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53 Cards in this Set

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(4)* functions of T3
4 Bs:

Brain maturation,
Bone growth,
Beta-adrenergic effects,
BMR increase
4 Bs
what is the cause of increased cortisol w/ low ACTH
(aside from Cushings)?
Chronic steroid use
(2) steps of Dexamethasone test to determine cause of Increased cortisol
(3 causes)
1. Give LOW dose
(result: Lower cortisol = Healthy)
(result: Higher cortisol = step 2)

2. Give HIGH dose
(result: Lower cortisol = ACTH-producing tumor)
(result: Higher cortisol = Cortisone producing tumor)
Dx:

Low cortisol; High ACTH
Primary Hypocortisol

(Addisons)
Dx:

Low cortisol; Low ACTH
Secondary Hypocortisol

(no ACTH; no skin pigmentation)
Dx:

High cortisol; Low ACTH
(2)
Primary Hypercortisol

(Cushings; chronic steroids)
Dx:

High cortisol; High ACTH
Secondary Hypercortisol

(Tumor)
Dx:

HTN, hypoK, metabolic alkalosis, low plasma renin
Primary Hyperaldosteronism

(Conn's syndrome)
Dx:

HTN, hypoK, metabolic alkalosis, high plasma renin
Secondary Hyperaldosteronism


(CRF, CHF, renal artery stenosis, cirrhosis; anything that stimulates venous pooling)
Dx:

low aldosterone, low cortisol, hypotension, skin pigmentation, Adrenal Atrophy, Absence of hormones, All 3 cortical divisions affected
Addison's Dz

(Primary Hypoaldosteronism and Hypocortisol)
MC tumor of the adrenal medulla in children
Neuroblastoma
Dx:

elevated Pressure, HA Pain, Perspiration, Palpitations, Pallor
Pheochromocytoma
Dx:

kidney stones, stomach ulcers, pituitary tumor
MEN I (Wermer's syndrome)

3P = Pancreas, Pituitary, Parathyroid
Dx:

medullary CA of thyroid, pheochromocytoma, parathyroid tumor
MEN II - Sipple syndrome
Dx:

medullary CA of thyroid, pheochromocytoma, mucosal neuromas
MEN III
Dx:

Inc ESR, jaw pain, very tender thyroid; hypothyroidism following flu-like illness
Subacute Thyroiditis

(de Quervain's Thyroiditis)
MC thyroid anomaly
Thyroglossal duct cyst
Dx:

Increased TSH at thyroid
Goiter
MCC of hypothyroidism
Iodine deficiency
Dx:

child w/ potbelly, pale, puffy-faced, impaired growth, protruding umbilicus and tongue, mental retardation

what is deficient?
Cretinism

(Iodine deficiency)
Dx:

hyperthyroidism, nodular goiter, no exophthalamos
Plummer Dz
Dx:

hypothyroidism w/ massive infiltrates of lymphocytes in germinal center
Hashimoto thyroiditis
Dx:

previous radiation of neck, "ground-glass" nuclei in thyroid, psammoma bodies
Papillary carcinoma of thyroid

(MC type of thyroid CA)
Dx:

Increased Calcium; Decreased Phosphorus
Primary Hyperparathyroidism

(Inc PTH)
Dx:

Decreased Calcium; Decreased Phosphorus
Secondary Hyperparathyroidism

(Dec Vit-D)
Dx:

Decreased Calcium; Increased Phosphorus
Primary Hypoparathyroidism

(Dec PTH)
Dx:

Increased Calcium; Increased Phosphorus
Secondary Hypoparathyroidism

(Inc Vit-D)
Dx:

stones, bones (pain) and groans (constipation)
Primary Hyperparathyroidism
Definition:

cystic bone spaces filled w/ brown fibrous tissue as a result of the osteoclastic reabsorption in primary hyperparathyroidism
(2 names)
Osteitis Fibrosa Cystica

(von Recklinghausen's syndrome)
Definition:

bone lesions due to secondary hypoparathyroidism due to renal Dz
Renal Osteodystrophy
(2) Physical exam signs of low calcium
tapping facial nerve -> contraction of facial muscles
(Chvostek's sign)

occlusion of Brachial artery w/ BP cuff -> carpal spasm
(Trousseau's sign)
Dx:

Decreased Calcium, Increased Phosphorus, Increased PTH, shortened 4th/5th digits, short stature

what protein is deficient?
Pseudohypoparathyroidism

(Dec Guanine Nucleotide BP)
Dx:

kussmaul respirations, hyperthermia, N/V, Abd pain, psychosis, dehydration, fruity breath
Diabetic Ketoacidosis
Dx:

adrenal insufficiency due to hemorrhagic necrosis of adrenal cortex, assoc c/ DIC, due to Meningococcemia
Waterhouse-Friderichsen syndrome
Dx:

hyperinsulinemia and hypoglycenia, CNS dysfunction, reversal of CSN symptoms w/ glucose administration
Insulinoma
Dx:

hypresecretion of HCl in stomach, recurrent peptic ulcer Dz, hypergastrinemia
Zollinger-Ellison syndrome
Dx:

rare tumor w/ watery diarrhea, hypokalemia, achlorhydria
VIPoma

(Inc VIP)
Dx:

Adrenal hyperplasia, High BP, Low Cortisol, High Androgens
11-Hydroxylase deficiency
Dx:

Adrenal hyperplasia, Low BP, Low Cortisol, High Androgens
21-Hydroxylase deficiency
Dx:

Adrenal hyperplasia, High BP, Low Cortisol, Low Androgens
17-Hydroxylase deficiency
Dx:

Increase in Dilute Urine, Hyposmolar serum
Primary Polydipsia
Dx:

Increase in Dilute Urine, Hyperosmolar serum
Diabetes Insipidus

(ADH deficiency = Neurogenic)

(ADH receptor issue = Nephrogenic)
Dx:

Increase in concentrated Urine, Hyposmolar serum
SIADH
what receptors promote insulin secretion?

inhibit?
promote: Beta receptors

inhibit: Alpha receptors
what stimulates both insulin and glucagon?
Amino Acids
what hormone is needed for GH to function correctly?
Thyroid hormones
Definition:

causes the increased synthesis of cartilage in epiphyseal plates of long bones; is a good measure of GH secretion
Insulin-like Growth Factor-1
(IGF-1: a somatomedian)
how is GH similar to glucagon?

insulin?
glucagon: Inc blood glucose and fat

Insulin: Inc uptake of AA into cells
Calcium change w/ Acidosis
Increased
Name bone calcium and phosphate
Hydroxyapatite
where is receptor for PTH in bone?
Osteoblasts

(which stimulate osteoclasts)
Which leads to Inadequate Bone Mineralization:
Vit-D deficiency or excess?

How?
Both

Deficiency: decalcification of bone
(Rickets/Osteomalacia)

Excess: Inc. bone Resorption
what fills the lumen of the thyroid follicle?
Thyroglobulin