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80 Cards in this Set
- Front
- Back
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what is the difference between pheo and neuroblastoma?
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neroblastoma does ot cause episodic hypertension
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what is common to TSH, LH, FSH, hCG?
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alpha subunit
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what are the acidophils? basophils?
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acidophils = GH, prolactin (maybe a chromophobe?)
basophils - FSH, LH, ACTH, TSH |
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what effect does insulin have on sodium?
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increase sodium reteniton in the kidneys
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name 6 organs that do not need isulin for glucose uptake
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BRICKL
brain, RBCs, intestine, cornea, kidney, liver |
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GLUT-1? GLUT-2
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Glut1 - RBC, brain. GLUT-2 = beta cells, liver, kidney
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what is the most common cell in pituitary gland?
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somatotrophs
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What 2 hormones regulate prolactin?
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dopamine and TRH (hypothyroidism causes hyperprolactinemia)
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what 2 hormones does somatostatin inhibit?
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GH, TSH
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prolactin regulates its own secretion via what?
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increasing dopamine syntehsis from hypothalamus
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what enzyme converts prenenolone to progesterone?
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3betahydroxysteroid dehydrogenase
Fetal adrenal gland lacks this enzyme, only makes DHEA (can't make androstenedione |
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what metabolites build up in 11betahydroxylase deficiency
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11-deoxycorticosterone, 11-deoxycortisol. no corticosterone, cortisol are made
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17-hydroxylase defciiecny causes what sex charateristics in men and women?
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men = pseudohermaphroditism (no internal structures cause of MIF, externally female)
women - externally phenotypic female with normal internal sex organs, but lacking secondary sexual characteristics |
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how does cortisol cause hypertension?
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upregulates alpha receptors on arterioles
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what effect does magnesium have on PTH, and are causes of low magnesium
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decrease free magnesium decreases PTH (due to diarrhea, aminoglycosides, diuretics, alcohol abuse)
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effect of PTH on osteoblasts/clasts?
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directly stimulates osteoblasts, indirectly osteoclasts
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what is PTH also known as
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1-84 (84 amino acids)
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in hyperPTH, what are the finger findings? skull findings?
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subperiosteal thinning on radial side of 2,3 fingers. skull has salt and pepper appearance
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D3 source? D2 source?
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D3 = sun, D2 = plants
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what effect does calcitriol have on bones?
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increases bone resorption of calcium and phosphate to increase it in blood and for new bone remodelling
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hormones of cAMP?
hint: FLAT CHAMP CG |
FSH, LH, ACTH, TSH, CRH, hCG, ADH, MSH, PTH, Glucagon, Calcitonin
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IP3 pathway?
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GnRH, GHRH, oxytocin, ADH V1, TRH
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tyrosine kinase?
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insulin, IGF-1, growth factors, cytokines, prolactin, GH (GH, prolactin, HPL are chemical homologues)
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Which use JAK STAT
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prolactin, GH, cytokines
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Which have intrinsic TK activity?
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insulin, growth factors FGF/PDGF
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which pathways use GTP?
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MapKinase/RAS and GPCR (which have intrinsic GTPase)
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which hormone has it's receptor in nucleus
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thyroxine and T3
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effects of Thyroid hormone?
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bone growth (permissive for GH), CNS maturation, increase B1 receptors in heart, increase basal metabolic rate via Na/K atpase, glycogenolysis, gluconeognesis, lypolysis
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which hormone feedsback back, T3 or T4
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T3
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what is the dexamethasone suppression test measuring?
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cortisol levels, not ACTH
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causes of secondary hyperaldosteronism?
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renal artery stenosis, CRF, CHF, cirrhosis, nephrotic syndrome
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causes of Addison's disease?
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CHRONIC insufficiency via autoimmune (most common in US), TB, metastasis
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what is a big difference between primary and secondary addisons?
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no pigmentation and no hyperkalemia (aldosterone works normally)
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what is waterhouse friderichsen syndrome associated with?
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DIC, endotoxic shock, Neisseria septicemia (no meningitis)
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Pheos?
malignant, calcify, kids? |
nope, benign, don't calcify, occur in adults
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paraneoplastic syndrome of neuroblastoma?
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opsoclonus-myoclonus (nonrhythmic eye movmeent with myoclonus). N-myc copies most prognosticotr. pseudorosettes on histo
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hypothyroidism - describe the skin. what about muscle. what about T3resin uptake?
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skin is dry an dcool
muscle - CPK increased due to myopathy T3 resin uptake - decreased (cause the resin will bind radiolabelled T3 that doesn't bind TBG) |
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Hashimotors - what is it like at begining?
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hashitoxicosis
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histo of hashimoto's? antibodies?
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histo: germinal center, lympohcytic infiltrate. hurthle cells (enlarged epithelial cells with abundant eosinophilic granular cytoplasm as a result of altered mitochondria)
antibodies: antimicrosomal, antithyrogobulin. |
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difference of sporadic and endemic cretinism?
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sporadic - defec tin T4 formation or development failure in thyroid formation, not lack of dietary iodine
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in thyroiditis, is there increased iodine uptake or decreased?
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decreased
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what is lympohcytic subacute thyroiditis? Painful or not?
