Reading...
Play button
Play button
Use LEFT and RIGHT arrow keys to navigate between flashcards;
Use UP and DOWN arrow keys to flip the card;
H to show hint;
A reads text to speech;
172 Cards in this Set
- Front
- Back
|
where is EPO made?
|
renal parenchymal cells (JG cells)
|
|
|
what's the signal for EPO release?
|
hypoxi
|
|
|
what's the inhibitor of EPO release?
|
inc O2
|
|
|
where does EPO go to act?
|
bone marrow
|
|
|
what's the 2nd messenger for EPO?
|
tyrosine kinase
|
|
|
inc RBC, inc O2, decr EPO - where's the problem?
|
bone marrow
|
|
|
inc RBC, decr O2, inc EPO, where's the problem?
|
lungs - can't pick up O2
|
|
|
inc RBC, inc O2, inc EPO - where's the problem?
|
kidneys
|
|
|
sign of chronic hypoxia
|
clubbing, polycythemia
|
|
|
where is aldosterone made?
|
zona glomerulosa
|
|
|
stimulus for aldosterone formation
|
hypovolemia, hyponatremia, hyperkalemia
|
|
|
inhibition of aldosterone formation
|
hypervolemia
|
|
|
where aldosterone goes to act
|
early collecting duct
|
|
|
action of aldosterone
|
inc Na in serum (inc water and volume and bp), decr K and H
|
|
|
2nd messenger for aldosterone?
|
none - it's a steroid
|
|
|
low K affects which 2 organs
|
heart (bradycardia) and skeletal muscle (weakness)
|
|
|
effects of inc aldosterone
|
inc Na, inc bp, decr K, decr H
|
|
|
2 enz deficiencies that can cause decr aldosterone
|
21 hydroxylase, 11hydroxylase
|
|
|
effects of 21hydroxylase def
|
decr Na (decr, water, decr bp), inc K, inc H, ambiguous genitalia in females
|
|
|
effects of decr 11OH def
|
inc Na (inc water, inc bp), decr K, decr H, ambiguous genitalia in females
|
|
|
2 causes of adrenal insufficiency in adults
|
abrupt withdrawal from steroids
autoimmune (Addisons) |
|
|
where is cortisol made?
|
zona fasciculata
|
|
|
stimulus for cortisol release
|
stress, hypoglycemia
|
|
|
inhibition of cortisol release
|
hyperglycemia
|
|
|
where does cortisol go to act?
|
everywhere - it's a permissive hormone
|
|
|
4 fxns of cortisol
|
upregulates all receptors during stress
inc glc via lipolysis, proteolysis, glycogenolysis decr inflammation maintain bp by adjusting TPR |
|
|
2nd messenger for cortisol?
|
none - it's a steroid
|
|
|
what is waterhouse friedrichson syndrome?
|
meningitis leading to sepsis leading to adrenal hemorrhage
|
|
|
things causing cushing's syndrome
|
adrenal adenoma
small cell carcinoma |
|
|
things causing cushings dz
|
pituitary adenoma
|
|
|
what's the dexamethasone suppression test? how does it work?
|
to figure out what is causing the inc in cortisol
give low dose - suppressed? then obesity, depression or NL variant not suppressed? give high dose - suppressed? then pituitary adenoma not suppressed? check ACTH - low? adrenal adenoma - high? small cell carcinoma |
|
|
where is testosterone made?
|
zona reticularis
|
|
|
what is the stimulus for testosterone production?
|
ACTH
|
|
|
fxn of testosterone
|
in utero, it's for external genitalia
also causes inc in appetite, aggression, volence, libido, and RBCs |
|
|
what controls manliness in utero? at puberty?
|
testosterone in utero and DHT at puberty
|
|
|
DOC for prostate cancer
|
leuprolide
|
|
|
where is epinephrine made?
|
adrenal medula
|
|
|
what's the stimulus for epinephrine?
|
stress/hypoglycemia
|
|
|
what inhibits epi production?
|
hyperglycemia
|
|
|
where does epinephrine work?
