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84 Cards in this Set
- Front
- Back
Combination of hyperthyroidism, nodular goiter & abscence of exopthalmus
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Plummer Dse
-"hot nodules" can be adenomas or non-neoplastic |
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Ovarian teratoma made of thyroid tissue
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Struma Ovarri
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Assoc. w/ various autoantibodies (Antithyroglobulin,Antithyroid Peroxidase,Anti-TSH receptor,Anti iodine receptor antibodies)
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Hashimoto Thyroiditis
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Focal destruction of thyroid tissue & granuloma inflammation due to viral infxn.(mumps,coxsackie virus)
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Subacute(de Quervain,granulomatous)thyroiditis
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1 molecule of DIT & Monoiodotyrosine (MIT) combine to form
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T3(triiodothyronine)
-3 to 4 times more active than T4, down regulates TRH receptors & inhibits TSH secretion |
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Antibodies to TSH receptors w/c incr. T3,T4 secretion & stimulate glandular hyperplasia in Graves Dse.
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Thyroid-stimulating immunoglobulin(TSI) & Thyroid growth immunoglobulin(TGI)respectedly
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Autonomic effects of T3 & T4
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B-andrenergic stimulation
-B-blockers(propranolol) are used in therapy for hyperthyroidism |
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Metabolic effect of T3 & T4
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Inc. glucose absorption in GIT, Glycogenolysis, Gluconeogenesis, glucose oxidation, lipolysis, & incr. catabolism
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Inversely proportional to the # of unbound thyroid hormone binding sites on TBG
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T3 resin uptake(Thyroid Hormone-binding ratio)
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Benign child tumor of Post. Pituitary charact. by nests & cords of squamous or columnar cells in loose stroma resembling appearance of the embryonic tooth bud enamel organ
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Craniopharyngioma(adamantinoma)
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Prognathism, enlargement of the face, vicera, feet, & hands(sausage-like fingers)
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Acromegaly
-growth hormone hypersecretion caused by somatotroph cell adenoma |
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Epigastric pain radiating to the back w/ an incr. in serum amylase & lipase
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Acute Pancreatitis
-major assoc. w/ alcoholism and gallstones |
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Migratory thrombophlebitis(Trousseau Syndrome)
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Carcinoma of the pancreas
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Severe retardation, short stature, coarse facies, protruding tongue, and umbilical hernia
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Cretinism(Hypothyroidism in children)
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Moon facies, hypertention, & accumulation of truncal fat
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Cuching syndrome
-caused by the action of cortisol |
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Most commonly caused by iatrogenic corticosteroid therapy
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Cushing synd.
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Marked incr. in free water clearance
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Diabetes Isipidus
-caused by lack of ADH |
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Increased Hemoglobin A1c(HbA1c)
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Diabtetes Mellitus
-HbA1c=serum marker for nonenzymatic glycosylation of proteins |
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Loss of pain sensation in extremities
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Diabetic neuropathy
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Retinal microaneurysms and cotton-wool spots
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Diabetic retinopathy
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Female w/ staring gaze & exopthalamos
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Graves' disease
-characterized by anti-TSH receptor antibodies in serum |
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Hypoglycemia & CNS impairment, w/c are reversed upon glucose administration, & increased serum C-peptide
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Insulinoma
-px. surreptitiously administering insulin do not have inc. C-peptide levels in serum |
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Most common thyroid carcinoma assoc. w/ exposure to ionizing radiation
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Papillary carcinoma of the thyroid
-histologically charact. by papillae lined by "Orphan Annie" nuclei or empty-looking nuclei |
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Paroxysmal hypertention, tachycardia, sweating, tremor, & hyperglycemia
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Pheochromocytoma
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Causes compression of the optic chiasm resulting in bitemporal hemianopsia
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Pituitary adenoma
-often visualized as radiographic enlargement of the sella turcica |
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Hypotension, hyperpigmentation, & dec.
heart rate |
Primary adrenal cortical insufficiency(Addisons disease)
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Osteitis Fibrosis Cyctica
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Primary hyperparathyroidism
-cysts, fibrinous accumulation, & focal hemorrhage in bone; also called brown tumor of bone |
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Premenopausal woman w/ amenorrhea, galactorrhea, loss of libido, & infertility
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Prolactinoma
-most common hyperfunctioning pituitary adenoma |
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Peripartal hypotension resulting in necrosis & destruction of the ant. pituitary
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Sheehan Synd
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Excessive resorption of free water w/ hyponatremia & cerebral edema, but no peripheral edema
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SIADH(syndrome of inappropriate antidiuretic hormone secretion)
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Tremor, tachycardia,increase in appetite w/ dec. in weight
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Thyrotoxicosis(hyperthyroidism)
-most commonly caused by Graves' dse. |
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Hypergastrinemia, hyperchlorhydria, & recurrent peptic ulcer dse.
