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Endocrinology & Metabolism
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Constructing Objectives |
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EN
2. Explain the principles of positive feedback and feed forward control of
hormone secretion. EN
3. Explain the bases of hormone
measurements; e.g., radio-immuno assay, ELISA. EN
4. Contrast the terms
endocrine, paracrine, and autocrine based on the site of hormone release and
the pathway to the target tissue. Provide
an example of each, and describe major differences in mechanisms of action
of peptides working through membrane receptors and steroids, vitamin D, and
thyroid hormones working through nuclear receptors. EN
5. Define hormone, target cell,
and receptor. EN
6. Compare and contrast hormone actions that are exerted through changes in
gene expression with those exerted through changes in protein
phosphorylation. EN
7. Understand the effects
of plasma hormone binding proteins on access of hormones to their sites of
action and degradation and on the regulation of hormone secretion. EN
8. Explain the effects of
secretion, excretion, degradation, and volume of distribution on the
concentration of a hormone in blood plasma. Pituitary
Gland - Posterior EN
10. List the target organs or cell types for oxytocin and describe its
effects on each. EN
11. Name the stimuli for oxytocin release during parturition or lactation. EN
12. List the target cells for
vasopressin and explain why vasopressin is also known as antidiuretic
hormone. EN
13. Describe the stimuli and
mechanisms that control vasopressin secretion EN
14. Identify disease states caused by a) over-secretion, and b) under-secretion
of vasopressin and list the principle symptoms of each. Pituitary
Gland - Anterior EN
16. Describe the biosynthesis,
structure, actions, and metabolism of the GH/prolactin family. EN
17. Describe the biosynthesis, structure, and actions of the POMC family:
ACTH, MSH, β-lipoprotein,
β-endorphin. EN
18. Identify appropriate hypothalamic factors that control the secretion of
each of the anterior pituitary hormones, and describe their route of
transport from the hypothalamus to the anterior pituitary. EN 19. Diagram the short-loop and long-loop negative feedback control of anterior pituitary hormone secretion. Predict the changes in secretory rates of hypothalamic, anterior pituitary, and target gland hormones caused by over-secretion or under-secretion of any of these hormones or receptor deficit for any of these hormones. EN 20. Explain the importance of pulsatile and diurnal secretion. Thyroid
Gland EN
22. Define “iodine pool”.
Describe the distribution of iodine and the iodide metabolic pathway.
Relate the distribution of radioiodide in the body to thyroid hormone
synthesis, metabolism, and excretion. EN
23. Describe factors that
control the synthesis, storage, and release of thyroid hormones.
Explain the importance of thyroid hormone binding in blood on free
and total thyroid hormone levels. EN
24. Understand the significance
of the conversion of T4 to T3 and reverse T3
(rT3) in extra-thyroidal tissues. EN
25. Describe the actions of
thyroid hormones on development and metabolism. EN 26. Understand the causes and consequences of a) over-secretion and b) under-secretion of thyroid hormones. Explain why either condition can cause an enlargement of the thyroid gland. Parathyroid
Gland, Ca++ and PO4- EN
28. List the target organs and
cell types for parathyroid hormone and describe its effects on each. EN
29. Describe the functions of
the osteoblasts and the osteoclasts in bone remodeling and the factors that
regulate their activities. EN
30. Identify the time course
for the onset and duration for each of the biological actions of parathyroid
hormone. EN
31. Describe the regulation of
parathyroid hormone secretion and the role of the calcium-sensing receptor. EN
32. Understand the causes and
consequences of a) over-secretion, and b) under-secretion of parathyroid
hormone. EN
33. Identify the sources of
vitamin D and diagram the biosynthetic pathway and the organs involved in
modifying it to the biologically active 1,25(OH2)D3
(1-25 dihydroxy cholecalciferol). EN
34. Identify the target organs and cellular mechanisms of action for vitamin
D. EN
35. Describe the negative
feedback relationship between the parathyroid hormone and the biologically
active form of vitamin D [1,25(OH2)D3]. EN
36. Describe the consequences
of vitamin D deficiency and vitamin D excess. EN
37. List the cell of origin and
target organs or cell types for calcitonin. EN
38. Name the stimuli that can
promote secretion of calcitonin. EN 39. Describe the actions of calcitonin and identify which (if any) are physiologically important.
