serotonin metabolized into what
5-HIAA
amine group of hormones
T3, T4, NE, EPI, serotonin
peptide group of hormones
GH, PRL, AVP, PTH, PCT
glycoprotein group of hormones
TSH, LH, FSH
steroid group of hormones
T4, adrenal hormones
anterior pituitary gland hormones
GH, ACTH, TSH, FSH, LH, PRL
organ source of gastrin, secretin
stomach, duodenum
organ source of beta-hCG
placenta
products of each zone in the adrenal gland?
(G, F, R, medulla)
_G: aldosterone
_F: cortisol
_R: testosterone, DHEA, progesterone, estrogen
_medulla: catecholamines
catecholamines include
DA, EPI, NE
effect of FSH
woman: follicular maturation, estrogen production
man: produce sperm
effect of LH
woman: ovulation
man: testicular testosterone production
regulation of FSH
low freq GnRH
women: estrogen NEG-FB
men: inhibin B NEG-FB
effect of PRL
lactation
PTH effect
increase Ca ion
increase Ca absorption in intestine
urine: Ca reabsorb, block PO4 reabsorb,
effect gastrin
HCl secretion in stomach
effect secretin
HCL secretion
bicarb release from pancreas
effect beta-hCG
stimulate ovary to produce progesterone during pregnancy
stimulate GH
ghrelin, hypoglycemia, sex steroid
alpha-agonist (NE), beta-blocker
inhibit GH
somatostatin, hyperglycemia, decrease both T4 and insulin
beta-agonist (EPI), alpha-blocker
purpose of GH
maintain normal glucose
opposite with insulin
true hypoglycemia indicator (level of GH and ACTH)
when both GH and ACTH decreased
effect cortisol
immune response
stress response
glucose homeostasis
progesterone effect
endometrial lining
increase in FSH during menstrual cycle
describe process from CRH to pregnenolone
CRH -> ACTH -> transport free CHOL into mitochondria -> pregnenolone
rate limiting step in steroid biosynthesis
chol -> pregnenolone
how much percent each layer of adrenal cortex
how much percent is adrenal medulla
G-15%; F-75%; R-10%
medulla 10%
describe what conversions and final product in G, F, R zones
G: pregnenolone -(3β)-> progesterone -(21β)->DOC -(11β)->corticosterone -(18OH)-> aldosterone
F: 17a-OH pregnenolone -(3β)-> 17a-OH progesterone -(21β)-> 11-deoxycortisol -(11β)->cortisol -> cortisone
R: DHEA /DHEA-S -(3β)-> androstenedione + androstenediol -> testosterone -> estradiol
effect LH
female: ovulation
male: testosterone production in testes
regulation LH
high freq GnRH
female: NEG-FB estrogen levels
male: NEG-FB inhibin B
3 mechanisms for catecholamine metabolism
reuptake into secretory vesicles
uptake in non-neuronal cells (mostly liver)
degradation
degradation of catecholamine depends on 2 enzymes?
COMT: in non-neuronal tissues
MAO: within neurons
an increase in TRH causes increase in
PRL
TSH
method employs a highly specific Ab for T4 (gold standard)
T4 by RIA
patient with high serum Ca, low serum PO4, high PTH -> what disorder
hyperparathyroidism
T3 resin uptake test is a measure of
binding capacity of TBG
major fraction of organic iodine in circulation is
T4 (thyroxine)
autoantibody binds to TSH receptor preventing TSH from binding
thyroid-stimulating immunoglobulin (TSI)
high titer of anti Tg-Ab and detection of antimicrosomal Ab -> what disorder
Hashimoto
is serotonin a hormone
no it's a neurotransmitter, not a hormone
alcohol consumption leads to
degradation of testosterone
liver cirrhosis -> less binding proteins -> defect in hormonal effects
cortisol peaks what time
8 AM
ACTH peaks when, lowest when
lowest: 11 PM -3 AM
peaks: 6 AM - 9AM
purpose of ACE inhibitor
for pts with HTN
lower angiotensin -> less aldosterone
symptoms hyper, hypothyroidism,
hyper: increased metabolic rates, increased heart rate, tremor
hypo: decreased metabolic rate, decreased heart rate, edema, constipation
what are the cyclic nonapeptide hormones
oxytocin, AVP
effect oxytocin
labor, lactation, POS-FB
what are hormones from hypothalamus, where is it stored?
