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55 Cards in this Set
- Front
- Back
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Stimulate glucagon release…
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Fasting, decr glucose, incr AA (arg), CCK, beta-agonists, Ach
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Inhibit glucagons release…
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Insulin, somatostatin, incr FA/ketoacids
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Which hormones in the anterior pituitary are inhibited by somatostatin…
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GH, TSH
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Signs and symptoms of 17a-hydroxylase def…
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Decr sex hormones but inr cortisol causing HTN and hypokalemia. XY: decr DHT so externally female but due to MIF, no internal sex structures. XX: all normal structure but lacking secondary characteristics
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Signs and symptoms of 21-hydroxylase def…
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Decr cortisol and incr ACTH. Elevated 17-hydroxypreg and prog. Masculinization, female pseudohermaphrodite, HYPOtsn and hyperkalemia, incr rennin, vol depletion, salt wasting, hypovolemic shock
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Actions/funxns of cortisol…
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Blood pressure maintanence by upreg a1 receptors on arterioles; decr bone formation by decr type I collagen; anti-Inflammatory; decr Immune funxn by blocking IL-2; incr gluconeogenesis, lipolysis, proteolysis
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Mg levels and PTH… what causs decr Mg…
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Decr Mg causes decr PTH secretion. Decr Mg due to: diarrhea, aminoglycosides, diuretics, alcohol abuse
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How are decr phosphate levels regulated…
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1,25 vit D syn in kidney causes incr P absorption in SI and more resorption from bone
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Endocrine hormones that work thru cAMP signaling pathway…
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FSH, LSH, ACTH, TSH, CRH, hCG, ADH (V2), MSH, PTH, glucagons, calcitonin
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Endocrine hormones that work thru cGMP signaling pathway…
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ANP, NO
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Endocrine hormones that work thru IP3 pathway…
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GnRH, GHRH, Oxytocin, ADH (V1), TRH
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Endocrine hormones tha work thru tyrosine kinase pathway…
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Insulin, IGF-1, FGF, PDGF, Prolactin, GH
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Funxn of thyroid hormones…
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Bone growth (synergistic w/ GH), Brain/CNS maturation, incr Beta1 receptors in heart, incr BMR thru upreg of Na/K ATPase, incr glycogenolysis, gluconeogenesis, liposlysis
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Funxn of thyroid peroxidase…
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Oxidation and organification of I as well as coupling of MIT and DIT
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Causes of endogenous Cushing’s syndrome and how distinguish them…
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Cushing dx from ACTH secreting pituitary adenoma which can be suppressed by high dose of dexamethasone; ectopic ACTH from cancer (small cell lung, bronchial carcinoids) that doesn’t suppress, and adrenal adenoma which gives nodular adrenal hyperplasia, incr ACTH, and doesn’t suppress
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Causes of secondary hyperaldosteronism…
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Renal artery stenosis, CRF, CHF, cirrhosis, nephrotic syndrome
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Causes of Addison’s dx…
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Adrenal atrophy or destruction by disease: HIV, CMV, Neisseria (WF syndrome), autoimmune, TB (calcifications), metastasis from lung or breast
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How distinguish primary adrenal insufficiency (Addison’s) from secondary…
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Primary has skin hyperpigmentation, incr ACTH, and hyperkalemia. Secondary has decr ACTH and no pigmentation or hyperK
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If a person has a pheochromocytoma that is only producing Nor but no Epi, what can you conclude…
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It is localized outside the adrenal medulla most likely since adrenal medulla is only place epi is formed
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Neuroblastoma findings, labs, etc…
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Children, anywhere along sympathetic chain. HVA, breakdown of DA, can be found in urine. Less likely to get HTN, but do get periorbital edema and bone pain. N-myc ongogene
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Histo findings and labs in Hashimotos…
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Lymphocytic infiltrate w/ germinal centers, follicles have scant colloid and have acidophilic cells (Hurthe). Antimicrosomal Abs and antithyroglobulin Abs.