Adrenal
Gland EN
41. Describe the biosynthesis
of the adrenal steroid hormones (glucocorticoids, mineralocorticoids, and
androgens) and the key structural features that distinguish each class. EN
42. Understand the cellular
mechanism of action of adrenal cortical hormones. EN
43. Identify the major actions
of glucocorticoids on metabolism and the target organs on which they are
produced. EN
44. Describe the actions of
glucocorticoid hormones in injury and stress. EN
45. Describe the components of
the neuroendocrine axis that control glucocorticoid secretion and describe
how factors in the internal and external environment influence the
neuroendocrine axis. EN
46. Identify the causes and
consequences of a) over-secretion and b) under-secretion of glucocorticoids
and adrenal androgens. EN
47. List the major
mineralocorticoids and identify their biological actions and target organs
or tissues. EN
48. Name the physiological
stimuli that cause increased mineralocorticoid secretion.
Relate these stimuli to regulation of sodium and potassium excretion.
List the factors can modulate the secretory response and explain how
they are detected. EN
49. Identify the causes and
consequences of a) over-secretion and b) under-secretion of
mineralocorticoids. EN
50. Diagram the negative
feedback control of aldosterone secretion. EN
51. Identify the chemical nature of catecholamines, their
biosynthesis, mechanism of transport within the blood, and how they are
degraded and removed from the body. Identify
how the structure of norepinephrine differs from epinephrine. EN 52. Describe the biological consequences of activation of the adrenal medulla and identify the target organs or tissues for catecholamines along with the receptor subtype that mediates the response. Understand the mechanism by which epinephrine and norepinephrine can produce different effects in the same tissues. Explain the change in the ratio of epinephrine to norepinephrine release from the adrenal medulla during sympathetic activation (fight and flight), or in prolonged food deprivation. EN
53. Name the key stimuli
causing catecholamine secretion. List the factors that can modulate a) the
secretory response and b) the responses of target tissues. EN
54. Describe the interactions
of adrenal medullary and cortical hormones in response to stress. EN
55. Identify disease states
caused by an over-secretion of adrenal catecholamines. Pancreas EN
57. List the target organs or
cell types for glucagon and describe its principal actions on each. EN
58. Identify the time course
for the onset and duration of the biological actions of glucagon. EN
59. Describe the control of
glucagon secretion. EN
60. List the major target
organs or cell types for insulin, the major effects of insulin on each, and
the consequent changes in concentration of blood constituents. EN
61. Identify the time course
for the onset and duration for the biological actions of insulin. EN
62. Understand the relationship
between blood glucose concentrations and insulin secretion. Describe the
roles of neural input and gastrointestinal hormones on insulin secretion.
List the factors that modulate the secretory response. EN
63. Identify disease states
caused by: a) over-secretion, b) under-secretion of insulin, or c) decreased
sensitivity to insulin, and describe the principal symptoms of each.
Growth EN
65. Understand the regulation
of growth hormone secretion. Identify
the roles of hypothalamic factors and IGF-I. EN
66. Identify the target organs
or cell types for insulin-like growth factors that account for longitudinal
growth. EN 67. Explain how thyroid, gonadal, and adrenal hormones modulate growth. EN
68. Understand the nature and
actions of local growth factors: epidermal growth factor, nerve growth
factor, platelet-derived growth factor, and angiogenic and antiangiogenic
factors.
Endocrine
Integration of Energy and Electrolyte Balance EN
70. Identify the hormones that
promote the influx and efflux of glucose, fat, and protein into and out of
energy storage pools and their impact on the uptake of glucose by tissues.
Establish specific roles for insulin, glucagon, glucocorticoids,
catecholamines, growth hormone, and thyroid hormone. EN
71. Describe the changes in
metabolic fuel utilization that occur in long- and short-term fasting and in
acute and sustained exercise. Understand
how increases or decreases in hormone secretion produce these changes. EN
72. Describe the role of
appetite and metabolic rate in the maintenance of long-term energy balance
and fat storage. Identify the
factors that regulate appetite and fuel oxidation. EN
73. Identify the normal range
of dietary sodium intake, sodium distribution in the body, and routes of
sodium excretion. Explain the
roles of antidiuretic hormone, aldosterone, angiotensin, and atrial
natriuretic hormone in the regulation of sodium balance. EN
74. Identify the normal range
of dietary potassium intake, potassium distribution in the body, and routes
of potassium excretion. Explain
how acute changes in aldosterone, insulin, and acid/base concentrations
affect the plasma potassium concentration and the movement of potassium into
and out of the intracellular compartment.
