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42 Cards in this Set
- Front
- Back
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What cell types require insulin for glucose uptake?
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Skeletal muscle and adipose tissue
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What part of the pancreas are the islet cells located?
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Tail
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What are the anabolic effects of insulin?
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Increase: Glucose transport, glycogen synthesis and transport, TG synthesis and storage, protein synthesis, cellular UPTAKE OF K AND AMINO ACIDS, NA RETENTION (kidney)
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What cells have GLUT1?
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RBCs, brain (take up glucose independent of insulin)
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What hormones abnormalities would you see in 17alpha-hydroxylase deficiency?
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Increased mineralocorticoids (hypertension, hypokalemia), Decreased glucocorticoids
Decreased sex hormones- Male pseudohermaphroditism, female sexual infantalism (lack secondary sex characteristics) |
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What hormone abnormalities would you see in 21alpha-hydroxylase deficiency?
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Decreased aldosterone- Hypotension, hyperkalemia, volume depletion (can lead to hypovolemic shock)
Decreased corticosteroids Increased sex hormones- Female pseudohermaphroditism |
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What hormone abnormalities would you see in 11B-hydroxylase deficiency?
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-Decreased aldosterone, BUT increased 11-deoxycorticosterone, which is a mineralocorticoid so you still see HYPERTENSION!!!!!
-Decreased corticosteroids -Increased sex hormones |
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What do all congenital adrenal enzyme deficiencies have in common?
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The adrenal gland will be enlarged because of increased ACTH (all have decreased cortisol)
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What are the functions of cortisol?
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1. Blood pressure- permissive effect with epinephrine because it upregulates alpha1 receptors
2. Decreases Bone formation 3. Anti-inflammatory 4. Decreases Immune function 5. INCREASES gluconeogenesis, lipolysis, proteolysis |
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What decreases PTH secretion?
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Decreased Mg!!!! This can be caused by diarrhea, aminoglycosides, diuretics, and alcohol use
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What hormones signal through cAMP?
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FSH, LH, ACTH, TSH, CRH, hCG, ADH (V2), MSH, PTH (FLAT CHAMP) + calcitonin, GHRH, glucagon
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What hormones signal through cGMP?
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ANP, NO (EDRF)- these are vasodilators
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What hormone receptors are intrinsic tyrosine kinases?
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Insulin, IGF-1, FGF, PDGF (growth factors)
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What hormones are receptor-associated tyrosine kinases? (JAK/STAT)
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Prolactin, GH, IL-2
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What is the function of thyroid hormone (T3/T4)?
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1. Bone growth
2. CNS maturation 3. Increased B1 receptors in the heart 4. Increase basal metabolic rate via increased Na/K ATPase activity 5. Increased glycogenolysis, gluconeogenesis, lipolysis 6. Can be used to stimulate surfactant production. |
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What is the acid base abnormality seen in primary adrenal insufficiency?
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AG acidosis
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What is associated with pretibial myxedema?
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Hyperthyroidism
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What is associated with periorbital/facial myxedema?
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Hypothyroidism
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How does T3 interact with ADH?
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Inhibits it
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What are the features of subacute thyroiditis? (de Quervain's)
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Increased ESR, jaw pain, early inflammation, very tender thyroid, MARKEDLY decreased iodide uptake, granulomatous inflammation
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What is Riedel's thyroiditis?
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Thyroid is replaced by fibrous tissue and is fixed, hard, and painless goiter; eosinophil and macrophage infiltrate. Hypothyroid
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What is toxic multinodular goiter?
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Focal PATCHES of hyperfunctioning follicular cells working independently of TSH due to a mutation in the TSH receptor. Increased T3/T4- Rarely malignant
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What is Jod-Basedow phenomenon?
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Thyrotoxicosis that occurs when a patient with iodide deficiency goiter is made iodine replete (can occur with radiocontrast iodide). Also called Plummer's disease
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What are the findings of hyperparathyroidism?
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1. Hypercalcemia, hypercalciuria- Stones
2. Hypophosphatemia 3. Increased PTH 4. Increased ALP- from bone turnover 5. Osteitis fibrosa cystica- cystic bone spaces filled with brown fibrous tissue (pain); Brown tumors- multinucleated osteoclasts and hemorrhagic debris 6. Weakness and constipation (peptic ulcer disease because Ca increases gastric release) |
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What is the MCC of hypoparathyroidism?
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Thyroid surgery leading to accidental surgical excision
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What is Albright's hereditary osteodystrophy?
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AD kidney unresponsiveness to PTH due to a mutation in the PTH receptor. Patients present with hypocalcemia, very high levels of PTH, shortened 4th/5th digits, short stature
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What are non-PTH related causes of hypocalcemia?
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Hypomagnesemia (alcoholics, diarrhea, diuretics, aminoglycosides, cisplatin), acute pancreatitis, hypoalbuminemia, DiGeorge syndrome
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How do you diagnose excess GH?
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Increased serum IGF-1, failure to suppress GH following oral glucose tolerance test
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What metabolic disorder is associated with acromegaly?
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Impaired glucose tolerance
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What can cause central DI?
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Pituitary tumor, trauma, surgery, sarcoidosis, histiocytosis X
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What can cause nephrogenic DI?
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Hypercalcemia, Lithium, demeclocycline
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How do you treat nephrogenic DI?
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Hydrochlorothiazide, indomethacin (to decrease RBF), amiloride
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How does the body respond to SIADH?
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The hyponatremia (decrease in serum osmolarity) causes decreased aldosterone. This allows NORMAL volume status. Very low Na levels can lead to seizure.
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What does osmotic damage from DM cause?
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1. Nephropathy- peripheral polyneuropathy (distal), neuropathic ulcers, somatic CN III involved
2. Cataracts- From sorbitol accumulation |
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What are the signs and symptoms of DKA?
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1. Kussmaul breathing (rapid/deep), N/V, abdominal pain, psychosis/delirium, dehydration, fruity breath odor
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What are the labs seen in DKA?
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1. Hyperglycemia
2. Increased H+ 3. Decreased HCO3- (AG metabolic acidosis) 4. Increased blood ketone levels 5. Leukocytosis 6. Hyperkalemia but depleted total K (decreased insulin shifts K out of cells) |
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What are the complications of DKA?
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1. Mucormycosis, Rhizopus
2. Cerebral edema 3. Cardiac arrhythmias (decreased K and Mg) 4. Heart failure |
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What are the symptoms of carcinoid syndrome and when is it seen?
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Recurrent diarrhea, cutaneous flushing, asthmatic wheezing, right sided valvular disease. NOT SEEN IF LIMITED TO GI TRACT
-Common in appendix, lung, SI |
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Which pancreatic islet cell tumor is associated with necrolytic migratory erythema?
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Glucagonoma
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How does MEN I present?
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Kidney stones and stomach ulcers (parathyroid tumor, pituitary tumor, pancreatic islet cell tumors)
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How does PTH increase bone resorption?
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It acts on osteoblasts to increase production of RANK-L and M-CSF (IL-1), which indirectly stimulates osteoclasts
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Which hormones signal through IP3?
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GnRH, Oxytocin, ADH (V1), TRH (GOAT)
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