Anatomy & Physiology: Endocrine
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| 1. Which cells produce T3 and T4. 2. Which cells produce calcitonin. 3. Which cells secrete parathyroid hormone? | 1. Follicular cells of the thyroid
2. Parafollicular (C cells) of the thyroid
3. Chief cells of the parathyroid
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| What are the 3 thyroid binding proteins? | 1. thyroid binding globulin
2. Transthyretin (prealbumin)
3. Albumin
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| Low total T₄ but normal TSH and free T₄ usually signifies... | deficiency in TH-binding proteins
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| Folicular cells secrete __ into the colloid space. Iodine is added to __ amino acid residues. | 1. thyroglobulin
2. tyrosine
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| 1. Enzyme that adds iodine to thyroglobulin 2. Peripheral tissues contain __ that convert T₄ into T₃ by removing iodine from tyrosine residues. | 1. thyroid peroxidase
2. Deiodinases
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| 1. How does estrogen effect thyroid binding globulin? 2. How does this effect bound T₄, free T₄, and total T₄? | 1. estrogen increases TBG synthesis
2. T4 temporarily decreases as more in bound to TBG. TSH levels increase until T₄ returns to equilibrium. Bound T₄ will be elevated above normal as will total T₄ but free T₄ will not be elevated.
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| 1. A preprohormone is synthesized in the __. 2. After cleavage of signal peptides, the prohormone is transported to the __. | 1. rough endoplasmic reticulum
2. golgi
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| 1. Thyroglobulin is released into the colloid space through the process of ___. 2. Iodide is transported into the follicular cell by __. | 1. exocytosis
2. sodium-iodide symporter NIS
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| Function of vitamin D | 1. ↑ gut absorption of dietary Calcium & phosphate
2. ↑ bone resorption of calcium
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| In vitamin D metabolism which metabolite is produced in the liver? Which is produced in the kidney? | 1. 25OH vitamin D in liver
2. 1,25(OH)₂ vitamin D in the kidney
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| Function of calcitonin | ↓ bone resorption of calcium
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| Which endorine hormones act through receptor associated tyrosine kinase (JAK/STAT) pathway? | GH, prolactin
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| Which enzyme is responsible for the second hydroxylation of vitamin D in the kidney? | 1α-hydroxylase
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| 1. What effect do sex steroid hormones have on bone? 2. What effect do glucocorticoids have on bone? | 1. ↓ bone resorption
2. bone resorption
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| 1. GH stimulates the production of IGF1 mainly in the __. 2. What negatively feeds back to inhibit GH release? | 1. liver
2. GH and IGF1
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| What are the effects of GH on blood sugar in the: 1. acute phase 2. chronic phase | 1. proinsulin - stimulates glucose and amino acid transport
2. anti-insulin - increased blood glucose, insulin resistance
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| What is the effect of the following hormones on growth? 1. thyroid hormone 2. glucocorticoids 3. sex steroids 4. insulin | 1. ↑ growth
2. inhibit growth
3. ↑ growth but closes epiphyseal plate
4. ↑ growth of fetus
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| 1. Primary hypoadrenalism is usually due to.. 2. Secondary hypoadrenalism is due to. | 1. decreased cortisol from autoimmune destruction of the adrenal cortex
2. decreased cortisol from ACTH deficiency
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| What is the cause of hyperpigmentation in primary adrenal insufficiency? | excess MSH and ACTH production from POMC precursor
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| 1. Which endocrine hormones are derivatives of tyrosine? 2. Carrier proteins that transport posterior pituitary hormones in circulation | 1. thyroid hormones
2. neurophysins
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| What part of the adrenal cortex are the following secreted 1. aldosterone 2. cortisol 3. androgens | GFR
1. glomerulosa
2. fasciculata
3. reticularis
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| 1. Where is ADH synthesized? 2. Where is oxytocin synthesized? | 1. supraoptic nucleus
2. paraventricular nucleus