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Signs and symptoms of subacute thyroiditis… histo findings…
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Often following flulike illness, can have early hyperthyroid signs then hypothyroid. Have jaw pain, tender thyroid, incr ESR. Histo shows granulomatous inflammation
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Riedel’s thyroiditis…
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Thyroid replaced by fibrous tissue (hypothyroidism). Presents w/ fixed, rocklike, painless goiter
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Pathophys of sudden death of Grave’s patient…
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After stressor such as infxn, trauma, child birth, radiation, etc. patient has catecholamine surge and gets arrhythmia
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Histo findings and prognosis of papillary thyroid carcinoma…
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Most common. Empty appearing (ground glass or orphan annie) nuclei, calcified psammoma bodies, nuclear grooves. Incr risk w/ childhood radiation but good prog
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Histo findings and pognosis of follicular CA of thyroid…
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Uniform, encapsulated follicles. Good prognosis
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Histo findings and prognosis of medullary carcinoma…
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From parafollicular C cells so produce calcitonin w/ sheets of cells in amyloid stroma. Asso w/ MEN 2A,B
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Causes of hypercalcemia…
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Calcium ingestion, HyperPTH, Hyperthyroid, Thiazides, MM, Pagets, Addisons, Neoplasms, ZE syn, Excess vit D, Excess vit A, Sarcoidosis
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Labs in primary hyperPTH… what can it lead to…
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Incr PTH, incr Ca, hypercalciuria so can get renal stones, incr ALP, incr cAMP (PTH decr cAMP levels). Get weakness and constipation, psychiatric symptoms or bone cysts filled w/ fibrous tissue (ost fibrosa cystica)
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What happens to the chief cells of parathyroid gland if get decr gut Ca or P absorption from CRF (decr vit D)… labs… what can it lead to…
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Get hyperplasia of chief cells. hypoCa, hyperphosphatemia, incr ALP, incr PTH. Can get bone lesions
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Pseudohypoparathyroidism…
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AD dx where kidney is unresponsive to PTH, hypocalcemia, shortened 4th,5th digits, short stature.
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Diagnosis of acromegally… Tx of GH secreting tumor…
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Incr levels of IGF-1, failure to suppress GH following glc load. Tx: Pituitary adenoma resection followed by octreotide administration
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GH levels increase when…
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Exercise, stress, hypoglycemia. Pathologically in pit adenoma (acromeg)
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Signs of Sheehan syn…
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Post partum get fatigue, anorexia, poor lactation, loss of pubic/axillary hair and low levels of pituitary hormones
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Causes of central DI… nephrogenic…
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Central: trauma, pit tumor (craniopharyngeoma), surgery, histiocytosis X. Nephrogenic: hyperCa, lithium, demeclocyline (ADH antag)
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Tx for nephrogenic DI…
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HCTZ, indomethacin, amiloride
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Serum Na and total body Na in SIADH…
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Low serum Na but NORMAL TBNa
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What are hormonal factors in DM that exacerbate the hyperglycemia…
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Unopposed secretion of GH and epinephrine
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What are osmotic factors in DM leading to dehydration and acidosis…
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Decr glc uptake cuases hyperglycemia, glycosuria, and electrolyte depletion. This is also fed by incr protein catabolism incr AA and urea in urine. Incr FFA in plasma leads to ketogenesis causing same problem
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What CNIII damage is most often seen in DM…
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Somatic fibers affected, get down and out gaze w/ ptosis but accommodation is okay
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Histo findings of beta cells of patient w/ DM II…
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Variable number of beta cells w/ amyloid deposits
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Lab findings in diabetic ketoacidosis…
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Hyperglycemia, anion-gap metabo acidosis, hyperK but depleted intracellular K, leukocytosis
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Complications of diabetic ketoacidosis…
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Mucormycosis, rhizopus infxn, cardiac arrhythmias, heart failure, cerebral edema and coma
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Short acting insulin… use… toxicity…
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Lispro, aspart, and regular. Used for DM, life-threatening hyperK and stress induced hyperglycemia. SEs: hypoglycemia, hypersensitiviy
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Long acting insulins…
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Glargine, determir
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1st generation sulfonyureas… use… SEs…
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Tolbtamide, chlorpropamide. Only used in DM2 since they require some islet funxn. Cause SIADH (chlorpropamide) and disulfram like rxn w/ alcohol
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2nd generation sulfonylureas… use… SEs…
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Glycuride, glimepiride, glipizide. Used only for DM2 (need islet cell funxn). SEs: hypoglycemia
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SE and contraindications of metformin…
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Can cause lactic acidosis and is contraindicated in renal failure
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MOA, use, and SEs of thiazolindinediones…
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Pioglitazone and rosiglitazone. PPAR agonists that incr sensitivity to insulin. Used for DM2, but takes a few weeks to work. SEs: wt gain, edema, hepatotoxicity, Rosi affects the heart
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Diabetes drugs that work by blocking brush border glucosidases… SEs…
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Acarbose and miglitol. Can cause GI disturbances
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MOA of pramlintide…
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Decr glucagons
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MOA of exenatide… SEs…
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Incr insulin and decr glucagons. Can caus N/V and pancreatitis
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MOA of sibutramine… use… sE…
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Ser and NE uptake inhibitor used for obesity. SE: HTN and tachycardia
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MOA of propylthiouracil and methimazole… toxicity…
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Inhibit organification of I and coupling of TH synthsis. PTU inhibits T4T3 conversion. SE: skin rash, agranulocytosis, aplastic anemia
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MOA and use of demeclocycline… toxicity…
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ADH antagonist, tetracycline. Used for SIADH. SEs: nephrogenic DI, photosensitivity, abnormal bones and teeth
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