Endocrine Path Part 1

Front 1

What are the 4 types of chemical communication?

Back 1

Endo, neuro, para, auto

Front 2

Blood to target cell explains ?

Back 2

Endocrine

Front 3

Axonal explains ?

Back 3

Neurocrine

Front 4

Diffusion thru IC fluid from one cell type to another explains ?

Back 4

Paracrine

Front 5

To self or identical cell explains ?

Back 5

Autocrine

Front 6

Name the major endocrine organs?

Back 6

Pineal, pituitary (ant & post), thyroid, parathyroid, adrenal medulla & cortex, stomach, pancreas, duodenum, ovary (follicle & corpus luteum), testis (endocrine cells, sperm-producing cells)

Front 7

What are the three major types of chemical messengers?

Back 7

Peptide or protein
Amine or amino acids
Steroids

Front 8

Name the different peptide/protein chemical messengers.

Back 8

Insulin, GH, vasopressin, angiotensin, erythropoietin, calcitonin, somatostatin, ACTH (corticotropin), glucagon, PTH

Front 9

Name the different amine/amino acid chemical messengers.

Back 9

Serotonin, thyroid hormone, DA, NE, Epi

Front 10

Name the steroid chemical messengers.

Back 10

Aldosterone

Front 11

Where is the pituitary located?

Back 11

Seleca tursica

Front 12

What is synthesized in the supraoptic & paraventricular nuclei via 2 neurons?

Back 12

AVP (Arginine Vasopressin)

Front 13

What is responsible for signaling the post. pit. to release AVP into the circulation?

Back 13

Magnocellular neurons

Front 14

What is responsible for signaling the median eminence to release AVP into PORTAL CIRCULATION?

Back 14

Parvocellular neurons

Front 15

What factors are in the venous drainage of ant pit cells?

Back 15

GH, prolactin, gonadotrophins, TSH, ACTH

Front 16

What factos are in the venous drainage of post pot cells?

Back 16

Vasopressin, Oxytocin

Front 17

What tissues contain V1 receptors? What is its fxn?

Back 17

Liver, smooth muscle, vascular cells, plts, CNS, most peri tissue.

Fxn: Vasoconstriction

Front 18

What tissues contain V2 receptors? What is its fxn?

Back 18

Kidney collecting duct cells

Fxn: Mediates OSMOREGULATION & H2O RETENTION

Front 19

What tissues contain V3 receptors? What is its fxn?

Back 19

CNS (adenohypophysis)

Fxn: Modulates corticotropin secretion

Front 20

What vasopressin AGONIST has affinity for ALL V - receptors?

Back 20

Argipressin (40u)

Front 21

What are Argipressin's clinical applications?

Back 21

CPR, intra-op HPTN, severe HD instability, vasodilatory shock

Front 22

What Vasopressin agonist has an affinity for the V2 receptor? What is used for?

Back 22

Desmopressin

DI (5 - 40u nasal)

Front 23

What Vasopressin agonist has an affinity for V1? It's used for?

Back 23

Terlipressin

Esophageal varices (1-2mg IV), Intra-op HPTN, GIB, PORTAL HTN

Front 24

Where does ADH bind?

Back 24

Receptors in the distal or collecting tubules.

Front 25

What promotes reabsorption of H2O back into circulation?

Back 25

ADH

Front 26

What happens in the absence of ADH?

Back 26

Kidney tubules virtually IMPERMEABLE to H2O; FLOWS OUT as urine.

Front 27

What stimulates ADH release?

Back 27

INC: Na+ ion conc, serum osmolarity.
DEC: BP, bld vol
Pain, emotional stress, nausea, varios meds, PPV

Front 28

When you think inadequate ADH secretion, think ?

Back 28

NEUROgenic DI

Front 29

Head trauma, neurosurgical procedures, and brain tumors are common cause of ?

Back 29

Neurogenic DI

Front 30

What disease state is usually an x-linked trat and causes an inability of renal collecting ducts to respond to ADH, HYPERCa++, and HYPOK+?

Back 30

NEPHROgenic DI

Front 31

What dz is an absense of ADH release d/t the destruction of post pit OR damage to renal tubule receptors?

Back 31

DI

Front 32

Polydipsia, polyuria, poorly concentrated urine, INCREASED SERUM osmo/Na+ (>145), and DECREASED URINE osmo are s/sx of ?

Back 32

DI

Front 33

What is DI exacerbated by?

Back 33

Ethanol, Dilantin, Chlorpromazine, Lithium

Front 34

Chemical diuresis, mannitol, urea, radiocontrast, hyperglycemia, loop diuretics, thiazides, Ethacrynic acid, ARF, chemo-induced, post-obs diuresis, and post-resuscitation diuresis are all diff dx of ?

Back 34

DI

Front 35

What pt's tx regimen would include IM hormone replacement & chlorpropamide (which may inc sens of renal tubules)?

Back 35

DI

Front 36

What would you mont intra-op on a DI pt?

Back 36

U/O & lytes

Front 37

What is the SQ & IM dose for Aqueous Vasopressin?

Back 37

2-5 u/q4-6 hours

Front 38

What is the IV gtt dose of Vasopressin?

Back 38

2.5 u/hr

Front 39

Intranasal dose of Desmopressin (V2)?

Back 39

5-10 mcg/day

Front 40

SQ dose of Desmopressin (V2)?

Back 40

0.5-1 mcg BID

Front 41

What dz has HIGH LEVELS of circulating VASOPRESSIN?

Back 41

SIADH

Front 42

Extracranial tumors, oat cell tumors, and head trauma can all be the cause of what?

Back 42

SIADH

Front 43

Hypothyroidism, Porphyria, Aderenal INSUFFICIENCY, infxn, & stress are all associated with?

Back 43

SIADH

Front 44

When the kidney continue to REABSORB water from renal tubules DESPITE HYPONATREMIA, this is ?

Back 44

SIADH

Front 45

What are the s/sx of SIADH?

Back 45

INC: URINE Na+ conc. & osmo
DEC: PLASMA Na+ and osmo

Front 46

What is the cause of decreased plasma osmolarity in SIADH?

Back 46

Hormone-induced H2O reabsorption by renal tubules

Front 47

Differential dx w/ SIADH?

Back 47

HYPONa+ (w/ ECF depletion), HYPONa+ (w/ excess ECF volume, adrenal INSUFF, hypothyroidism

Front 48

Medical tx for SIADH?

Back 48

RESTRICT fluid - 500mL/day
DEMECLOCYCLINE: 600-1200mg/day
IV NaCl

Front 49

MOA of Demeclocycline?

Back 49

Antagonizes renals effects of ADH

Front 50

Estimating fluid volume status w/ CVP, PA, or TEE, checking plasma & urine lytes, AVOIDING nausea (causes an INC in ADH) are peri-op considerations for ?

Back 50

SIADH