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Pitt NUR 0013 - Exam 1 study Guide

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NUR 0013 1st EditionExam # 1 Study Guide Lectures: 1 - 9Chapters 16-18Chapter 16 The Endocrine System 1. General characteristics of endocrine system2. Definition of a hormonea. Secreted small amt by epithelial cellsb. Directly into blood or extracellular tsc. Travels a distanced. Acts on specific ts called target cells3. Know the classes of hormones a. Steroids derivative i. Example: adrenal cortex and gonadsii. Long half life- connects on plasma membrane iii. Lipid soluble- can easily cross cell membraneiv. Non-polarv. direct gene activationb. Amino acid derivativei. Example: thyroid, epi and NE adrenal medullaii. Water –soluble: needs a transport to cross cell membrane iii. Polar, short half-life iv. Most common type (protein, peptides ect) c. Eicosanoids i. not real hormones by some – bc effect is very local 1. Autocirne 2. Paracrine ii. Derived from cell membrane (arachnoid acid) iii. Leukotrienes and prostaglandins 4. Know cell response to a hormonea. Cell membrane permeability and potential can change by opening and closing ionchannels b. Can activate enzymes synthesis c. mRNA synthesis and direct gene activation d. can influence and affect mitosis 5. Hormone Receptorsa. Membrane bound i. What types of hormone bind to them?1. amino acid hormones2. Activation of 2nd messengers- cAMPb. Intracellular receptors i. What types of hormones bind to them? – steroid hormonesii. Causes new mRNA to be made6. Hormone effects on their target tissuesa. Up regulationb. Down regulationc. Specificity of hormone receptors – affinity, competitiond. Permissiveness- needs another hormone to have greatest effect, Synergism- 2 hormoneswork together to have best results and Antagonism- 2 hormones work against eachother.7. Review positive and negative feedback mechanisms a. axes:i. GnRHFSH, LHsex hormonesii. TRHTSHTHiii. CRHACTHCortisoliv. Primary versus secondary disease8. Know the anatomy of the endocrine glandsa. Pituitary - anterior vs. posterior(ADH and Oxytocin) i. Posterior Pituitary1. ADH- small peptide. Targets: kidney. Causes reabsorption of water fromthe nephrons. Is a vasopressin. Lowers BP. Alcohol inhibits ADH.a. Diabetes imsipidies- hypo secretion of ADH. Excessive urination.Dry mouth 2. Oxytocin – small peptide. “Love hormone” targets: ovaries andmammary gland. Contraction when ready for birth. ii. Anterior Pituitary1. Non-Tropic hormones:a. Growth hormone (somatotropin)- protein. Targets most body ts.Important in anabolic growth. (somastatin)- inhibits GH. GHRH.GHIH. Hyper secretion – gigantism in children. Acronomony inadults. Hypo secretion- dwarfism b. Prolactin. Protein target: mammary glands. Milk ejection.Dopamine (PIH) controls it, 2. Tropic (4 of 6 are) anterior pituitarya. TSH- glycoprotein. Most metabolic active hormone. Thyroidglad. TRH (Hypothalamus). –TSH (anterior pituitary)- TH (thyroidGland)b. FSH – glycoprotein. Maturation of follicular cells in ovaries andestrogen production. Sperm secretion in testes. GnRH- byhypothalamusc. LH – glycoprotein. Ovulation and progesterone secretion offollicular cells in ovaries. Sperm cell production in testes. Issecreted by GnRH from the hypothalamus.d. ACTH – peptide. Targets adrenal cortex. CRH. Increasesglucocorticoid hormone production. Is derived from precursormolecule called: propriomelanocortin. iii. Thyroid - follicles and Para follicular cells1. TH hyper section: graves. Hypo: myexima 2. Calcitonin- inhibits osteoclast activity in the bone. Reabsorption of Caiv. Parathyroid- PTH increase blood ca levelsv. Adrenals - cortex vs. medulla1. Medulla – epi and NE2. Cortexa. Zona glomerulus – secretes minerocortiol: reabsorption of Na .secretion of K by the nephrons in the kidney. b. Zona fasciluars – secretes gluccoorticol aka cortisol. Hypo-Addison. Hyper- Cushing’sc. Zona retiularis – secretes gonacorticol – sex hormones not veryimportant in humansvi. Pancreas – islets vs. acinar cells1. Insulin – (beta) lowers blood sugar levels. 2. Glycogen –increase blood sugar levelsChapter 17 (blood)1. Know the composition of blooda. The amount that is plasma.i. 55% 2. The amount that is formed elements.a. RBC- 45% WBC- 1% Platelets3. plasma a. 95% water 8% protein b. plasma proteins, nutrients, gases.c. plasma proteinsi. albumin – (60%)osmotic pressure in capillariesii. globulin- (36%)transport binding proteins and some antibodiesiii. fibrinigin – ( 4%) important in clotting 4. Know the structure and function of a RBC, and the structure of the hemoglobin molecule. a. RBC transports oxygen b. A-nucleated c. Hemoglobin molecules which carries O. t/o the circulatory system and carbonic anhydrase – CO2 and H20 to exchange. Hemoglobin has 4 protein chains attached to heme group 5. RBC disorders we discussed.a. Lack of RBCi. Hemmoratic – autoimmuneii. Hemolytic – ecoliiii. Aplastic ( bone arrow destroyed)b. Low RBC counti. Low Iron countii. Pernicious (lack of intrinsic factors hence vit B12)c. Defective hemoglobini. Sickle cell anima – amino acid chain defectiveii. Thalassemias – globulin chain prob6. Know EPO and its role in RBC formationa. RBC formation:i. Hemocytoblast- EPO…myeloid stem cell– proerthroblast- early erthroblast- late erthroblast- normoblast- reticulocyte- erythrocytes ii. EPO is secreted by the kidney when there is a decrease in RBC or oxygen depletion7. white blood cellsa. Neutrophils - grandulocytes. Most abundant 50-70% kills bacteria and fungal infections. Via Respiratory blast b. Lymphocytes – agrandulocytes. 20- 30% B-cells Antibodies kill virus . T-cells antigensc. Monocytes – agrandulocytes largest 3-8% chronic long term clean upd. Eosinophils – grandulocytes. 2-4% allergic rxn e. Basophils – grandulocytes less than 1%. Anti-histamine . chemo,.8. Be sure to go over the production of formed elements.a. Proerythroblasts, reticulocytes, myeloblasts, lymphoblasts, monoblasts, megakaroblasts(megakaryocytes)b. What is a reticulocyte? – What is the significance of seeing them in circulation – they control how much RBC is in production 9. Hemostasisa. What causes a clot to form? – tear in epithelial ts in blood vessels b. Vascular spasmc. Platelet plug formationd. Coagulation (role of platelets and fibrin) i. Clot retraction1. Fibrinolysis2. Know the effects of thrombin and fibrin on proper


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