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BRS Physiology questions
questions from BRS physiology review book, per Chris, UTCOM class of 2014
329
Physiology
Professional
03/18/2011

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Term
Question
Definition
Answer
Term
What are the types of hormones?
Definition
Protein/peptide hormones Steroid hormones Amine hormones
Term
How are protein and peptide hormones synthesized?
Definition
Preprohormone synthesis occurs in the ER The signal peptide is cleaves to give the prohormone The prohormone trafficks to the Golgi Additional proteolytic cleavages occur to give the mature hormone The hormone is packaged into secretory granules for later use
Term
What precursor molecule are steroid hormones derived from?
Definition
Cholesterol
Term
What precursor molecule are amine hormones derived from?
Definition
Tyrosine
Term
What hormone class includes the thyroid hormones, epinephrine, and norepinephrine?
Definition
The amine hormones
Term
Where is thyrotropin-releasing hormone (TRH) produced?
Definition
Hypothalamus
Term
What is the major action of thyrotropin-releasing hormone (TRH)?
Definition
Stimulates secretion of TSH and prolactin
Term
Where is corticotropin-releasing hormone (CRH) produced?
Definition
Hypothalamus
Term
What is the major action of corticotropin-releasing hormone (CRH)?
Definition
Stimulates secretion of ACTH
Term
Where is gonadotropin-releasing hormone (GnRH) produced?
Definition
Hypothalamus
Term
What is the major action of gonadotropin-releasing hormone (GnRH)?
Definition
Stimulates secretion of LH and FSH
Term
Where is growth hormone-releasing hormone (GHRH) produced?
Definition
Hypothalamus
Term
What is the major action of growth hormone-releasing hormone (GHRH)?
Definition
Stimulates secretion of growth hormone
Term
Where is somatotropin release-inhibiting hormone (somatostatin; SRIF) produced?
Definition
Hypothalamus
Term
What is the major action of somatotropin release-inhibiting hormone (somatostatin; SRIF)?
Definition
Inhibits secretion of growth hormone
Term
Where is prolactin-inhibiting factor (dopamine; PIF) produced?
Definition
Hypothalamus
Term
What is the major action of prolactin-inhibiting factor (dopamine, PIF)?
Definition
Inhibits secretion of prolactin
Term
Where is thyroid-stimulating hormone (TSH) produced?
Definition
Anterior pituitary
Term
What is the major action of thyroid-stimulating hormone (TSH)?
Definition
Stimulates synthesis and secretion of thyroid hormones
Term
Where is follicle-stimulating hormone (FSH) produced?
Definition
Anterior pituitary
Term
What is the major action of follicle-stimulating hormone (FSH)?
Definition
Stimulates growth of ovarian follicles Stimulates secretion of estrogen
Term
Where is leutinizing hormone (LH) produced?
Definition
Anterior pituitary
Term
What is the major action of leutinizing hormone (LH)?
Definition
Stimulates ovulation Stimulates formation of the corpus luteum Stimulates ovarian synthesis of estrogen and progesterone
Term
Where is growth hormone (GH) produced?
Definition
Anterior pituitary
Term
What is the major action of growth hormone (GH)?
Definition
Stimulates protein synthesis and overall growth
Term
Where is prolactin produced?
Definition
Anterior pituitary
Term
What is the major action of prolactin?
Definition
Stimulates milk production and breast development
Term
Where is adrenocorticotropic hormone (ACTH) produced?
Definition
Anterior pituitary
Term
What is the major action of adrenocorticotropic hormone (ACTH)?
Definition
Stimulates synthesis and secretion of adrenal cortical hormones
Term
Where is B-lipotropin produced?
Definition
Anterior pituitary
Term
What is the major action of B-lipotropin?
Definition
Unknown in humans
Term
Where is melanocyte-stimulating hormone (MSH) produced?
Definition
Anterior pituitary
Term
What is the major action of melanin-stimulating hormone (MSH)?
Definition
Stimulates melanin synthesis
Term
Where is oxytocin produced?
Definition
Posterior pituitary
Term
What is the major action of oxytocin?
Definition
Milk ejection Uterine contractions
Term
Where is antidiuretic hormone (vasopressin; ADH) produced?
Definition
Posterior pituitary
Term
What is the major action of antidiuretic hormone (vasopressin; ADH)?
Definition
Stimulates water reabsorption in the renal collecting ducts
Term
Where are L-thyroxine (T4) and triiodothyronine (T3) produced?
Definition
Thyroid gland
Term
What are the major actions of L-thyroxine (T4) and triiodothyronine (T3)?
Definition
Stimulates skeletal growth Increases oxygen consumption Stimulates heat production Stimulates protein, fat, and carb utilization Perinatal maturation of the nervous system
Term
Where are glucocorticoids (cortisol) produced?
Definition
Adrenal cortex
Term
What is the major action of glucocorticoids (cortisol)?
Definition
Stimulates gluconeogenesis Anti-inflammatory Immunosuppressive
Term
Where is estradiol produced?
Definition
Ovary
Term
What is the major action of estradiol?
Definition
Stimulates growth and development of female reproductive organs Initiates the follicular phase of the menstrual cycle
Term
Where is progesterone produced?
Definition
Ovary
Term
What is the major action of progesterone?
Definition
Initiates the luteal phase of the menstrual cycle
Term
Where is testosterone produced?
Definition
Testes
Term
What is the major action of testosterone?
Definition
Stimulates spermatogenesis Stimulates the development of male secondary sex characteristics
Term
Where is parathyroid hormone (PTH) produced?
Definition
Parathyroid gland
Term
What is the major action of parathyroid hormone?
Definition
Increases serum Ca concentration Decreases serum phosphate concentration
Term
Where is calcitonin produced?
Definition
Thyroid gland (parafollicular cells)
Term
What is the major action of calcitonin?
Definition
Decreases serum Ca concentration
Term
Where is aldosterone produced?
Definition
Adrenal cortex
Term
What is the major action of aldosterone?
Definition
Stimulates renal Na reabsorption Stimulates renal H and K secretion
Term
Where is 1,25-dihydroxycholecalciferol produced?
Definition
Kidney
Term
What is the major action of 1,25-dihydroxycholecalciferol?
Definition
Increases Ca absorption in the intestine Stimulates bone mineralization
Term
Where is insulin produced?
Definition
Pancreas (beta cells)
Term
What is the major action of insulin?