|
liver and adrenal cortex
|
|
|
2nd messenger for epi
|
cAMP
|
|
|
what's the rule of 10s for pheochromocytoma
|
10% malignant
10% bilateral 10% in kids 10% familial 10% metastatic at dx |
|
|
pt comes in with lots of sweating, a headache and HTN - has inc urinary VMA - you have a suspicion of what it could be - what can you give to confirm your suspicion?
|
phentolamine
|
|
|
how do you treat a pheo?
|
phenoxybenzamine
|
|
|
what is a pheo?
|
inc in NE and epi
|
|
|
what's the difference between pheo and neuroblastoma
|
neuroblastoma has hypsarrythmia and opsoclonus
|
|
|
what are the 6 stress hormones and when do they work?
|
epi - works immediately
glucagon - works w/in 20min insulin, ADH - work w/in 30min cortisol - works w/in 2-4 hrs GH - works w/in 24hrs |
|
|
where is glucagon made?
|
pancreatic alpha cells
|
|
|
what's the stimulus for glucagon?
|
hypoglycemia and stress
|
|
|
what in inhibits glucagon
|
hyperglycemia
|
|
|
where does glucagon act?
|
adrenal cortex, liver, adipose tissue
|
|
|
what does glucagon do?
|
inc glc by stimulating GNG, glycogenolysis, lipolysis and ketogenesis
|
|
|
pt comes in w/ inc glc, inc lipids and inc ketones - dx?
|
glucagonoma
|
|
|
what is always the outcome of a glucagonoma?
|
DM2
|
|
|
which hormone is responsible for DKA?
|
glucagon
|
|
|
Treatment for a glucagonoma?
|
octreotide
|
|
|
which organs do not depend on insulin for glc uptake?
|
BRICKLE
B = brain R = RBC I = Intestine C = cornea/cardiac K = kidney L = liver E = exercising muscle |
|
|
where is insulin made?
|
pancreatic beta cells
|
|
|
stimulus for insulin
|
stress
hyperglycemia |
|
|
fxn of insulin
|
inc ANABOLIC processes
|
|
|
2nd messenger for insulin
|
tyrosine kinase
|
|
|
what's the difference between an insulinoma and a nessidioblastosis?
|
insulinoma is in adults
nessidioblastosis is in infants |
|
|
what will be the levels of insulin and c-peptide in:
insulinoma sulfonylurea exogenous injection |
insulinoma and sulfonylurea will have inc in both
exogenous will have inc insulin, but decr c-peptide |
|
|
where is somatostatin made?
|
pancreatic delta cells and duodenum
|
|
|
what's the stimulus for somatostatin?
|
insulin and glucagon and other duodenal hormones
|
|
|
what is the fxn of somatostatin?
|
inhibits things such as insulin and glucagon
|
|
|
MOA of octreotide?
|
somatostatin analog so slows gastric emptying
|
|
|
what will someone with a somatostatinoma present w/?
|
severe constipation
|
|
|
where is secretin made?
|
duodenum S cells
|
|
|
what's the stimulus for secretin release?
|
low pH
|
|
|
what is the fxn of secretin?
|
stimulates production of bicarb from pancreas and gallbladder - inhibits gastrin and slows gastric emptying
|
|
|
what is the 2nd messenger of secretin?
|
cAMP
|
|
|
where is CCK made?
|
duodenum Icell
|
|
|
what's the stimulus for CCK release?
|
food, especially fats
|
|
|
what inhibits CCK release?
|
high pH
|
|
|
where does CCK act?
|
pancreas (digestive enzs)
gallbladder (bile) |
|
|
what does CCK do?
|
fat and protein digestion
|
|
|
2nd messenger for CCK?
|
IP3/DAG
|
|
|
which type of opioid can you give to someone w/ abdominal pain?
|
meperidine - doesn't work on CCK
|
|
|
where is GIP made?
|
duodenum
|
|
|
what is the fxn of secretin?
|
stimulates production of bicarb from pancreas and gallbladder - inhibits gastrin and slows gastric emptying
|
|
|
what is the 2nd messenger of secretin?
|
cAMP
|
|
|
where is CCK made?
|
duodenum Icell
|
|
|
what's the stimulus for CCK release?
|
food, especially fats
|
|
|
what inhibits CCK release?
