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'Hormones' (Prolactin (Secretion (Pulsatile (Highest secretion…

- - - - Levadopa and bromocriptine are dopamine agonists
    - - Highest secretion during REM sleep
      - Peak serum levels between 4am and 6am
- - - - Within an hour of deep sleep
      - After exercise, physical stress, tramua
- - - - CRH inhibits ACTH
  - - - ACTH can control its own secretion
      - Glucocorticoids affect ACTH production
    - - Glucocorticoids decrease ACTH synthesis
- - - - Iodide is bound to serum protein albumin
      - Sodium symports iodide to the follicular cells
      - Oxidation: iodide oxidizes and becomes iodine
        
        Organification creates MIT and DIT
        
        Glycoprotein thyroglobulin exists in the follicular lumen of colloid
        
        Iodine combines with the tyrosine part of thyroglobulin
        
        1 iodine + tyrosine = MIT (monoiodotyrosine)
        
        2 iodine + tyrosine = DIT (diiodotyrosine)
        
        MIT and DIT are inactive forms
        
        Coupling creates T3 and T4
        
        MIT + DIT = T3
        
        DIT + DIT = T4
        
        T3 and T4 are active forms
  - - - If T3T4 is bound to a hormone, it is considered inactive
    - - Locations
        
        Brain
        
        Kidney
        
        Konads
        
        Muscle
        
        Heart
      - TR alpha 2 prevents thyroid hormone binding, blocking the action of other receptors
    - - Locations
        
        Pituitary gland
        
        Liver
      - TR beta 2 in the hypothalamus and pituitary participates in feedback control of the thyroid axis
  - - - Promotes bone formation, along with growth hormone and somatomedin
      - Stimulates bone maturation after ossification and fusion of the growth plates
      - Effects in adulthood
        
        Controls
        
        Learning
        
        Memory
        
        Body temperature
        
        Increases consumption of oxygen molecules by cells
        
        Metabolism
        
        Blood pressure
        
        Blood sugar
        
        Deficiency leads to obesity because of low metabolism
        
        Excess leads to weight loss
        
        GI tract
        
        Controls glucose absorption
        
        Increases glucose metabolism
        
        Glycogenolysis
        
        Breakdown of glycogen and conversion into glucose
        
        Gluconeogenesis
        
        Formation of new glucose from fatty acids, lactic acids, and amino acids
        
        Increases lipolysis (breakdown of fatty tissue)
        
        Protein synthesis and degradation
        
        Indirectly increases the sensitivity of alpha 1 and beta 1 adrenergic receptors to noradrenaline
        
        Controls blood pressure via alpha 1 receptor
        
        Controls heart function via beta 1 receptor
        
        Oversecretion
        
        Hypertension
        
        Heart problems
        
        Palpitation
        
        Extrasystole
        
        Arrhythmia
        
        Deficiency
        
        Decreases blood pressure
        
        Hypotension
        
        Bradycardia
  - - - Total T4, T4 RIA, Thyroxine, or T4
      - Determines the total amount of bound and unbound T4 in the blood
    - - Determines the amount of free T4 in the blood
    - - Determines the total amount of bound and unbound T3 in the blood
      - Total T3, T3 RIA, Triiodothyronine, or T3
      - Used to diagnose different types of hyperthyroidism
      - In hypothyroidism, these levels stay in the normal range (95 - 190 ng/dL)
    - - Determines the amount of free T3 in the blood
      - Small amount of free hormones (20 - 63 ng/dL) may be responsible for the biological activity of thyroid hormones
    - - Measures TSH and T4 levels in the blood
    - - Patient takes a pill containing radioactive iodine
      - If there is a tumor, the tissue can't absorb the iodine
      - Take a biopsy of the tissue
- - - - Low blood pressure
      - Low blood sodium
    - - Renin enzyme is secreted
        
        Renin converts angiotensinogen into angiotensin 1
        
        ACE (angiotensin converting enzyme) converts AG 1 into AG 2
        
        AG 2 acts as a vasoconstrictor and stimulates secretion of aldosterone into the bloodstream
        
