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85 Cards in this Set
- Front
- Back
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most common adrenal tumor in adults and children
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pheocromocytoma (adults); neuroblastoma (children); neuroblastoma does not cause hypertension
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drainage of adrenals
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right adrenal vein --> IVC; left adrenal vein --> left renal vein
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common and specific subunits of adenohypophysis hormones
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α subunit is common to TSH, FSH, LH, hCG; β subunit gives specificity
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acidophillic and basophillic cells of adenohypophysis
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acidophillic --> GH, prolactin; basophilic --> FSH, LH, ACTH, TSH
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histology if islets of Langerhans
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peripheral --> α cells --> glucagon; central --> β cells --> insulin; delta cells --> somatostatin --> interspersed
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alkaline phosphatase
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very increased in Paget's disease; increased in hyperPTH, osteomalacia and osteitis fibrosa cystica
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sex steroid binding globulins SHBG
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↑ SHBG --> ↑ total testosterone ↓ free testosterone --> gynecomastia; ↓ SHBG --> hirsutism
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functions of thyroid hormones
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bone growth with GH, CNS maturation, ↑ CO HR SV contractility, ↑ basal metabolic rate by ↑ Na/K ATPase and O2 consumption, ↑ glycogenolysis, ↑ lipolysis, ↑ gluconeogenesis
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insulin dependant organs
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muscle and adipose (GLUT-4 receptors); brain and RBC are independent of insulin (GLUT-1)
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functions of cortisol
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anti-inflammatory, ↑ gluconeogenesis lipolysis preteolysis, ↓ immune function, maintains blood pressure, ↓ bone formation
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hormones that increase cAMP second messenger
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ACTH, LH, FSH, TSH, ADH, Hcg, MSH, CRH, PTH, calcitonin, glucagon
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hormones that use cGMP as second messsenger
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ANP, EDRF, NO
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hormones that is IP3 as second messenger
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GnRH, TRH, GHRH, ADH, oxytocin
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hormones that use tyrosine kinase receptor
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insulin, IGF-1, FGF
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pheochromocytoma
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episodes of ↑ blood pressure, headaches, perspiration, palpitations; Rx: phenoxybenzamine (irreversible α-blocker)
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Hashimoto's histology
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lymphocytic infiltrate with germinal centers
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Reidel's histology
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thyroid tissue replaced by fibrous tissue
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de Quervain's (subacute) histology
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granulomaous inflammation
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difference between thyroid adenoma and malignancy
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adenoma is hot nodule; malignancy is cold nodule
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Rx of acromegaly
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octeotride
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osteitis fibrosa cystica
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cystic bone spaces lined by osteoclasts and filled with brown fibrous tissue results in bone pain. ↑ALP
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renal osteodystrophy
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bone lessions due to secondary hyperparathyroidism in CRF
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Rx diabetes insipidus
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central --> desmopressin; nephrogenic --> amiloride, hydrochlorothiazide, indomethacin
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pontine myelinolysis
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due to correcting hyponatremia too fast --> spastic quadriplegia and pseudobulbar palsy
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water deprivation test
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if urine osmolarity doesn’t increase --> diabetes insipidus; if it does --> SIADH
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Rx carcioid syndrome
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octeotride
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types of insulin
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short acting --> lispro, aspart; intermediate --> NPH; long-acting --> lente, ultra-lente
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layers of the epidermis
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basalis, spinosum, granulosum, lucida, carneum; "Bad Skin Grows in Layers to Corneum"
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tight junction
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zona occludens; at the apical lateral membranes
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intermediate junction
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zona adherens; below zona occludens; E-cadherin binds actin filaments
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desmosome
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macula adherens; cadherins connect to intermediate filaments
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gap junction
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formed by conexon with central channel
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hemidesmosome
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binds basal cell membrane to basement membrane via integrins
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unhappy triad knee injury
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damage to medial collateral ligament, medial meniscus and anterior cruciate ligament
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function of supraspinatus
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abducts arm with deltoid
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function of infraspinatus
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laterally rotates arm
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teres minor
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adducts and laterally rotates arm
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subscapularis
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medially rotates and adducts arm
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Paget's disease
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↑hat size and hearing loss due to auditory foramen narrowing; ↑↑↑ALP, normal PTH and Ca; leads to osteosarcoma
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osteosarcoma
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men 10-20 y/o; commonly found at the knee
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Ewing's sarcoma
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most common in boys < 15; onion skin appearance in bone; translocation 11;22
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chondrosarcoma
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most common in men 30-60 y/o; malignant cartilaginous tumor
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osteoarthritis
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wear and tear no systemic inflammation; improves with rest, gets worst at the end of the day
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rheumatoid arthritis
