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72 Cards in this Set

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