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23 Cards in this Set

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Diabetes Insipidus

Two types...

Describe dehydration test
ADH deficiency.

Neurogenic and Nephrogenic

Test used to differentiate between the two types. If urine osmolarity goes up after ADH administration, it is neurogenic, and if it does not, it is nephrogenic.
SIADH
ADH hypersecretion...

Hyponatermia
Wolff Chaikoff Effect
Iodine deficiency and Iodine excess cause a decrease in Thyroid synthesis.

(high levels of iodine decrease thyroid function)
Graves Disease
Thyroid gland (via TSH receptros) is stimualted by a TSH receptor antibody (TSI). TSI Ab causes gland hypertrophy and hyperthyroidism.

(Pt hyperthyroid and has a goiter)
Hashimoto's Thyroiditis
Ab against Thyroid destroy thyroid gland.

Elevated TSH and low (or normal, if early) T4.
Clinical findings of hypothyroidism
(1) Decreased BMR
(2) Cold intolerance
(3) Lethargic, Slow
(4) Decreased SNS response
(5) Glycogen accumulates
(6) Muscle stiffness
(7) MYXEDEMA - Non-pitting edema
Clinical finding of hyperthyroidism
(1) Increased BMR - Increase appetite
(2) Increased SNS, Anxiety, Palpitations
(3) Heat intolerance, moist-warm skin
(4) Eye changes - Perioribital edema
Effects of Cortisol...

(1) On Glucose..
(2) On Protein...
(3) On Fat
(4) On bone
(5) Kidney
(6) Fetus
(1) ACts to raise blood glucose and glycogen.

(2) Breaks down protein (muscle) to use as glucose source

(3) Lipolysis on extremities and centrepital Lipogenesis

(4) Inhibits bone formation

(5) Kidney - Anti-ADH actions (loose water).

(6)Promotes development of lungs, surfactant.
Summarize..Diabetogenic, Ketogenic, Increase obesity and Increases appetite.
How does cortisol impact blood cell numbers?
Increases Neutrophils, Platlets and Erythrocytes.

Decreases lymphocytes and eosinophils.
Cushin's disease...
Increasing Cortisol levels. Pituitary tomor, ectopic tumor or adrenal secreting tumor.

Centripetal obesity, Hyperglycemic, Hypertension, Amenorrhea, Impotence, Osteoporosis, Personality changes.
Which hormone has anti-inflammatory and immunosuppresive actions>
Cortisol
SAME - Syndrome of Apparent Mineralocorticoid Excess
11-beta OHsteriod DHD deficiency - Cortisol remains active and starts working on Aldosterone receptors.
Addison's disease
Primary Adrenal insufficiency. High ACTH, but cortisol, aldo not produced.

Hypotension, Weakness, Hypovolemic, Weight loss, Hyponatremia, Hyperkalemia
Conn's disease
Primary Hyperaldosteronism - Aldosterone secreting tumor

Hypertension, Hypokalemic, Metabolic Alkalosis
Metabolic effects of Epi
Increase blood Glc

Break down liver, muscle, fat glucose. Synthesize Glc in liver. Release Glucagon from pancreas.
How does drop in Blood glucose impact Epi release?
It increases it.
Pheochromocytoma
EC cells in adrenal medulla r messed up.

Paroxysmal, intermittant HBP
Severe headache
Excessive perspiration
Palpitation
Anxiety, Nervousness, Blurred vision
Insulin promotes cell uptake of...

Insulin stimulates (metabolically)
Glucose (via GLUT4)
Amino Acids
Potassium

Metabolically...causes glc uptake and storage. Adipose tissues, Muscle, Liver will take up glc. And synthesize glycogen.
List few conditions that can be diabetogenic.
Cushing's, Pheochromocytoma, Acromegaly, Hyperthyroidism, Pregnancy
What is the mechanism of action of following drugs...

Insulin
Sulphonylureas
Glucophase
GLP1
Amylin agonist
Insulin -
Sulphonylureas - Stimulate insulin release - Glucophage - Upregulates insulin receptors
GLP1 - Stimulates insulin secretion
Amylin agonist - Stimulates insulin secretion and inhibits glucagon release
Testicular Feminization

Presents as..
Genetic disorder. Androgen receptor is on the X-chromosome hence, XY male has one androgen receptor.

Presents as...female with infertility. External female genitalia but blind vaginal pouch.
5alpha - DHT deficiency
XY male, Internally male but externally female.

At puberty, virilization occurs (because testosterone is responsible for puberty not DHT). No gynecomastia. No PROSTATE.

Autosomal Recessive Disease
Turner Syndrome
XO

Internally and externally female but underdeveloped sex organs. GONADAL DYSGENESIS