USMLE Step 1 Web Prep Mechanism of Hormone Action

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ENDOCRINOLOGY
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Chapter 1: Mechanism of Hormone

General Characteristics

ction

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"a#$e I%&1&1:

S'mmar( of the Differences )et*een the "*o Ma+or C$asses of Hormones Lipi,&So$'#$e Hormones -steroi,s. th(roi, hormones/ 0ater&So$'#$e Hormones -pepti,es. proteins/ - #!ter s!r$ace o$ the cell %e%&rane - -rod!ction o$ second %essen+ers e.+. c'.- Ins!lin does not !tili/e c'.instead acti0ates %e%&rane&o!nd t"rosine 1inase - (econd %essen+ers %odi$" action o$ intracell!lar proteins *en/"%es, *act 0er" 2!ic1l",

1. Receptors 2. Intracell!lar 'ction

- Inside the cell !s!all" in the n!cle!s - (ti%!lates the s"nthesis o$ speci$ic ne) proteins *slo) actin+ hor%ones: s"nthetise hor%ones and s"nthetise a ne) protein,,

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"a#$e I%&1&1:

S'mmar( of the Differences )et*een the "*o Ma+or C$asses of Hormones Lipi,&So$'#$e Hormones -steroi,s. th(roi, hormones/ 0ater&So$'#$e Hormones -pepti,es. proteins/

3. (tora+e

- ("nthesi/ed as needed e2ception: th"roid hor%ones *stored &o!nd to protein,

- (tored in 0esicles prohormone stored in 0esicle alon+ )ith an en/"%e )hich splits o$$ the acti0e hor%one $i+!re

4. -las%a 4ransport

- 'ttached to proteins )hich ser0e as carriers e2ceptions: adrenal andro+ens *)atersol!&le steroid hor%ones,

- 5issol0ed in plas%a *$ree !n&o!nd,

5. 6al$-li$e

- 7on+ *ho!rs da"s, to a$$init" $or protein carrier 44- has the lon+est hal$li$e 7ipid 8sol!&le hor%ones has lon+er hal$-li$e than )ater-sol!&le

- (hort *%in!tes, to .9 IG:1- ins!lin-li1e +ro)th $actor 1- )atersol!&le peptide hor%one- circ!late stron+l" &ond to proteins- lon+er hal$-li$e co%parin+ to other )ater-sol!&le 4he lar+er the si/e o$ the %olec!les- the lon+er the hal$-li$e. *proportional to their %olec!lar si/e,

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Ro$e of Li4er in Hormona$ Re5'$ation

4he li0er prod!ces proteins that &ind lipid sol!&le hor%ones ;.+. cortisol-&indin+ +lo&!lin th"roid-&indin+ +lo&!lin estro+en<testosterone-&indin+ +lo&!lin 4his e=plains )h" d!rin+ pre+nanc" and other states )ith a rise in estro+en: 1. 4otal plas%a lipid sol!&le hor%one increases 2. :ree plas%a hor%one is nor%al and th!s the indi0id!al )ill not sho) si+ns o$ h"per$!nction 33>- &o!nd to proteins 1>- $ree hor%ones *a0aila&le to the tiss!es can di$$!se their,- so it?s an acti0e $or% o$ circ!lation it?s onl" a $ree hor%one that creates ne+ati0e $eed&ac1 and precisel" re+!late. @o! do not re+!late total hor%one not re+!late &o!nd hor%ones. @o! re+!late onl" $ree $raction. I$ li0er prod!ces %ore protein %ore hor%ones )ill &e &o!nd red!ces $ree $raction transientl" and %ore hor%ones )ill &e secreted. ;stro+en increases the circ!latin+ le0el o$ &o!nd hor%ones. It )on?t a$$ect the $ree $or% *it?s re+!lated &" $eed&ac1,. 4otal hor%ones- %ainl" %eas!re &o!nd $ractionnot +ood inde= to acti0it".

7!theal phase and pre+nanc"- $ree hor%ones the sa%e -re+nance- &o!nd $raction 8ele0ated. 'nd total $raction is also ele0ated.
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6RO6ER"IES O7 RECE6"ORS
Hormone specificit( #nl" a$$ects cells )hich possess receptors 'C46 does so onl" in the adrenal corte= 76 onl" in +onadal tiss!e Hormone acti4it( Ander nor%al conditions receptors are not sat!rated *n!%&er o$ receptors not deter%ine hor%one acti0it", -las%a concentration o$ free hor%one is !s!all" indicati0e o$ acti0it" 6i+h le0els o$ a hor%one can ca!se receptors to decrease *do)n-re+!lation tiss!e resistance, 8 hor%one sat!rate the re%ained receptors- then it?s the n!%&er o$ receptors not the concentration o$ $ree hor%one that deter%ines 5ia&etes 2- tiss!e resistance to the ins!lin *concentration o$ $ree ins!lin is not the +ood inde= o$ hor%one acti0it",

-er%issi0e action 8 sin+le hor%one %!st &e present &e$ore another hor%one can act. Gl!ca+on )ill not )or1 )itho!t o$ cortisol. Gl!ca+on- pre0ents h"po+lice%ia