Comparison between growth hormone and thyroid hormone regarding their effects on: a) Protein metabolism GH Thyroid Hormone y Increase transport of AA into interior of y Dose dependent: cell through cell membrane 1. Small dose: -increases rate of formation of proteins y Increased protein synthesis by direct by ribosomes. effect on ribosomes -increases RNA synthesis by genes y Stimulates transcription of DNA into RNA y Decreases catabolism of protein & 2. Large dose: - excess catabolism of muscle proteins. AA(protein sparer)

b) Growth Growth Hormone(GH) y Indirect action: -On cartilage and bone -causing mainly liver and other tissues to form somatomedins A,B ,C leading to proliferation of chondrocytes and appearance of osteoblasts Thyroid Hormone Due to the hormone s action on protein synthesis. Thyroid hormones are required for production & action of GH & insulinlike growth factor Promotes growth and development of brain during fetal life and for first few years of life. Essential for normal myelination & development of nervous system in infant Deficient of thyroid hormone during infancy and childhood can cause mental retardation

y y




2. Factors controlling insulin secretion Factors increasing insulin secretion 

Factors decreasing insulin secretion 

Hyperglycemia Amino acid e.g: arginine & lysine GIT hormones, e.g: gastrin, secretin, cholecystokinin, gatric inhibitory peptide Stimulation of vagus nerve

Hypoglycaemia Somatostatin Hypokalemia Sympathetic nervous produced by norepinephrine acting adrenergic receptors

system released on 2-

3. Functions of Sertoli Cell:  Provide special environment for germinal cells to develop  Secrete fluid to provide appropriate nutrients for newly formed sperms 

Special role in converting spermatids into spermatozoa(spermiation)  Secrete several hormones: Mullerian inhibitory factor(MIF) Inhibit formation of fallopian tube from mullerian ducts in male fetus Estradiol(estrogen) Required as one of stimulatory factors in spermatogenesis Inhibin Feedback inhibitory effect on anterior pituitary gland to prevent oversecretion of FSH Androgen binding protein(ABP) Maintain high testosterone level in seminiferous tubules

4. Proliferative phase of endometrium cycle: a) Hormone responsible: estrogen b) Changes that occur:  Stromal cells & epithelial cells proliferate rapidly  Increase no. Of stromal cells, endometrial glands and blood vessels in the first 2 weeks of endometrial cycle  At time of ovulation, endometrium is approximately 3-4 mm thick 5. Neural centers that regulate food intake: Hypothalamic Center  Feeding(Hunger) center: -site: lateral hypothalamus -role: causes eating behaviour -lesion: causes lack of desire for food and progressive inanition a condition characterized by: y marked weight loss, y muscle weakness, y decreased metabolism  Satiety center: -site: ventromedial nuclei of hypothalamus -role: causes complete satiety and cessation of eating -lesion: hyperphagia and extreme obesity( hypothalamic obesity ) Other areas  Amygdala & prefrontal cortex: -site: limbic system -lesion: moderate hyperphagia characterized by loss of the mechanism of appetite control of type and quality of food eaten with attempttion to eat all sorts of food(omniphagia) 
Brain stem centers: -site: brain stem -role: control actual mechanics of feeding

6. Dynamics of glomerular filtration: 

Pressure inside the glomerular capillaries causes fluid to filter through the capillary membrane into Bowman s capsule. Colloid osmotic pressure of the blood and pressure in the Bowman s capsule both oppose the filtration.

7. Role of kidney in acid-base balance:

Regulating concentration Of HCO3 in

Reabsorption of filtered HCO3 Generation of New HCO3

Via ammonia

pH regulation


Secretion of H+ ions

via phosphate 


Kidney regulates the pH by regulating concentration of HCO3 in plasma and secretion of hydrogen ions. Tubular secretion: The epithelial cells of the proximal, distal tubules and collecting ducts ALL secrete hydrogen ions into the tubular fluid The kidneys generate new HCO3 to replace HCO3 lost in buffering the various strong acids formed in the body. The kidneys generate new HCO3 via ammonia & phosphate

PROBLEM SOLVING: Problem 1: a) Cushing s Syndrome secondary to hypersecretion of ACTH due to pituitary tumor. Cortisol is abnormally high. b) Functions of cortisol: Protein Metabolism Cortisol reduces cellular protein in ALL body cells EXCEPT those of the liver. Incresed liver proteins & PPs Increased blood amino acids Increased rate of deamination of AA and converts it into glucose Increased protein synthesis in liver Increased formation of plasma in liver Calcium Metabolism i. Lowers plasma calcium level and over long periods of time, they causes osteoporosis by: -inhibit cellular replication & protein bone synthesis -inhibit osteoblasts -anti-Vit D effect; decrease absorption of calcium & phosphate from intestine - increase renal excretion of calcium


ii. iii. iv. v. vi.

c) Cause of hypertension in this patient is due to i. Increased vascular reactivity to catecholamines, increasing the pressor effect. ii. Major mineralocorticoid effect leads to salt & water retention d) Other hormones that can cause hyperglycemia:

*note: All hormones are hyperglycaemic except INSULIN. Problem 2: 1. C-below 30 ml/min 2. D- plasma creatinine Problem 3: a) b) c) d) Problem 4: 1. GFR=UXV/P= 56X1.5/0.2=420ml/min . Therefore, answer is b 2. d- 90 ml/min 3. a- filtration and secretionby PCT 4. a- 1200 ml/min


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