Endocrine Flashcards
(33 cards)
What permissive effects does cortisol have?
Increased vascular and bronchial smooth muscle reactions to catecholamines
What does additive, synergistic, and permissive mean?
Additive: 2+2 =4, Synergistic: 2+2>4, and permissive: one is useless but expands th range of other
What are some effects of glucocorticoids on muscle?
Increase lipolysis and protelysis, hence muscle wasting and increased BUN. Catabolic - muscle weakness.
Glucocorticoid effects on skin?
Inhibit fibroblast proliferation and collage formation - skin thinning
Glucocorticoid effects regarding glucose?
Increase gluconeogenic enzymes and glycogenesis. Increased liver protein synthesis, gluconeogenesis and glycogenesis and without insulin you see rise in glucose
Amenorrhea with intense fear of eating has what MSK issues and why?
Anorexia causes loss of pulsatile GnRH which leads to decreased LH/FSH and later decreased estrogen. Low estrogen leads to osteoporosis.
What lifestyle change is the single best preventative measure?
Smoking cessation - MI risks drop immediately, all else takes a bit to fall.
What is the difference between hirsutism and virilization?
Virilization is hirsutism (terminal hair growth) with acne, clitoromegaly, increased muscle mass and libido, and voice deepening.
What causes hirsutism and how do you treat?
Cushing, polycystic ovarian disease, ovarian/adrenal tumors. Also isolated and idiopathic
How would you treat hirsutism?
Spirolactone (anti-androgenic), flutamide (testosterone receptor antagonist), or finasteride (5-alpha reductase inhibitor)
What drug is clomiplene?
Anti-estrogen that increased GnRH and LH/FSH. For infertility
What is milotane used for
adrenocortical carcinoma
Medroxyprogesterone is what?
Depo Provera. Progesterone only OCP. Give IM 1x/12 wks.
If a man has a testicular mass and is having heat intolerance, diarrhea, and increased reflexes, why?
Testicular mass (or ovarian masses) like teratomas can produce hCG that is structurally similar to TSH.
A man has visual defects with sudden CV collapse and HAs and CN paralysis. How would you treat?
Guy has pituitary apoplxy - acute bleeding into a pre-existing pituitary adenoma. Medical emergency, can look like Sub Hemorrage but characteristic visual change. ACTH deficiency -> CV collapse. Treat with neurosurg and prompt corticosteroids.
What is the pathology responsible for complete central DI
Neurophysin mutation from hypothalamus. Causes hereditary hypothalamic DI.
Distribution of pancreatic cell types?
B cells in center, alpha cells in periphery. Somatostatin interspersed.
Regulation of insulin?
Hyperglycemia and GH increased. Cortisol decrease. B agonists increased while alpha 2 agonists inhibit.
How is C-peptide released and what can it be used for?
Equimolar concentrations along with insulin. Not extracted on 1st pass in liver, can measure endogenous insulin levels.
How does insulin relate to ketoacid formation and lipolysis
Inhibits ketoacid formation and lipolysis
How do you treat hypoglycemia, medical setting and not?
IM glucagon in non-medical, dextrose in not.
Relation of epinephrine and glucose?
Increases by increasing glycogenolysis and glucogenesis.
Symptoms and progression of hypoglyemia
Originally monitored by epi and glucago, less so by cortisol and GH. Increases lipolysis and gluconeogesis. Decreases peripheral glucose consumption. Adrenergic effects -> sweating, tremors, palpitations,nervous. Then later CNS symptoms -> behavioral and CNS changes.
What are you scared of with beta-blockers and diabetes?
Can mask effect as non-selective beta blockers can block hepatic gluconeogenesis and peripheral glycogenolysis and lipolysis. Inhibit epi and norepi. Give B1 antagonist instead.
