloodstream
  • Autocrine Effect: Hormones act on the same cell that produced them
  • Intracrine Effect: Hormones are synthesized and act within the same cell

Structural Classification of Hormones

  • Amines and Amino Acids: Derived from single amino acids (e.g., norepinephrine, epinephrine, thyroid hormones)
  • Peptides and Proteins: Range from small molecules to large proteins (e.g., thyrotropin-releasing hormone, growth hormone)
  • Steroids: Derived from cholesterol (e.g., cortisol, estrogen, testosterone)

Synthesis, Release, Transport, and Elimination of Hormones

  • Synthesis and Release: Varies based on hormone structure, with protein hormones synthesized and stored in vesicles and steroid hormones synthesized and secreted immediately.
  • Mechanism: Protein hormones utilize vesicle-mediated release pathways. Precursor hormones are often modified, and if extra amino acids exist, they are considered a prohormone.
  • Release Mechanism: Hormone cell stimulation triggers vesicle movement to the cell membrane, releasing hormones.
  • Non-Vesicle-Mediated Hormones: Include some nonpolypeptide hormones and neurotransmitters, such as catecholamines.
  • Transport: Hormones circulate as free or unbound molecules or bound to transport carriers.
  • Half-life Examples: Thyroxine and Aldosterone have varying half-lives.
  • Drugs: Certain drugs compete with hormones for binding to transport carriers.

Metabolism and Elimination of Hormones

  • Hormones must be continuously inactivated to prevent accumulation.
  • Mechanisms include intracellular and extracellular processes.
  • Peptide hormones and catecholamines are degraded by enzymes in the blood or tissues.
  • Steroid hormones are transported bound to protein carriers and remain inactive in the bound state.

Mechanisms of Hormone Action

  • Hormones interact with high-affinity receptors linked to effector systems within the cell.
  • These mechanisms influence metabolic activities such as ion transport at the cell surface and stimulation of nuclear transcription.
  • Reaction time varies depending on the mechanism (e.g., milliseconds for neurotransmitters, days for thyroid hormones).

Hormone Receptors

  • Cell-Surface Receptors: Used by peptide hormones and catecholamines; hormones bind to surface receptors
  • Intracellular Receptors: Used by steroid and thyroid hormones, which cross the cell membrane and bind to intracellular receptors

Control of Hormone Levels

  • Hormone secretion varies over a 24-hour period with diurnal fluctuations, cyclic secretion, and feedback regulation.
  • Hypothalamic-Pituitary Regulation: The hypothalamus and pituitary form a control unit for various endocrine and physiological functions, connected by the hypophysial portal system.

Diagnostic Tests in Endocrinology

  • Direct Measurement of Hormones: Measures hormone levels in blood or other samples
  • Indirect Methods: Assess the physiological effects of hormones (e.g., blood glucose as a marker for insulin availability)
  • Radioimmunoassay (RIA): Measures plasma hormone levels through competitive binding
  • Immunoradiometric Assay (IRMA): A more specific version of RIA that uses two antibodies for better specificity.
  • Autoantibody Testing: Detects autoimmune endocrine disorders

Stimulation and Suppression Tests

  • Used to evaluate suspected hypofunction or hyperfunction of an endocrine organ
  • Hormonal testing and imaging are important aspects of diagnosis and management in endocrinology.

Hypofunction and Hyperfunction of the Endocrine System

  • Hypofunction: Decreased activity resulting in reduced hormone production (e.g., developmental issues, enzyme deficiencies, gland destruction, aging/atrophy, or receptor defects)
  • Hyperfunction: Excessive hormone production due to overstimulation or abnormal gland activity (e.g., hyperplasia, hormone-producing tumors).

Hormone Secretion Patterns

  • Hormone secretion varies over a 24-hour period (diurnal fluctuations).
  • Cyclic secretion, such as in female sex hormones.
  • Feedback regulation, such as insulin (glucose levels) and antidiuretic hormone (water levels)

Growth Hormones

  • Growth hormone (GH) has several metabolic effects, including stimulating protein synthesis, mobilizing fatty acids, and antagonizing insulin actions.
  • It plays a crucial role in growth, particularly during childhood, by promoting bone and cartilage formation.