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morning stiffness improves during the day; affects synovial joints with pannus formation; rheumatoid factor +, HLA-DR4; systemic symptoms: fever, fatigue, pleuritis, pericarditis
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Sicca syndrome
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dry eyes, dry mouth, nasal and vaginal dryness, chronic bronchitis, reflux esophagitis
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causes and Rx of gout
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Lesch-Nyhan, PRPP excess, ↓excretion of uric acid by thiazides, ↑cell turnonver, VonGierke; Rx: allopurinol, probenecid, colchicine, NSAIDs
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ankylosing spondylitis
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chronic inflammatory disease of spine joints; bamboo spine, uveitis, aortic regurgitation
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polymyalgia rheumatica
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associated with temporal arteritis; ↑ESR; affects hip and shoulder joints in women over 50 years old
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polymyositis Vs. dermatomyositis
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progressive symmetric proximal muscle weakness caused by CD8 cells; dermatomyositis also has a rash around the eyes; biopsy of muscle shows inflammatory cells, ↑CK, ↑aldolase, ANA+, anti-JO-1+
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albinism
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normal melanocyte number with decreased melanin due to tyrosinase mutation
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impetigo Vs. cellulitis
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impetigo = superficial epidermis infection; cellulitis = dermis and subcutaneous tissue infection
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acute gout Vs. chronic gout Rx
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acute --> colchicine and indomethacin; chronic --> probenecid, allopurinol
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sperm parts
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acrosome derived from Golgi apparatus; flagellum derived from centrioles; neck has mitochodria; feeds on fructose
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spermatogonium
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diploid 2N; 46XY
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primary spermatocyte
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diploid 4N; 46 sister chromatids XX and YY
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secondary spermatocyte
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haploid 2N; 23 sister chromatids plus XX or YY
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spermatid
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haploid N; 23X or 23Y
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stimulus for granulosa and theca cells
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granulosa --> FSH activates aromatase; theca cells --> LH activates desmolase
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actions of estrogens
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growth of follicle and endometrial proliferation, feedback inhibition of LH and FSH, LH surge
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source and actions of progesterone
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source: corpus luteum and placenta; stimulation of endometrial glansa, maintenance of pregnancy, mucus production, inhibition of LH/FSH, uterine relaxation
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mentrual cycle
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proliferative phase varies in length, luteal phase is 14 days; 14 days prior to menses = ovulation; estrogen stimulates proliferation, LH surge and ovulation on day 14; corpus luteum produces progesterone and maintains pregnancy
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meiosis and ovulation
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primary oocyte is arrested in prophase until puberty; just prior to ovulation meiosis I completes --> secondary oocyte gets arrested in metaphase; if fertilization occurs, meiosis II completes
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lactation
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during pregnancy estrogen inhibits prolactin; following labor estrogen decreases; suckling is required to maintain milk production
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implantation
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occurs 6 days after fertilization; trophoblasts secrete beta-hCG detectable in blood 1 week after fertilization and in urine home test 2 weeks after conception
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hypospadia
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due to failure of urethral folds to close
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epispadia
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due to faulty positioning of genital tubercule
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5-alpha-reductase deficiency
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ambiguous genitalia until puberty "penis at 12"
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hydatidiform mole
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↑beta-hCG, enlargement of uterus; complete mole is 46XX completely paternal origin; no fetus; can lead to choriocarcinoma
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preeclampsia/eclampsia
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preeclampsia --> hypertension, proteinuria, edema; eclampsia add seizures; associated with HELLP syndrome; thrombocytopenia, hyperuricemia; Rx.: IV magnesium sulfate and diazepam
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abruptio placentae
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painful bleeding
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placenta accreta
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massive hemorrhage
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placenta previa
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painless bleeding
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ectopic pregnancy
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pain without bleeding; ↑beta-hCG
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polyhydramnios
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esophageal atresia, duodenal atresia, anencephaly
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oligohydramnios
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renal agenesis
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polycystic ovarian syndrome
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↑LH, ↑testosterone, ↓FSH; amenorrhea, infertility, obesity
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ovarian cancer marker
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CA-125
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MCC ovarian tumor
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serous cystadenocarcinoma --> malignant; followed by serous cystadenoma --> benign
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fibroadenoma
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firm, small, mobile mass changes with menstrual cycle; benign
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intraductal papilloma
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tumor of lactiferous ducts; serous or bloody discharge; benign
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breast carcinoma
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overexpression of estrogen receptors or erb-B2; prognostic factor: axillary lymph node involvement
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cryptorchidia
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undescended testis; no spermatogenesis; increased risk of germ cell tumors
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varicocele
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dilated vein in pampiniform plexus
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hydrocele
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incomplete fusion of processus vaginalis
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spermatocele
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dilated epididymal duct
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