Chapter 5: Endocrine Gland
Subject
- The Endocrine system consists of a group of organs that have NO DUCTS and
therefore are also known as DUCTLESS GLANDS that secrete hormones directly into
the bloodstream
- Pituitary Gland; Located at the base of the brain. Consists of two parts: anterior lobe
and posterior lobe. It is sometimes known as the master gland. It controls the
functions of other endocrine glands and is in turn controlled by the hypothalamus
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- Negative feedback: The negative feedback occurs when hormone feedback to
Decrease the production of its own hormone. (- ve)
- Positive feedback: Positive feedback occurs when hormone feedback to Increase its
own production. (+ve)
- Thyroid gland secretes thyroid hormones LEVOTHYROXINE (T4),
TRIIDOTHYRONIN (T3) AND CALCITONIN, which in turn controls the body's
metabolic rate.
- Thyroxin or levothyroxine naturally occurs in levothyroxine (L) isomer form produced
in the thyroid gland. Synthesis of thyroid hormones is stimulated by TSH.
- Triiodothyronine (Ts): Metabolically active form or active thyroid hormone. The iodide
pump (trap) is present in thyroid follicular epithelial cells. Actively transports iodine
into the thyroid follicular cells for incorporation into thyroid hormones.
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- Levothyroxine T4 converts in the liver and other organs to tiiodothyronin T3 by
deiodination (deiodinase). Controls the rate of metabolic function in the body.
- Reaction that converts T to Ts is? deiodination
- Enzyme that catalyzes conversion of T4 to Ts is? deiodinase
- Calcitonin has a peptide structure. Secreted by parafollicular cells (C-cells).
- Hypocalcemia hormone means it reduces blood calcium ion concentration by moving
Ca from blood to bones.
- Used in the treatment of osteoporosis-associated vertebral fractures.
- Hypercalcemia stimulates calcitonin production.
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- Thyroid function tests (normal serum TSH is 0.3 to 5.5 mU/L).
- Subclinical hypothyroidism is de ned by an elevated TSH with normal thyroid
hormone levels. If subclinical hypothyroidism is con rmed, consider treatment,
especially in patients with serum TSH >10 mU/L (normally 0.3-6 mU/L, depending on
the laboratory).
- A 50-year-old woman complains of progressive weight gain of 10 kg in 1 year, feeling
fatigue, postural dizziness, wait gain, excessive sweating, coarse skin, constipation,
and cold intolerance. Based on her physical ndings and laboratory investigation. Her
condition was diagnosed as hypothyroidism. What laboratory test is used to begin
thyroid replacement therapy? Serum TSH
- Parathyroid Glands; Four tiny glands in the posterior surface of the thyroid gland,
which is positioned on the esophagus, produce parathyroid hormone (PTH), which
regulates the calcium metabolism in the body.
- PTH plays an important in role in calcium and phosphate metabolism.
- Hypocalcemia = Stimulate PTH production.
- Hypercalcemia = Stimulate calcitonin production
- Hypocalcemia stimulates parathyroid hormone production and stimulates vitamin D
activation.
- 'The level of calcium in the body is managed by calcitonin which decreases calcium
levels and parathyroid hormone which increases calcium levels.
- Stimulate the reabsorption of calcium in the kidney and inhibit the reabsorption of
phosphate.
- PTH hormone 1 Ca absorption in the intestine via activation of vitamin D and 1
reabsorption of Ca in the kidney.
- Stimulate the production of 1, 25-(OH)-Vitamin D.
- There is 3-way relationship with calcium, vitamin D and parathyroid hormone. When
vitamin D levels are extremely low in the body, the parathyroid gland is affected and
usually tried to compensate by releasing more of the parathyroid hormone. This PTH
helps deposit calcium into bone. Vitamin D causes calcium to be absorbed from the
gut into bloodstream
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- If in elderly increase parathyroid hormone (PTH) increase can cause? Decrease in
blood phosphate levels.
- Pancreas is present in the upper right side of the body and spread to the left side. In
the pancreas, the islets of Langerhans and acini produce digestive enzymes. Islets
produce 3 types of hormones;
- nsulin is produced by beta cells of islets of Langerhans.