Definition
Decreases blood glucose concentration Decreases blood amino acid concentration Decreases blood fatty acid concentration
Term
Where is glucagon produced?
Definition
Pancreas (alpha cells)
Term
What is the major action of glucagon?
Definition
Increases blood glucose concentration Increases blood fatty acid concentration
Term
Where is human chorionic gonadotropin (HCG) produced?
Definition
Placenta
Term
What is the major action of human chorionic gonadotropin (HCG)?
Definition
Stimulates estrogen and progesterone synthesis in the corpus luteum
Term
Where is human placental lactogen (HPL) produced?
Definition
Placenta
Term
What is the major action of human placental lactogen (HPL)?
Definition
Stimulates estrogen and progesterone synthesis in the corpus luteum Stimulates protein synthesis and overall growth
Term
How does negative feedback work?
Definition
Self-limiting A hormone has biologic actions that inhibit further secretions of that hormone
Term
What type of feedback regulation is most commonly seen in hormone secretion?
Definition
Negative feedback
Term
What is the negative feedback loop that terminates insulin secretion?
Definition
Increased blood glucose Insulin is secreted from the pancreatic B cells This increases glucose uptake by the tissues, and decreases plasma glucose As blood glucose concentration decreases, further secretion of insulin is inhibited
Term
How does positive feedback work?
Definition
This is a rare mechanism, and it both explosive and self-reinforcing A hormone has biologic actions that cause more secretion of that hormone
Term
What is the positive feedback loop that regulates estrogen secretion?
Definition
Estrogen causes LH to be secreted from the anterior pituitary just before ovulation LH acts on the ovaries and causes estrogen to be secreted?
Term
How do hormones determine the sensitivity of a target tissue?
Definition
They regulate the number or sensitivity of receptors
Term
How do inhibitory hormones work?
Definition
They decrease the number or affinity of receptors for itself or another hormone
Term
How does progesterone affect hormone sensitivity in the uterus?
Definition
It decreases it It downregulates its own receptor Also downregulates the estrogen receptor
Term
How do excitatory hormones work?
Definition
Increase the number or affinity of receptors for itself or other hormones
Term
How does estrogen affect hormone sensitivity in the ovary?
Definition
Estrogen upregulates its own receptor It also upregulates the LH receptor
Term
What are G proteins?
Definition
GTP-binding proteins that couple hormone receptors to effector molecules Have intrinsic GTPase activity Three subunits: a, B, and y The a subunit can bind GTP or GDP Can be stimulatory (Gs) or inhibitory (Gi)
Term
What second messenger systems are G proteins involved in?
Definition
Adenylyl cyclase Ca-calmodulin IP3
Term
What determines the activity of a G protein?
Definition
When the a subunit is bound to GDP, the G protein is inactive When GTP is bound, the G protein is active The G protein binds GTP and hydrolyzes it to GDP
Term
What mechanism of hormone action does ACTH use?
Definition
cAMP
Term
What mechanism of hormone action does LH use?
Definition
cAMP
Term
What mechanism of hormone action does FSH use?
Definition
cAMP
Term
What mechanism of hormone action does TSH use?
Definition
cAMP
Term
What mechanism of hormone action does ADH use when it binds V2 receptors?
Definition
cAMP
Term
What mechanism of hormone action does HCG use?
Definition
cAMP
Term
What mechanism of hormone action does MSH use?
Definition
cAMP
Term
What mechanism of hormone action does CRH use?
Definition
cAMP
Term
What mechanism of hormone action do B1 and B2 adrenergic receptors use?
Definition
cAMP
Term
What mechanism of hormone action does calcitonin use?
Definition
cAMP
Term
What mechanism of hormone action does PTH use?
Definition
cAMP
Term
What mechanism of hormone action does glucagon use?
Definition
cAMP
Term
What mechanism of hormone action does GnRH use?
Definition
IP3
Term
What mechanism of hormone action does TRH use?
Definition
IP3
Term
What mechanism of hormone action does GHRH use?
Definition
IP3
Term
What mechanism of hormone action does angiotensin II use?
Definition
IP3
Term
What mechanism of hormone action does ADH use when it binds the V1 receptor?
Definition
IP3
Term
What mechanism of hormone action does oxytocin use?
Definition
IP3
Term
What mechanism of hormone action do alpha 1 adrenergic receptors use?
Definition
IP3
Term
What mechanism of hormone action do glucocorticoids use?
Definition
Steroid
Term
What mechanism of hormone action does estrogen use?
Definition
Steroid
Term
What mechanism of hormone action does testosterone use?
Definition
Steroid
Term
What mechanism of hormone action does progesterone use?
Definition
Steroid
Term
What mechanism of hormone action does aldosterone use?
Definition
Steroid
Term
What mechanism of hormone action does vitamin D use?
Definition
Steroid
Term
What mechanism of hormone action does thyroid hormone use?
Definition
Steroid
Term
What mechanism of hormone action does insulin use?
Definition
Activation of a tyrosine kinase
Term
What mechanism of hormone action does IGF1 use?
Definition
Activation of a tyrosine kinase
Term
What mechanism of hormone action does ANP use?
Definition
cGMP
Term
What mechanism of hormone action does EDRF use?
Definition
cGMP
Term
What mechanism of hormone action does nitric oxide use?
Definition
cGMP
Term
How does the adenylate cyclase mechanism work?
Definition
The hormone binds to a receptor in the membrane GDP is released from the G protein GTP replaces it Adenylate cyclase converts ATP to cAMP cAMP activates PKA, which phosphorylates various targets cAMP is degraded to 5'-AMP by phosphodiesterase
Term
What is the relationship between G protein activation and adenylyl cyclase activation?
Definition
If the G protein is stimulatory (Gs), AC is activated If the G protein is inhibitory (Gi), AC is also inhibited
Term
What inhibits phosphodiesterase?
Definition
Caffeine Therefore, phosphodiesterase inhibitors augment the physiologic actions of cAMP
Term
How does the IP3 mechanism work?
Definition
The hormone binds to a cell membrane receptor A G protein activates PLC PLC liberates IP3 and DAG from membrane phospholipids IP3 mobilizes Ca from the ER Ca and DAG activate PKC, which phosphorylates various targets
Term
How does the Ca-calmodulin mechanism work?
Definition
A hormone binds to a receptor in the cell membrane Plasma membrane Ca channels are opened, and Ca is released from the ER This causes intracellular Ca to increase Ca binds to calmodulin, and this complex modulates physiologic actions
Term
How does the steroid hormone and thyroid hormone mechanism work?
