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110 Cards in this Set
- Front
- Back
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anterior pituitary hormones with similar alpha subunits but different beta subunits
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FSH, LH, hCG, TSH
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where are beta cells located in relation to alpha cells in panc islets...
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beta cells central surrounded by alpha (glucagon cells) delta cells in random
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ATP causes the exocytosis via depolarization and closure of K channels.... what drug closes this
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diazoxide
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effect of insulin on the kidney, and cell K...
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increased Na retention in the kidney and cause decreased K due to cellular uptake (can use insulin with hyper K)
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cells that use Glut1
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RBC and Brain
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bidirectional glucose transporter of the liver, beta cells, intestine
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Glut 2 (glucokinase)
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TRH stimulates which two...
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TSH and prolactin (which is tonically inhibited by dopamine)
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spermatogenesis is decreased in men with decreased GnRH due to which pitu hormone
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dopamine
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ketoconazole and ACTH act oppositely on the same enzyme...which enzymes
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desmolase
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order of hormones
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17, 3B, 21,11
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what builds up with 21 OH def...besides androstenidione
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17-progest and progesterone
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why are all adrenal glands enlarged with CAH
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excess ACTH owing to decreased cortisol
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effects of cortisol (BBIIG)
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blood pressure (increase alpha 1 causing permissive effect...give in septc show... dec bone, dec inflam, dec immune, breakdown and gluconeogen
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where does PTH increase Ca resoprtion
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DCT
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decrease in free Mg does what to PTH
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decrease PTH
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decrease PTH owing to Mg can be caused by
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decreased MG...diarrhea, amingoglycosides, duiretics, EtOH
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what is the mechanism of action for PTH stimulating bone resorption
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osteoBLASTS increase production of M-CSF and RANK-L which stimulate osteoclasts
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effect on increased PTH on urinary cAMP
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increase urinary cAMP
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low phosphorous levels cause...
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increase active vit D and therefore bone release of P and increased absorption of P
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two tricky IP3 acting hormones
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GnRH and TRH
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tricky cAMP acting hormones
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ACTH, CRH, ADH (V2), MSH, GHRH, glucagon (Calcium regulation)
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order of steroid hormone
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bind in cyto or nucleous, transform receptor to expose binding site for DNA, bind to enhancer on DNA
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increased SHBG in male causes...decreased SHBG in females
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male...decreased free thus gyneco
females...increase free thus huirstism |
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thyroid effect (follicular cells) is synergistic with...
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GH for bone formation
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action of peroxidase afeter Na aided entry into cell
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oxidation, oragnification, coupling
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inhibitors of iodine uptake into cell
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Anions, perchlorate, pertechnetate KI...competeitive inhib of Na channel
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cushings disease of adrenal origin is most likely
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adenoma, carcinoma, hyperplasia
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weird cushings effects
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peptic ulcers, cataracts, psychosis, insomnia
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causing of secondary hyperaldosteronism (low plasma volume)
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renal artery stenosis, chronic renal disease, cirrhosis, nephrotic, CHF
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high aldosterone levels with low renin with high renin
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low renin...conns
high renin...secondary to sensed low blood volume(renal/chf) |
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distinguishing secondary addisions disease from primary...
