Use LEFT and RIGHT arrow keys to navigate between flashcards;
Use UP and DOWN arrow keys to flip the card;
H to show hint;
A reads text to speech;
125 Cards in this Set
- Front
- Back
From what embryologic structure is the adrenal cortex derived?
|
mesoderm
|
|
From what embryologic structure is adrenal medulla derived?
|
neural crest
|
|
What is the primary regulatory control of the adrenal medulla's release of catecholamines (epi, norepi)?
|
preganglionic sympathetic fibers
|
|
What is different about adrenal drainage between left and right adrenal glands?
|
Left adrenal vein drains to left renal vein before draining into IVC
(just like left gonadal vein!) |
|
What anterior pituitary hormones are basophilic?
|
FSH
LH ACTH TSH "B-FLAT" |
|
What hormones are released from the posterior pituitary?
|
oxytocin
ADH (synthesized in the hypothalamus) |
|
Where is melanotropin (MSH) made?
|
anterior pituituary
|
|
From what embryologic origin is the anterior pituitary derived?
|
oral ectoderm
|
|
What pituitary hormones share the same alpha subunit with hCG?
|
TSH
LH FSH |
|
Where are the following cell types found in a pancreatic islet?
- alpha - beta - delta |
a: outside (glucagon)
B: INSide (INSulin) d: interspersed |
|
On what cell types are the following glucose transporters found?
GLUT-1 GLUT-2 GLUT-4 |
GLUT-1: RBCs, Brain
GLUT-2: kidneys, cornea, intestine, liver GLUT-4: adipose, muscle |
|
What glucose transporter is bidirectional?
|
GLUT-2
|
|
What glucose transporter is insulin-responsive?
|
GLUT-4
|
|
How is insulin release from the pancreas triggered by glucose?
|
GLUT-2 glucose uptake --> increased ATP from metabolism --> K+ channels close --> Ca channels open --> cell depolarizes --> insulin released
|
|
What effects of insulin are mediated through the RAS/MAPK pathway?
|
cell growth
DNA synthesis |
|
What effects of insulin are mediated through the P13K pathway?
|
glycogen, lipid, protein synthesis
GLUT-4 transport/insertion into membrane |
|
What compounds decreased the cellular response to insulin via phosphorylation of serine (instead of tyrosine) residues?
|
glucagon
catecholamines TNF-a glucocorticoids |
|
What regulates the release of prolactin from the anterior pituituary?
|
TRH stimulates
Dopamine inhibits |
|
What effect does prolactin have on the release of other pituitary hormones?
|
decreases GnRH release
increases dopamine synthesis, thereby decreasing its own release |
|
What effect does somatostatin have on the release of other pituitary hormones?
|
decreases TSH
decreases GH |
|
externally phenotypic female
no internal reproductive structures OR externally phenotypic female with normal internal structures; no secondary sexual characteristics hypertension, hypokalemia |
17a-hydroxylase deficiency
- high aldosterone - low cortisol - low sex hormones |
|
masculinization/ female pseudohermaphrodism
hypotension hyperkalemia high renin high ACTH |
21a-hydroxylase deficiency
- low mineralocorticoids - low cortisol - high sex hormones |
|
hypertension
high ACTH masculinization |
11a-hydroxylase deficiency
- high deoxycorticosterone (but low aldosterone) - low cortisol - high sex hormones |
|
What are the effects of cortisol on the following:
- blood pressure - bone formation - inflammation - immune function - gluconeogenesis - lipolysis, proteolysis |
- increased BP by upregulating a1
- decreased bone formation - decreased inflammation - decreased immune response - increased gluconeogenesis - increased lipolysis, proteolysis |
|
What hormones regulate PTH? How?
|
Decreased Ca increases PTH
Decreased Mg decreases PTH (diarrhea, aminoglycosides, diuretics, alcohol abuse) |
|
cholecalciferol
|
D2, from milk and sun
|
|
ergocalciferol
|
D3, from plants
|
|
calcitrol
|
1,25-(OH)2 vitamin D (synthesized in kidney from liver's storage form)
|
|
What are the products of:
- parathyroid chief cells - thyroid parafollicular cells |
- chief cells: PTH
- parafollicular (C) cells: calcitonin |
|
Signaling pathway of:
FSH |
cAMP
|
|
Signaling pathway of:
LH |
cAMP
|
|
Signaling pathway of:
ACTH |
cAMP
|
|
Signaling pathway of:
TSH |
cAMP
|
|
Signaling pathway of:
CRH |
cAMP
|
|
Signaling pathway of:
hCG |
cAMP
|
|
Signaling pathway of:
ADH (V2) |
cAMP
|
|
Signaling pathway of:
MSH |
cAMP
|
|
Signaling pathway of:
PTH |
cAMP
|
|
Signaling pathway of:
calcitonin |
cAMP
|
|
Signaling pathway of:
glucagon |
cAMP
|
|
Signaling pathway of:
ANP |
cGMP
|
|
Signaling pathway of:
NO |
cGMP
|
|
Signaling pathway of:
GnRH |
IP3
|
|
Signaling pathway of:
GHRH |
IP3
|
|
Signaling pathway of:
oxytocin |
IP3
|
|
Signaling pathway of:
ADH (V1) |
IP3
|
|
Signaling pathway of:
TRH |
IP3
|
|
Signaling pathway of:
glucocorticoid |
steroid
|
|
Signaling pathway of:
estrogen |
steroid
|
|
Signaling pathway of:
progesterone |
steroid
|
|
Signaling pathway of:
testosterone |
steroid
|
|
Signaling pathway of:
aldosterone |
steroid
|
|
Signaling pathway of:
vitamin D |
steroid
|
|
Signaling pathway of:
T3/T4 |
steroid
|
|
Signaling pathway of:
insulin |
tyrosine kinase
|
|
Signaling pathway of:
IGF-1 |
tyrosine kinase
|
|
Signaling pathway of:
FGF |
tyrosine kinase
|
|
Signaling pathway of:
PDGF |
tyrosine kinase
|
|
Signaling pathway of:
prolactin |
tyrosine kinase
|
|
Signaling pathway of:
GH |
tyrosine kinase
|
|
How does T3 increase heart rate and CO?
