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)