- Glucagon is produced by alpha cells.
- Somatostatin and gastrin produced delta cells (extra pancreatic cells).
- Insulin is peptide with 51 amino acid chain. Q. Stored in vesicles in combination with
zine. Half-life insulin is 3 to 5 min controls blood glucose concentration.
- Insulin (tyrosine kinase receptors):
- Increase insulin secretion when elevate blood glucose, amino acids and fatty acids).
- Increase glucose uptake into cell.
- Glycogenesis: Increased glycogen storage in liver, and muscle.
- Decrease gluconeogenesis: Decrease synthesis of glucose from non-carbohydrate
source.
- Lipogenesis: Fat/triglyceride storage (adipose tissue).
- INSULIN PROMOTES K* UPTAKE INTO THE CELL
- Insulin † glucose uptake, † glycogenesis, Q. V gluconeogenesis and V
GLYCOGENOLYSIS
- Glucagon Stimulated breakdown of glycogen to glucose (glycogenolysis) in the liver
thus increase blood glucose levels.
- Insulin decreases? Gluconeogenesis (formation of glucose from non-carbohydrate
sources)
- Insulin increases? Glucose uptake into the cell and stimulates glycogen synthesis.
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- What are the fasting plasma glucose levels is considered as hyperglycemia? > 7
mmol/L
- What is the main cause of hypoglycemia? Excessive insulin intake
- Prosinsulin levels can be elevated in individuals with type 2 diabetes mellitus, so type
2 DM the proinsulin levels? Higher than normal.
- Insulin binds with what cell surface receptors? Tyrosine kinase
- Examples of hyperglycemia symptoms? Polyphagia, glycosuria, polyuria, polydipsia.
- Diabetes Insipidus (DI): Anti-diuretic hormone (vasopressin) de ciency causes
diabetes insipidus Insuf cient ADH due to dysfunction of hypothalamic nuclei (e.g.
tumors, hydrocephalus, histocytosis, and trauma). Passage of large volumes of dilute
urine. A decrease in ADH causes a large volume of dilute urine, polyuria, polydipsia
and polyphagia.
- Diabetes insipidus central: There is NO ADH production, Autoimmune, Treatment:
Antidiuretic hormone
- Diabetes insipidus nephrogenic: ADH is present but kidney does not respond,
Acquired or drugs (lithium)
- Diabetic insipidus is caused by a de ciency of? ADH or vasopressin
- Diabetes insipidus nephrogenic is caused by? Lithium
- Thymus Gland: Regulates the development of T-lymphocytes in the immune system.
- Pineal Gland: Small cone-shaped gland and the smallest of all glands located in the
midbrain. Large in children and begins to shrink at puberty. Only brain structure that
does not come in a pair
- Produces melatonin and dimethyl tryptamine in the dark.
- Pineal gland functions include In uencing circadian rhythms e.g. sleep and
temperature (regulates day and night cycle). Sexual development regulates the
mating behavior
- What hormone glad shrink after puberty age? Pineal gland
- Hypocorticosteroids. Addison's disease is chronic adrenal insuf ciency; Causes
autoimmune reactions, HIV and tuberculosis.
- Signs and symptoms: Chronic fatigue that gradually worsens, muscle weakness,
weight loss and loss of appetite, nausea, diarrhea, or vomiting.
- Treatment: Replacement of missing cortisol and udrocortisones.
- Hypercorticosteroids. Cushing’s syndrome or hypercortisolism or
hyperadrenocorticism is caused by high levels of cortisol in the blood. Cushing
syndrome or disease caused by a pituitary tumor releases too much
adrenocorticotropic, stimulating the adrenal gland to overproduce cortisol.
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- Signs and symptoms: Rapid weight gain, moon face, buffalo hump, reduced libido
and easy bruising.
- Treatment: Removal of adrenals. Postoperative steroid replacement (hydrocortisone
or prednisolone).