|
high pH
|
|
|
where does CCK act?
|
pancreas (digestive enzs)
gallbladder (bile) |
|
|
what does CCK do?
|
fat and protein digestion
|
|
|
2nd messenger for CCK?
|
IP3/DAG
|
|
|
which type of opioid can you give to someone w/ abdominal pain?
|
meperidine - doesn't work on CCK
|
|
|
where is GIP made?
|
duodenum
|
|
|
what is the stimulus for GIP?
|
glucose
|
|
|
what inhibits GIP?
|
high pH
|
|
|
fxn of GIP?
|
enhances insulin secretion
|
|
|
where does GIP act?
|
beta cells of the pancreas
|
|
|
what is the 2nd messenger for GIP?
|
c-GMP
|
|
|
what is a pt w/ a hx of gastrectomy at inc risk for over time if they keep having osmotic diarrhea?
|
DM2
|
|
|
what causes osmotic diarrhea if pt has history of gastrectomy?
|
dumping syndrome - timing is off for insulin secretion from GIP - will get transient hyperglycemia followed by hypoglycemia
|
|
|
where is VIP made?
|
duodenum (Auerbach's plexus)
|
|
|
what stimulates VIP release?
|
duodenal hormones
|
|
|
what inhibits VIP release?
|
high pH
|
|
|
fxn of VIP?
|
inhibition
|
|
|
2nd messenger for VIP
|
cAMP
|
|
|
which GI hormonal problem cuases watery diarrhea? osmotic diarrhea?
|
watery = VIP
osmotic = GIP |
|
|
where is gastrin made?
|
antrum of stomach (G cells) and from duodenum and pancreas
|
|
|
stimulus for gastrin release?
|
high pH
|
|
|
where does gastrin go to act?
|
parietal cells of stomach
|
|
|
fxn of gastrin?
|
make HCl and intrinsic factor
|
|
|
2nd messenger for gastrin
|
Calcium
|
|
|
patient comes in w/ stomach pain upon eating - lab values show hypercalcemia as well - what are you thinking?
|
Zollinger-Ellison syndrome (inc gastrin)
|
|
|
MCC macrocytic anemia
|
pernicious anemia
|
|
|
where is ANP made?
|
right atrium
|
|
|
stimulus for ANP release?
|
high volume (stretches R atrium)
|
|
|
where does ANP act?
|
kidney
|
|
|
fxn of ANP
|
dilates afferent renal artery and inhibits aldosterone
|
|
|
2nd messenger for ANP
|
NO (which causes an inc in cGMP)
|
|
|
from which embryological origin are the superior parathryoids? inferior?
|
superior is from 4th pharyngeal pouch
inferior from 3rd pharyngeal pouch |
|
|
stimulus for PTH release
|
low Ca, high P
|
|
|
where does PTH go to act?
|
osteoclasts of bone and kidney (PCT and late DCT)
|
|
|
fxn of PTH?
|
stimulate osteoclastic activity (brkdn bone and inc serum Ca) - inc secretion of P and activate 1alpha hydroxylase
|
|
|
MCC of hypOparathyrodism?
|
thyroidectomy
|
|
|
what's the difference b/t pseudo hypOparathyroidism and pseudo-pseudo hypOparathyroidism?
|
pseudo is linked to albright's syndrome - severe receptor resistance
pseudo pseudo has NL Ca, and mild resistance to the receptor |
|
|
MCC of isolated hypercalcemia in adults?
|
parathyroid adenoma
|
|
|
cause of 1ry hyperparathyrodism?
|
parathyroid adenoma
|
|
|
cause of 2ry hyperparathyroidsm
|
renal failure
can also be due to renal osteodystrophy |
|
|
how can you tell the difference b/t 1ry and 2ry hyperparathyroidism?
|
2ry will have inc PTH w/ decr Ca
1ry will have inc PTH and Ca |
|
|
name the bone problem:
decr mineralization and soft bones |
osteomalacia
|
|
|
name the bone problem:
osteoclastic activity > osteoblastic activity decr bone matrix |
osteoporosis
|
|
|
name the bone problem:
decr osteoclastic activity - bone thick and inflexible |
osteopetrosis
|
|
|
name the bone problem:
decr bone mass decr bone matrix and mineralization |
osteopenia
|
|
|
name the bone problem:
inc alk phos and Ca inc osteoclastic activity |
osteitis deformans
|
|
|
name the bone problem:
scarred bone |
osteosclerosis
|
|
|
where is Vit D made?
