Endocrine

Front 1

Somatastatin?

Back 1

Paracrine substance released by Delta cells in the pancreas.
Acts on beta cells to decrease insulin and alpha cells to decrease glucogon.

Front 2

TSH?

Back 2

TSH is released from anterior pituitary gland. Promotes T4 production.

Front 3

Paraventricular nucleus?

Back 3

Neuronal nucleus in the hypothalamus. Contains oxytocin and vasopressin neurons which project to the posterior pituitary. Also contains neurons that regulate ACTH and TSH secretion (which project to the anterior pituitary)

Front 4

Anterior pituitary?

Back 4

Synthesizes and secretes important endocrine hormones, such as ACTH, TSH, PRL, GH, endorphins, FSH, and LH.

Front 5

Special capillary system connecting the hypthalamus to the anterior pituitary>

Back 5

Hypothalamic-hypophyseal portal system.

Front 6

Controls how quickly the body burns energy, makes proteins, and how sensitive the body should be to other hormones?

Back 6

Thyroid

Front 7

Which is more active, T3 or T4?

Back 7

T3

Front 8

Which is more abundant, T3 or T4?

Back 8

T4

Front 9

Up to 80% of the T4 is converted to T3 by peripheral organs such as the?

Back 9

liver, kidney and spleen

Front 10

Which lipid is the precursor to most steroid hormones?

Back 10

LDL cholesterol

Front 11

Hormone target cell activation depends on which 3 major factors?

Back 11

Relative number of hormone receptors
Circulating hormone concentrations
Receptor affinity

Front 12

3 types of endocrine stimuli?

Back 12

Humoral
Neural
Hormonal

Front 13

Humoral stimuli?

Back 13

Hormones secreted in direct response to alterations in circulating levels of ions or nutrients

Front 14

Neural stimuli?

Back 14

Hormones secreted in response to nerve fiber activation

Front 15

Hormonal stimuli?

Back 15

Hormone release from one endocrine organ causes hormone release from another endocrine organ

Front 16

Infundibulum?

Back 16

Neuronal connection between the hypothalamus and the posterior pituitary

Front 17

Hypothalamic Hypophyseal Tract (HHT)?

Back 17

Neural tract from supraventricular nucleus in hypothalamus across the infundibulum to anterior AND posterior lobes.

Front 18

Hormones produced by the adrenal cortex?

Back 18

Corticosteroids and Mineralocorticoids

Front 19

Hormones produced by the adrenal medulla?

Back 19

Catecholamines: adrenaline (epinephrine), noradrenaline (norepinephrine), and dopamine

Front 20

Effect of cortisol on inflammation?

Back 20

Decreases pro-inflammatory cytokines: TNF, IL-1 and IL-6

Front 21

Cushing's syndrome is marked by?

Back 21

Excess cortisol

Front 22

Lysodren?

Back 22

Mitotane: Inhibits 11-hydroxylation of 11- deoxycortisol and deoxycorticosterone
Result = decreased cortisol and aldosterone

Front 23

Metopirone?

Back 23

Metyrapone: Inhibition of 11-hydroxylation
Loss of inhibitory feedback to pituitary and hypothalamus
Increased production of steroid precursors, causing indirect inhibition of steroid production.

Front 24

Cytadren?

Back 24

Aminoglutethimide: Inhibitor of endogenous adrenal corticosteroid synthesis. Inhibits enzymatic cleavage of cholesterol to ∆5-pregnenolone: Blocks other steps in steroid synthesis:

Front 25

Nizoral?

Back 25

Ketoconazole: inhibitor of endogenous adrenal corticosteroid synthesis. Inhibits C17-20 lyase activity of P45017α. Decreases conversion of pregnelone to 17α hydroxypregnelone.

Front 26

Periactin?

Back 26

Cyproheptadine: Mechanism of action - acts centrally to reduce ACTH secretion, primarily through serotonin production. Decreases ACTH production by antagonizing 5-HT, which decreases cortisol.

Front 27

Name the three hormones produced and stored in the thyroid.

Back 27

Thyroxin (T4)
Triidothyronine (T3)
Calcitonin

Front 28

Thyroid hormone synthesis - occurs by 6 major steps. List these steps.

Back 28

Formation and storage of thyroglobulin
Iodide trapping and oxidation to iodine
Iodination
Iodotyrosine coupling
Colloid endocytosis
Cleavage of T3 and T4 for release

Front 29

TBG?

Back 29

Thyroxin binding globulin, binds 68-75% of thyroxine.

Front 30

TTR?

Back 30

Transthyretin: binds 10-15% thyroxine

Front 31

Remaining thyroid hormone is bound to?

Back 31

Albumin and Lipoproteins

Front 32

Parathyroid hormone (PTH) is produced by _____cells?

