Q.No.3: Name the hormones secreted by the thyroid glands.
Briefly
discuss the functions of thyroid hormones.
The thyroid gland secretes two primary hormones: thyroxine (T_4) and triiodothyronine (T_3).
It also secretes a third hormone, calcitonin.
The primary functions of the thyroid hormones (T_3 and T_4) are:
● Metabolic Regulation: Thyroid hormones are the primary regulators of the basal
metabolic rate (BMR). They increase the rate of carbohydrate, fat, and protein
metabolism, leading to increased oxygen consumption and heat production (calorigenic
effect). This is a crucial function for maintaining body temperature.
● Growth and Development: They are essential for normal growth and development,
particularly for the maturation of the central nervous system (CNS) in infants and children.
Deficiency during this period can lead to cretinism.
● Cardiovascular System: They increase heart rate, stroke volume, and cardiac output.
This is achieved by upregulating beta-adrenergic receptors in the heart.
● Nervous System: Thyroid hormones are crucial for normal neurological function. They
promote neuronal growth and myelination and enhance nerve impulse transmission.
● Gastrointestinal System: They increase the rate of gastrointestinal motility and
secretion.
Calcitonin, on the other hand, is a calcium-regulating hormone. It works to decrease blood
calcium levels by inhibiting osteoclast activity (bone resorption) and stimulating osteoblast
activity (bone formation), thus promoting calcium deposition in bones.
Q.No.4: Define the menstrual cycle. Give an account of the different
phases of the endometrial cycle and the hormones involved.
The menstrual cycle is a recurring cycle of physiological changes in fertile females, regulated
by hormones, that leads to the preparation of the uterus for a potential pregnancy. The cycle
averages 28 days and is marked by menstrual bleeding (menses) at its beginning.
Phases of the Endometrial Cycle:
1. Menstrual Phase (Days 1-5):
○ Description: This phase involves the shedding of the functional layer of the
endometrium, which results in menstrual bleeding. This occurs when fertilization
and implantation do not happen.
○ Hormones: This phase is triggered by a sharp decrease in progesterone and
estrogen levels due to the degeneration of the corpus luteum.
2. Proliferative Phase (Days 6-14):
○ Description: Following menses, the remaining basal layer of the endometrium
starts to regenerate and thicken. Glands and blood vessels grow and become more
numerous.
○ Hormones: This phase is driven by increasing estrogen levels, which are
secreted by the growing ovarian follicles. Estrogen stimulates the proliferation of
endometrial cells.
3. Secretory Phase (Days 15-28):
○ Description: The endometrium becomes highly vascularized, edematous, and rich
in glycogen and nutrients, making it ready for a potential embryo. The glands
become coiled and secrete a thick, glycogen-rich mucus.
○ Hormones: This phase is dominated by progesterone, secreted by the corpus
luteum. Progesterone further prepares the endometrium for implantation and
inhibits uterine contractions.
Q.No.5: Name the sex hormones and their sources. What is the
meaning of sex determination? How does it happen?
Sex Hormones and Sources:
Hormone Group Specific Hormones Primary Source
Androgens Testosterone Testes (Leydig cells), Adrenal
cortex
Estrogens Estradiol, Estrone, Estriol Ovaries (granulosa cells),
Adrenal cortex, Placenta
(during pregnancy)
Progestogens Progesterone Ovaries (corpus luteum),
Placenta
Sex Determination:
Sex determination is the biological process by which a sexually reproducing organism
develops its reproductive organs and sex-related characteristics. In humans, this is a genetic
process that establishes the sex of the individual.
How Sex Determination Happens:
● Genetic Basis: Human sex is determined at the moment of fertilization by the sex
chromosomes. Females have two X chromosomes (XX), and males have one X and one
Y chromosome (XY).
● The SRY Gene: The presence or absence of the Sex-determining Region Y (SRY)
gene on the Y chromosome is the key factor.
○ If a Y chromosome is present, the SRY gene is expressed. This gene codes for
the testis-determining factor (TDF), a protein that initiates the development of the
primordial gonads into testes.
○ In the absence of the SRY gene (XX), the primordial gonads develop into ovaries.
● Hormonal Influence: Once the testes or ovaries are formed, they begin to secrete
hormones (androgens or estrogens, respectively) that drive the development of the
internal and external reproductive organs.
Q.No.6: Mrs. Selina, a 25-year-old woman, came to her physician with
complaints that she had not been able to put on rings that she used to
fit and her face had changed slightly over the last few months. An
investigation revealed a fasting blood glucose of 9 mmol/L and a
serum growth hormone of 7 ng/mL.
a) What is the most likely diagnosis?
The most likely diagnosis is acromegaly, which is a hormonal disorder that results from the
excess production of growth hormone (GH) by the pituitary gland after the fusion of the
epiphyseal plates. The enlarged hands (cannot put on rings) and altered facial features are
classic signs. The elevated fasting blood glucose is a key clue, as high GH levels can cause
insulin resistance, leading to hyperglycemia (diabetes mellitus).
b) What were the clinical features present in this patient's face? (Write the
features you know).
