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74 Cards in this Set
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alpha subunit of hormones
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common to TSH, LH, FSH, hCG
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reason why high hCG can lead to hyperthyroidism
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beta subunit of hormones
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determines hormone specificity
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analogous to idiotype, whereas alpha subunit is analogous to isotype
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Acidophils
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GH, prolactin
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Basophils
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FSH, LH, ACTH, TSH
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IN which part of the pancreas are endocrine cells most common
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tail
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Tissues that don't need insulin for glucose uptake
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Brain, RBC, intestines, cornea, kidney, liver
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GLUT-1
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RBCs, brain
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GLUT-2
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Pancreas, intestinal cells, kidney, liver
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GLUT-4
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adipose tissue, skeletal muscle, cardiac muscle
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insulin responsive
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GLUT-5
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transports fructose in small intestines
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Cortisol effect on ADH release
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inhibits it
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ADH also increases the release of ACTH, so it would make sense that cortisol would come back and negatively inhibit ADH release
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TRH effect on prolactin
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increases secretion
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Regulation of dopamine
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TRH promotes release of prolactin
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dopamine inhibits release of prolactin, and prolactin also inhibits release of prolactin by increasing dopamine synthesis
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Desmolase
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initial step in steroid synthesis. Converts cholesterol into pregnenolone
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3beta hydroxysteroid dehydrogenase
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converts pregnenolone into progesterone
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18alpha hydroxylase
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aka Aldosterone synthase. Converts corticosterone into aldosterone
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Why does the fetal adrenal cortex predominantly produce DHEA and not corticoids?
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because it lacks 3beta hydroxysteroid dehydrogenase
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17a hydroxylase deficiency
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hypertension, hypokalemia. Male = pseudohermaphrodite. Female = normal, lacks 2nd sexual characteristics
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Most common congenital bilateral adrenal hyperplasia
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21 hydroxylase deficiency
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How does cortisol maintain the blood pressure
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upregulates alpha1 receptors on arterioles
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At what point in the day is cortisol the highest?
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morning
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Causes of Mg2+ deficiency
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diarrhea, aminoglycosides, diuretics, alcohol abuse
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Increase in urine cAMP
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PTH
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phosphate homeostasis
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decreased serum levels lead to an increase in 1a hydroxylase activity
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Receptor for calcitonin
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found on osteoclasts
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cGMP hormones
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ANP, NO
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cAMP hormones
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FLAT CHAMP: FSH, LH, ACTH, TSH, CRH, hCG, ADH (V2), MSH, PTH, calcitonin, glucagon, GHRH
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IP3 hormones
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GnRH, oxytocin, ADH (V1), TRH
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Receptor tyrosine kinase hormones
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Insulin, IGF-1, FGF, PDGF
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JAK/STAT tyrosine kinase
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Prolactin, GH
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Pregnancy and OCP effect on TBG
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increases TBG, which increases total T4, but maintains normal T4
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Steroid and nephrotic syndrome effect on TBG
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decrease TBG, which decreases total T4, but maintains normal free T4
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Enzyme that converts T4 to T3 in periphery
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5' deoidinase
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Is T3 or T4 more potent
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T3
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rT3
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reverse T3 that can only be formed from T4. Thus, exogenous T3 administration would show a low level of T3
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Treatment of adrenocortical carcinoma
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mitotane
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Cushing's syndrome w/ low ACTH
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due to ectopic production of cortisol, such as an adrenal adenoma, carcinoma, or hyperplasia
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Metabolic alkalosis effect on Ca2+
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leads to deprotonation of albumin COOH side chains, whcih leads to increased binding of Ca2+, and decrease of free Ca2+ concentration
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Difference between primary and secondary adrenal insufficiency
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Primary: caused by adrenal atrophy, has hyperpigmentation and hyperkalemia
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Secondary: no hyperpigmentation, normal aldosterone
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Cosyntropin
