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78 Cards in this Set
- Front
- Back
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zona glomerulosa
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aldosterone
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zona fasciculata
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cortisol, sex hormones
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zona reticularis
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sex hormones
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adrenal medulla (chromaffin cells)
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catecholamines
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pheochromocytoma
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most common tumor of adrenal medulla in adults
episodic HTN |
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neuroblastoma
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most common in children.A malignant tumor composed of neuroblasts, most commonly in the adrenal gland
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posterior pit (from neuroectoderm)
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vasopressin and oxytocin (both made in HT)
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ant pit (from oral ectoderm, Rathke's pouch)
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FSH, LH, ACTH, GH, TSH, MSH, prolactin
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beta subunit
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determines hormone specificity
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alpha cells of islets
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glucagon
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beta cells of islets
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insulin
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delta cells of islets
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somatostatin
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prolactin inhibited by
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dopamine (bromocriptine)
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what stimulates prolactin
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dopamine antagonists (most antipsychotics)
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prolactin inhibits
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GnRH synthesis and release- inhibits ovulation
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increased prl causes...
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infertility, amenorrhea, galactorrhea
males: decreased testo, libido, sperm (infertility), impotence, gynecomastia, galactorrhea |
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causes of increased prl
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pregnancy, breast feeding, stress, prolactinoma, DA antagonists (haloperidol, domperidone, metacloprimide), methyldopa
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somatostatin inhibits
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GH and TSH
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stimulates bone and muscle growth
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GH (IGF)
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stimulats milk production and secretion
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prl
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stimulates milk secretion during lactation
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oxytocin
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responsible for female secondary sex characteristics
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estrogen
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stimulates metabolich activty
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thyroid hormone
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increases blood glucose level and decreases protein synthesis
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cortisol
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responsible for male secondary sex characteristics
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testosterone
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prepares endomitrium for implantation/maintenance of preg
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progesterone
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stimulates adrenal cotex to synthesize and secrete cortisol
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ACTH
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stimulates follicle maturation in females and spermatogenesis in males
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FSH
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increases plasma Ca, increases bone resoprtion
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PTH
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decreases plasma ca, increase bone formation
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calcitonin
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stimulates ovulation in females, testosterone synthesis in males
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LH
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stimulates thyroid to produce TH and uptake iodine
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TSH
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progesterone is from
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ovary, placenta
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atrial natriuretic hormone is from
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atria
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testosterone is from
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testis, ovaries, ZR of adrenal cortex
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calcitonin is from
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parafollicular C cells of thyroid
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estradiol is from
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ovaries
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estriol is from
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placenta
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estrone is from
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adipose
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estrogen in males is from
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testes
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cAMP (Gs)
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ACTH, LH/FSH/hCG/TSH, ADH (V2, kidney), glucagon, MSH, CRH, calcitonin/PTH, beta
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IP3/DAG (Gq)
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GnRH, TRH, GHRH, ATII, ADH (V1 vessels), oxytocin, A1, M1, M3
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nucleus
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glucocorticoids, estrogen/progesterone, testosterone, aldosterone, vit D, thyroid H
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tyrosine kinase
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insulin, IGF-1, growth factors (PDGF)
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insulin dependent organs
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skeletal muscle and adipose via GLUT4
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glucose independent
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brain and RBCs
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pit adenoma
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most commonly prolactinoma - amenorrhea, galactorrhea, low libido, infertility
tx with bromocriptine |
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SIADH
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excessive water retention, hyponatremia, urine osm > serum osm
low Na can lead to seizures (correct slowly!) tx: demeclocycline, H2O restriction |
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causes of SIADH
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ectopic ADH (small cell lung cancer)
CNS disorders/head trauma pulm disease drugs (cyclophosphamide) |
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carcinoid syndrome
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secrete high levels of 5HT
results in diarrhea, cutaneous flushing, asthmatic wheezing, right sided vavlular disease increased 5HIAA in urine tx: octreotide |
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Zollinger Ellison syndrome
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gastrin secreting tumor of pancreas or duodenum
causes recurrent ulcers may be associated with MEN 1 |
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Sheehans
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postpartum hypopituitism
caused by infarction of pituitary gland following severe bleeding and hypoperfusion during delivery may cause fatigue, anorexia, poor pactation, loss of hair |
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neuroblastoma
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most common tumor of adrenal medulla in children
HVA in urine |
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pheochromocytoma
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most common tumor of AM in adults
derived from chromaffin cells (NCC), VMA in urine assoc with NF, MEN II/III tx with alpha ag (phenoxybenzamine) episodic: HTN, pain, perspiration, tachy, palpitations, pallor |
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MEN I
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pancreas, parathyroid and pit tumors; presents with kidney stones and stomach ulcers
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MEN II
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medullary carc of thyroid, pheochromocytoma, parathyroid tumor
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MEN III
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medullary carc of thyroid, pheochromocytoma, mucosal neuromas
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ret gene
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MEN II and III
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MEN
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AD inheritance
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cretinism
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lack of dietary iodine, sporadic caused by defect in T4 formation or developmental failure in thyroid formation
pot bellied, pale, puffy face with protruding umbilicus, protuberant tongue |
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acromegaly
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excess GH in adults
large tongue with deep furrows, deep voice, large hands and feet, coarse facial features, impaired glucose tolerance (insulin resistance), increased GH in children- gigantism tx: octreotide |
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The most common cause of hypothyroidism. |
Hashimoto's thyroiditis |
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Lab findings in Hashimoto's thyroiditis |
High TSH, low T4, antimicrosomal antibodies |
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Exophthalmos, pretibial myxedema, and diminution TSH |
Graves' disease |
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The most common cause of Cushing's synfrome |
Iatrogenic steroid administration.The second most common cause is Cusjhing's disease |
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A patient presents with signs of hypocalcemia, high phosphorus, and low PTH |
Hypoparathyroidism |
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"Stones, bones, groans, psychiatric overtones" |
Signs and symptoms of hypercalcemia |
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A patient complains of headache, weakness, and polyuria; exam reveals hypertension and tetany. Labs reveals hypernatremia, hypokalemia, and metabolic alkalosis. |
1st hyperaldosteronism (due to Conn's syndrome or bilateral adrenal hyperplasia |
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A patient presents with tachycardia, wild swings in BP, headache, diaphoresis, altered mental status, and a sense of panic. |
Pheochromocytoma |
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Should Alfa or Beta-antagonists be used first in treating pheochromocytoma? |
Alfa-antagonists (phentolamine andphenoxybenzamine) |
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A patient with a history of lithium use presents with copious amounts of dilute urine |
Nephrogenic diabetes insipidus (DI) |
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Treatment of central DI |
Administration of DDAVP disminution serum osmolality and free water restriction |
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A postoperative patient with significant pain presents with hyponatremia and normal volume status |
SIADH due to stress |
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An antidiabetic agent associated with lactic acidosis |
Metformin |
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A patient presents with weakness, nausea, vomiting, weight loss, and new skin pigmentation. Labs show hyponatremia and hyperkalemia. Treatment? |
1st adrenal insufficiency (Addison's disease). Treat with replacement glucocorticoids, mineralocorticoids, and IV fluids. |
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Goal hemoglobin A1C for a patient with DM. |
<7.0 |
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Treatment of DKA |
Fluids, insulin, and aggressive replacement of electrolytes (e.g., K+) |
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Why are Beta-blo9ckers contraindicated in diabetics? |
They can mask symptoms of hypoglycemia |