Back 32

Chief cells

Front 33

Grave’s Disease?

Back 33

Hyperthyroidism?

Front 34

Toxic multinodular goiter?

Back 34

Hyperthyroidism?

Front 35

Non-toxic (common) goiter?

Back 35

Hypothyroidism?

Front 36

Irreversible symptoms of hypothyroidism?

Back 36

Carpal tunnel
Neuropathy
Cerebral dysfunction

Front 37

Etiology & Epidemiology of Hypothyroidism?

Back 37

Hashimoto’s disease:
Autoimmune destruction of thyroid.
Iatrogenic hypothyroidism:
Radioactive iodine or thyroidectomy.
Iodine deficiency: Rare

Front 38

Thyroid dessicated [USP]?

Back 38

Armour Thyroid, Thyroid Strong , Thyrar, S-P-T

Front 39

Levothyroxine?

Back 39

[T4] (generic, Synthroid, Levothyroid, Unithroid, Levo-T, Levoxyl, Levolet, Novothyrox),

Front 40

Liothyronine?

Back 40

[T3] (generic, Cytomel, Triostat),

Front 41

Liotrix?

Back 41

[4:1 ratio of T4 to T3] (Thyrolar, Euthyroid),

Front 42

Anti-thyroid drugs?

Back 42

Propylthiouracil (generic, PTU, Propacil)

Methimazole (MMI, Tapazole)

Front 43

Advantage of levothyronine (T4)?

Back 43

Constant potency and longer duration due to depot effect.

Front 44

Advantage of Liothyronine (T3)?

Back 44

Rapid onset and shorter duration due to binding affinity

Front 45

Radioactive iodine - 131

Back 45

Sodium Iodide-131 (131I )
Half-life: 8.04 days. Emits both beta and gamma radiation. Beta radiation kills cells.

Front 46

Sodium Iodide-123 ( 123I)

Back 46

Sodium Iodide-123 ( 123I)
Half-life: 13 hours in the thyroid gland. Emits only gamma radiation Gamma radiation gives diagnostic property without cell damage.

Front 47

Insulin-dependent glucose uptake requires mobilization of?

Back 47

GLUT-4

Front 48

GLUTs 1 and 3 responsible for approx. ____ of glucose uptake:

Back 48

60%

Front 49

GLUT-2 essential for ________?

Back 49

hepatic glucose turnover

Front 50

Postprandial hyperglycemia ____ activity of GLUT-2 and hepatic glucose uptake

Back 50

Increases

Front 51

Fasting ____activity of GLUT-2 and hepatic glucose uptake:

Back 51

decreases

Front 52

Where is glucagon produced?

Back 52

in the pancreas

Front 53

What does glucagon do?

Back 53

Glucagon causes the liver to convert stored glycogen into glucose and release it into the bloodstream.

Front 54

What is the primary short term energy storage in animal cells?

Back 54

Glycogon

Front 55

Where is glycogon produced?

Back 55

Glycogon is made primarily by the liver and the muscles, but can also be made by the brain, uterus, and the vagina

Front 56

True or false, only the glycogen stored in the liver can be made accessible to other organs

Back 56

True.

Front 57

True or false, the brain is permeable to glucose, so insulin is not required.

Back 57

True

Front 58

True or false, 90% destruction of Beta cells is required before the full onset of type 2 diabetes occurs?

Back 58

True

Front 59

1 unit of insulin is the quantity required to decrease blood glucose by _____.

Back 59

45 mg/dl

Front 60

100 U/mL insulin + ?

Back 60

3.6mg/ml. Most commercial preparations contain approximately 3.6 mg/ml

Front 61

“Standard” insulin products contain ≤ ____ pro-insulin or other impurities

Back 61

10 ppm

Front 62

“Purified” insulin contains ≤ ____ proinsulin or other impurities

Back 62

1 ppm

Front 63

Humilin R and Novolin R?

Back 63

Clear, colorless solutions of Regular insulin (crystalline zinc) in neutral buffer

Front 64

Humilin R and Novolin R onset and duration?

Back 64

Onset: 30-60 minutes
Duration: 6-10 hours

Front 65

Lispro?

Back 65

Lispro (Humolog) is rapid acting insulin available in a pen or vial: Synthetic rDNA modification of the B chain

Front 66

Lispro onset and duration?

Back 66

Onset: 15-30 minutes
Duration: 3-6.5 hours

Front 67

Aspart?

Back 67

(Novolog) Rapid acting, synthetic rDNA modification of the B chain.
Alteration of the B chain involves substitution of Aspartate fro Proline B28. This decreases onset to 10-20 minutes and duration to 3-5 hours

Front 68

NPH?

Back 68

Neutral Protamine Hagedorn (NPH) insulin-isophane insulin suspension:
Novalin N and Humulin N

Front 69

Novolin N and Humulin N, onset and duration?