|
Increases # of B1 receptors on heart
|
|
What conditions change the amount of TBG?
|
hepatic failure - decreased
pregnancy - increased |
|
What does thyroid peroxidase do?
|
Oxidation of I-
Coupling of MIT and DIT (TG + I2) |
|
HTN, buffalo hump, moon facies, hyperglycemia, osteoporosis
high ACTH increased cortisol after low lose of dexamethasone decreased cortisol after high dose of dexamethasone |
pituitary ACTH-secreting adenoma (Cushing disease)
|
|
HTN, buffalo hump, moon facies, hyperglycemia, osteoporosis
high ACTH increased cortisol after low lose of dexamethasone increased cortisol after high dose of dexamethasone |
ectopic ACTH-secreting tumor
(SCLC, bronchial carcinoid) |
|
HTN, buffalo hump, moon facies, hyperglycemia, osteoporosis
low ACTH increased cortisol after low lose of dexamethasone increased cortisol after high dose of dexamethasone |
adrenal adenoma/ carcinoma/ nodular adrenal hyperplasia
|
|
Causes of HTN, hypokalemia, metabolic alkalosis, episodic weakness, low plasma renin
|
Conn syndrome (hyperaldosteronism)
|
|
Causes of HTN, hypokalemia, metabolic alkalosis, episodic weakness, high plasma renin
|
CHF
renal artery stenosis cirrhosis nephrotic syndrome chronic renal failure |
|
Causes of hypotension, low cortisol, skin hyperpigmentation
|
Addison's disease:
autoimmune TB metastasis |
|
Organism responsible for adrenal hemorrhage, acute adrenocortical insufficiency, septicemia, DIC, endotoxic shock
|
Neisseria meningitides
|
|
Treatment for:
episodic pressure, pain, perspiration, palpitations, pallor elevated urine VMA |
Phenoxybenzamine: irreversible a-antogonists
|
|
Cells of origin for:
episodic pressure, pain, perspiration, palpitations, pallor elevated urine VMA |
chromaffin cells from neural crest
|
|
Syndromes with:
episodic pressure, pain, perspiration, palpitations, pallor elevated urine VMA |
MEN 2A, 2B
neurofibromatosis type I Von-Hippel Lindau Sturge-Weber |
|
N-myc oncogene
urine HVA elevated anywhere along sympathetic chain or adrenal medulla |
neuroblastoma
|
|
pretibial myxedema
|
Grave's disease
|
|
facial/periorbital myxedema
|
hypothyroidism
|
|
warm, most skin
fine hair |
hyperthyroidism
|
|
dry, cool skin
coarse, brittle hair |
hypothyroidism
|
|
moderately enlarged, non-tender thyroid
Hurthle cells antimicrosomal (anti-thyroid peroxidase) antibodies antithyroglobulin antibodies HLA-DR5 lymphocytic infiltrate |
Hashimoto's thyroiditis
|
|
pot-bellied
pale puffy-faced protruding umbilicus protuberant tonue |
cretenism (lack of dietary iodine or defect in T4 formation)
|
|
after flulike illness
granulomatous inflammation elevated ESR jaw pain early inflammation tender thyroid gland |
subacute thyroiditis
(deQuervain's) |
|
non-tender, fixed, hard thyroid
|
Riedel's thyroiditis (fibrotic tissue replaces thyroid)
|
|
proptosis
EOM swelling presents during stress pitting edema and thickening over tibia stress-induced catecholamine surge --> arrythmia ---> death |
Grave's disease (thyroid receptor Ig/TSI)
|
|
patches of hyperfunctioning follicular cells
mutation in TSH receptor |
toxic multinodular goiter
|
|
most common thyroid cancer
"ground glass nuclei" "solid balls" of follicular cells with vessels and fibrous stroma in center psammoma bodies nuclear grooves |
papillary carcinoma (increased risk with childhood irradiation)
|
|
uniform follicles, good prognosis
|
follicular carcinoma
|
|
from parafollicular cells
produces calcitonin sheets of cells in amyloid stroma associated with MEN 2A, 2B |
medullary thyroid carcinoma
|
|
thyroid cancer associated with Hashimoto's
|
thyroid lymphoma
|
|
thyroid cancer in older pts with poor prognosis
|
undifferentiated/ anaplastic
|
|
What can cause hypercalcemia?
