Hypothalamic Hormone: Stimulates anterior pituitary thyrotropes to release TSH
Thyrotropin releasing hormone (TRH)
Hypothalamic Hormone: Inhibits release of several anterior pituitary hormones, including GH
Somatostatin (SST)
Hypothalamic hormone: Stimulates anterior pituitary gonadotrophs to release FSH and LH
Gonadotropin releasing hormone (GnRH)
Hypothalamic hormone: Stimulates anterior pituitary corticotropes to release ACTH
Corticotropin releasing hormone (CRH)
Hypothalamic hormone: Stimulates anterior pituitary somatotrophs to release GH
Growth hormone releasing hormone (GHRH)
Anterior pituitary hormone: Stimulates thyroid gland growth, promotes T4 and T3 synthesis and secretion
Thyroid stimulating hormone (TSH)
Anterior pituitary hormone: Females- stimulates ovarian sex steroid production, LH mid-cycle peak initiates ovulation. Males- stimulates testis synthesis and secretion of testosterone
Luteinizing hormone (LH)
Anterior pituitary hormone: Females: stimulates ovarian early follicular cycle follicle development and preparation for ovulation. Males: stimulates testis synthesis and secretion of testosterone
Follicle-stimulating hormone (FSH)
Anterior pituitary hormone: Promotes growth of bones and organs; promotes muscle protein synthesis, regulates metabolism of fat and liver
Growth hormone (GH)
Hypothalamic hormones:
TRH, SST, GnRH, CRH, GHRH
Anterior pituitary hormone: Stimulates breast development and milk production
Prolactin
Anterior pituitary hormone: Stimulates adrenal gland growth and hormone secretion, particularly cortisol secretion
Adrenocorticotropic hormone (ACTH)
Anterior pituitary hormones
TSH, LH, FSH, GH, prolactin and ACTH
Posterior pituitary hormone: Controls renal water retention to regulate BP and blood volume, also functions as vasoconstrictor
Vasopressin (AVP, ADH)
Posterior pituitary hormone: Stimulates uterine contraction, initiates milk ejection (let-down)
Oxytocin
Thyroid hormones: maintain normal functions of most tissues, increase the body's metabolic rate, required for normal development and function of the brain
T3 (more active) and T4
Hormone: increases blood calcium level by promoting absorption (from kidneys or intestine) or release (from bone breakdown)
Parathyroid hormone (PTH)
Adrenal hormone: Cortex-Targets most tissues, particularly liver, adipose, muscle, immune cells; many physiological functions, including metabolic regulation, BP maintenance, immune modulation
Cortisol
Adrenal hormone: Cortex- acts on the kidney to promote sodium retention and potassium excretion; required for normal BP maintenance
Aldosterone
Adrenal hormone: Cortex- act on many target tissues to promote the development and maintenance of male characteristics
Androgens
Adrenal hormone: Medulla-act on many target tissues to increase BP, blood glucose, catabolism; active in stress responses
Epinephrine and norepinephrine
Pancreatic hormone: targets liver, muscle and fat. Lowers blood glucose levels, promotes growth, anabolic hormone
Insulin
Pancreatic hormone: targets liver, raises blood glucoses levels, catabolic hormone
Glucagon
Pancreatic hormone: Acts locally within pancreas, paracrine action inhibits glucagon and insulin release
Somatostatin (SST)
Two major theories for the patho of diabetic micrangiopathy
1. Buildup of Advanced glycation end products (AGEs)- like spikey balls rolling through your veins 2. Increased reactive oxygen species d/t excessive glucose metabolism, AKA oxidative stress
Lab to measure endogenous insulin production
C-peptide
Gerontologic metabolic considerations
No real patterns. Maybe decreased incidence of graves while increased incidence of multinodular goiter and thyroid adenoma, more subtle hyperthyroid presentation- associated with a. fib
Pediatric considerations
Congenital hypothyroidism: Most common endocrine disorder at birth
Symptoms of hyperprolactinemia
amenorrhea, infertility, hypogonadism, galactorrhea and headaches
Pathogenesis of hypoprolactinemia
Rare, occurs in conjunction with general pituitary damage or compression d/t another pituitary adenoma
Cushing disease v. syndrome
Disease: hypercortisolism s/t pituitary tumor Syndrome: any time the body is making too much cortisol (umbrella)
Symptoms of hypercortisolism
Abdominal adiposity, facial rounding, abdominal striae, easy bruising, HTN, hyperglycemia
Most common cause of hypocortisolism
Addison's disease (autoimmune adrenocortical destruction)
Symptoms of hypocortisolism
Low sodium, high potassium, high ACTH (causes skin hyperpigmentation), hypotension, tachycardia, stress sensitivity, weight loss and fatigue
Hypofunction of posterior pituitary
Diabetes insipidus (DI), lots of dilute urine, can occur from head trauma that compresses the pituitary stalk (reducing AVP secretion), desmopressin replacement if chronic
Hyperfunction of posterior pituitary
Syndrome of inappropriate ADH (SIADH), water retention leads to hypervolemia, dilutional hyponatremia, risk of brain damage from hyponatremia, can be caused by nonpituitary neoplasms that secrete AVP
Actions of thyroid hormone
Speeds things up- increase and growth. Maintains normal brain function (activity, cognition and reflexes). Stimulates CV system (increase HR, SV and BP)
Why we don't test thyroid on acutely ill patients
Euthyroid sick syndrome
Proteolysis breaks down muscle proteins to gain amino acidsfor
hepatic gluconeogenesis
Why visceral obesity is linked with insulin resistance
Fat around the abdominal organs releases fatty acids and cytokines that promote liver insulin resistance
Critical acute complication of T2DM. Precipitating event is often an infection that results in decreased fluid intake and increased stress hormone secretion
Hyperosmolar hyperglycemic syndrome- blood glucose often higher than those seen in DKA (hyperosmotic)
Pathogenesis of gestational DM
Similar to type 2 DM (insulin resistance), also placenta degrades insulin, resulting in more stress of the beta cells
Guidelines for PSA testing
Men 50 to 69, but guidelines continue to evolve
RAA hormone family
Renin, angiotensin and aldosterone
RAA axis effects
decrease potassium, increase sodium and increase BV and BP
Responsible hormone: Hashimotos
Hypothyroid
Responsible hormone: Graves Disease
Hyperthyroid
Responsible hormone: Addison's Disease
hypocortisol (also hypoaldosterone)
Responsible hormone: Cushing syndrome or disease
hypercortisol
This pregnancy hormone contributes to insulin resistance
chorionic somatomammotropin
Process of creating glucose from non-glucose sources
Gluconeogenesis
Process of synthesizing glycogen in the liver
Glycogenesis
Process of breaking down glycogen in to glucose
glycogenolysis