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74 Cards in this Set

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