        Aldosterone binds to aldosterone receptor in the collecting tubule
        
        Absorption of
        
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        Excretion of
        
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        By this way, aldosterone increases blood pressure
- - - - Increases calcium reabsorption
    - - Accelerates absorption of calcium
      - Blocks reabsorption of phosphate
      - Converts vitamin D3 into vitamin D
    - - Removes extra calcium from bone and releases it into the bloodstream
- - - - 5 Hydroxytryptophan
        
        5 Hydroxytryptophan decarboxylase
        
        Serotonin
        
        Melatonin
- - - - Treats inflammatory and some autoimmune diseases such as arthritis, dermatitis, eczema, and some allergic reactions
      - Promotes synthesis of lipocortin (inhibitor of phospholipase)
        
        Phospholipase A2 helps convert arachidonic acid into prostaglandin E2 and leukotriene
        
        Leukotriene levels increase during inflammation in the respiratory system (asthma)
        
        Prostaglandin E2 levels increase during fever
        
        Because glucocorticoids inhibit the precursor of prostaglandin and leukotriene (arachidonate), it has antiinflammatory properties
      - Inhibits release of histamine and serotonin from mast cells and platelets
    - - Appetite center located at the anterior hypothalamus
    - - Stimulates gluconeogenesis in the liver, forming new glucose from fatty acid, amino acid, and lactic acid
      - Inhibits glucose uptake in muscle and adipose tissue
      - Increases and maintains blood glucose levels
    - - Stimulates fat breakdown in adipose tissue
      - Fatty acids released by lipolysis are used to produce energy
      - Glycerol released provides a substrate for gluconeogenesis
    - - Cortisol inhibits the rejection of an organ by a patients body. Check levels after operations for organ transplants
      - Mechanism
        
        Inhibit genes that code for these cytokines
        
        Interleukin 1, 2, 3, 4, 5, 6, and 8
        
        Tumor necrosis factor gamma (TNF gamma)
        
        Reduced cytokine production causes reduced T cell proliferation
      - IL 1 and 2 levels increase during viral infections and cancer
      - Suppresses the release of antibodies from B cells
  - - - Hypertension
        
        Cortisol increases systolic/diastolic pressures and TPR
        
        BP = TPR X cardiac output
        
        Cardiac output = heart rate X stroke volume
      - Hyperglycemia
        
        Increased cortisol causes increased gluconeogenesis
      - Increased skin fragility
        
        Risk for skin cancer
      - Osteoporosis
        
        Risk for skin cancer
      - Weight gain from appetite increase
      - Sex hormone disorder
        
        Androgen oversecretion in female causes infertility, irregular menstruation/ovulation, and suppression of female sex hormones
      - Growth failure/delayed puberty
      - Excitatory effect on CNS
  - - - Dexamethasone is a synthetic cortisol
      - Applying a small amount of dexamethasone will artificially increase cortisol levels
      - Patient levels
        
        ACTH should decrease
        
        CRH should decrease
      - When ACTH levels stay elevated, the problem is in the anterior pituitary or hypothalamus (Secondary cushing's disease)
    - - Administer a small amount of synthetic ACTH
      - Normal reaction of adrenal cortex
        
        Increase in aldosterone, cortisol, and androgen
        
        When there is no increase, there is primary addison's disease
    - - Administer a small amount of CRH
      - Normal reaction
        
        Increase in aldosterone, cortisol, and androgen
        
        No increase indicates problem with anterior pituitary
- - - - Sunlight activates 7 dehydroxycholesterol
        
        7 dehydrocholesterol is converted into previtamin D3
        
        Previtamin D3 is transported to the liver by a2 globulins
        
        Previtamin D3 becomes Vitamin D3 (25 hydroxycalciferol) in the liver
        
        25 hydroxycalciferol gets into the kidney
        
        PTH converts vitamin D3 into vitamin D (1.25 dihydroxycalciferol)
- - - - Increases after menstruation
- - - - Vasoconstrictor
    - - Vasodilator
- - - - Increases heart rate
      - Increases contractility of myocardium
      - Increases conduction velocity
      - Blocked by Propranolol
      - Blocked by Atenolol
        