Back 69

Onset: 1-2 hours
Duration 16-24 hours

Front 70

Lantus?

Back 70

Long-acting (slow) insulin.
Onset: 1.1 hours
Duration: 24 hours

Front 71

Lowest potency sulfonylurea?

Back 71

Tolbutamide

Front 72

Highest potency sulfonylurea?

Back 72

Glimiperide

Front 73

Sulfonylurea MOA?

Back 73

Stimulates insulin release from beta cells and reduces glucose output from the liver.

Front 74

Diabinase?

Back 74

Chlorpropamide: Sulfonylurea

Front 75

Amaryl?

Back 75

Glimiperide: Sulfonylurea

Front 76

Glucotrol?

Back 76

Glipizide: Sulfonylurea

Front 77

Diabeta or Micronase?

Back 77

Glyburide: Sulfonylurea

Front 78

Tolinase?

Back 78

Tolazamide: Sulfonylurea

Front 79

Prandin?

Back 79

Rapaglinide. Stimulates insulin release from Beta cells.

Front 80

Starlix?

Back 80

Neteglinide. Stimulates insulin release from Beta cells.

Front 81

Prandimet?

Back 81

Rapglinide and metformin.

Front 82

Glucophage?

Back 82

Metformin. Biguanide: Decreases hepatic glucose production, decreases intestinal glucose absorption and improves insulin sensitivity.

Front 83

Avandia:

Back 83

Rosiglitazone. PPARg agonist: lowers blood glucose by improving target cell response to insulin

Front 84

Glucovance

Back 84

Glyburide and metformin

Front 85

Actos?

Back 85

Pioglitazone. PPARg agonist: lowers blood glucose by improving target cell response to insulin

Front 86

Which PPARg agonist has an active metabolite?

Back 86

Actos (Pioglitazone)

Front 87

Acarbose?

Back 87

Precose: Inhibits alpha-glucosidase at the intestinal brush border.

Front 88

Miglitol?

Back 88

Glyset: Inhibits alpha-glucosidase at the intestinal brush border.

Front 89

Pramlintide?

Back 89

Symlin: Amylin analog. Decreases appetite.

Front 90

Exenatide?

Back 90

Exenatide (Byetta): Incretin Mimetic. Binds GLP-1 receptors

Front 91

Insulin chemistry?

Back 91

Small, simple protein
6000 daltons
51 amino acids
21 AAs in A chain
3 disulfied bonds
2 disulfied bonds between A and B chains

Front 92

Insulin glargine?

Back 92

Lantus: Long acting insulin

Front 93

A1c?

Back 93

The average blood glucose over a 6-8 week period.

Front 94

A1c target?

Back 94

<7% per ADA

Front 95

Januvia?

Back 95

Sitagliptin: Dipeptidyl peptidase-4 inhibitor. Increases GLP-1 levels by inhibiting the degradation enzyme DPP4

Front 96

BPH occurs in the _________ zone.

Back 96

transitional zone

Front 97

Postate cancer usually occurs in the _______ zone

Back 97

peripheral zone

Front 98

Hyperplasia?

Back 98

An abnormal or unusual increase in the elements composing a part

Front 99

Hypertrophy?

Back 99

Excessive development of an organ or part; specifically: increase in bulk (as by thickening of muscle fibers) without multiplication of parts

Front 100

Leydig cells?

Back 100

Produce Testosterone, Androstenedione and Dehydroepiandrosterone (DHEA)

Front 101

Sertoli cells?

Back 101

A Sertoli cell’s main function is to nurture the developing sperm cells through the stages of spermatogenesis. Because of this, it has also been called the "mother cell".

Front 102

Primary hypogonadism?

Back 102

Testicular Failure

Front 103

Secondary hypogonadism?

Back 103

Imbalance of the HPA Axis.

Front 104

Hypergonadism causes?

Back 104

Increased FSH
Increased LH
Low testosterone
Impaired sperm production

Front 105

Hypogonadism causes?

Back 105

Low or low-normal FSH
Low or low-normal LH
Low testosterone

Front 106

_________ is an enzyme that converts testosterone, the male sex hormone, into the more potent dihydrotestosterone

Back 106

5-alpha reductase

Front 107

5a-reductase is produced only in specific tissues of the male human body, namely the_________________.

Back 107

skin, seminal vesicles, prostate and epididymis.

Front 108

Propecia?

Back 108

Finasteride (Propecia) inhibits the function of type 2 5a-reductase

Front 109

Avodart?

Back 109

Dutasteride: inhibits both forms of 5a-reductase

Front 110

Androstenedione?

Back 110

Hormone produced in the adrenal glands and gonads as an intermediate step in the biochemical pathway that produces testosterone and the estrogens estrone and estradiol

Front 111

17β-hydroxysteroid dehydrogenase?