|
Calcium ingestion (milk-alkali)
Hyperparathyroidism Hyperthyroid Iatrogenic (thiazides) Multiple myeloma Paget's disease Addison's disease Neoplams Zollinger-Ellison Excess vitamin A Excess viamin D Sarcoidosis |
|
cystic bone spaces filled with brown fibrous tissue
subperiosteal reabsorption |
osteitis fibrosa cystica (hyperparathyroidism)
|
|
hypocalcemia
shortened 4th/5th digits round face short stature |
Albright's hereditary osteodystrophy
(pseudohypoparathyroidism) |
|
tapping of facial nerve --> contraction of facial muscles
|
hypocalcemic tetany
|
|
occlusion of brachial artery with BP cuff --> carpal spasms
|
hypocalcemic tetany
|
|
Treatment for:
- amenorrhea - galactorrhea - low libido - infertility - bitemporal hemianopia |
pituitary prolactinoma:
- Bromocriptine - Cabergoline |
|
Treatment for:
- large tongue - deep voice - large hands/feet - coarsened facial features - high IGF-1 - failure to suppress serum GH with oral glucose |
acromegaly:
- octreotide - resection |
|
fatigue
anorexia poor lactation loss of public and axillary hair post-partum |
Sheehan's syndrome (hypopituitarism due to infarct)
Replace cortisol and TSH |
|
Causes of:
- dilute urine (specific gravity <1.006) - serum osmolality > 290 - dilute urine after water deprivation - dilute urine after desmopressin |
nephrogenic diabetes insipidus:
- hereditary - hypercalcemia - lithium - demeclocycline Treat with: amiloride, hctz, indomethicin |
|
Causes of:
- dilute urine (specific gravity <1.006) - serum osmolality > 290 - dilute urine after water deprivation - concentrated urine after desmopressin |
central diabetes insipidus
- pituitary tumor - histiocytosis X - trauma - surgery Treat with intranasal desmopressin |
|
Causes of:
- water retention - hyponatremia - urine osmolality > serum osmolality |
SIADH:
- ectopic secretion (SCLC) - head trauma - pulmonary disease - cyclophosphamide Treat with demeclocycline (ADH antagonist) |
|
In diabetes, what process are the following attributable to?
- cataracts - glaucoma - retinopathy (hemorrhage, exudate, microaneurysm, angiogenesis) |
- cataracts: osmotic damage (sorbitol)
- glaucoma: non-enzymatic glycosylation - retinopathy: non-enzymatic glycosylation |
|
Which form of DM is associated with:
- HLA D3/D4 - amyloid deposition in B cells - strong genetic predisposition - common polyuria, polydipsia, thirst, weight loss |
- HLA D3/D4: DM1
- amyloid deposition in B cells: DM2 - strong genetic predisposition: DM2 - common polyuria, polydipsia, thirst, weight loss: DM1 (more often) |
|
management of DKA?
|
- fluids
- potassium (to replete intracellular stores) - insulin - glucose afterwards if necessary |
|
increased urine 5-HIAA
|
carcinoid tumor
|
|
increased urine HVA
|
neuroblastoma (dopamine breakdown)
|
|
increased urine VMA
|
pheochromocytoma (NE breakdown)
|
|
inheritance pattern of MEN1, 2A, 2B
|
autosomal dominant
|
|
associated with ret oncogene
|
MEN 2A, MEN 2B
|
|
tumors in MEN 1
|
parathyroid (--> kidney stones)
pituitary pancreatic (ZE --> ulcers, insulinoma, VIPoma, glucagonoma) |
|
tumors in MEN2
|
parathyroid
pheochromocytoma medullary thyroid carcinoma |
|
tumors in MEN 2B
|
parathyoid
medullary thyroid carcinoma oral/intestinal ganglioneuromatosis (marfanoid habitus) |
|
Lispro
|
short-acting insulin
|
|
Aspart
|
short-acing insulin
|
|
NPH
|
intermediate-acting insulin
|
|
glargine
|
long-acting insulin
|
|
detemir
|
long-acting insulin
|
|
tolbutamide
|
1st generation sulfonylurea
|
|
chlorpropamide
|
1st generation sulfonylurea
|
|
glyburide
glipizide glimepiride |
2nd generation sulfonylureas
|
|
metformin
|
biguanide
can cause lactic acidosis in renal failure |
|
pioglitazone
rosiglitazone |
thiazolindeinediones:
PPAR-gamma induction |
|
acarbose
|
a-glucosidase inhibitor (brush border)
|
|
miglitol
|
a-glucosidase inhibitor (brush border)
|
|
pramlintide
|
mimetic (decreases glucagon)
|
|
exenatide
|
GLP-1 mimentic
can cause pancreatitis |