Definition
The hormone diffuses across the membrane and binds to its receptor The hormone-receptor complex translocates to the nucleus and dimerizes These dimers act as transcription factors, and they bind to steroid-responsive elements (SREs) in DNA to initiate transcription New mRNA is produced and is eventually translated into protein
Term
What connects the hypothalamus to the anterior pituitary?
Definition
The hypothalamic-hypophysial portal system Blood from the hypothalamus (containing high concentrations of hypothalamic organs) is delivered to the anterior pituitary Those hypothalamic hormones stimulate or inhibit the release of anterior pituitary hormones
Term
What is the organization of the posterior pituitary?
Definition
Derived from neural tissue Nerve cell bodies are found in the hypothalamic nuclei Posterior pituitary hormones are synthesized in the nerve cell bodies, packaged into secretory granules, and transported down the axons to the posterior pituitary for circulatory release
Term
What are the hormones produced by the anterior pituitary?
Definition
GH Prolactin TSH LH FSH ACTH
Term
What hormones are glycoprotein hormones?
Definition
TSH LH FSH
Term
What are the main features of glycoprotein hormones?
Definition
Each hormone has an alpha and a beta subunit The alpha subunit is the same for all The beta subunits are different, and are responsible for the unique biological activities of each hormone
Term
What are the products of POMC processing?
Definition
POMC (pro-opiomelanocortin) Gives rise to ACTH, melanocyte-stimulating hormone (MSH), B-lipotropin, and B-endorphin
Term
Where are a-MSH and B-MSH produced?
Definition
The intermediary lobe This is a rudimentary structure in adult humans
Term
What is the hormone that determines normal growth to adult size?
Definition
Growth hormone (somatotropin)
Term
What is the structure of growth hormone?
Definition
Single-chain polypeptide Homology to prolactin (also to human placental lactogen)
Term
What type of secretion characterizes GH production?
Definition
Pulsatile secretion
Term
What environmental factors stimulate GH production?
Definition
Sleep Stress Hormones related to puberty Starvation Exercise Hypoglycemia
Term
What environmental factors inhibit GH production?
Definition
Somatostatin Somatomedins Obesity Hyperglycemia Pregnancy
Term
How does the hypothalamus control GH secretion?
Definition
GHRH stimulates synthesis and secretion of GH Somatostatin inhibits GH secretion by blocking GHRH response
Term
What is the GH negative feedback loop that is mediated by somatomedins?
Definition
Somatomedins are produced by GH-stimulated target organs They inhibit GH secretion from the anterior pituitary They also stimulate hypothalamic somatostatin secretion
Term
What is the GH negative feedback loop that is mediated by GHRH and GH?
Definition
GHRH inhibits its own hypothalamic secretion GH inhibits its own pituitary secretion GH stimulates hypothalamic somatostatin secretion
Term
What are the actions of GH in the liver?
Definition
Somatomedins (IGF) are produced IGF serves as the intermediary of several physiologic actions
Term
What type of receptor is the IGF receptor?
Definition
Receptor tyrosine kinase (similar to insulin receptor)
Term
What are the two types of physiologic effects mediated by GH?
Definition
Direct effects IGF effects (GH --> IGH production in the liver)
Term
What are the direct effects of GH?
Definition
Decreased glucose uptake (diabetogenic) Increased lipolysis Increased protein synthesis Increased lean body mass Increased IGF production
Term
What are the IGF-mediated effects of GH?
Definition
Increased protein synthesis in chondrocytes Increased linear growth (pubertal growth spurt) Increased protein synthesis in muscle Increased lean body mass Increased protein synthesis Increased organ size
Term
What are the symptoms of GH deficiency in children?
Definition
Failure to grow Short stature Mild obesity Delayed puberty
Term
What are some causes for GH deficiency?
Definition
Lack of GH Hypothalamic dysfunction -- decreased GHRH release Failure to generate IGF in the liver GH receptor deficiency
Term
How would you treat GH excess?
Definition
Somatostatin analogs such as octreotide This will inhibit GH secretion
Term
What are the symptoms of GH excess?
Definition
Acromegaly Before puberty: increased linear growth (gigantism) After puberty: periosteal bone growth, increased organ size, glucose intolerance
Term
What is the hormone responsible for lactogenesis?
Definition
Prolactin
Term
What hormone acts in conjunction with estrogen to promote breast development?
Definition
Prolactin
Term
What hormone is prolactin structurally homologous to?
Definition
GH
Term
How is prolactin secretion regulated?
Definition
PIF (dopamine) is produced by the hypothalamus, and this inhibits prolactin secretion TRH stimulates prolactin secretion Prolactin inhibits its own secretion by stimulating PIF secretion
Term
What would happen to prolactin secretion if you disrupted the hypothalamo-hypophysial tract?
Definition
You would have increased and sustained lactation This is because you would no longer be delivering inhibitory PIF
Term
What are the actions of prolactin?
Definition
Milk production in the breast Breast development (in conjunction with estrogen) Inhibition of ovulation (by decreasing GnRH) Inhibition of spermatogenesis (by decreasing GnRH)
Term
What is a symptom of prolactin deficiency?
Definition
Failure to lactate
Term
What are the symptoms of prolactin excess?
Definition
Galactorrhea (spontaneous lactation that is not associated with pregnancy) Decreased libido Failure to ovulate Amenorrhea (inhibition of GnRH secretion)
Term
What might cause prolactin excess?
Definition
Hypothalamic destruction, resulting in loss of PIF Prolactinomas (prolactin-secreting tumors)
Term
How would you treat prolactin excess?
Definition
Bromocriptine -- acts as a dopamine/PIF agonist and reduces secretion
Term
What are the hormones of the posterior pituitary?
Definition
ADH Oxytocin
Term
How are the posterior pituitary hormones made?
Definition
They are synthesized in hypothalamic nuclei and packaged into secretory granules with their respective neurophysins Travel down the nerve axons for secretion by the posterior pituitary
Term
Where is ADH produced?
Definition
The supraoptic nuclei of the hypothalamus
Term
What does ADH do?
Definition
Increases water permeability of the late distal tubule and collecting ducts
Term
What factors increase ADH secretion?
Definition
Increased serum osmolarity Volume depletion Pain Nausea Hypoglycemia Nicotine, opiates, antineoplastic drugs
Term
What factors decrease ADH secretion?
Definition
Decreased serum osmolarity Ethanol alpha-adrenergic agonists ANP
Term
What are the actions of ADH?
