Diseases Flashcards
(56 cards)
Tumor of beta cells of pancreas causing increase in insulin and c-peptide secretion
Insulinoma
suphonyl urea drugs that cause release of insulin by blocking ATP dependent K+ channels
Metformin, Tolbutamide, Glyburide
(1) Deficiency of Insulin
(2) Fasting Plasma Glucose (FPG) lefel of 126 mg/dL or higher OR FPG level of 200 mg/dL or higher 2 hours after a 75g oral glucose tolerance test (OGTT)
(3) Polyuria due to glucosuria
(4) Polydipsia (thirst)
(5) Polyphagia
(6) Hyperglycemia
(7) Increased blood AA levels
(8) Hypotension
(9) Hyperkalemia
(10) Metabolic acidosis
(11) Increased susceptibility to infections
Diabetes Mellitus
(1) Increase in production of Ketoacids due to insulin deficiency
(2) Kussmaul’s breathing/air hunger: rapid, deep breathing due to chemoreceptors
(3) Breath will have fruity acetone odour
Diabetic Ketoacidosis
(1) Islet cell antibodies are detected which slowly destroy beta-cells of pancreas
Latent Autoimmune Diabetes of Adults (LADA)
(1) Stress
(2) GH, Glucagon, Cortisol, Epinephrine
(3) Increase blood sugar levels by anti-insulin action and gluconeogenesis by liver
(4) Increase protein catabolism
(5) increase lipolysis
(6) Promote vasoconstriction
(7) Promote bronchodilation
(8) Promote glycogenolysis
(9) Anti-inflammatory actions (inhibit phospholipase A2 via synthesis of lipocortin)
(10) Prevent rejection of transplanted organs
Glucocortocoids
Enzyme that liberates arachidonate from membrane phospholipids arachidonate
Phospholipase A2
Precursore for inflammatory mediators like prostaglandins and leukotrienes
Arachidonate
Inhibitor of phospholipase A2
Lipocortin
(1) Reabsorption of Sodium and water, excretion of potassium and secretion of H+
Mineralocorticoids (Aldosterone)
(1) Hypercortisolism due to:
a) high pharmacological doses of glucocorticoids
b) pituitary adenoma secreting ACTH
c) bilateral hyperplasia of adrenal glands
d) adrenal adenoma
e) adrenal carcinoma
(2) hyperglycemia
(3) Increased protein catabolism
(4) redistribution of fat (moon face, buffalo hump, lemon stick appearance)
Cushing’s Syndrome
Pituitary adenoma secreting ACTH leading to high cortisol and androgens (Secondary Hypercortisolism)
Cushing’s Disease
(1) Diagnose and differentiate between primary/secondary cause for Cushing’s disorder
(2) Low dose normally would decrease ACTH due to negative feedback, in turn decreasing cortisol (not suppressed in secondary disease/cushing’s disease/acth secreting tumor)
(3) High dose will suppress both ACTH and cortisol in Cushing’s disease- if ACTH is still high must be ectopic ACTH or tumor of lung
Dexamethasone (DMT) Suppression Test
inhibitor of steroid hormone synthesis used to treat Cushing’s Syndrome
Ketoconazole
(1) autoimmune destruction of adrenal cortex leading to adrenal crisis/adrenocortical insufficiency
(2) decreased GC, MC and Androgen secretion
(3) Increased ACTH - leads to hyperpigmentation
Addison’s sease
if cortisol increases, defect is in Anterior Pituitary (secondary adrenal disease)
if no improvement, defect in adrenal gland itself (primary adrenal disease)
ACTH Stimulation Test
(1) Hyperaldosteronism caused by an aldosterone secreting tumor
(2) hypertenstion
(3) hypokalemia
(4) Metabolic alkalosis
Conn’s Syndrome
(1) Congenital Virilizing Adrenal Hyperplasia
(2) Excess secretion of androgens
(3) Deficiency of aldosterone and GC
(4) In Females: Baldness, Hirsuitism, small breasts, amenorrhea, heavy arms & legs, male pattern of hair growth, precocious pubic hair, clitoromegaly, ambiguous genitalia at birth
(5) In Males: leads to Precocious Pseudopuberty
(6) Hypostension
(7) Hypoglycemia
(8) Hyperkalemia
21 B Hydroxylase Deficiency
(1) Congenital Virilizing Adrenal Hyperplasia
(2) Hypoglycemia
11 B Hydroxylase Deficiency
(1) Tumor of chromaffin tissues of adrenal medulla resulting in hypersecretion of catecholamines
Pheochromocytoma
(1) Hypercalcemia
(2) Hypophosphatemia
(3) Hyperphosphaturia
(4) Nephrocalcinosis
(5) Increased bone resorption
(Primary caused by parathyroid adenoma)
Hyperparathyroidism
(1) Low calcium levels over stimulating PTH secretion
Due To:
(2) Vitamin D Deficiency
(3) Renal Failure (increasing phosphate levels)
(4) Pregnancy demands for calcium
Secondary Hyperparathyroidism
Treatment for hypercalcemia by inhibiting calcium reabsorption
Furosemide
Treatment for hypercalcemia by inhibiting bone resorption
Etidronate
