CC2 LEC FINALS

LECTURE / TOPIC 1 TRANSCRIBED BY: ANGELICA AGUILAR & IVAJ

DO NOT REDISTRIBUTE W/O PERMISSION!

BASIC ENDOCRINOLOGY 4. GLYCOPROTEIN

- are conjugated proteins bound to carbohydrates
TOPIC OUTLINE
1 Introduction - Examples
2 Hormone Classification • FSH
3 Growth Hormone • LH
4 Adrenocorticotropic Hormone • thyroid-stimulating hormone
5 Thyroid Hormone 5. STEROID
6 Parathyroid Hormone - all derived from a lipid, typically cholesterol

INTRODUCTION - Examples
*ENDOCRINOLOGY • sex hormones
- study of the endocrine • Estrogen
• ENDOCRINE = associated with hormones • Progesterone
• Aldosterone
- HORMONES = chemical messenger or substances • Testosterone
• Secreted into the circulation after production by • Cortisol
the TISSUE SOURCE • other androgens like dehydroepiandrosterone
o Act on an organ away from the tissue (DHEA)
source or TARGET TISSUE 6. FATTY ACIDS
- made up of small fatty acid derivatives of arachidonic
acid
HORMONE CLASSIFICATION
1 AMINE - Examples
2 PEPTIDE • Eicosanoids
3 PROTEIN • Leukotrienes
4 GLYCOPROTEIN • Prostaglandins
5 STEROID • thromboxanes
6 FATTY ACIDS
1. AMINE - rapidly degraded and are only effective in the body for
- tryptophan or tyrosine are modified to create amine seconds
hormones
HORMONES
- Examples
1 GROWTH HORMONE
• norepinephrine
2 ADRENOCORTICOTROPIC HORMONE (ACTH)
• triiodothyronine
3 THYROID HORMONE
• thyroxine
4 PARATHYROID HORMONE
• serotonin
• urinary 5- hydroxyindoleacetic acid
1. GROWTH HORMONE
- very short half-lives CONCEPT
2. PEPTIDE - Hypothalamus (brain) = “mother gland”
- is generally considered to be an unbroken chain of • Inhibiting hormone = stop production
amino acids of 50 or less • Releasing hormone = stimulate production
o Growth Hormone Releasing Hormone
- Examples (GHRH) → stimulate anterior pituitary
• insulin gland
• vasopressin
• oxytocin - Anterior Pituitary = “master gland”
• Produces GROWTH HORMONE
- Most peptide hormones found in humans have around o Growth and development
20 amino acids. ▪ Act on bones, muscles, cells,
3. PROTEIN etc
- made of chains of amino acids *Regulates blood glucose

- Examples - Bones, Muscles, cells etc.

• ACTH • Tissue source of GH = Hypothalamus
• Calcitonin • Target tissue = Anterior pituitary gland
• Insulin CLINICAL SIGNIFICANCE
• glucagon 1 Acromegaly
• oxytocin 2 Gigantism
3 Dwarfism

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CC2 LEC FINALS
LECTURE / TOPIC 1 TRANSCRIBED BY: ANGELICA AGUILAR & IVAJ
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- Increase CLINICAL SIGNIFICANCE

• Acromegaly 1 Cushing Syndrome
• Gigantism 2 Hypocortisolism
3 Conn’s Syndrome
- Decrease 4 Addison’s Disease
• Dwarfism a. CORTISOL
• Increase = Cushing syndrome → Primary
- abnormality due to hypercortisolism
• anterior pituitary tumor o classification
o anterior pituitary → shrinkage → ▪ Primary = problem in adrenal
decrease GH production → dwarfism gland
• overactivity of hypothalamus *Due to adrenal adenoma
o increase GHRH → Anterior pituitary (tumor)
produce ↑ GH → acromegaly/ ▪ Secondary = APG
gigantism ▪ Tertiary = hypothalamus
GIGANTISM ACROMEGALY o Signs and symptoms
- man holding - Specific part ▪ Buffalo hump
the baby is 8ft, of body is ▪ Moon face
2.5 inches tall enlarged ▪ Obesity or weight gain
-Ex. Feet, especially in the abdomen
facial, feature, ▪ Stretch marks
hands ▪ Easily bruises (ecchymosis) =
due to thin skin
DWARFISM DWARFISM
▪ Hypertension
- Short supply of GH in
▪ Poor wound healing
childhood
o Cortisol = normally exhibits diurnal
variation (highest in the morning)
- 2 types:
▪ Cushing = no diurnal
1. Lorrain
variation
2. Frohlich’s
*Collect at 11pm – 3am

• Decrease (hypocortisolism) = decrease

2. ADRENOCORTICOTROPIC HORMONE (ACTH) cortisol production
CONCEPT o Primary = under reactive adrenal
- Hypothalamus = mother gland gland
• Produce CORTICOTROPIN RELEASING ▪ Atrophy = decrease in size
HORMONE (CRH) o Secondary = under reactive APG →
o Tissue source = hypothalamus decrease ACTH
o Target tissue = APG
o Stimulates APG to produce ACTH b. ALDOSTERONE
• Increase (hyperaldosteronism) = CONN’S
- Anterior Pituitary gland = target tissue SYNDROME (rare)
• Produce ADRENOCORTICOTROPIN o Primary hyperaldosteronism:
HORMONE (ACTH) overreactive adrenal gland
o Tissue source = APG o Signs and symptoms
o Target tissue = Adrenal gland ▪ headaches
o Function = stimulates Adrenal gland to ▪ muscle weakness or cramps
produce cortisol and aldosterone ▪ nausea
▪ frequent urination
- Adrenal gland ▪ heart palpations
• Produces
o Cortisol = regulates blood glucose (↑ • Decrease (hypoaldosteronism) = ADDISON’S
blood glucose) DISEASE
▪ Target: FATS → trigger o Signs and symptoms
LIPOLYSIS or breakdown of ▪ Underweight
lipids ▪ Over pigmentation in the face
▪ Target: LIVER → protein ▪ Fatigue
catabolism ▪ Muscle weakness
o Aldosterone ▪ Lethargy
▪ Target: KIDNEY = regulate Na,
Cl, H20 (electrolytes)