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Subacute painless lymphocytic thyroiditis – known as silent thyroiditis.
features a small goiter without tenderness. This condition tends to have a phase of hyperthyroidism followed by a return to a euthyroid state, and then a phase of hypothyroidism, followed again by a return to the euthyroid state. The time span of each phase can vary; however, each phase usually lasts 2-3 months. heavy lymphocytic infiltrate, germinal centers |
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when does Graves present? what is the cause of death?
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presents during stress (pregnancy). catecholamine stress induced surrge leads ot death by arrhthmia. the dermopath of graves = pretibial myxedema, diffuse lower skin thickening
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what is a toxic multinodular goiter?
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focal patches of hyperfuncitoning follicular cells independently working due to mutation in TSH receptor, nodules not malignant
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what is Jod-Basedow phenomenon
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JodBasedow effect - iodine overload may stimulate autonomous nodules. This can cause THYROTOXICOSIS in patient with toxic multinodular goiter following administration nof iodine rich radiographic contrast media and iodinated drugs (amiodarone)
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What cancer occurs with Hashimoto's?
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lymphoma
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what thyroid cancer has best prognosis? what is the mutation in both familial and sporadic medullary carcinoma?
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papillary has best prognosis. follicular is second best.
medullary carcinoma has RET protooncogene in both forms |
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some causes of hypercalcemia?
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hyperthyroid (breaking odwn of bone), addison's disease, zollinger-ellison syndrome, excess vitamin D or A, paget's disease if patient is immobilized
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most common cause of hyperPTH primary?
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adenoma
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what is the calcium level in urine of primary hyperPTH
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hypercalciuria (renal stones)
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what is trousseua's sign
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occlusion of brachial artery with BP cuff gives a carpal spasm
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what is Albright's hereditary osteodystrophy?
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pseudohypoparathyrodism
AD, short stature, retardation, short 4/5 digits. Gs subunit not responsive |
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what is pituitary apoplexy?
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a bleed into the adenoma
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what is the cause of laron dwarfism?
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defective GH receptor at liver
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treatment of acromegaly? diagnosis of it?
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pituitary adenoma resection followed by octreotide
diagnosis - serum IGF1 levels and failure to suppress serum GH following GTT |
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what factors increase GH?
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stress, exercise, hypoglycemia
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what are some causes of central DI?
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histiocystotis X, pituitary tumor, trauma
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treatment of central DI? nephrogenic DI?
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central - intranasal desmopressin
nephorgenic - HCTZ, indomethacin, or amiloride |
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in SIADH, what is the total body volume?
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normal
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causes of SIADH?
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ectopic ADH, CNS disorders, pulmonary disease, cyclophosphamide, oral hypoglycemic agent chlorpropamide, carbamazepine, oxcarbazepine (a derivative of carbamazepine),
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what fat does your waist represent? what about hip?
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waist = visceral fat
hip = subcutaneous |
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what are the osmotic injuries in DM?
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neuropathy (schwann cells), cataracts
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what is more genetic, DMI or II
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DMII
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what is the cause of ketoacidosis? which ketoacid is made in the highest quantity?
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increased free fatty acids
beta-hydroxybutyrate is made most |
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what is the rule of 1/3 with carcinoids? treatment?
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1/3 metastasize
1/3 present with 2nd malignancy 1/3 are multiple tx - octreotide |
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what is the newest addition to MEN2A = sipple's syndrome?
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lichen amyloidosis
pruritic, scaly, papular, and pigmented, and located in the interscapular region or on the extensor surfaces of the extremities |
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what is MEN 2b?
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medullary thyroid, pheo, oral and intestinal ganglioneuromatosis with marfanoid habitus
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what are the short acting insulin? intermediate? longa cting?
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short acting = lispro, regular, aspart
intermeidat e= NPH (2 shorts/day) long acting = glargine, determir lispro, aspart as the fastest acting |
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what are the first generation sulfonylureas and side effects?
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tobutamide
chlorpropamide (note: chlorpromazine = antipsychotic) disulfiram reaction |
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how does metformin work?
contraindications? |
decreases hepatic gluconeogenesis and increases glycolysis. overall acts as insulin sensitizer
contraindications - renal failure or heart failure |
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what are 3 side effects of thiazolidinediones/glitazones?
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edema, hepatoxicity, CV toicity (contraindicated in CHF)
check LFTs |
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pramlintide MOA?
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amylin analogue cosecreted by beta cells that causes decreased glucagon
reduces postprandial glucose increases via the following mechanisms: 1) prolongation of gastric emptying time, 2) reduction of postprandial glucagon secretion, and 3) reduction of caloric intake through centrally-mediated appetite suppression |
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exenatide MOA? side effect?
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GLP-1 mimetic that increases isulin release
may cause pancreatitis |
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sitagliptin MOA?
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DPP-4 inhibitor that increases insulin. DPP IV degrades incretin (GLP-1)
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how does orlistat work?
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alters fat metabolism by inhibitng pancreatic lipases
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what is Sibutramine?
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SNRI and MAOi for obesity management
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treatment of thionamide induced agranulocytosis?
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G-CSF (filgrastim)
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what is octreotide used for?
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acromegaly, carcinoid, gastinoma, glucagonoma, esophageal bleeding
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oxytocin uses?
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stimulate labor, uterine contractions, milk let down, and control uterine hemorrhage
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names of glucocorticoids? mechanism?
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hydrocortisone, triamcinolone, budesonide, beclomethasone
mechanism - decrease PLA2 and COX2 expression |
