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24 Cards in this Set

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myxedema
due to long standing hypothyroidism
Sx: dilated cardiomyopathy, slow speech, intellectual fxn, fatigue, lethargy, cold intolerance, periorbital edema
'sulfa' oral hypoglycemics
chlorpropamide and glipizide

[can use metformin instead if someone is allergic to sulfa drugs]
Reidel thyroiditis
'rock like' stroma
rare form of chronic thyroiditis characterized by marked fibrous rxn that destroys most or all of the thyroid gland
etiology is unknown
affects middle aged and older, mostly women
stridor, dyspnea, dysphagia, laryngeal nerve paralysis
pituitary apoplexy
life threatening infarction of pituitary gland, can result after obstetric hemorrhage
Tx: replace glucoroticoids and thyroid hormone
Hashimoto's may be associated with
thymic hyperplasia, benign thymomas and malignant thymomas
Laron dwarfism
congenital absence of GH receptors (will see absence of GHBP in the blood)
plasma concentrations of IGF-1 are low
papillary thyroid carcinoma histo
small solid balls of neoplastic follicular cells
->contain microscopic blood vessels and fibrous stroma
follicular carcinoma
difficult to distinguish from thyroid follicular adenoma upon FNA
follicular cells + colloid
generalized resistance to thyroid hormone [Refetoff's syndrome]
mutation of thyroid hormone receptor gene
normal negative feedback doesn't work also: so high T4, T3, TSH
subacute lymphocytic vs granulomatous thyroiditis
lymphocytic is PAINLESS
pseudohypoparathyroidism
due to end organ insensitivity to PTH
hypocalcemia, hyper-phos, decreased VD 1,25
but HIGH serum PTH
*failure of injected PTH to increased urine cAMP*
developmental defects, MR, shortened metacarpals
medullary thyroid carcinoma
presence of AMYLOID and polygonal tumor cells.
scany colloid and normal follicular cells
autoantibodies seen in type 1 DM
anti-glutamic acid decarboxylase [GAD]
INGESTION of glucose differs from IV admin...
leads to secretion of GIP that stimulates insulin secretion

(so higher insulin levels in ingested glucose vs IV)
primary means of action of PTU
inhibits peripheral conversion of T4 to T3
SST from hypothalamus inhibits
TSH and GH release
only reliable indicator of metastatic potential of pheochromocytomas
presence of distant metastases

*CAN'T determine microscopically
lab test to look for presence of thyroid C cell hyperplasia
(which is medullary carcinoma: see in MEN IIa and IIb)

pentagastrin-stimulated calcitonin studies
prolactin has closest structural homology to what other hormone?
GH
ACTH is or is not a long term regulator of aldos production
is NOT
(so low ACTH would not affect aldos levels)

AT-II and K are main long term regulators of aldos
increase in estrogen does this to TBG
increases synthesis (so increases total serum T4)
->but does not alter free T4
HLA types at risk for type 1 DM
heterozygous individual with DR3/DR4 (33x normal risk)

homozygous for DR2 = LESS risk
alpha 2 receptor agonists (clonidine) have this effect on insulin
directly inhibit insulin secretion
which neurotransmitter causes release of NE from adrenal medulla?
ACh