AVP, oxytocin
BP cut off for AVP
osmolality cut off value for AVP
5-10% fall in BP will trigger AVP release
284, if increased -> increase in AVP release
values for AVP and osmolality for cases of DI (diabetes insidipus)
low AVP, high osmo
describe menstrual cycle (follicular phase, luteal phase)
follicular: low estrogen, low progesterone, rise in FSH, endometrium thickening
luteal: estrogen peaks before ovulation, high LH (POS-FB)
typical duration of menstrual bleeding: 3-5 days
when to know menopause
female experience amenorrhea for 12 months
usually at age 51
all anterior pituitary hormones secrete in what fashion
pulsatile
action of TRH, GnRH, dopamine
TRH: release TSH and PRL
GnRH: release LH, FSH
DA: inhibit PRL
anterior hormones, which ones are tropic, which ones direct effector?
tropic: LH, FSH, TSH, ACTH
direct effector: GH, PRL
feedback hormones for LH, FSH, ACTH, GH
estradiol, testosterone
inhibin
cortisol
IGF-1
GH is peaked when
onset of sleep
GH reference range for male and female
male: 0.01-1
female: 0.01-3.5
what is the first test for deficient or excess growth
IGF-1 testing
how to evaluate GH for oral glucose loading testing method
overnight fast -> 75g glucose load -> measure 0, 30, 60, 90, 120 mins after ingestion
GH undetectable for normal individuals
acromegaly patients -> GH fail to suppress and may even rise
gold standard for GH deficiency
current method?
insulin-induced hypoglycemia
combine GHRH with L-arginine or L-DOPA
symptoms of GH deficiency
high body fat, less muscle, less stamina
anxiety, depression, fatigue
low bone density
sensitive to heat, cold
reference range PRL
male: 4-15.2
female: 4.8-23.3
symptom hyperprolactinemia
abnormal range for PRL
women: amenorrhea, galactorrhea, decreased libido
PRL > 150
consequence of PRL excess is
hypogonadism
cause of hypopituitarism
tumor, trauma, infection
radiation therapy, surgery
familial, idopathic, immunologic,
treatment of panhypopituitarism
replacement therapy
pulsatile GnRH infusions
gonadotropin preparation
symptom of hyperaldosteronism
HTN, hypoK, metabolic alkalosis,
symptom of pheochromocytoma
HTN, anxiety, dizzy, irregular heartbeat, sweating
Cushing syndrom symptom
HTN, weight gain, red/purple stretch marks, muscle weakness,
congenital adrenal hyperplasia symptoms
inappropriate virilization, infertility
primary adrenal insufficiency symptoms
loss appetite, weight loss, pigmentation skin
hypotension, hypoglycemia, weakness,
other products of adrenal cortex
VIP: vasoactive inhibitory peptide
adrenomedullin
ANP: atrial natriuretic peptide
products of R zone
aldosterone, adrenal androgens (DHEA, testosterone), estrogens
symptom hypercortisolism
HTN, hyperglycemia, obesity, weakness,
cause of adrenal hyperplasia
low cortisol, high ACTH and CRH -> overproduction of androgens
most common hormone excess condition for a functional pituitary gland is
prolactinoma
Kallmann syndrome lab results
low testosterone, low FSH, low LH
test of first choice for diagnosis of pheochromocytoma is
Plasma free metanephrines provide the best test for excluding or confirming pheochromocytoma
preferred screening test for Cushing syndrome (hypercortisolism) and also the most sensitive test is
UFC (urine free cortisol)
sensitive testing for aldosterone excess is
adrenal vein sampling
the “gold standard” to determine the source of hypercortisolism in ACTH-dependent Cushing syndrome is
what sampling it needs
Inferior petrosal sinus sampling (IPSS)
ACTH sample from vein connecting to pituitary gland
which one is tropic hormone: thyroxine, GH, PTH, testosterone
thyroxine
what type of hormones straight into the bloodstream
Endocrine glands secrete hormones straight into the bloodstream
what types of hormones fat-soluble and repel water (hydrophobic)
Steroids: Hormones such as estrogen, testosterone, progesterone, cortisol, and those produced in the thyroid are fat-soluble and repel water (hydrophobic)