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33 Cards in this Set
- Front
- Back
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male, Ed. can't sustain erection. gynecomastia and expressible galactorea. the hormone responsible for this condtion is normally inhibited by
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dopamine
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female, progressive weakness weight gain, amenorrhea and cold intolerance. hoarsness and absence. enlarged thyroid. TSH levels are elvated. she is diagnosed with iodine deficency goiter. the enargement of her thyroid is due to increased synthesis of
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thyroglobulin
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fmale chronic renal failure. low serum calciu,. elevated pth levels. which of the following reactions of vitamin d metabolism is most likely impaired
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25hccalciferol to 1,25 hdc calciferol
decreased alpha hydroxylase |
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diabetic ketoacidusis. the key enzyme responsible for synthesis of ketone bodies in hepatocytes is
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mitochondrial hmg coa synthase
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the metobolic defect that led to ketoacisidposis was
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increased catabalism of muscle proteins
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boy has rickets, what are his labs
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calcium is decreased, phosphate is decreased and ALP is increased
if vitamin deficiency you'll see calcium decreased,phosphate increased and alp decreased |
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guy has delayed puberty, low lebido and growth retardatin. feminine fetaures, gynecomastia. hyperprolactinemia and low gonadotropins. x ray shows expanded sella. the mechanism causing this problem involves direct suppression of ?
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GnRH secretion from the hypothalamus
dispute, i would say LH and FSH secreation from the anterior pituitary due to the prolactinoma |
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acromegally. this patient needs to be screened for associated?
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colonic polyps
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what is the DIRECT effect of growth hormone
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lipolysis
stimulation of skeletal growth and protein synthesis is indirect, via IGF |
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20 yo female, polyuria, polydipsia, nocturia.no head trauma or infections. poor appetite.
elevated serum osmolality elevated serum sodium very low urine osmolality no glucose in urine urine remains hypo osmolar after water deprevation, administering vasopressin DOES NOT HELP |
NEPHROGENIC DIABETES INSIPIDUS, THE URINE is always hypotonic
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prolactinoma. suffering from severe peptic ulcer disease. family history of pituitary and pancreatic tumors
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this is men 1
check serum calcium for parathyroid tumor 3 ps- pituitary, pancreas, parathyroid |
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42 year old presents like hypothyroid pt
low uptake of iodine labs show decreased tsh and t4. injecting trh does nothing whats the diagnosis |
secondary hypothyroidism
primary -thyroid gland doesn't produce, will see elevated tsh and reduced t4 secondary- pituitary doesn't secrete tsh tertiary- hypoththalmus doesn't secrete trh iodine deficiency leads to goiter hashimotos or primary hypothyroidism has ELEVATED tsh, low t4, low t3 |
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female, sever muscle cramps,SOB, tingling in hands and feet. undergone subtotal thyrodectamy.
low calcium, high posphate. what does her ECG show |
prolonged qt interval,
a shortened qt interval is due to hyper calcemia |
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what doe labs show in pagets disease?
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normal everything
normal calcium normal phosphate normal pth it has variable alp osteoperosis, shows normal everything (ca, phosphate, pth,alp) osteopetrosis shows normal everything exept elevated alp ostomalacia and rickets shwos decrease calcium and phosphate, elevated alp and elevated pth |
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male, pain in hips and ribs, constipation. x ray shows multiple osteolytic lesioons. multiple lesions throughout body. x ra shows nephrolithiasis. bone marro waspirate shows plasma cell infiltrate.
urine calcium is elevated.whats the pth level here? |
multiple osteolitic lesion suggests malignant bone disease that has metastazied which causes hyper calcemia. this in turn is pth INDEPENDANT
other malignancies that are pth independant and cause hyper calcemia- squamus cell ca of the lung that secrets PTHrP, hemolytic neoplasms like multiple myeloma because they activate osteoclasts which release calcium from bone |
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pt with lightheadnedness, excessive tiredness, sleepy and hungry. symptoms resolve upon eating sugary foods. low fasting glucose, elevated insulin. negative urinary sulfonylrea. normal pituitary axis. abdominal scal revls a mass in the tail of the pancreas. what would an additional lab finding be
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increased plasma concentration of c peptide, this is an insulinoma
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old male. polyuria, polydypsia. dehydration. low urine osmolality. serum osmolality greater than urine osmolality. vasopressin administration reduces serum osmolality and improves urine osmolality. what is the dx?
