Samenvatting van het vak "Stowisseling & Hormonen 1" gegeven door prof. De Block in de 2e Bachelor Geneeskunde aan de UA. Volledige samenvatting gebaseerd op slides én lesnotities.
Bevat onder andere duidelijke overzichten van de hypothalamo-hypofysaire assen.
Fysiologie van het groeihormoon.............................................................................................................. 40
Synthese en secretie..........................................................................................................................40
Hypothalamo-hypofysaire-groeihormoon as...........................................................................40
Controle van GH-secretie....................................................................................................... 41
Werking van GH................................................................................................................................. 42
Fysiologische effecten............................................................................................................ 42
Pathologie.......................................................................................................................................... 43
GH-deficiëntie.........................................................................................................................43
GH-excess..............................................................................................................................43
Fysiologie van de hypothalame-hypofysaire gonadale as bij de man....................................................44
Anatomie............................................................................................................................................ 44
Hormonaal systeem........................................................................................................................... 45
GnRH en LH/FSH synthese................................................................................................... 45
Testes als eindorgaan.............................................................................................................46
Testosteron.........................................................................................................................................47
Biologische effecten van testosteron en dihydrotestosteron.................................................. 48
Fysiologie van de bijnier............................................................................................................................. 50
Morfologie...........................................................................................................................................50
Histologie................................................................................................................................50
Synthese van bijnierschorshormonen................................................................................................ 50
Synthese van cortisol............................................................................................................. 51
Synthese van aldosteron........................................................................................................ 52
Synthese van androgenen......................................................................................................52
Pathofysiologie....................................................................................................................... 52
Glucocorticoïden - cortisol..................................................................................................................53
Hypothalamo-hypofysaire-bijnier as....................................................................................... 53
Adrenocorticotroop hormoon (ACTH).....................................................................................54
Werking van glucocorticoïden................................................................................................ 54
Mineralocorticoïden - aldosteron........................................................................................................ 56
Controle van aldosteron......................................................................................................... 56
Werking van aldosteron.......................................................................................................... 56
Androgenen........................................................................................................................................56
Synthese van bijniermerghormonen...................................................................................................57
Biosynthese van catecholamines........................................................................................... 57
Werking van catecholamines..................................................................................................57
Metabolisatie van catecholamines..........................................................................................58
Pathofysiologie: hyperfunctie............................................................................................................. 58
2
Fysiologie van de schildklier...................................................................................................................... 62
Anatomie en histologie....................................................................................................................... 62
Synthese van iodothyronines............................................................................................................. 62
Biosynthese van iodothyronines.............................................................................................62
Transport van iodothyronines................................................................................................. 64
Transformatie van iodothyronines.......................................................................................... 64
Schildklierwerking...............................................................................................................................65
Hypothalamo-hypofysaire-schildklier as................................................................................. 65
Metabole activiteit van schildklierhormonen........................................................................... 66
Schildklierfunctie testen......................................................................................................................67
Pathologie: hyperthyroïdie..................................................................................................................67
Graves-Basedow.................................................................................................................... 68
Toxisch adenoom....................................................................................................................68
Toxische multinodulaire goiter................................................................................................ 68
Jodium-geïnduceerde hyperthyroïdie..................................................................................... 69
Thyroïditis............................................................................................................................... 69
Kliniek van hyperthyroïdie...................................................................................................... 70
Pathologie: hypothyroïdie...................................................................................................................70
Etiologie..................................................................................................................................71
Hashimoto = chronisch autoimmune thyroïditis......................................................................71
Kliniek van hypothyroïdie........................................................................................................72
Fysiologie van de bijschildklier.................................................................................................................. 73
Anatomie en histologie....................................................................................................................... 73
Synthese van parathyroïdhormoon (PTH)..........................................................................................73
Controle van PTH................................................................................................................... 73
Werking van parathyroïdhormoon (PTH)........................................................................................... 75
Werking van PTH in nieren.....................................................................................................75
Werking van PTH in bot..........................................................................................................76
Werking van PTH in darmen.................................................................................................. 77
Calcium metabolisme......................................................................................................................... 77
Calcium homeostase.............................................................................................................. 78
Fosfaat homeostase............................................................................................................... 79
1,25-dihydroxy-vitamine D3....................................................................................................79
Calcitonine..............................................................................................................................80
Fysiologie van het lipidenmetabolisme..................................................................................................... 81
Lipiden................................................................................................................................................81
Cholesterolmetabolisme......................................................................................................... 81
Lipoproteïnen..................................................................................................................................... 83
Lipoproteïnen..........................................................................................................................83
3
, Apolipoproteïnen.................................................................................................................... 83
Exogene en endogene pathway.........................................................................................................84
Exogene cholesterolpathway..................................................................................................85
Endogene cholesterolpathway............................................................................................... 85
Regulatie van LPL.................................................................................................................. 86
Regulatie van LDL-receptor....................................................................................................86
Implicaties voor de kliniek.................................................................................................................. 87
Bepaling van bloedlipiden.......................................................................................................87
Hyperlipidemie........................................................................................................................88
Werkingsmechanismen van lipiden-verlagende medicatie................................................................ 89
Cholesterolverlagende medicatie........................................................................................... 89
Triglyceriden verlagende medicatie........................................................................................ 91
Effecten van lipidenverlagende medicatie.............................................................................. 92
Gewichtshomeostase.................................................................................................................................. 93
Lichaamssamenstelling en metabolisme............................................................................................93
Antropometrische metingen....................................................................................................93
Metabolisme........................................................................................................................... 94
Centraal zenuwstelsel........................................................................................................................ 94
Hypothalamus.........................................................................................................................94
Melanocortine systeem...........................................................................................................95
Autonoom (perifeer) zenuwstelsel......................................................................................................95
Communicatie tussen vetcellen en hersenen.....................................................................................95
Leptine....................................................................................................................................95
Adiponectine...........................................................................................................................96
Communicatie tussen gastro-intestinaal stelsel en hersenen............................................................ 97
Ghreline.................................................................................................................................. 97
Glucagon-like peptide-1 (GLP-1)............................................................................................98
Oxyntomoduline......................................................................................................................99
Communicatie tussen pancreas en hersenen.................................................................................... 99
Insuline................................................................................................................................... 99
Amyline.................................................................................................................................100
Communicatie tussen smaakpapillen en hersenen..........................................................................100
Communicatie tussen lever en hersenen......................................................................................... 100
FGF-21................................................................................................................................. 100
Communicatie binnen de hersenen..................................................................................................101
Circadiaans ritme..................................................................................................................101
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