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| What increases growth hormone secretion? | 1. sleep
2. stress
3. arginine (high protein meal)
4. hypoglycemia
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| What are the two hormones that decrease growth hormone release? | 1. somatostatin
2. somatomedins (IGF)
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| Where are somatomedins produced? | the somatomedin IGF is produced in the liver after growth hormone binding
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| Which hormone is produced by the following pancreatic cell types: 1. α 2. β 3. δ | 1. insulin
2. glucagon
3. somatostatin
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| Where are the following glucose transporters located: 1. GLUT1 2. GLUT2 3. GLUT4 | 1. RBCs, brain
2. β islet, liver, small intestine
3. (insulin responsive) adipose tissue, muscle,
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| Which enzymes does insulin stimulate for: 1. glycolysis 2. liver synthesis of fatty acids 3. release of fatty acids from VLDL 4. storage of glucose as glycogen | 1. glucokinase, PFK-2, PDH
2. acetyl CoA carboxylase
3. lipoprotein lipase
4. glycogen synthase
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| How does glucose trigger insulin release? | 1. glucose enters liver cells through GLUT-2 transporter and undergoes glycolysis
2. ATP ↑ in cell and K + channels close
3. cell depolarizes and calcium channels open
4. Exocytosis of insulin
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| How does glucagon affect: 1. blood glucose 2. fatty acid level 3. urea production | 1. ↑ glycogenolysis and gluconeogenesis
2. ↑ lipolysis
3. amino acids used for gluconeogenesis and resulting amino groups incorporated into urea
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| 1. Inhibits prolactin release 2. Hormones that increases prolactin release 3. Which hormone does prolactin inhibit | 1. dopamine
2. TRH, estrogen
3. GnRH
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| 1. How does cortisol increase blood pressure? 2. How does PTH effect phosphate? | 1. upregulates α1 receptors on arterioles
2. ↓ kidney reabsorption of phosphate
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| What 3 ways does PTH increase calcium? | 1. ↑ bone resorption
2. ↑ kidney reabsorption
3. ↑ vitamin D production → ↑ GI absorption
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| What is the mechanism of vitamin D activation by PTH? | PTH stimulates kidney 1α-hydroxylase
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| What is the mechanism of bone resorption by PTH? | PTH ↑ production of macrophage colony-stimulating factor and RANK-L in osteoblasts which stimulate osteoclasts
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| 1. How does PTH effect calcium and phosphate 2. How does vitamin D effect calcium and phosphate? | 1. ↑ calcium reabsorption, ↓ phosphate reabsorption
2. ↑ both calcium and phosphate reabsorption
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| Which endocrine hormones act through IP₃ (Gαq)? | GOAT
1. GnRH
2. Oxytocin
3. ADH (V1 receptor)
4. TRH
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| Which hormone binds a nuclear steroid receptor? | T₃/T₄
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| Which hormones bind cytosolic steroid receptors? | VET CAP
1. vitamin D
2. estrogen
3. testosterone
4. cortisol
5. aldosterone
6. progesterone
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| Hormones that act through cAMP | FLAT CHAMP
1. FSH
2. LH
3. ACTH
4. TSH
5. CRH
6. hCG
7. ADH (V2 receptor)
8. MSH
9. PTH
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| Hormones that act through intrinsic tyrosine kinase (MAP kinase pathway) | insulin, IGF1, PDGF
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| By which mechanism do thyroid hormones effect: 1. cardiac output 2. basal metabolic rate | 1. ↑ β1 receptors in hear
2. ↑ Na+/K+ ATPase activity
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| 1. What is calcitriol? 2. How many phosphate groups are attached to it? | 1. hormonally active vitamin D
2. 3 hydroxyl groups
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| What 3 components compose serum calcium? | 1. albumin bound calcium
2. phosphorus bound calcium
3. free, ionized calcium
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| What is the physiological cause of tetany seen with hypocalcemia? | lower threshold potential of nerve causes partial depolarization
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| How does glucagon effect insulin levels? | 1. glucagon promotes release of somatostatin → ↓ insulin (and glucagon) secretion