Back 111

Required for conversion of androstenedione to testosterone

Front 112

Aromatase?

Back 112

Required for the conversion of androstenedione to estrogen

Front 113

Conversion of androstenedione to estrone occurs in _______?

Back 113

adipose tissues

Front 114

PSA _______ is relatively specific for PCa

Back 114

> 10 ng/ml

Front 115

5α-Reductase Inhibitors?

Back 115

Suppress prostate growth:
Size by 20% in 6 months
PSA by 50%
Slows disease progression

Front 116

first 6 steps in ovarian cycle?

Back 116

1. Activation of primordial follicle – conversion to cuboidal cell type
2. Proliferation of follicle cells – increases follicle size
3.Maturation of follicle cells to granulosa cells
Granulosa cells:
4.Formation of theca folliculi and zona pellucida
Theca folliculi:
Zona pellucida:
5.Formation of antrum - secondary follicle
6.Formation of vesicular follicle
“Corona radiata’

Front 117

Luteal phase (steps 8 and 9) of ovarian cycle?

Back 117

Formation of corpus luteum (CL):
This is due to the collapse of the ruptured follicle and antrum. The antrum then fills with blood, becoming the corpus hemorrhagicum.

Front 118

Formation of corpus albicans?

Back 118

This occurs if pregnancy does not, forming 10 days after the corpus luteum.

Front 119

Progesterone production?

Back 119

Day 15: sharp drop LH, FSH and Estrogen and beginning of Progesterone secretion

Front 120

Most potent progestin OCs?

Back 120

Desogestrel
Levonorgestrel

Front 121

Monophasic OCs?

Back 121

Fixed dose of estrogen to progestin for 21 days; 7 day placebo pills

Front 122

Librel?

Back 122

active pills for the entire year

Front 123

Extended-cycle OCs increase number of hormone-containing pills from _____?

Back 123

21 to 84 days followed by 7-day placebo phase

Front 124

Seasonale® (EE 30 mcg + levonorgestrel 0.15 mg)?

Back 124

84-day active pills; 7-day pill-free interval

Front 125

Seasonique® (EE 30/10 mcg + levonorgestrel 0.15 mg)

Back 125

84-day active pills; 7-day low-dose estrogen

Front 126

Yaz® (EE 20 mcg + drospirenone 3 mg)?

Back 126

24-day active pills; 4-day pill free; minimize duration of withdrawal bleeding and menstrual-related symptoms; FDA-approved for premenstrual dysphoric disorder and moderate acne

Front 127

Loestrin-24® Fe (EE 20 mcg + norethindrone 1 mg)?

Back 127

24-day active pills; 4-day pill free; minimize duration of withdrawal bleeding and menstrual-related symptoms

Front 128

Lybrel® (EE 20 mcg + levonorgestrel 90 mcg)?

Back 128

Active pill taken every day (no pill-free interval). May decrease endometriosis-related menstrual pain inadequately relieved by COC

Front 129

Progestin-Only Minipills?

Back 129

Provide 28 days of active hormone

Front 130

Women with migraine headaches, history of thromboembolic disease, heart disease, cerebrovascular disease, SLE with vascular disease, and hypertriglyceridemia should?

Back 130

Consider progestin-only methods (pills, DMPA, and the levonorgestrel intrauterine system)

Front 131

Women > 35 yrs who are smokers or are obese, or who have hypertension or vascular disease

Back 131

Use progesterone-only methods

Front 132

OC of choice with no coexisting medical conditions?

Back 132

OC with < 35 mcg ethinyl estradiol and < 0.5 mg norethindrone recommended

Front 133

OC for adolescents and underweight women (<110 lb), women > 35 yrs and perimenopausal women?

Back 133

May have fewer side effects with 20–25 mcg EE (less bloating and breast tenderness)

Front 134

OC for Women > 160 lb?

Back 134

May have higher contraceptive failure rates with low-dose OCs; consider 35 – 50 mcg of EE

Front 135

OC for women with heavy menses?

Back 135

Due to higher endometrial activity, may benefit from initiating 50 mcg EE OC

Front 136

OC for women with light menses?

Back 136

May be initiated on 20 mcg EE OCs

Front 137

OC for women with oily skin, acne and hirsutism?

Back 137

Use low androgenic OCs

Front 138

OCs for acne?

Back 138

Ortho Tri-Cyclen® (ethinyl estradiol 35 mcg + norgestimate), Estrostep® (ethinyl estradiol 20/30/35 mcg + norethindrone) and Yaz® (ethinyl estradiol 20 mcg + drosperinone)

Front 139

Orth Evra?

Back 139

CHC patch containing 0.75 mg EE and 6 mg norelgestromin