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3. THYROID HORMONE - Goiter = can cause hyperthyroidism or

CONCEPT hypothyroidism
- Tissue Source = Hypothalamus (tertiary) • Hyperthyroidism = Toxic goiter
• Releases THYROTROPIN RELEASING • Hypothyroidism = deficiency of iodine
HORMONE (TRH) o Iodine = important component
o Target tissue = APG in the production of thyroid
hormones
- Anterior Pituitary Gland (secondary)
• Produces THYROID STIMULATING HORMONE - Hashimoto’s = most common cause of hypothyroidism
(TSH) • Autoimmune disease = produces autoantibodies
o Target tissue = Thyroid Gland o Anti-TPO (thyroid peroxidase antibody)
o Anti-Tg (thyroglobulin antibody)
- Thyroid Gland (primary) • Primary hypothyroidism = autoantibodies
• Produces T3 and T4 targeting the thyroid gland
o Target tissue: different cells
o Regulate - Myxedema = advanced form of
▪ Metabolism hypothyroidism
▪ Temperature • Puffiness (sweeling)
▪ Heartrate • Fatigue
• Hormone: Calcitonin • Obesity
o Overactivity • Dry, thickened skin
▪ Decreased Blood Ca • Mental impairment
▪ Tetany: nerve problems • Thin brittle hair
leading to muscle spasms or
cramps
- Cretinism / Congenital hypothyroidism
o Underactivity
▪ Osteoporosis (brittle bones) • Appears among newborns
▪ Kidney stones o Protuberant abdomen
↓ calcitonin = ↑ Blood Calcium o Short stature
o Infertility
CLINICAL SIGNIFICANCE
o Neurological impairment
- Hyperthyroidism = increase T3 and T4
o Constant fatigue
• Primary = over reaction of the thyroid gland
o Obesity
o ↑ T3 and T4
Examples
• Secondary = over reaction of the APG
CASE # 1
o ↑TSH
• FT3 = low
▪ Causes ↑T3 & ↑T4 even
though the thyroid gland is • FT4 = low
normal • TSH = high
• Tertiary = over reaction of the hypothalamus
o ↑ TRH -SOLUTION
▪ Causes ↑TSH, ↑T3 & ↑T4 • Thyroid hormones (T3 and T4) → low =
hypothyroidism
- Hypothyroidism = decrease T3 and T4 • TSH → high
• Primary = under reaction of the thyroid gland o Assuming that the thyroid gland is
o ↓ T3 & T4 normal, FT3 and FT4 should be
• Secondary = under reaction of the APG elevated
o ↓ TSH → ↓ T3 & T4 ▪ but FT3 and FT4 is low →
under reactive thyroid gland
• Tertiary = under reaction of the hypothalamus
(PRIMARY)
o ↓ TRH
CAUSES
-condition = PRIMARY HYPOTHYROIDISM
1 Grave’s disease
2 Goiter
3 Hashimoto’s CASE #2
4 Myxedema • FT3 = high
5 Cretinism / Congenital hypothyroidism • FT4 = high
- Grave’s disease = most common cause of • TSH = low
hyperthyroidism
• Autoimmune disease = produces autoantibodies -SOLUTION
o Thyroglobulin antibodies • Thyroid hormones (T3 and T4) → high =
o Thyroid-stimulating antibodies hyperthyroidism
▪ Mimics the action of TSH → ↑
• TSH → low
T3 & T4

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CC2 LEC FINALS
LECTURE / TOPIC 1 TRANSCRIBED BY: ANGELICA AGUILAR & IVAJ
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o Assuming that the thyroid gland is o Promotes reabsorption of calcium in

normal, FT3 and FT4 should be
decrease
▪ but FT3 and FT4 is high →
over reactive thyroid gland
(PRIMARY)
-condition = PRIMARY HYPERTHYROIDISM
GIT and kidney
- UNDERACTIVITY
• Low blood calcium (hypocalcemia); high bone
Ca
o No Ca resorption in the bone
• Tetany = involuntary muscle contraction

- OVEREACTIVITY
• High blood calcium, low bone Ca
• Osteoporosis
CASE #3A
A. INITIAL
• TRH = low
• TSH = low
• FT3/ FT4 = low

-SOLUTION
• Thyroid hormones (T3 and T4) → LOW =
hypothyroidism
• TSH low
• TRH → low
o All low → under reactive Hypothalamus
(low TRH) = TERTIARY
-condition = TERTIARY HYPOTHYROIDISM

CASE #3B
B. FOLOW UP – after injection of exogenous TRH
• TRH = increase
• TSH = low
• FT3 and FT4 = low

-condition = SECONDARY HYPOTHYROIDISM

CASE #4
• FT3 = high
• FT4 = high
• TSH = high

-SOLUTION
• Thyroid hormones (T3 and T4) → high =
hyperthyroidism
• TSH → high
o Since T3 and T4 are also high in
response to high TSH = normal thyroid
gland; hence
▪ APG overreactive → high TSH
(SECONDARY)
-condition = SECONDARY HYPERTHYROIDISM

4. PARATHYROID GLAND
-hormone: parathormone (PTH)
• Increase blood calcium in cases of
hypocalcemia
o Promotes calcium resorption from the
bones
▪ Stimulates osteoclastic activity
→ Ca in bones released to
circulation

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