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Zollinger-Ellison Synd.
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Inhibits secretion of Prolactin from ant. pituitary
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Dopamine(PIF),Bromocriptine(dopamine agonist),Somatostatin,Prolactin(neg. feedback)
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Salt-losing hyponatremia leading to hypotension and virilization of female infants
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21-hydroxylase def.
-most common enzymatic defect in congenital adrenal hyperplasia |
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Ant. pituitary tumor w/c causes galactorrhea, decreased libido, failure to ovulate
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Prolactinoma(excess prolactin)
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Inhibits the iodide(I-)pump
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Thiocyanate & Perchlorate Anions
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Used to reduce thyroid hormone synthesis in tx. of hyperthyroidism by inhibiting "peroxidase"
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Propylthiouracil
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2 molecules of Diiodotyrosine(DIT) combine to form
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T4(thyroxine)
-synthesized more than T3 |
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Most common thyroid anomaly
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Thyroglossal duct cyst
-does not lead to alteration in thyroid fxn. |
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Most common cause of secondary hyperparathyroidism
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Renal failure
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Malignant catecholamine producing tumor of early childhood charact. by amplification of the N-myc oncogene w/ thousands of gene copies per cell(Karyotypic changes)
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Neuroblastoma
-malignant cells may differentiate into benign cells reflective of reduction of gene amplification |
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Factors w/c stimulate insulin release(tyrosine kinase receptor)
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Inc. bld. glucose, inc. A.A, inc. F.A, glucagon, GIP, GH, cortisol
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Factors w/c stimulate glucagon release(cAMP mechanism)
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Dec. bld.glucose, inc. A.A, CCK(cholecystokinin), norepinephrine, epinephrine, acetylcholine
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Adrenogenital synd. showing inc. aldosterone levels w/ dec. androgen & glucocorticoid levels
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17 alpha-Hydroxylase Def.
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General apathy, cold intolerance, obesity, & constipation
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Myxedema(hypothyroidism)
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Adrenal insufficiency & vascular collapse due to hemorrhagic necrosis of the adrenal cortex
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Waterhouse-Frederichsen Synd.
-assoc. w/ DIC;due to Meningococcemia in assoc. w/ Meningococcal meningitis |
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Drug used to inhibit steroid hormone synthesis in tx. of Cushing's Dse.
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Ketoconazole
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Endocrine disorder presenting w/ hypertension, hypokalemia, metabolic alkalosis & inc. serum renin
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Secondary Aldosteronism
-as compared to Conn's Synd(Primary Aldosteronism)in w/c serum renin is low |
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Malignant tumor of the thyroid w/c originates from C cells & produces calcitonin
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Medullary Carcinoma
-assoc. w/ Multiple Endocrine Neoplasia(MEN)Synd. IIa & IIb(III) |
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Enzyme stimulated by ACTH to inc. steroid hormone synthesis by inc. conversion of cholesterol to pregnelone
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Cholesterol Desmolase
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Procedure use to test the neg. feedback control of cortisol in the hypothalmic-pituitary-adrenocortical axis
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Dexamethasome Suppression Test
-based on the ability of Dexamethasome(potent synthetic glucocorticoid) to inhibit ACTH secretion |
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Factors w/c regulate aldosterone secretion
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ACTH, Renin-Angiotensin System(Angiootensin II) & potassium
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Actions of glucocorticoid(cortisol)
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Gluconeogenesis, Anti-inflamatory effects, suppression of immune response, maintenance of vascular responsiveness to catecholamines
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Enzyme synthesized by glucocorticoid w/c inhibits Phospholipase A2, an enzyme w/c provides arachidonate, a precursor for prostaglandin & leukotriene synthesis
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Lipocortin
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Anti-inflammatory effects of glucocorticoids
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Inhibit formation of arachidonate, production of interleukin-2(IL-2) & release of histamine & serotonin
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In determinng the origin of cause for Cushing Synd.,an inc. in ACTH secretion would come from these origin
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Pituitary & Ectopic ACTH production
-as compared to adrenal where ACTH levels are low |
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Endocrine disorders caused by deficient ACTH, no hyperpigmentation, no volume contracion, no hyperkalemia or metabolic acidosis
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Secondary Adrenocortical insufficiency
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Actions of insulin on liver, adipose tissue & muscle
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Inc. glucose,K,A.A uptake; promote glycogen form. & fat deposition; inhibit glycogenolysis,ketoacid form,lipolysis,protein degradation, gluconeogenesis
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Actions of Somatostatin released from the hypothalmus & delta cells(pancreas)
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Inhibit secretion of GH(hypothalmus) & inhibit secretion of insulin, glucagon, gastrin(pancreas)
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Causes of Cushing's Synd.