Definition
Increases water permeability of the principal cells of the late distal tubule and CD via V2 receptors (cAMP mechanism) Constriction of vascular smooth muscle via V1 receptors (IP3/Ca mechanism)
Term
Where in the hypothalamus does oxytocin originate?
Definition
The paraventricular nuclei
Term
What does oxytocin do?
Definition
Causes ejection of milk from the breast when stimulated by suckling
Term
How does suckling regulate oxytocin secretion?
Definition
This is the major stimulus for secretion Afferent fibers carry impulses from the nipple to the spine Relays in the hypothalamus trigger secretion from the posterior pituitary The sight or sound of the infant can stimulate secretion even in the absence of suckling
Term
How do dilation of the cervix and orgasm regulate oxytocin production?
Definition
They both stimulate secretion
Term
How does oxytocin induce milk ejection?
Definition
It causes the myoepithelial cells to contract Milk is forced from the mammary alveoli into the ducts
Term
How does oxytocin induce uterine contractions?
Definition
During pregnancy, oxytocin receptors in the uterus are upregulated as birth approaches
Term
What hormone stimulates the synthesis of thyroid hormone?
Definition
TSH
Term
How are thyroid hormones produced?
Definition
Thyroglobulin is synthesized from tyrosine in the thyroid follicular cells It is then packaged into secretory vesicles and exocytosed into the follicular lumen Iodide is transported into the follicular cells and oxidized to iodine Tyrosine residues of thyroglobulin react with I2 to form monoiodotyrosine (MIT) and diiodotyrosine (DIT) Two molecules of DIT combine to form thyroxine (T4) One molecule each of DIT and MIT combine to form triiodothyronine (T3) Iodinated thyroglobulin is stored as colloid in the follicular lumen until needed When the cells are stimulated by TSH, colloid is endocytosed into the follicular cells Lysosomal enzymes digest thyroglobulin to release T3 and T4 into circulation Leftover MIT and DIT are deiodinated and the iodine is recycled In the circulation, T3 and T4 is usually bound to thyroxine-binding globulin (TBG)
Term
During thyroid hormone synthesis, how is iodide transported into the cell?
Definition
I pump or Na-I cotransport These transporters actively transport iodine into the cell Inhibited by thiocynate and perchlorate anions
Term
What enzyme catalyzes the oxidation of I- during thyroid hormone synthesis?
Definition
Peroxidase (associated with the cell membrane) Inhibited by propylthiouracil
Term
How do you treat hyperthyroidism?
Definition
Propylthiouracil This will inhibit the oxidation of iodide to iodine during thyroid hormone synthesis
Term
What is the Wolff-Chaikoff effect?
Definition
High levels of iodide will inhibit the formation of MIT and DIT
Term
What are the relative quantities and activities of synthesized T3 and T4?
Definition
T4 is more abundant T3 is more active
Term
What enzyme deiodinates MIT and DIT to recycle iodine?
Definition
Thyroid deiodinase
Term
Why does deficiency of thyroid deiodinase mimic I2 deficiency?
Definition
In both cases, you are unable to synthesize new MIT and DIT because there isn't enough iodine available
Term
What happens to TBG levels during hepatic failure?
Definition
TBG levels rise This leads to a decrease in total thyroid hormone levels, but normal levels of free hormone
Term
What happens to T4 in peripheral tissues?
Definition
It is converted to T3 by 5'-iodinase It can also be converted to inactive reverse T3 (rT3)
Term
What is the pathway that stimulates thyroid hormone production?
Definition
TRH from the hypothalamus stimulates TSH secretion in the anterior pituitary TSH stimulates synthesis and secretion in the thyroid via the cAMP mechanism
Term
What is the primary symptom of chronic TSH elevation?
Definition
Hypertrophy of the thyroid gland
Term
What is the negative feedback loop for thyroid hormone?
Definition
T3 downregulates TRH receptors in the anterior pituitary, which inhibits TSH secretion
Term
What are thyroid-stimulating immunoglobulins?
Definition
IgG molecules that bind to TSH receptors on the thyroid Stimulate synthesis of T3 and T4 High concentrations found in patients with Graves' disease
Term
How much more potent is T3 than T4?
Definition
3x more potent
Term
What are the effects of thyroid hormone upon growth?
Definition
Required for attainment of adult stature Promote bone formation in conjunction with somatomedins Stimulate bone maturation
Term
In a patient with thyroid deficiency, how does bone age compare to chronologic age?
Definition
Bone age is less than it should be This is because thyroid hormone is required for bone maturation
Term
What are the effects of thyroid hormone upon the CNS during the perinatal period?
Definition
Required for CNS maturation Deficiency causes irreversible mental retardation
Term
How can neonatal hypothyroidism-associated mental retardation be avoided?
Definition
Hormone replacement therapy There is only a narrow window when this is effective, so screening for neonatal hypothyroidism is both necessary and mandatory
Term
What are the effects of hyperthyroidism upon the CNS in the adult?
Definition
Hyperexcitability Irritability
Term
What are the effects of hypothyroidism upon the CNS in the adult?
Definition
Listlessness Slowed speech Somnolence Impaired memory Decreased mental capacity
Term
Why are beta blockers such as propanolol good adjunct treatments for hyperthyroidism?
Definition
Thyroid hormone upregulates B1 adrenergic receptors in the heart This basically makes you overly sensitive to sympathetic stimulation Beta blockers prevent this
Term
What are the effects of thyroid hormone upon basal metabolism rate?
Definition
O2 consumption and BMR are increased in all tissues except the brain, gonads, and spleen This increases heat production
Term
What are the metabolic effects of thyroid hormone?
Definition
Overall, metabolism increases Glucose absorption in the GI tract increases Glycogenolysis increases Gluconeogenesis increases Glucose oxidation increases Lipolysis increased Protein synthesis AND degradation are increased
Term
What is the overall effect of thyroid hormone upon protein metabolism?
Definition
Overall, it is catabolic (although protein synthesis does increase -- degradation increases more)
Term
What are the three zones of the adrenal cortex?
Definition
Zona glomerulosa Zona fasciculata Zona reticularis
Term
What hormone is produced by the zona glomerulosa?
Definition
Aldosterone
Term
What are the effects of thyroid hormone upon the autonomic nervous system?
Definition
Has many of the same actions as sympathetic neurotransmitters because it upregulates B1 adrenergic receptors in the heart
Term
What is the effect of thyroid hormone upon the Na-K ATPase?