- Over use of corticosteroid cause? Cushing syndrome
- Addison's disease is caused by? De ciency of corticosteroids
- A patient who is using high dose prednisone likely can experience? Weight gain, easy
bruising (Cushing syndrome)
- A patient who abruptly stops using prednisone, may experience? Weight loss, chronic
fatigue, diarrhea (Addison disease).
- Menstrual cycle: Ovaries, Produces two hormones estrogen and progesterone.
- Estrogen: Controls the development of female sex characteristics and reproductive
system
- Progesterone: Prepares the lining of the uterus for implantation of a fertilized egg.
- Ovulation cycle and menstruation: During the menstrual cycle, estrogen is produced
by the ovarian follicles. After ovulation estrogen is produced by the corpus luteum.
During pregnancy ovulation does not occur. It is suppressed by high levels of
estrogen and progesterone’s.
- Pregnancy test. Human chorionic gonadotropin (hCG) hormone levels are elevated in
rst 3 months of pregnancy ( rst trimester).
- Progestin's in pregnancy is produced by the ovaries, corpus luteum and placenta.
- Ovulation Tests detects? LH
- Pregnancy test detects? hG
- How many days after ovulation menstrual periods begins? 14 days
- What hormone does the pregnancy blood test detect? Progesterone.
- Menopause. Cessation of menstrual periods for at least 6 months to 1 year is referred
as menopause. Occurs when the ovaries stop producing estrogen. Ovarian follicles
are depleted at approximately 51 years of age so the average age for Q. ,
menopause is 51 years.
- Early menopause is de ned as menopause before 45 years of age and premature is
before 40 years of age.
- There are 2 most common symptoms.
- Vasomotor symptoms: Hot ashes, night sweats, mood swings, sleeplessness,
lethargy, and depression.
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- Urogenital atrophy symptoms: This leads to dryness of the vagina, dyspareunia
(painful intercourse).
- What is the average age for menopause? 51 yo
- Most common symptoms of menopause? Hot ashes
- What is NOT a menopause symptom? Flank pain
- Epinephrine is released from? (adrenal medulla)
- Aldosterone is released from? (outer layer of adrenal cortex)
- ACTH is secreted by? (anterior pituitary hormone)
- Oxytocin is secreted from? (posterior pituitary gland)
- ADH is secreted from? (posterior pituitary gland)
- De ciency of ADH gives... (diabetes insipidus)
- Symptom of diabetes insipidus (22, 23, 25)
- Symptoms of diabetes mellitus (22, 23, 25)
- Symptoms of hypoglycemia (19, 20, 21, 24)
- What hormones are released from posterior pituitary gland? ADH and oxytocin.
- Hypothyroidism laboratory investigation include, Increase serum TSH & decrease in
T3 and T4)
- Epinephrine is released from? Adrenal medulla
- Aldosterone is released from? Adrenal cortex (outer)
- Testosterone to 5-hydroxy testosterone is catalyzed by? 5-alpha reductase
- Diabetes mellitus symptoms? 3 Poly (poly urea, polydipsia, polyphagia).
- Hypoglycemia symptoms? (sweating, palpitation, confusion, fatigue)
- Symptoms of hyperthyroidism? Weight loss, sensitivity to heat, tachycardia, and
diarrhea.
- Symptoms of hypothyroidism? Weight gain, edema, and sensitivity to cold,
constipation, hypertension, and bradycardia.
- Symptoms of Cushing syndrome? Hypercorticosteroidism, edema, weight gain, moon
face, puffy face, and buffalo hump.
- Addison disease is → hypocorticosteroids
- Ovulation (day 14), occurs 14 days before menses (day of 1 of menses) regardless of
cycle length.
- Menses (days 1-4). The endometrium is sloughed because of the abrupt withdrawal
of estrogen and progestin.
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- Pregnancy: is characterized by steadily increased levels of estrogen and
progestin which maintain the endometrium for fetus, suppress ovarian follicular
function by inhibiting FSH and LH.
- What gland shrinks after age of puberty? Pineal gland undergoes a process of
calci cation with aging and melatonin levels decrease in 60 year old and over.
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