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Exogenous corticosteroid medication(most common),hyperproduction of ACTH(by pituitary),adrenal cortical adenoma,adrenal carcinoma,ectopic prod. of ACTH(small cell carcinoma)
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Ca+ resorption of the organic matrix of bone due to PTH is reflected in increased
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Hydroxyproline excretion
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PTH inc. intestinal Ca+ reabsorption by stimulating production of this enzyme in the kidney
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1,25-dihydroxycholacalciferol
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Pathophysiology of inc. PTH(most commonly caused by Parathyroid Adenoma)
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Hypercalcemia,hypophosphatemia,phosphaturia effect of PTH, inc. filtered load of Ca+, inc. urinary cAMP, inc. bone resorption
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Pathophysio. of chronic renal failure in causing renal osteodystrophy
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Dec. GFR~inc. serum phosphate~dec. ionized Ca+ due to phosphate-Ca complexes;dec. production of 1,25-dihydroxychole. by dse. kidney;inc. PTH due ti dec. serum Ca+ leads to inc. bone resorption & osteomalacia
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Active form of Vit.D
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1,25-dihydroxycolecalciferol
-catalyzed by 1alpha-hydroxylase |
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Factors w/c inc. 1alpha-hydroxylase activity in the production of Vit. D
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Dec. (Ca+,phosphate,PTH)
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Hormone secreted from the parafollicular cells of the thyroid; stimulated by high serum Ca+; inhibitsbone resorption; used to tx. hypercalcemia
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Calcitonin
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Hormones secreted from the testes(sertoli cells)w/c cause atrophy of the mullerian ducts(become the female internal genital tract)
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Antimullerian Hormone
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Hormones secreted from the testes(leydig cells)w/c stimulate growth & differentiation of the Wolffian ducts(become the male internal genital tract)
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Testosterone
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Hormone found in the accessory sex organs(ex.Prostate) used to convert testosterone to its active form(dihydrotestosterone)
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5 alpha-reductase
-inhibited by Finasteride w/c is used in tx. of BPH |
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Hormone produced by Sertoli cells in the testes w/c inhibits release of FSH from the ant. pituitary
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Inhibin
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Actions of testosterone
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Differentiation of Wolffian ducts, pubertal growth, spermatogenesis in Sertoli cells, inc. libido
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Effects of FSH & LH on Sertoli cells & Leydig cells in the testes, respectedly
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Maintain spermatogenesis & promote testosterone synthesis
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Effects of FSH & LH on the ovaries
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Steroidogenesis in the ovarian follicle & corpus luteum, follicular involvement beyond the antral stage, ovulation, luteinization
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Actions of estrogen
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Neg.&post. feedback effect(FSH,LH)secretion;maturation & maitenance of(fallopian tubes,uterus,cervix, vagina);develop. female secondary sex charact.at puberty;develop. of breast; upregulates(estrogen,LH,progesterone) receptors;proliferation & devel. of ovarian granulosa cells;maintains preg.;lowers uterine threshold to contractile stimuli during preg,;stimulate prolactin secretion
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Actions of Progesterone
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Neg. feedback effect on(FSH,LH)during luteal phase; maintains secretory activity of uterus during luteal phase; maintaince preg.; raises uterine threshold to contractile stimuli; develop. of breast
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Hormone produced by Theca cells w/c later diffuses granulosa cells
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Testosterone
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Enzyme found in Granulosa cells w/c convert testosterone to 17B-estradiol
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Aromatase
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Benign tumor of the adrenal medulla (chromaffin cells) resulting in inc. renal excretion of catecholamines & their metabolites(metanephrine,normetanephrine,vanillylmandelic acid)
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Pheochromocytoma
-if derived from extra adrenal chromaffin cells, called Paraganglioma |
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Hormone level of FSH compared to LH during senescence
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FSH>LH
-as compared to childhood(FSH>LH) & puberty(LH>FSH) |
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In Cushing Synd., a neg. Dexamethasome Suppression Test, signifies the origin of excess production of ACTH comes from
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Adrenal Neoplasm
-if Pituitary in origin, the test would be positive |
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Adrenogenital Synd. w/c show dec. cortisol & aldosterone levels w/ inc. 17-hydroxyprogesterone & progesterone levels resulting in inc. androstenedione
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21 Beta-Hydroxylase def.
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Most common cause of hypothyroidism in iodine sufficient areas
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Hashimoto Thyroiditis
-histologically charact. by dense lymphocytic infiltrate & germinal centers in the thyroid |
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Parathyroid dse. resulting in end-organ resistance to PTH due to a defective Gs protein in the kidney & bone
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Pseudohypoparathyroidism type Ia- Albright's hereditary osteodystrophy
-not correctable by exogenous adm. of PTH; inc. PTH levels, hypocalcemia, hyperphosphatemia |