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secondary is due to low ACTH...therefore no hyperK and no tan/pigmentationk and will respond to ACTH
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tertiary hypoadrenal
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fast withdrawl from glucosteriod... need to wait for the pituitary to catch up therefore do this slwoly
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rate limiting step in NE synth
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tyrosine hydroxylase...next is B6 needing decarboxylase...then dopamine hydroxylase (copper) for NE...then PMNT for EPI
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breakdown of NE is done by
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COMT...methy thransfer
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bombesian positive
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neuroblastoma along with lung and gastric
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HVA in the urine of a child...biopsy show perifibal psuedorossets
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adrenalneuroblastoma...nmyc...remember it can be anywhere along the sympathetic chain
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course skin and brittle hair
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hypothyroid
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fine hair and moist skin
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hyperthyroid
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which is afib and which is depression
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afib is hyper and depression is hypothyroid
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causes of increased CPK
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hypothyroid, statins, polymyositis, ducheenes ( pale with decreased striations and musicous material)
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HLA-DR5, which large oxyphilic cells with granular cytoplasm
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hasimotos (huethle cells)
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sporatic form comes from random mutation in T4... presents with protruding umbilicus, pot bellied, large tongue
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cretinism
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increased ESR with jaw pain and tender anterior neck with hyptohtyroid
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subacute granuloustous de quarvian
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rock hard, painless with fibrosis and macropgaes
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reiters (hypothyroid)
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hisotlogy looks like decreased colloid with papillary projections...come about during stress such as childbirth (hyperthyroid)
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Graves
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stress induced catecholamine surge leads to death from arrhythmia...complication of graves and hashimotos
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thyrotoxicosis...give beta blockers to decrease heart stuff and decrease periph conversion of t4 to t3
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many nodules function indep of TSH...hot nodules
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toxic multnodular goiter..
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radiodye with iodine given to a person who is iodine deficient... thyrotoxicosis
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jod-basedow penomenon where I def person gets huge influx and gets thyrotoxicosis
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thyroid cancer with nuclear grooves, ground glass nucleai optically clear and childhood radition conncetion
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papillary
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thyroid cancer associated with ras mutation and iodine deficinecy
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follicular
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pleomorphic giant cells in thyroid of older patinet
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anaplastic
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hyper Ca, Ca in urine, kidney stones, increased urine cAMP, increased alk phos
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hyperPTH...stone, bones (osteitis fibrosis cystica), groans (abdomonal pain and consitpation and pancreatitis)
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increased alk pho and cystic bone spaces with brown fibrous tissue and bone pain
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osteitis fibrosis cystica from increase PTH due to primary, decreased vit D or renal
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causes of secondary hyper PTH (decreased Ca)
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chronic renal disease or low Vit D
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Low D vs renal disease
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renal disease with have INCREASED Phospahet because it can function to clear it (both will have low Ca and increase PTH)
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teritary hyper PTH (autonomous)
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hyper PTH from renal disease but far exceeed needed... increase PTH with normal Ca
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AD defect which results in hypoPTH symptoms low Ca and short 4th and 5th fingers but PTH is elevated
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psuedohypoPTH...look for child with tetanty
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psedohypoPTH often have resisance to which other hormones...
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similar alpha/beta...LH, FSH, TSH, hCG
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person with tetant...cheeck and BP cuff
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hypoPTH...surgery, autoimmune, digeroge
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sheehans vs apoplexy
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sheehan is ischemia from overgrowth...apoplexy is hemorrahge from overgrowth
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dopamine agonist for treatment of prolactinoma
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carbergoline
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large tongue, impaired glucose tolerance (DM), voice, larges hands and feet, increased teeth space...
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acromegally...diagnosed with GH suppression test with oral glucose challenge, or night look at IGF levels
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no decrease in GH with oral glucose shows what
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acromegally
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treatment for acromegally...
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adenoma out and octeotide
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causes of DI
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histiocytosis X, lithium and demeclcyclin
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treatment for nephorgenic DI
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thiazide, indomethacin (decrease renal fow), amiloride (close Na channels)
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decreased aldosterone with unrine omolarity> plasma, normal volume state, hyponatremia
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SIADH
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causes of SIADH
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ectopic, cyclophosphamide, chlorpromaide
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osmotic dmage in DM caused by aldose reductase making sorbitol
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lens (catracts) retina and schwann cells (periph neuro)
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testing for DM
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fasting glucose over 126 (type 1 and 2)...
oral glucose challnge (gestational) |
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HLA DR protective against DM and bad for DM type 1
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2/2 vs bad is 3/4
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type two diabetic with presentation of DKA but no ketones in the urine...
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hyperosmolar crisis... body have enough to prevent ketosis but not to prevent hyperglycemia with increased glucose over 800
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hyperkalcemia (with depleted intercellualr stores due to low insulin), late ammonia increase due to muslce breakdown, hypovolemia, hypoNA in type 1 DM... treat with
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volume, insulin, replete K, and Mg
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thickened rugal of stomach
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ZE
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necrolytic migratory erthytema stomatosis and abdominal pain
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gastinoma
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stones, constipation, steatorrhea...