Hormones Essential for Growth and Maturation

  • Growth hormone (GH): Promotes bone and cartilage growth and regulates metabolic processes.
  • Insulin: Supports growth by its role in carbohydrate and fat metabolism; deficiency can impair growth in children.
  • Thyroid hormones: Essential for bone growth and epiphyseal closure; low levels delay growth processes.
  • Androgens: Stimulate protein synthesis, contributing to growth.
  • Glucocorticoids: Excessive levels inhibit growth.

Hypothalamic-Pituitary-Target Cell Feedback

  • Complex hormone regulation within the thyroid, adrenal cortex, and gonads
  • The hypothalamus secretes a releasing hormone, stimulating the anterior pituitary to secrete a tropic hormone.
  • The tropic hormone then stimulates a peripheral target gland to produce its hormone

Positive and Negative Feedback

  • Negative Feedback: Most common; hormone or its effect inhibits further secretion to maintain balance
  • Positive Feedback: Less common; hormone stimulates continued secretion until a specific event occurs

Diabetes Mellitus

  • Metabolic disorder characterized by hyperglycemia
  • Imbalance between insulin availability, glucose utilization, and glucose production
  • Type 1 Diabetes: Beta cell destruction, absolute insulin deficiency
  • Type 2 Diabetes: Insulin resistance, relative insulin deficiency
  • Other Types: Genetic defects, endocrinopathies, diseases of the pancreas, drug or chemical induction, or infections

Diagnostic Tests for Diabetes

  • Fasting Blood Glucose Test (FPG): measures glucose levels after an 8-hour fast
  • Casual Blood Glucose Test: measures blood glucose without regard for the time of the last meal
  • Oral Glucose Tolerance Test (OGTT): measures the body's ability to store glucose after ingesting a glucose solution
  • Capillary Blood Glucose Monitoring: Measures blood glucose from a finger-stick or forearm sample
  • Continuous Glucose Monitoring (CGM): Provides frequent glucose readings using subcutaneous catheters
  • Glycated Hemoglobin (A1C) test: Measures average blood glucose over the past 6-12 weeks.

Diabetes Treatment

  • Goals: Normalize blood glucose to prevent short- and long-term complications
  • Components: Medical Nutrition Therapy (MNT) tailored for individual needs, exercise, and pharmacological treatment

Acute and Chronic Complications of Diabetes

  • Acute Complications: Diabetic ketoacidosis (DKA), hyperosmolar hyperglycemic state (HHS), and hypoglycemia
  • Chronic Complications: Microvascular complications (neuropathies, nephropathies, retinopathies), macrovascular complications (coronary artery disease, cerebrovascular disease, and peripheral vascular disease), foot ulcers, and gastrointestinal motility disorders

Sex-Hormone Therapy

  • Estrogen therapy for girls or testosterone therapy for boys can accelerate epiphyseal plate closure in precocious puberty

Other Pancreatic Disease and Endocrine Disorders

  • Various diseases can cause diabetes by affecting pancreas function or increasing hepatic glucose production, or decreasing glucose utilization
  • Diabetes is possible as a result of, or in combination with, other disorders

Adrenal Function

  • The adrenal glands are involved in multiple metabolic functions, including response to stress and regulating electrolyte balance
  • Cortisol: crucial for maintaining blood glucose levels, immune response and metabolic processes
  • Aldosterone: regulates sodium and potassium balance, vital for blood pressure control

Adrenal Disorders

  • Adrenal cortical insufficiency (Addison's disease): deficiency in adrenal cortical hormones and elevated ACTH levels, triggered primarily by autoimmune destruction of adrenocortical tissue.
  • Congenital adrenal hyperplasia (CAH): Genetic disorder, resulting from abnormalities in adrenal steroid synthesis or excretion

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Test your knowledge on hormones and their mechanisms in this quiz. Explore questions related to hormonal effects, synthesis, and classification of different types of hormones. Perfect for students studying biology or medicine.

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