|
skin > liver > kidney
|
|
|
stimulus for Vit D release?
|
decr Ca and P
|
|
|
where Vit D acts
|
kidney and GI
|
|
|
fxn of Vit D
|
makes CaATPase and CBP - stimulates osteoblastic activity
|
|
|
fxn of CBP (Ca bisphosphanate)
|
build bone - activates osteoclasts and then osteoblasts
|
|
|
vit D deficiency in adults? kids?
|
osteomalacia in adults
rickets in kids |
|
|
where is calcitonin made?
|
parafollicular cells
|
|
|
stimulus for calcitonin release?
|
high Ca
|
|
|
where calcitonin acts
|
bone
|
|
|
fxn of calcitonin
|
inhibit osteoclastic activity and then stimulate osteoblastic activity to make bone
|
|
|
syndromes involved in MEN I
|
pancreatic adenoma, parathyroid adenoma, pituitary adenoma
|
|
|
syndromes involved in MEN II
|
pheochromocytoma, parathyroid adenoma, medullary carcinoma of thyroid
|
|
|
syndromes involved in MEN III
|
same as MEN II (pheo and medullary carcinoma of thyroid) - plus neuroma/ganglioneuroma
|
|
|
fxn of bisphospanates
|
inhibit osteoclastic activity
|
|
|
which drugs for bone issues do you have to take standing up and with a huge glass of water? why?
|
bisphosphonates b/c they're very corrosive in the GI
|
|
|
MC pituitary tumors
|
nonfxnl adenomas
|
|
|
MC FXNL pituitary tumors
|
prolactinoma
|
|
|
Rx for pituitary tumors
|
bromocryptine
|
|
|
Rx for GH tumors
|
Octreotide
|
|
|
MCC of hypothyroidism in US
|
hashimoto's
|
|
|
MCC of hypothyroidism worldwide
|
iodine deficiency
|
|
|
hypothyroidism w/ painful jaw
|
DeQuervain's
|
|
|
hypothyroidism that can be drug induced or after pregnancy
|
lyphocytic thyroiditis
|
|
|
which drugs can cause hypothyroidism
|
amiodarone and IFN alpha
|
|
|
hypothyroidism w/ "woody neck" (why is it woody?)
|
riedel's struma - woody b/c of fibrosis
|
|
|
hypothyroidism in kids
|
cretinism
|
|
|
MCC hyperthyroidism in US
|
Grave's
|
|
|
benign adenoma in an older person w/ hyperthyroidism
|
plummer's syndrome
aka toxic multinodular goiter |
|
|
this treatment of hyperthyroidism can cause oral ulcers
|
PTU
|
|
|
this treatment for hyperthyroidism is contraindicated in pregnancy
|
Methimazole
|
|
|
when do you give T3 (instead of T4) to ppl w/ hypothyroidism?
|
T3 to those w/ liver dzs
|
|
|
which hormones are basophils?
|
FSH, LH, TSH, ACTH
(B-flat) |
|
|
which hormones are acidophils?
|
Prolactin, GH
(GAP) |
|
|
Which hormones are secreted by the posterior pituitary?
|
ADH and Oxytocin
|
|
|
Where does ADH act?
|
collecting duct of the kidney and endothelial vessels
|
|
|
fxn of ADH
|
inc volume, inc secretion of vWF and factor 8
|
|
|
where does oxytocin act?
|
mammalary glands and uterus
|
|
|
what does oxytocin do?
|
eject milk
eject baby |
|
|
what are 6 fxns of thyroid hormone?
|
bone growth
CNS to inc symps ANS to inc beta fxns inc basal metabolic rate inc HR, inc RR inc catabolic brkdn to get ATP |
|
|
what substance inhibits PRH release from the hypothalamus?
|
dopamine
|
|
|
what substance inhibits GHRH release from the hypothalamus
|
Somatostatin
|