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somatostatinoma
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what is unique to all MEN sydromes
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angiofibromas and lipomas... rememebr II has PTH while 3 has ganglioneuromatosis
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short acting insulin
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lispro, aspart and normal
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long acting insulin
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glargine and detemir (NPH is intermediate
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adverse effects of insulins...
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hypoglyc...lipodystophy at injection site, weight gain
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tolbutamide and chlorpromazine
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first gen sulfonyurea cause disulfiram and SIADH (chlorpropamide)
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work opposite of diazoxide and can cause hypoglycemia
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second gen sulfonyurea
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biggest concern is lactic acidosis
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metformin which decreases gluconeo and increase periph uptake
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contraindicated for DM with renal failure and avoid the use of IV contrast
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metformin
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hepatotoxicity and water rentention with benfits of decrease glucose and TG and CRP with increased HDL
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zones... increase adiponectin
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exenatide increased satiety and dec gastric empty but has which side effect
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pancreatitis
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defference is propothiuracil and methimazole...
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PPU is good for preg, decreased periph conversion of t4 to t3 and has shorter half life... both cause agranulocytosis and aplasic anemia
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demeclocyclin can be used for
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SIADH (works against chlorpropamide)... look for the urine osmolar to be greater than blood osmol with TBW normal and hypoNA
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orlistat and sibutramine
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weight loss drugs... inhib pan lipase and SNRi contra with heart problems
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central DI vs nephro DI vs psycholgenic...
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give desmopressin and >50% change is neuro...<10% is psychogenic (urine osmol is stable)
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effects of DM periph neuropahy...endoneural inflammation with CD4
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burning...distal symetirc burning with weak DTR...autonomic causes constipation, urinary incontinence, orhtostatic HTN...CN 3 and 4...ulnar, median, and peroneal nerves
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where are estradiol, estriol, and estrone made
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estradiol= ovary
estriol= placenta estrone= fat |
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POMC increased stimulation with addisons becomes...
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MSH, lipotropins and beta-endorphin
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weird drug causes of hyperprolactinemia (D antag)
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metocloparamide and methyldopa
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octeotide in liver cirrhosis...
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decreased blood flow to prevent esoph
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common causes of hyperCa
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increased PTH (adenoma85% hyperplasia15%) malignancy, breast and MM with PTHr (renal and SCC)..increased antacids and vit D
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recent study using IV contract dye with iodine...
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thyrotoxicosis with iodine given to iodine deficinet (Jud Base)
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thyroid cancer associated with activated tyrosine kinase receptor...
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medullary and papillary
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thyroid cancer associated with Ras and Pax8-PPAR mutation
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follicular
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thyroid cancer associated with RET and NTRK1 is ...also BRAF gene (serine/threonine kinase)
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papillary
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sitaGLIPTIN and saxaGLIPTIN
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GLP-1 analog which decease glucagon, increase insulin, and delay gastric empty
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Exentide (pancreatitis) liraglutide and pramlintide (with type 1 or 2 people taking insulin)...
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GLP1 like and amylin respetvly... both decrease glucose
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Dm drug that helps lower Tg and LDL too
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metformin and zones
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should not be used in patients with elevated creatinine
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metformin
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should not be used in patients with cirrhosis, elevated cr, or inflam bowel disease
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acarbose and miglitol
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not associated with weight gain, used with overweight DM
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metformin
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metbolized by liver, great for DM with renal disease
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zones
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NASH, chronically elevated ALTs associated with
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obestity, DM, hyperlipid and insulin resistance...worsens Hep C...chronically
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ipsilateral face, horseness, swallowing and gag (NAmbiguous 9 and 10), ipsi horners, ipsi 8 (vertigo with nystagmus)...ipsilated gait due to inferior cerbella peduncle
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lateral medullary sydrome (wallenbergs)...PICA....5,8,9,10, symp, cerbellum, pain and temp
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ret gene mutation
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MEN IIa and IIb, medullary and papillary
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