        Used in patients with asthma because it won't bind to beta 2 receptors
    - - Relaxation and Dilation
      - Inhibits peristalsis
    - - Relaxes smooth muscles of bronchi
      - Agonist is Albuterol
    - - Excess sweating
      - Muscle contraction
      - Vasoconstriction
      - Contraction of sphincters
      - Calcium influx into cell
      - Hypertension
      - Increased cardiac contraction
      - Pupil dilation
      - Increases blood pressure
    - - Adrenal medulla
      - Sympathetic paraganglia
      - Brain
      - Spinal cord nerve cells
      - Synaptic vesicles of postganglionic autonomic nerves
    - - Located on fat cells
      - Lipolysis, fat breakdown
      - Increase in free fatty acid levels
    - - Found in adrenal medulla, nonadrenergic neurons, and specialized mast cells
  - - - High serum levels stimulate the hypothalamus, causing nervousness
  - - - Tyrosine hydroxylase converts tyrosine into dihydroxyphenylalanine (DOPA)
        
        DOPA decarboxylase converts DOPA into dopamine
        
        Dopamine beta hydroxylase converts dopamine into norepinephrine
        
        Phenylethanolamine N methyltransferase converts norepinephrine into epinephrine
  - - - Secretion is stimulated by acetylcholine release from preganglionic sympathetic fibers innervating the medulla
        
        Catecholamines bind to albumin in the blood and are carried in the circulation
        
        Catecholamines bind to adrenergic receptors on cell surfaces
        
        Adrenergic receptors are 7 pass transmembrane proteins that are coupled to G proteins
        
        Stress stimulates secretion, including exercise, hypoglycemia, and trauma
- - - - Peripheral osmoreceptors in the walls of blood vessels are stimulated
        
        Vagus and glossopharyngeal cranial nerves take the information about blood osmolarity to the hypothalamus
        
        Supraoptic and paraventricular nuclei release ADH into the posterior pituitary gland
        
        ADH is carried by the blood stream to the collecting tubules in the nephron
        
        ADH binds to V2 receptors in collecting tubule, activating aquaporin
        
        Aquaporin inserts on the tubule membrane as a bridge/channel for water
        
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        Thirst center in the hypothalamus is stimulated
  - - - Location
        
        Liver
        
        Smooth muscles of blood vessels
      - Controls gluconeogenesis in the liver
      - Controls vasoconstriction in the smooth muscle of the skin
    - - Location
        
        Collecting tubules of the kidney
      - G protein coupled receptor
      - Activation of adenyl cyclase
- - - - First two weeks
        
        Day 13, 14, 15
        
        Fertilization
        
        Remnants of follicle cell secrete progesterone, main pregnancy hormone
        
        FSH and LH levels decrease during pregnancy (controlled by prolactin)
        
        Low prolactin causes abortion because FSH and LH become active again
        
        No fertilization
        
        Menstruation occurs for 3 - 7 days
        
        Estrogen decreases before menstruation
        
        Estrogen increases after menstruation
        
        Ovulation
        
        Elimination of ovum
        
        Migration of ovum toward fallopian tube
        
        Controlled by LH
        
        High FSH levels for development of follicle cells and ovum
    - - FSH receptors in seminiferous tubule in testicle
        
        Controls spermatogenesis, sperm maturation, after puberty
  - - - Ovulation
      - Maintains corpus luteum
    - - Controls leydig cells, which secrete testosterone
- - - - Levels increase after exercise and sexual activity
      - May prevent release of substance P
      - Precursor: lipotropin
    - - Corticotropin-like intermediate lobe peptide
      - Stimulates pancreatic enzyme secretion
        
        Amylase
        
        Carb digestion
        
        Lipase
        
        Lipid digestion
        
        Protease
        
        Protein digestion
    - - Melanocyte stimulating hormone
      - Protects the skin by stimulating melanin cells
    - - Controls body fat
      - Precursor of endorphins
      - Levels decrease with age
- - - - Decision making
      - Social behavior
      - Problem solving
    - - Movement
      - Deficiency
        
        Parkinsons
      - Excess
        
        Schizophrenia
    - - Emotional and sexual behavior
      - Connected to limbic system
      - Cocaine
        
        Stimulates dopamine
        
        Stimulates the limbic system
        
        False sense of pleasure
    - - Inhibits prolactin secretion
      - Suppresses TSH
- - - - Potassium
      - Sodium
- - - - Inhibit growth hormone
    - - Inhibit gastric hormones like gastrin
    - - Inhibit insulin and glucagon