Overview Hormone Source Action Regulation Notes Gastrin G cells (stomach-antrum) ↑ gastric H+ secretion ↑ growth of gastric mucosa ↑ gastric motility ↑ by stomach distension ↑ by amino acids, small peptides ↑ by vagal stimulation (GRP) ↓ by stomach pH < 1.5 ↓ by somatostatin ↑↑ in Zollinger-Ellison syndrome Phenylalanine and tryptophan are potent stimulators Cholecystokinin (CCK) I cells (duodenum, jejunum) ↑ pancreatic secretion ↑ gallbladder contraction and relaxation of sphincter of Oddi ↓ gastric emptying ↑ by amino acids, small peptides ↑ by fatty acids A patient with cholelithiasis (gallstones) experiences worsened pain after fatty food ingestion due to ↑ release of CCK Secretin S cells (duodenum) ↑ pancreatic HCO3- secretion ↑ biliary HCO3- secretion ↓ gastric H+ secretion ↑ by H+ in duodenum ↑ by fatty acids in duodenum ↑ HCO3- neutralizes gastric H+ in duodenum, essential for fat digestion (pancreatic lipases have pH optimums between 6 and 8) Somatostatin D cells ( GI mucosa) delta cells (endocrine pancreas) ↓ gastric H+ and pepsinogen secretion ↓ pancreatic and small intestine fluid secretion ↓ gallbladder contraction ↓ insulin and glucagon release ↑ by H+ ↓ by vagal stimulation Inhibitory hormone Antigrowth hormone effects (digestion and absorption of substances needed for growth) Somatostatin is treatment for VIPoma and carcinoid tumors Glucose-dependent insulinotropic peptide (GIP) K cells (duodenum, jejunum) exocrine: ↓ gastric H+ secretion endocrine: ↑ insulin secretion by pancreatic beta cells ↑ by fatty acids ↑ by amino acids ↑ by oral glucose An oral glucose load is utilized by cells more rapidly than an equivalent IV glucose load Vasoactive intestinal polypeptide (VIP) parasympathetic ganglia in sphincters, gallbladder, and small intestine ↑ intestinal water and electrolyte secretion ↑ relaxation of intestinal smooth muscle and sphincters ↑ by distention and vagal stimulation ↓ by adrenergic input VIPoma is a non-α, non-β islet cell pancreatic tumor that secretes VIP and causes copious diarrhea Nitric oxide (NO) - ↑ smooth muscle relaxation ( lower esophageal sphincter) - Loss of NO secretion is implicated in ↑ lower esophageal tone of achalasia Motilin small intestine (upper duodenum) increases GI motility produces migrating motor complexes (MMCs) ↑ in fasting state - Ghrelin P/D1 cells (stomach) ↑ growth hormone, ACTH, cortisol, and prolactin secretion ↑ before meals ↓ after meals Regulates hunger, meal initiation Lost following gastric bypass surgery Associated with hyperphagia in Prader-Willi Neuropeptide-Y neurons of sympathetic nervous system ↑ appetite, ↓ energy expenditure Ghrelin ↑ release Leptin ↓ release - Glucagon-like peptide 1 (GLP-1) L cells (endocrine cells of the intestinal epithelium) ↑ glucose-induced insulin secretion from pancreatic β-cells ↓ glucagon secretion ↓ GI motility and secretions Promotes satiety Secreted in response to meal intake Degraded by dipeptidyl peptidase IV -
QUESTIONS 1 of 6 1 2 3 4 5 6 Previous Next Lab Values Blood Hematologic Cerebrospinal Sweat, Urine, and BMI Blood, Plasma, Serum Reference Range ALT 8-20 U/L Amylase, serum 25-125 U/L AST 8-20 U/L Bilirubin, serum (adult) Total // Direct 0.1-1.0 mg/dL // 0.0-0.3 mg/dL Calcium, serum (Ca2+) 8.4-10.2 mg/dL Cholesterol, serum Rec: < 200 mg/dL Cortisol, serum 0800 h: 5-23 μg/dL //1600 h: 3-15 μg/dL 2000 h: ≤ 50% of 0800 h Creatine kinase, serum Male: 25-90 U/LFemale: 10-70 U/L Creatinine, serum 0.6-1.2 mg/dL Electrolytes, serum Sodium (Na+) 136-145 mEq/L Chloride (Cl-) 95-105 mEq/L Potassium (K+) 3.5-5.0 mEq/L Bicarbonate (HCO3-) 22-28 mEq/L Magnesium (Mg2+) 1.5-2.0 mEq/L Estriol, total, serum (in pregnancy) 24-28 