Definition
It upregulates it; this is why oxygen consumption is also increased
Term
What are the effects of thyroid hormone upon the cardiovascular and respiratory systems?
Definition
Heart rate and stroke volume increase, resulting in increased cardiac output Ventilation rate increases
Term
What hormones are produced by the zona fasciculata?
Definition
Glucocorticoids (cortisol)
Term
What hormones are produced by the zona reticularis?
Definition
Androgens (dehydroepiandrosterone and androstenedione)
Term
What are the 21-carbon steroid hormones?
Definition
Progesterone -- the precursor for the rest Deoxycorticosterone Aldosterone Cortisol
Term
How is progesterone modified to make deoxycorticosterone?
Definition
Hydroxylation at C21 Note that deoxycorticosterone has mineralocorticoid activity, not glucocorticoid
Term
How is progesterone modified to make glucocorticoids?
Definition
Hydroxylation at C17 Note that there is a pregnenolone intermediate
Term
How is pregnenolone modified to give androgens?
Definition
Cleavage of the C20,21 side chain This gives a 19C steroid hormone (dehydroepiandrosterone or androstenedione)
Term
Where does the conversion of pregnenolone to androgens take place?
Definition
Adrenal cortex
Term
How are adrenal androgens excreted?
Definition
Lost as 17-ketosteroids in the urine
Term
How do the testes produce testosterone?
Definition
They convert androstenedione (from the adrenal cortex) to testosterone
Term
What major family of hormones does aldosterone belong to?
Definition
Mineralocorticoids
Term
What are the 18C steroid hormones?
Definition
The estrogens
Term
How are estrogens produced?
Definition
The A ring of testosterone is oxidized (aromatization) This occurs in the ovaries and placenta, but not in the adrenal cortex or testes
Term
How does glucocorticoid secretion vary throughout the day?
Definition
Oscillates with a 24 hour periodicity (circadian rhythm) Cortisol levels are highest just before waking, and lowest in the evening
Term
What hormones stimulate the secretion of glucocorticoids?
Definition
CRH (from the hypothalamus) ACTH (from the anterior pituitary)
Term
How does CRH stimulate glucocorticoid secretion?
Definition
CRH-containing neurons in the paraventricular nuclei are stimulated, and CRH is delivered to the anterior pituitary CRH binds to receptors on corticotrophs cAMP signaling cascade POMC is synthesized (ACTH precursor) ACTH is secreted
Term
How does ACTH stimulate glucocorticoid secretion?
Definition
Increases steroid hormone synthesis in all zones of the adrenal cortex by stimulating cholesterol desmolase (which produces pregnenolone) Upregulates its own receptor on the adrenal cortex to increase ACTH sensitivity cAMP mechanism
Term
What can cause adrenal cortex hypertrophy?
Definition
Overstimulation with ACTH (overproduction of steroid hormones)
Term
What is the negative feedback loop for cortisol?
Definition
Cortisol inhibits CRH secretion from the hypothalamus Also inhibits ACTH secretion from the anterior pituitary
Term
How does the dexamethasone suppression test work?
Definition
Dexamethasone is a synthetic glucocorticoid that inhibits ACTH secretion It is used to determine the extent to which you can inhibit cortisol secretion
Term
How do people with ACTH-secreting tumors of the anterior pituitary respond to the dexamethasone suppression test?
Definition
Low doses have no effect High doses inhibit cortisol secretion This is because you are reducing the stimulus (ACTH) for cortisol production
Term
How do people with adrenal cortical tumors respond to the dexamethasone suppression test?
Definition
Not even a high dose inhibits cortisol secretion This is because the cells have lost responsiveness to ACTH and just churn out cortisol
Term
How is aldosterone secretion regulated?
Definition
Tonic control is mediated by ACTH Also affected by the renin-angiotensin system and serum potassium
Term
How does the renin-angiotensin system cause aldosterone to be secreted?
Definition
Decreased blood volume causes renal perfusion pressure to decrease Renin is secreted and cleaves angiotensinogen to angiotensin I Angiotensin I is converted to angiotensin II by ACE Angiotensin II acts on the zona glomerulosa of the adrenal cortex to cause corticosterone to be metabolized to aldosterone Aldosterone increases renal Na absorption
Term
How does hyperkalemia impact aldosterone secretion?
Definition
Hyperkalemia increases aldosterone secretion Aldosterone promotes K excretion, which restores plasma K to normal
Term
What family of hormones is primarily responsible for response to stress?
Definition
Glucocorticoids
Term
How do glucocorticoids stimulate gluconeogenesis?
Definition
Increase protein catabolism in the muscle Decrease protein synthesis (these two things provide amino acids for gluconeogenesis) Decrease glycolysis Decrease insulin sensitivity of adipose tissue Increase lipolysis, which provides glycerol to the liver for gluconeogenesis
Term
How do glucocorticoids mediate anti-inflammatory effects?
Definition
Induce lipocortin synthesis, which inhibits phospholipase A2 Recall that PLA2 liberates arachidonic acid, a precursor for prostaglandins and leukotrienes, from membrane phospholipids They also inhibit histamine and serotonin degranulation in mast cells and platelets
Term
How do glucocorticoids suppress the immune system?
Definition
Inhibit the production of IL2 Inhibit T cell proliferation These are both important in cellular (T cell-mediated) immunity
Term
Why are glucocorticoids used to prevent organ rejection?
Definition
They suppress cellular immunity
Term
How do glucocorticoids contribute to the maintenance of vascular response to catecholamines?
Definition
Cortisol upregulates alpha1 adrenergic receptors on arterioles This increases their sensitivity to norepinephrine
Term
What are the cardiovascular effects of cortisol excess and deficiency?
Definition
Excess -- hypertension Deficiency -- hypotension This is because cortisol upregulates alpha 1 receptors on arterioles, which sensitizes them to norepinephrine
Term
What are the effects of aldosterone on electrolyte transport in the nephron?
Definition
Increased Na reabsorption Increased K and H secretion These changes occur in the late distal tubule and CD
Term
What is Addison's disease?
Definition
Primary adrenocortical insufficiency Usually caused by autoimmune distruction of the adrenal cortex, results in adrenal crisis
Term
What are the symptoms of primary adrenocortical deficiency?