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central diabetes insipidus
psychogenic polydipsia has the urine outptut normalized with water restriction |
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50 yo, irritability, muscle cramps, tetany and seizures. labs reveal hypocalcemia. pth level was decreased, alp level was normal, phosphate levels were elevated. these features suggest?
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previous subtotal thyrodectomy, loss of c cells
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male, progressive weight gain. central obesity. protruding hump. purple stretch marks on ab. labs show increased fasting blood glucose, increased cortisol and elevated ACTH. high dose dexamethasone test supresses the pallasma cortisol. what is the dx?
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cushings disease (a pituitary problem)
cushings syndrome is an adrenal problem and not suppressed by high dose dexa |
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headaches. elevated bp. abdominal ct shows mass in left adrenal. resection shows mass arisess from adrenal cortex
lab investigatins befor surg would have revealed? |
low serum renin
this is conns syndrome, which causes hyper aldosteronism in the presence of low renin |
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45 year old lady has acromegaly. elevated hba1c levels. the condition is most likely relaed to
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excess prod. of igf 1
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further lab investigations of the above questioon would produce?
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failure to dsuppress growth hormone by glucose admin
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person has diabetes.what is the pathogenisis of the postural hypotension related to
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these changes caused by intracellular sorbitaol accumulation causes nuropathy including motor, sensory and autonomic degeneration. osmotic damage occurs in orgns with aldose reductase. also results in cataracts
nonenzymatic glycosylation thickens small vessals and causes glucoma, nephropathy, and sclerosis of LARGE vessals whcih results in ulcers |
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female has hyperparathyroidism, and elevated calcium. the clinical feature that is consistent with this diagnosis would be?
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constipation
low calcium increases permeability of neurons to sodium causing excess depol- this will make trousseaus and chvosteks signs positive high calcium decreases permeability of neurons to sodium because calcium the sodium channels which results in stones, bones and abdominal groans |
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person starving themselves. pancreas secretes a hormone. the enzyme stimulated by this hormone in the liver is?
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the hormone is glucagone which causes glycogenolysis, gluconeogenisis and lypolys sand ketone production
glycogenolysis is caused by glycogen phosphorlyase acetyl coa carboxylase helps make fatty acids glycogen synthase helps makes glycogen hmg coa reductase helps produce cholesterol pyruvate kinase is used in glycolisis to make pyruvate |
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male, low bp. low fastibg blood sugar. low cortisol. what are the labs
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high renin, low aldosterone, low serum sodium
this is addisons, which is progressive destruction of the adrenal glands |
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female with ambiguous genitals. low bp. hyponeutremia and hyperkalemia. elevated ACTH and androstenedione but decreased cortisol and deoxycortisone. child has deficiecny where/
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21 beta hydroxylase defish
if theres a 1 first, the person will have elevated mineralcorticoids ie aldosterone and have hypertension |
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male, increase in weight, brusies on skin. back acne. elevated bp. truncal obesity with hyperpigmentation. radiaograph of spin shows a compression and fracture at t11. he most likely has?
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small cell carcinoma of the lung- ectopic tissue producing ACTH. it could also be cushings disease which comes from excess ACTH from a pituitary adenoma. if it were an adrenal tumor you would NOT see pigmentation due to ACTH. a medullary cacinoma would secrete calcitonin
cortisol is produced in the zona fasciulata NOt the zona glomerulosa (thats aldosterone) remember it gets sweeter as you get deeper, salt sugar sex |
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africn american female. anterior neck swelling. pain on swallowing and fever. had an uppre resipratory viral infection. febrile and tachicardic. enlarged, tendor thyroid. dx?
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dequaavarian thyroditis
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meningitis and hyponeutremia why does he have hyponeutremia?
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SIDAH
hyponeutremia results in excess water retenion which results in many of the patients meningismal symptoms |
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woman delivers. has fatigue and wieght gain, no period. delivery had excessive hemorage. unable to breast feed. low LH, low estradiol, low TSH, low ACTH, low GH, low prolactin. injection of TRH didn't raise TSH or prolactin. what explains this?
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anterior pituitary necrosis aka shehan syndrome
its not pan pituitary neceosis because then she'd have problems with ADH and oxytocin |
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3y yo w headache palpitation nervousness and sweeating with elevated blood pressure
mri showed hyperplasia of parathyroid glands what is this associated with |
this is men 2 a
so men 2 has pheochromocytoma and medullary carcinoma 2 a has parathyorid cancer 2 b has mucosal neuromas |
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squamus cell carcinioma of the lung causes hypercalcemia. what are the labs
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decreased PTH (its PTH rP that increases), decreased serum posphate
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