Explain the chronic regulation of body potassium balance and plasma
potassium levels by aldosterone through its actions on renal excretion,
intestinal excretion, and dietary appetite/absorption. EN
75. Identify the normal range
of dietary calcium intake, calcium distribution in the body, and routes of
calcium excretion. Explain the
regulation of the plasma calcium concentration by parathyroid hormone,
vitamin D, and calcitonin based on exchange with bone, renal excretion, and
intestinal excretion and/or absorption. EN 76. Identify the normal range of dietary phosphate intake, phosphate distribution in the body, and routes of phosphate excretion. Explain the regulation of the plasma phosphate concentration by parathyroid hormone, vitamin D, and calcitonin based on exchange with bone, renal excretion, intestinal excretion and/or absorption.
Reproductive
Physiology - Male EN
78. Describe spermatogenesis and the role of different cell types in this
process. EN
79. Describe the endocrine
regulation of testicular function: the role of the GnRH pulse generator, FSH,
LH, testosterone, and inhibin. EN
80. Identify the cell of origin for testosterone, its biosynthesis,
mechanism of transport within the blood, how it is metabolized and how it is
eliminated. List other
physiologically produced androgens. EN
81. List the target organs or
cell types for testosterone and describe its effects on each. EN
82. Describe the cellular
mechanisms of action for testosterone. EN
83. List the neural, vascular,
and endocrine components of the erection and ejaculation response. EN
84. Identify the causes and
consequences of over-secretion and under-secretion of testosterone for a)
prepubertal and b) postpubescent males. EN
85. Compare and contrast the
actions of testosterone, dihydrotestosterone, estradiol, and Müllerian
inhibitory factor in the development of the male and female reproductive
tracts.
Reproductive
System - Female EN
87. Describe ovulation and the
formation and decline of the corpus luteum and the roles of pituitary
hormones in each of these processes. EN
88. Describe the hormonal
regulation of estrogen and progesterone biosynthesis and secretion by the
ovary. Identify the cells
responsible for their biosynthesis, the mechanism of their transport in the
blood, and how they are degraded and removed from the body. EN
89. List the target organs or
cell types for estrogen action and describe its effects on each. EN
90. Describe the cellular
mechanisms of action for estrogen. EN
91. List the principal
physiological actions of progesterone, its target organs or cell types, and
describe its effects on each and the importance of “estrogen priming.” EN
92. Describe the cellular
mechanisms of action for progesterone. EN 93. With time on the x-axis, diagram the changes in the endometrium and the ovary seen during the menstrual cycle and correlate these changes with changes in blood levels of FSH, LH, estradiol, progesterone, and inhibin. Describe how the changes in ovarian steroids produce the proliferative and secretory phases of the uterine endometrium and menstruation and the changes in basal body temperature during the menstrual cycle. EN
94. Trace the pathways of sperm
and egg transport that can result in fertilization and the movement of the
fertilized embryo to the uterus. EN
95. List the protein hormones secreted by the placenta and describe the role
of human chorionic gonadotropin (hCG) in the rescue of the corpus luteum in
maintaining pregnancy early post-implantation. EN
96. Describe the interactions between the placenta and the fetal adrenal
cortex in the production of estrogens during pregnancy. EN
97. Discuss the roles of
oxytocin, relaxin, and prostaglandins in the initiation and maintenance of
parturition. EN
98. Explain the role of
estrogens, progesterone, placental lactogen, prolactin, and oxytocin in
mammary gland development during puberty, pregnancy, and lactation. EN 99. Explain the basis for the inhibition of milk secretion during pregnancy and the initiation of lactation after parturition. EN
100. Differentiate between milk
secretion and milk ejection, and describe the hormonal regulation of both
during lactation, including the role of suckling. EN
101. Explain the physiological bases for the antifertility actions of
contraceptive steroid hormones. EN
102. Describe the age-related
changes in the male and female reproductive systems, including the
mechanisms responsible for these changes, at the following times:
a. In utero
development
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