Definition
Decreased adrenal glucocorticoids, androgens, and mineralocorticoids Increased ACTH because of lost negative feedback loop Hypoglycemia from cortisol deficiency Weight loss, nausea, vomiting, weakness Hyperpigmentation Decreased pubic and axillary hair in women because of decreased adrenal androgens ECF volume contraction, hypotension, hyperkalemia, and metabolic acidosis because of aldosterone deficiency
Term
What is the mechanism for hyperpigmentation in Addison's disease?
Definition
Low cortisol levels stimulate ACTH ACTH contains the MSH fragment Melanin production is stimulated
Term
What is the difference between primary and secondary adrenocortical deficiency?
Definition
Primary -- general destruction of the adrenal cortex Secondary -- loss of ACTH secretion from the anterior pituitary
Term
How do the symptoms of secondary adrenocortical deficiency differ from those of Addison's disease?
Definition
No hyperpigmentation (because there is no ACTH) No volume contraction, hyperkalemia, or metabolic acidosis (because aldosterone is normal)
Term
What is Cushing's disease?
Definition
A type of adrenocortical excess that is caused by ACTH overproduction Usually caused by the clinical administration of glucocorticoids
Term
What causes adrenocortical excess?
Definition
Administration of pharmacologic doses of glucocorticoids Primary hyperplasia of the adrenal glands
Term
What are the symptoms of adrenocortical excess?
Definition
Increased cortisol and androgen levels Decreased ACTH (if caused by adrenal hyperplasia or exogenous glucocorticoids) Increased ACTH (if caused by ACTH overproduction) Hyperglycemia from elevated cortisol Increased protein catabolism and muscle wasting Central obesity Poor wound healing Virilization of women from elevated adrenal androgens Hypertension from elevated cortisol and aldosterone Osteoporosis from elevated cortisol (bone resorption) Striae
Term
How would you treat Cushing's disease?
Definition
Ketoconazole This inhibits steroid hormone synthesis
Term
What is Conn's syndrome?
Definition
Hyperaldosteronism Caused by aldosterone-secreting tumors
Term
What are the symptoms of Conn's syndrome?
Definition
Hypertension (Na reabsorption) Hypokalemia (K secretion) Metabolic alkalosis (H secretion) Decreased renin secretion because of increased ECFV and hypertension)
Term
What is 21B-hydroxylase deficiency?
Definition
The most common abnormality of the steroidogenic pathway Belongs to a group of disorders that constitute adrenogenital syndrome
Term
What are the symptoms of 21B-hydroxylase deficiency?
Definition
Decreased cortisol and aldosterone (because their precursor can't be synthesized) Accumulation of 17-hydroxyprogesterone and progesterone (because they can't be metabolized) Increased ACTH (because of decreased feedback inhibition by cortisol) Adrenocortical hyperplasia Increased adrenal androgens (because 17-hydroxyprogesterone accumulates) Increased urinary 17-ketosteroids Virilization in women Early linear growth and appearance of pubic/axillary hair Suppression of gonadal function in men and women
Term
What are the symptoms of 17a-hydroxylase deficiency?
Definition
Decreased androgens and glucocorticoids Increased mineralocorticoids (because precursor accumulates) Lack of pubic and axillary hair in women due to lack to androgens Hypoglycemia from glucocorticoid deficiency Metabolic alkalosis, hypokalemia, and hypertension because of excess aldosterone Increased ACTH because of decreased cortisol
Term
How is the endocrine pancreas organized?
Definition
Islets of Langerhans Contains alpha, beta, and delta cells Gap junctions link each cell type to itself, as well as to each other for rapid communication Portal blood supply allows insulin-containing blood from the beta cells to bath alpha and delta cells
Term
How does insulin affect K transport?
Definition
Insulin causes K to be taken up into cells, producing hypokalemia
Term
What are the major effects of glucagon?
Definition
Increased glycogenolysis Decreased glycogen synthesis Increased gluconeogenesis Lipolysis Ketoacid production -- acetoacetate and BHB are produced from acetyl CoA
Term
How is glucagon secretion regulated?
Definition
Glucagon is secreted in response to decreased blood glucose
Term
What tissues does glucagon act upon?
Definition
Liver Adipose tissue
Term
How does glucagon inhibit glycolysis?
Definition
It decreases the production of fructose 2,6-bisphosphate This decreases PFK activity
Term
What is the effect of glucagon upon urea production?
Definition
Amino acids are consumed as gluconeogenesis increases The resulting amino groups are incorporated into urea Urea production increases
Term
How are the endocrine cells of the pancreas organized within the pancreas?
Definition
Beta cells -- center of the islet Alpha cells -- periphery of the islet Delta cells -- scattered throughout
Term
What are the secretory products of the three cell types of the endocrine pancreas?
Definition
Alpha cells -- glucagon Beta cells -- insulin Delta cells -- somatostatin and gastrin
Term
What is the structure of insulin?
Definition
Contains an A and a B chain Chains are joined by two disulfide bonds
Term
How is insulin processed?
Definition
Proinsulin is synthesized as a single polypeptide chain In the storage granules, the connecting (C) peptide is cleaved by proteases to give mature insulin
Term
What is the clinical relevance of C peptide?
Definition
Used to monitor beta cell function in diabetic patients on insulin therapy
Term
How is insulin secretion regulated?
Definition
Blood glucose concentration is the primary regulator Increased blood glucose stimulates insulin secretion An initial burst is followed by sustained secretion
Term
What is the mechanism of insulin secretion?
Definition
Glucose binds to GLUT2 on pancreatic beta cells Glucose enters the cell and is oxidized to ATP ATP closes K channels in the plasma membrane The beta cells depolarize Depolarization opens Ca channels Intracellular Ca concentration increases Insulin granules exocytose
Term
How do sulfonylurea drugs work?
Definition
Similar to ATP, these drugs close ATP-gated K channels This causes pancreatic beta cells to depolarize Ca influx triggers insulin exocytosis
Term
What is the structure of the insulin receptor?
Definition
Tetramer with two alpha subunits and two beta subunits The beta subunits span the cell membrane and have tyrosine kinase activity When insulin binds, the tyrosine kinases autophosphorylate the beta subunits The phosphorylated receptor then phosphorylates intracellular proteins Insulin-receptor complexes enter the target cells; insulin therefore down-regulates its own receptor in target tissues
Term
What are the tissues targeted by insulin?
Definition
Liver Skeletal muscle Adipose tissue
Term
How does insulin decrease blood glucose concentration?