The classic facial features of acromegaly include:
● Protruding Jaw (Prognathism): The mandible grows, causing the lower jaw to extend
forward.
● Enlarged Nose: The nose becomes broader and larger.
● Thickened Lips and Tongue: The soft tissues of the face and mouth swell.
● Prominent Brow Ridge: The supraorbital ridges become more pronounced.
● Coarsening of Facial Features: The overall facial appearance becomes rougher and
less defined.
c) What was the explanation for the development of diabetes in this patient?
The development of diabetes (hyperglycemia) in this patient is due to the metabolic effects of
excess growth hormone. GH is a diabetogenic hormone. It antagonizes the action of insulin,
a phenomenon known as insulin resistance.
● GH stimulates the liver to produce more glucose and inhibits the uptake of glucose by
peripheral tissues like muscle and adipose tissue.
● This leads to persistently high blood glucose levels, a state of hyperglycemia, which, if left
untreated, can progress to Type 2 diabetes mellitus.
Q.No.7: Discuss insulin, mentioning its: a) chemical nature, b) source
of secretion, c) chemical structure, d) mechanism of action, e)
metabolic function.
a) Chemical Nature:
Insulin is a peptide hormone.
b) Source of Secretion:
Insulin is secreted by the beta (\beta) cells of the Islets of Langerhans in the pancreas.
c) Chemical Structure:
Insulin consists of two polypeptide chains, an A-chain (21 amino acids) and a B-chain (30
amino acids), linked together by two disulfide bonds. A third disulfide bond is present within
the A-chain.
d) Mechanism of Action:
Insulin binds to a specific tyrosine kinase receptor on the surface of target cells (e.g., muscle,
liver, adipose tissue). This binding triggers a series of intracellular signaling events, primarily
involving phosphorylation cascades. A key event is the translocation of GLUT4 glucose
transporters from the cytoplasm to the cell membrane in muscle and adipose tissue. This
increases the cell's permeability to glucose, allowing it to enter the cell and be utilized or stored.
e) Metabolic Function:
Insulin is the body's primary anabolic and hypoglycemic hormone. Its main functions are:
● Carbohydrate Metabolism: Promotes glucose uptake by cells, stimulates glycogenesis
(glucose to glycogen) in the liver and muscle, and inhibits glycogenolysis (glycogen
breakdown) and gluconeogenesis (new glucose formation).
● Fat Metabolism: Promotes lipogenesis (fat synthesis) in adipose tissue and inhibits
lipolysis (fat breakdown).
● Protein Metabolism: Stimulates the uptake of amino acids and promotes protein
synthesis.
Q.No.8: Give the distribution of calcium (Ca^{2+}) in plasma. Write
four (4) functions of calcium (Ca^{2+}) in our body. How is the serum
calcium (Ca^{2+}) level regulated? What is tetany?
Distribution of Calcium in Plasma:
Total plasma calcium is approximately 9-10.5 mg/dL. It exists in three forms:
● Ionized or Free (Ca^{2+}): 50% (The physiologically active form).
● Protein-Bound: 40% (Mainly bound to albumin).
● Complexed with Anions: 10% (e.g., with phosphate and citrate).
Functions of Calcium (Ca^{2+}):
1. Structural Support: Forms the mineral matrix of bones and teeth (hydroxyapatite),
providing rigidity and strength.
2. Muscle Contraction: Essential for the excitation-contraction coupling in all types of
muscle (skeletal, smooth, and cardiac).
3. Nerve Impulse Transmission: Plays a critical role in the release of neurotransmitters at
nerve terminals.
4. Blood Coagulation: Acts as a cofactor (Factor IV) in the intrinsic and extrinsic
coagulation pathways.
Regulation of Serum Calcium Level:
Serum calcium levels are tightly regulated by three key hormones:
● Parathyroid Hormone (PTH): Secreted by the parathyroid glands. Increases serum
calcium by:
○ Stimulating osteoclasts to resorb bone.
○ Increasing calcium reabsorption in the renal tubules.
○ Promoting the formation of calcitriol (active vitamin D), which increases intestinal
calcium absorption.
● Calcitriol (Active Vitamin D): Formed in the kidneys. Increases serum calcium by
increasing intestinal absorption of calcium and phosphate.
● Calcitonin: Secreted by the thyroid gland. Decreases serum calcium by inhibiting
osteoclast activity and promoting calcium deposition in bone.
What is Tetany?
Tetany is a medical sign characterized by involuntary muscle contractions and hyperexcitability
of the nerves. It is typically caused by hypocalcemia (abnormally low levels of ionized calcium
in the blood). The lack of calcium increases the excitability of nerve fibers, leading to
spontaneous firing and uncontrolled muscle spasms. This can manifest as carpopedal spasms,
convulsions, and even laryngospasm.