wks // 32-36 wks 30-170 ng/mL // 60-280 ng/mL 28-32 wk // 36-40 wks 40-220 ng/mL // 80-350 ng/mL Ferritin, serum Male: 15-200 ng/mLFemale: 12-150 ng/mL Follicle-stimulating hormone, serum/plasma Male: 4-25 mIU/mL Female: premenopause: 4-30 mIU/mL midcycle peak: 10-90 mIU/mL postmenopause: 40-250 pH 7.35-7.45 PCO2 33-45 mmHg PO2 75-105 mmHg Glucose, serum Fasting: 70-110 mg/dL2-h postprandial:<120 mg/dL Growth hormone - arginine stimulation Fasting: <5 ng/mLProvocative stimuli: > 7ng/mL Immunoglobulins, serum IgA 76-390 mg/dL IgE 0-380 IU/mL IgG 650-1500 mg/dL IgM 40-345 mg/dL Iron 50-170 μg/dL Lactate dehydrogenase, serum 45-90 U/L Luteinizing hormone, serum/plasma Male: 6-23 mIU/mL Female: follicular phase: 5-30 mIU/mL midcycle: 75-150 mIU/mL postmenopause 30-200 mIU/mL Osmolality, serum 275-295 mOsmol/kd H2O Parathyroid hormone, serume, N-terminal 230-630 pg/mL Phosphatase (alkaline), serum (p-NPP at 30° C) 20-70 U/L Phosphorus (inorganic), serum 3.0-4.5 mg/dL Prolactin, serum (hPRL) < 20 ng/mL Proteins, serum Total (recumbent) 6.0-7.8 g/dL Albumin 3.5-5.5 g/dL Globulin 2.3-3.5 g/dL Thyroid-stimulating hormone, serum or plasma .5-5.0 μU/mL Thyroidal iodine (123I) uptake 8%-30% of administered dose/24h Thyroxine (T4), serum 5-12 μg/dL Triglycerides, serum 35-160 mg/dL Triiodothyronine (T3), serum (RIA) 115-190 ng/dL Triiodothyronine (T3) resin uptake 25%-35% Urea nitrogen, serum 7-18 mg/dL Uric acid, serum 3.0-8.2 mg/dL Hematologic Reference Range Bleeding time 2-7 minutes Erythrocyte count Male: 4.3-5.9 million/mm3Female: 3.5-5.5 million mm3 Erythrocyte sedimentation rate (Westergren) Male: 0-15 mm/hFemale: 0-20 mm/h Hematocrit Male: 41%-53%Female: 36%-46% Hemoglobin A1c ≤ 6 % Hemoglobin, blood Male: 13.5-17.5 g/dLFemale: 12.0-16.0 g/dL Hemoglobin, plasma 1-4 mg/dL Leukocyte count and differential Leukocyte count 4,500-11,000/mm3 Segmented neutrophils 54%-62% Bands 3%-5% Eosinophils 1%-3% Basophils 0%-0.75% Lymphocytes 25%-33% Monocytes 3%-7% Mean corpuscular hemoglobin 25.4-34.6 pg/cell Mean corpuscular hemoglobin concentration 31%-36% Hb/cell Mean corpuscular volume 80-100 μm3 Partial thromboplastin time (activated) 25-40 seconds Platelet count 150,000-400,000/mm3 Prothrombin time 11-15 seconds Reticulocyte count 0.5%-1.5% of red cells Thrombin time < 2 seconds deviation from control Volume Plasma Male: 25-43 mL/kgFemale: 28-45 mL/kg Red cell Male: 20-36 mL/kgFemale: 19-31 mL/kg Cerebrospinal Fluid Reference Range Cell count 0-5/mm3 Chloride 118-132 mEq/L Gamma globulin 3%-12% total proteins Glucose 40-70 mg/dL Pressure 70-180 mm H2O Proteins, total < 40 mg/dL Sweat Reference Range Chloride 0-35 mmol/L Urine Calcium 100-300 mg/24 h Chloride Varies with intake Creatinine clearance Male: 97-137 mL/minFemale: 88-128 mL/min Estriol, total (in pregnancy) 30 wks 6-18 mg/24 h 35 wks 9-28 mg/24 h 40 wks 13-42 mg/24 h 17-Hydroxycorticosteroids Male: 3.0-10.0 mg/24 hFemale: 2.0-8.0 mg/24 h 17-Ketosteroids, total Male: 8-20 mg/24 hFemale: 6-15 mg/24 h Osmolality 50-1400 mOsmol/kg H2O Oxalate 8-40 μg/mL Potassium Varies with diet Proteins, total < 150 mg/24 h Sodium Varies with diet Uric acid Varies with diet Body Mass Index (BMI) Adult: 19-25 kg/m2 Calculator ( ) xy AC 7 8 9 ÷ 4 5 6 × 1 2 3 - 0 . = + Sorry, this question is for PEAK Premium Subscribers only Upgrade to PEAK Sorry, this question is for PEAK Premium Subscribers only Upgrade to PEAK Sorry, this question is for PEAK Premium Subscribers only Upgrade to PEAK Sorry, this question is for PEAK Premium Subscribers only Upgrade to PEAK Sorry, this question is for PEAK Premium Subscribers only Upgrade to PEAK Sorry, this question is for PEAK Premium Subscribers only Upgrade to PEAK