Definition
Increases glucose uptake into target cells by mediating the insertion of glucose transporters into the cell membrane Promotes formation of glycogen in the muscle and liver Decreases gluconeogenesis by increasing the production of fructose 2,6-bisphosphate, which stimulates PFK
Term
How does insulin decrease blood fatty acid and ketoacid concentrations?
Definition
Stimulates TAG synthesis Inhibits lipolysis Inhibits ketoacid formation because less acetyl CoA from fatty acid degradation is available
Term
How does insulin decrease blood amino acid concentration?
Definition
Stimulates amino acid uptake into cells Increases protein synthesis Decreases protein degradation Therefore, insulin is anabolic
Term
How does insulin cause hypokalemia?
Definition
Increases K uptake into cells
Term
How could diabetes produce hypotension?
Definition
Hyperglycemia causes the blood glucose concentration to exceed the Tm of the kidney Unabsorbed glucose acts as an osmotic diuretic in the urine Causes excess water to be lost in the urine, resulting in ECF volume contraction
Term
How could diabetes produce metabolic acidosis?
Definition
Overproduction of ketoacids Patients will increase their ventilation rate in order to compensate
Term
What does somatostatin do?
Definition
Inhibits the secretion of insulin, glucagon, and gastrin
Term
How is Ca transported in the blood?
Definition
40% is bound to plasma proteins 60% is unbound and is ultrafilterable
Term
What does it mean for Ca to be ultrafilterable?
Definition
Includes Ca that is complexed to anions such as phosphate, as well as free, ionized Ca
Term
Is free ionized Ca biologically active?
Definition
Yes
Term
What factors determine the overall serum Ca concentration?
Definition
Intestinal absorption Renal excretion Bone remodeling
Term
How is Ca balance maintained?
Definition
Net intestinal absorption must be balanced by urinary excretion
Term
Under what conditions is a positive Ca balance observed?
Definition
Seen in growing children Intestinal absorption exceeds urinary excretion, and the excess is deposited in growing bones
Term
Under what conditions is a negative Ca balance observed?
Definition
Pregnancy and lactation Urinary excretion exceeds intestinal absorption, and the deficit comes from maternal bones
Term
What hormone is involved in the regulation of serum Ca?
Definition
PTH
Term
Where is PTH produced?
Definition
Synthesized and secreted by the chief cells of the parathyroid glands
Term
What causes PTH to be secreted?
Definition
Decreased serum Ca Mildly increased serum Mg (note that greatly increased Mg will inhibit PTH secretion and produce symptoms of hypocalcemia)
Term
What are the major functions of PTH?
Definition
Increase serum Ca Decrease serum phosphate
Term
How does PTH increase serum Ca?
Definition
Increases bone resorption -- brings Ca and phosphate into the ECF Inhibits renal phosphate absorption in the proximal tubule Increases renal Ca reabsorption in the distal tubule Increases intestinal Ca absorption by stimulating production of vitamin D3 in the kidney
Term
What is an indicator bone resorption?
Definition
Increased hydroxyproline secretion
Term
What is the phosphaturic effect?
Definition
PTH inhibits phosphate reabsorption in the renal proximal tubule, effectively increasing phosphate excretion Urinary cAMP is also excreted
Term
What is the most common cause of primary hyperparathyroidism?
Definition
Parathyroid adenoma
Term
What are the symptoms of primary hyperparathyroidism?
Definition
Hypercalcemia Hypophosphatemia Increased phosphate excretion Increased urinary Ca excretion (because of the increased filtered Ca load) Increased urinary cAMP Bone resorption
Term
What causes humor hypercalcemia of malignancy?
Definition
PTH-related peptide (PTH-rp) is secreted by some malignant tumors PTH-rp has all of the physiological actions of PTH
Term
What are the symptoms of humor hypercalcemia of malignancy?
Definition
Hypercalcemia Hypophosphatemia Increased urinary phosphate excretion Decreased serum PTH levels due to feedback inhibition from high serum Ca
Term
What are some causes of hypoparathyroidism?
Definition
Thyroid surgery Congenital
Term
What are some symptoms of hypoparathyroidism?
Definition
Hypocalcemia Tetany Hyperphosphatemia Decreased urinary phosphate excretion
Term
What is Albright's hereditary osteodystrophy?
Definition
Also known as pseudohypoparathyroidism type 1a Defective Gs protein in the kidney and bone, which causes end-organ resistance to PTH Hypocalcemia and hyperphosphatemia are observed, and they are not correctable by administration of exogenous PTH Circulating PTH levels are increased (stimulated by hypocalcemia)
Term
How does chronic renal failure impact Ca and phosphate homeostasis?
Definition
Decreased GFR leads to increased serum phosphate Serum phosphate complexes with Ca and decreases free ionized Ca The diseased renal tissue produces less 1,25-dehydroxycholecalciferol, which contributes to the decreased plasma Ca
Term
What is renal osteodystrophy?
Definition
Increased PTH Decreased vitamin D3 This causes increased bone resorption and osteomalacia
Term
What role does vitamin D play in bone mineralization?
Definition
Provides Ca and phosphate to the ECF for bone mineralization
Term
What diseases does vitamin D deficiency cause?
Definition
Rickets (children) Osteomalacia (adults)
Term
How is vitamin D synthesized?
Definition
The active form is 1,25-dihydroxycholecalciferol It is produced in the kidney by 1a-hydroxylase
Term
How does vitamin D affect Ca and phosphate homeostasis?
Definition
Increases intestinal Ca absorption Increases intestinal phosphate absorption Increases renal reabsorption of Ca and phosphate Increases bone resorption
Term
What stimulates calcitonin production?
Definition
Increased serum Ca
Term
What does calcitonin do?
Definition
Inhibits bone resorption
Term
How is calcitonin used clinically?
Definition
Used to treat hypercalcemia
Term
What determines genetic sex?
Definition
Sex chromosomes Males are XY Females are XX
Term
What determines gonadal sex?
Definition
The presence of testes in males and ovaries in females
Term
What determines phenotypic sex?
Definition
The characteristics of the internal genital tract and external genitalia
Term
What dictates development of the male phenotype?
Definition
Testes secrete antimullerian hormone and testosterone Testosterone stimulates the growth and differentiation of the Wolffian ducts, which develop into the male internal genital tract Antimullerian hormone causes the mullerian ducts to atrophy (they would have become the female internal genital tract)
Term
What dictates development of the female phenotype?
Definition
The ovaries secrete estrogen Since there is no testosterone, the wolffian ducts do not differentiate into the male genital tract Since there is no antimullerian hormone, the mullerian ducts aren't suppressed and develop into the female internal genital tract
Term
What cells produce testosterone?