2. glucagon binds pancreatic β-cell → ↑cAMP → insulin secretion
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| How does insulin effect glucagon levels? | insulin directly inhibits glucagon release
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| Why is insulin levels higher after oral glucose than IV glucose? | incretins (e.g. GLP-1) are released from the intestines following oral glucose and they stimulate β-cell insulin secretion
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| How does insulin deficiency lead to an increase in ketones? | without insulin, lipolysis is increased producing increased ketoacids
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| Why does growth hormone excess lead to hyperglycemia? | Growth hormone actions:
1. ↑ gluconeogenesis
2. ↓ glucose uptake into insulin sensitive tissues
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| 1. The activity of which adrenal enzyme is increased by ACTH? 2. The activity of which adrenal enzyme is increased by angiotensin II? | 1. Desmolase (converts cholesterol to pregnenolone)
2. Aldosterone synthase
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| Why does ↑ GH lead to gigantism while ↑ adrenal androgens do not when both promote bone growth? | androgens aromatized to estrogens which lead to premature epiphyseal plate closure leading to short stature while GH → ↑ IGF which does not
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| How do anabolic steroids effect total T4, free T4 and TSH levels? | anabolic steroids divert poteins (plasma proteins) into building muscle. thyroid binding globulin is low
1. ↓ total T4
2. normal free T4
3. normal TSH
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| Drainage of the: 1. Left adrenal 2. Right adrenal | 1. left adrenal → left adrenal vein → left renal vein → IVC
2. right adrenal → right adrenal vein → IVC
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| Embryologic origin of: 1. adrenal cortex 2. adrenal medulla 3. posterior pituitary 4. anterior pituitary | 1. mesoderm
2. neural crest
3. neuroectoderm
4. oral ectoderm (Rathke's pouch)
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| Which hormones share a common α subunit to LH? | TSH, LH, FSH, hCG
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| 1. What causes somatostatin secretion from the hypothalamus? 2. Common cause of death from acromegaly or gigantism? | 1. somatomedin (IGF) from liver as a feedback mechanism for Growth Hormone regulation
2. cardiomegaly; GH causes IGF release from liver, IGF increases organ size
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| How does pulsative GnRH vs non-pulsatile GnRH effect pituitary secretion of LH and FSH? | 1. pulsatile stimulates pituitary secretion
2. nonpulsatile inhibits secretions
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| Which hormone: 1. ↑ breast milk production 2. ejection of milk from breast | 1. prolactin
2. oxytocin
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| T4 vs T3 1. longer half life 2. created in peripheral tissues 3. negative feedback on TRH | 1. T4
2. T3
3. T3
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| 1. Number one cause of cushing syndrome 2. What is cushing's disease 3. What is the most likely cause of ectopic ACTH secretion? | 1. exogeneous steroids
2. ACTH secreting pituitary adenoma
3. small-cell lung cancer
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| How is epinephrine level effected by cortisol? | cortisol sytimulates the enzyme PNMT which converts norepinephrine to epinephrine leading to increase epi levels
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| How do thyroid hormones effect: 1. protein synthesis 2. lipid store levels 3. cholesterol levels 4. plasma glucose levels | 1. ↑
2. ↓ through lipolysis
3. ↓ through lipolysis
4. ↑ through gluconeogenesis and glycogenolysis
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| 1. How do sleep, stress and glucose levels effect GH secretion? 2. Which amino acid increased GH secretion? | 1. sleep, stress and hypoglycemia ↑ GH secretion
2. Arginine
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| How does cortisol effect: 1. Blood pressure 2. Bone 3. immune function 4. Glucose levels | 1. maintains blood pressure
2. ↓ bone formation
3. ↓ immune function
4. ↑ gluconeogenesis and lipolysis
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| PTH vs vitamin D in calcium increase: 1. acts on gut 2. acts on bone 3. acts on kidney | 1. vitamin D
2. PTH
3. PTH
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