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derivative of ACTH, given to diagnose adrenocortical insufficiency
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Abnormal metyrapone test
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11B-hydroxylase is inhibited, but there is no increase in 11-deoxycortisol or 17-hydroxycorticosteroids in the urine because the adrenals are insufficient
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Metabolite of Dopamine
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HVA
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Metabolite of NE
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VMA
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Metabolite of E
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metanephrine
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Prolactin levels in primary hypothyroidism
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Increased because TRH is increased to stimulate an increase in TSH
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myxedema coma
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emergent hypothyroid condition where the patient is hypothermic, hypoventilated, hypotensive
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CD8 mediated T-cell attack on thyroid
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Hashimoto's thyroiditis
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Granulomatous inflammation of thyroid
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Subacute thyroiditis
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Elevated ESR, jaw pain, very tender thyroid, often following flu
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Lymphocytic subacute thyroiditis
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Painless
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Reidel's thyroiditis tx
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corticosteroids, tamoxifen, surgery
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may fibrose surrounding structures such as the trachea
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acute thyroiditis
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often due to bacterial infection
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painful thyroid, lymphadenopathy, initial hyperthyroid
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Thyroid storm in Graves'
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stress-induced catecholamine surge leading to death by arrhythmia
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Toxic multinodular goiter etiology and labs
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focal patches of hyperfunctioning follicular cells working independently of TSH due to a mutation in the TSH receptor
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increased T3, T4, uneven I131 uptake
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Jod_basedow phenomenon
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thyrotoxicosis if a patient w/ iodine deficiency goiter is made iodine replete
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Metastasis of papillary carcinoma vs. follicular carcinoma
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Papillary: lymph node
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Follicular: hematogenous
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Euthyroid sick syndrome
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5' deiodinase doesn't work, but inner ring of deiodinase does (which converts T4 to rT3)
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labs: normal T4, normal TSH, decreased T3, increased rT3
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Subperiosteal resoprtion w/ cystic degeneration
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Hyperparathyroidism effect on bone
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Hyperparathyroidism Sx
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hypercalciuria (stones), bone resoprtion (bones), constipation (groans), and psychiatric problems (moans)
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Difference between primary and secondary hyperparathyroidism
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Primary: hypercalcemia, hypercalciuria, hypophosphatemia increased alk phos
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Secondary: hypocalcemia, hyperphosphatemia, increased alk phos
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Pseudohypoparathyroidism
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autosomal dominant kidney unresponsiveness to PTH
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hypocalcemia, short stature, short 4th and 5th fingers (as opposed to Turner's, which only has a short 4th finger)
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Tx of pituitary adenoma
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bromocriptine, cabergoline (dopamine agonists)
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Pegvisomant
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GH receptor antagonist used in acromegaly. Decreases IGF-1 levels
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Dx of acromegaly
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Increased IGF-1, or failure to suppress serum GH w/ oral glucose tolerance test
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Sx of Sheehan
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fatigue, anorexia, poor lactation, loss of pubic/axillary hair
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Tx for nephrogenic DI
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thiazide: leads to ECF contraction, decreased GFR, increased PCT reabsorption of H20 and Na+
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Which diabetes has amyloid deposits
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Type 2
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K+ status in DKA
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hyperkalemia, but low total K+
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Dx of Zollinger-Ellison syndrome
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secretin injection. Measure stomach acid levels, then inject secretin, and acid levels should increase. This is because secretin increases pancreatic secretion, and since the gastrin is coming from the pancreas, it will increase
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MEN associated w/ angiofibromas and lipomas
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MEN 1
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MEN w/ oral and intestinal ganglioneuromatosis
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MEN 2B
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First generation sulfonylureas
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tolbutamide, chlorpropramide
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Thiazolidinediones MOA and S/E
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MOA: increase insulin sensitivity by binding PPAR-gamma and increasing adiponectin levels
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S/E: weight gain, edema, hepatotoxicity, CV toxicity
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Exanatide MOA and S/E
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MOA: increase insulin, decrease glucagon
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S/E: nausea, pancreatitis
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Drug that controls uterine hemorrhage
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oxytocin
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