Definition
Leydig cells
Term
How does LH stimulate testosterone synthesis?
Definition
It stimulates cholesterol desmolase, the first step in the testosterone biosynthetic pathway
Term
How do accessory sex organs synthesize DHT?
Definition
They contain 5a-reductase This converts testosterone to its active form, DHT
Term
How would you pharmacologically treat benign prostatic hyperplasia?
Definition
5a-reductase inhibitors (finasteride) This blocks the activation of testosterone to DHT
Term
What regulates the secretion of FSH and LH?
Definition
GnRH from the hypothalamus
Term
What does FSH do in men?
Definition
Acts on the Sertoli cells to maintain spermatogenesis
Term
How do the Sertoli cells inhibit FSH secretion?
Definition
After being stimulated by FSH, they produce inhibin, which inhibits further FSH secretion
Term
What does LH do in men?
Definition
Acts on the Leydig cells to promote testosterone synthesis Testosterone reinforces the spermatogenic effects of FSH in the Sertoli cells
Term
How does testosterone inhibit LH secretion?
Definition
Directly inhibits LH secretion from the anterior pituitary Inhibits the release of GnRH from the hypothalamus
Term
What are the actions of testosterone?
Definition
Differentiation of the epididymis, vas deferens, and seminal vesicles Pubertal growth spurt and its cessation Libido Spermatogenesis Deepening of voice Increased muscle mass Growth of the penis and seminal vesicles
Term
What are the actions of DHT?
Definition
Differentiation of penis, scrotum, and prostate Male hair pattern Male pattern baldness Sebaceous gland activity Growth of prostate
Term
What causes androgen insensitivity syndrome?
Definition
Aka testicular feminizing syndrome Caused by a deficiency of androgen receptor in target tissues Testosterone and DHT actions are absent
Term
What are the symptoms of androgen insensitivity syndrome?
Definition
Female external genitalia No internal genital tract Elevated testosterone levels due to lack of receptors (lack of feedback inhibition)
Term
What happens during puberty in terms of hormone production?
Definition
Puberty is initiated by the onset of pulsatile GnRH secretion from the hypothalamus FSH and LH are secreted in a pulsatile fashion GnRH upregulates its own receptor in the anterior pituitary
Term
Where are androgens produced in females?
Definition
Theca cells produce testosterone (stimulated by LH) Testosterone diffuses to the granulosa cells, which contain aromatase and convert testosterone to estradiol (stimulated by FSH)
Term
What are the effects of FSH and LH upon the ovaries?
Definition
Steroidogenesis in the ovarian follicle and corpus luteum Follicular development beyond the antral stage Ovulation Luteinization
Term
What are the actions of estrogen?
Definition
Negative and positive feedback on FSH and LH secretion Maturation and maintenance of the fallopian tubes, uterus, cervix, and vagina Development of female secondary sex characteristics Breast development Upregulates estrogen, LH, and progesterone receptors Proliferation and development of ovarian granulosa cells Maintains pregnancy Lowers the uterine threshold to contractile stimuli during pregnancy Stimulates prolactin secretion (but blocks its action on the breast)
Term
What are the actions of progesterone?
Definition
Negative feedback effects upon FSH and LH secretion during the luteal phase Maintains secretory activity of the uterus during the luteal phase Maintains pregnancy Raises the uterine threshold to contractile stimuli during pregnancy Breast development
Term
What are the phases of the menstrual cycle?
Definition
Follicular phase (days 0-14) Ovulation (day 14) Luteal phase (days 14-28) Menses (days 0-4)
Term
What happens during the follicular phase of the menstrual cycle?
Definition
A primordial follicle develops, with atresia of neighboring follicles LH and FSH receptors are upregulated in the theca and granulosa cells Estradiol increases and causes proliferation of the uterus FSH and LH are suppressed by the negative feedback effect of estradione Progesterone is low
Term
What happens during ovulation in the menstrual cycle?
Definition
Occurs 14 days before menses, regardless of cycle length A burst of estradiol at the end of the follicular phase has a positive feedback effect on the secretion of FSH and LH (LH surge) Ovulation occurs as a result of the LH surge Estrogen levels decrease just after ovulation Cervical mucous increases in quantity, and becomes less viscous (more penetrable by sperm)
Term
What happens during the luteal phase of the menstrual cycle?
Definition
The corpus luteum begins to develop, and it produces estrogen and progesterone The vascularity and secretory activity of the endometrium increase to prepare for a fertilized egg Basal body temperature increases If fertilization does not occur, the corpus luteum regresses at the end of the luteal phase, and estrogen and progesterone levels decrease
Term
What happens during menses?
Definition
The endometrium is sloughed off because of the abrupt withdrawal of estradiol and progesterone
Term
What happens to estrogen and progesterone levels during pregnancy?
Definition
They steadily increase This maintains the endometrium for the fetus, suppresses ovarian follicular function, and stimulates breast development
Term
What does human chorionic gonadotropin do?
Definition
It rescues the corpus luteum from regression It is produced by the placenta in response to fertilization
Term
What hormonal changes occur during the first trimester?
Definition
The corpus luteum produces estradiol and progesterone HCG peaks at week 9 and then declines
Term
What hormone changes occur during the second and third trimester?
Definition
The placenta produces progesterone The fetal adrenal gland and placenta produce estrogens The major placental estrogen is estriol Human placental lactogen is produced throughout the pregnancy, and its actions are similar to GH and prolactin
Term
What happens during parturition?
Definition
Throughout pregnancy, progesterone increases the threshold for uterine contraction Near term, the estrogen/progesterone ratio increases, which makes the uterus more sensitive to contractile stimuli The initiating event in parturition is unknown
Term
What happens to prolactin levels during pregnancy?
Definition
They steadily increase because estrogen stimulates prolactin secretion
Term
Why doesn't lactation occur during pregnancy?
Definition
Estrogen and progesterone block the action of prolactin on the breast After parturition, estrogen and progesterone levels decrease and lactation begins
Term
How does suckling affect lactation?
Definition
It stimulates both oxytocin and prolactin secretion This maintains lactation
Term
How does lactation suppress ovulation?
Definition
Prolactin continues to be produced, and has the following effects: Inhibits GnRH secretion Inhibits the action of GnRH on the anterior pituitary, so LH and FSH secretion are antagonized Inhibits LH and FSH from acting on the ovaries
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