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72 Cards in this Set
- Front
- Back
- 3rd side (hint)
most common adrenal tumor in kids
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neuroblastoma
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responsible for fetal lung maturation and surfactant production
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fetal adrenal gland
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pituitary hormone subunit that determines hormone specificity
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Beta subunit
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insulin is
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inside
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BRICK L
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don't need insulin for glucose uptake
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brain, RBC, intestine, cornea, kidney, liver
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GLUT-1
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RBCs, brain
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GLUT-2
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bidirectional. beta islet cells, liver, kidney, small intestine
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GLUT-4
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insulin responsive. adipose, skeletal muscle
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insulin signaling
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ATP from glucose metab closes K+ channels and depolarizes cells.
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doesn't cross placenta
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beta agonists _______ insulin release
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stimulate
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alpha agonists _________ insulin secretion
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inhibit
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anabolic effects of insulin
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increase Na retention in kidneys
increase protein synthesis in muscle increase cellular uptake of K and amino acids |
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TRH stimulates
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TSH and prolactin
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somatostatin inhibits
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GH, TSH
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17alpha hydroxylase deficiency
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HTN, Hypok
XY: decr DHT leads to psuedohermaphorditism. phenotypic female, no internal reproductive structure due to MIF |
XX: externally phenotypic female with normal internal sex organs but lacks secondary sex characteristics
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21alpha hydroxylase deficiency
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most common.
hypoten, hyperK, incr renin, volume depletion, masculinization, female pseudohermaphroditism |
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11alpha hydroxylase deficiency
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HTN d/t 11-deoxycorticosterone, masculinization
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cortisol
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bound to corticosteroid-binding globulin
BBIIG: maintains BP, decr bone formation, anti-inflamm/IS, incr insulin resist, incr gluconeo, lipoloysis, proteolysis |
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PTH incr _________ in osteo_______ stimulating osteo________
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RANK-L, blasts, clasts
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common causes of decr Mg (thus Decr PTH)
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diarrhea, aminoglycosides, diuretics, alcohol abuse
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cAMP endocrine hormones
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FLAT CHAMP
FSH, LH, ACTH, TSH, CRH, hCG, ADH V2R, MSH, PTH, calcitonin, GNRH, glucagon |
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IP3 endocrine hormones
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GOAT
GnRH, Oxytocin, ADHV1R, TRH, H1, ATII, Gastrin |
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nuclear steroid receptors
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T3/T4
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JAK/STAT hormones
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prolactin, GH, IL2/6/8
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SHBG
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steroids lipophilic, so need binding globulins to incr solubility
in men, SHBG lowers free testosterone, leading to gynecomastia |
in women, decr SHBG raises free testosterone, leading to hirsutism. SHBG increases in pregnancy
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TBG changes
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decr in hepatic failure, incr in pregnancy and OCP use
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T4 converted to T3 in periphery by
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5' deiodinase
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peroxidase
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responsible for oxidation and organification of iodide
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PTU inhibits
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peroxidase and 5 deiodinase
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methimazole inhibits
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peroxidase
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Wolff-Chaikoff effect
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transient decr in T3/T4 d/t excess iodide ingestion, which inhibits iodide pump
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endogenous cushings
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70% pituitary adenoma
15% adrenal |
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primary hyperaldosteronism
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Conn's. HTN.
tx: spironolactone, a K sparing diurectic that is an aldosterone antagonist |
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secondary hyperaldosteronism
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d/t renal artery stenosis, chronic renal failure, CHF, cirrhosis, nephrotic syndrome. high renin
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Addisons
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hyponatremic volume contraction
all 3 cortical divisions affected |
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pheochromocytoma
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from chromaffin cells of neural crest
assoc with neurofibromatosis Urinary VMA elevated |
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neuroblastoma
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homovanillic acid (breakdown produce of dopamine) elevated in urine. less likely to develop HTN. overexpression of N-myc oncogene
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hypothroid GI sx
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constipation
(diarrhea for hyper) |
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thyroid storm lab result
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incr ALP d/t incr bone turnover
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primary hyperPTH lab values
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incr alk phos, incr cAMP in urine
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secondary hyperPTH
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renal osteodystrophy: bone lesions d/t hyperPTH d/t renal dz
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hypoPTH
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hypocalcemia, tetany
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pseudohypoPTH
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Albright's hereditary osteodystrophy: AD kidney unresponsiveness to PTH. hypocalcemia, short 4/5 digits, short stature
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GH incr in response to
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stress, exercise, hypoglycemia
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DI
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dx: water deprivation
tx:nDI HCTZ, indomethacin, amiloride |
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SIADH tx
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demeclocycline or water restriction
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DM glycosylation
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diffuse thickening of basement membranes in small vessels leads to glaucoma and nephropathy
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DM osmotic damage
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neuropathy and cataracts (sorbitol)
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DM dx
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fasting serum glucose, glucose tolerance test, HbA1c
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DMII histology
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islet amyloid deposit
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DKA
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Kussmaul
labs: AG metab acid, HyperK but depeleted intracell K tx: K+, glucose may be necessary |
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carcinoid syndrome
sx lab tx |
sx: asthmatic wheezing, RS valve dz
lab: incr 5-HIAA in urine tx: octreotide |
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Zollinger Ellison
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MEN I
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MEN I presentation
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kidney stones and stomach ulcers
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MEN2B
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oral/intestinal ganglioneuromatosis, marfinoid habitus
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rapid insulin
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lispro
aspart regular (short acting) |
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intermediate insulin
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NPH
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long acting insulin
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glargine, determir
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insulin actions
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incr protein synthesis and K uptake in muscle, aid TG storage in fat cells
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sulfonylureas
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close K channel in beta cell membrane, depolarizing it and triggering insulin release via incr Ca influx
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useless in DM1
1st gen: disulfiram like 2nd gen: hypoglycemia |
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metformin
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biguanide. decr gluconeogen, incr glycolysis, incr periph glucose uptake (insulin sensitivity)
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can be used even if no islet fxn.
tox: lactic acidosis, CI in renal failure |
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glitazones/thiazolidinediones
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incr insulin sens in periph tissue. binds PPAR-gamma nuclear transcription regulator
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WG, edema, hepatotox, heart fail
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PPAR
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regulate fatty acid storage and glucose metab. incr insulin sens and levels of adiponectin
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alpha glucosidase inhibitors
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acarbose, miglitol
inhibit intestinal brush border alpha glucosidases, decr postpran hyperclycemia |
GI disturb
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pramlintide
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decr glucagon (mimetic)
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tox: hypoglycemia, N, diarrhea
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exenatide
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GLP1 analog. incr insulin, decr glucagon release
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tox: N/V, pancreatitis
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PTU, methimazole tox
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agranulocytosis, aplastic anemia, hepatotox (PTU), teratogen (meth)
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GH used in
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Turner
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octreotide used in
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acromegaly, carcinoid, gastrinoma, glucagonoma
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oxytoxin used in
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to control uterine hemorrhage
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demeclocycline MOA, use
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ADH antag (tetracycline family)
for SIADH |
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glucocorticoid MOA, use, tox
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MOA: decr LT and PG prod by inhibiting PLA2 and COX2
use: Addisons tox: adrenal insuff if stop abrupt |
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