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Flashcards in Endocrine Deck (49):
1

PPAR-y

Nuclear receptor that is bound by –glitazones (TZD’s)
- Transcriptional Regulator
- Increases GLUT4 gene expression (adipocytes)
-Weight gain and edema are a side effect

2

Sulfonureas

Bind regulatory subunit of Katp channel on pancreatic Beta cells to close them (calcium influx → insulin release)

3

Aldosterone in Addison’s (Primary Adrenal Insufficiency):

- Low aldosterone: Decreased serum Na and Bicarb
(Decreased Na reabsorption) & Increased serum K and Cl (Decreased H+ and K+ excretion)

4

Decreased Deep Tendon Reflexes with _______

Hypothyroidism

5

Reverse T3

Inactive form of thyroid hormone that is generated with peripheral conversion of T3 to T4

6

Diabetics should _______

Inspect feet daily because risk of infections
- May have peripheral arterial disease (due to atherosclerotic femoral arteries)

7

Pseudohypoparathyroidism

High PTH, low Ca due to resistant PTH receptors

8

Hashimoto's Thyroiditis

Looks like germinal centers on histology

9

High levels of vitamin D

Increase both Ca and PO4, and decrease PTH

10

Craniopharyngioma

- Bitemporal hemianopsia
- Calcified, resembles tooth enamel
- Solid, cystic, and calcified; filled with machinery oil liquid

11

Kallman’s Syndrome

No GnRH because failed to migrates from olfactory placode, anosomia

12

Waterhouse-Friedrichsen

Acute primary adrenal insufficiency due to n. meningitides

13

Neurophysins

Carrier proteins for oxytocin and ADH
- Produced by hypothalamus

14

Alpha2 and Somatostatin: Effect on Insulin

Decrease insulin release

15

TZD's (glitazones)

PPARgamma → decreases insulin resistance
- Transcriptional regulation

16

DPP4 inhibitors

-gliptins

17

Increased secretion of insulin:

Sulfonureas and DPP4

18

Increased sensitivity of insulin

Metformin and TZDs (glitazones)

19

Ophthalmopathy in Grave's treated w/

Glucocorticoids

20

JAK/STAT receptor signaling pathway used by:

Growth Hormone and Prolactin

21

Osteitis fibrosa cystica

(resorption of subperiosteum)
- Seen with Primary hyperparathyroidism
- Stones, bones, groans, psychiatric overtones

22

Neuroblastoma

- Tumor of adrenal medulla in young children
- Non-rhythmic conjugate eye movements and myoclonus aw/ paraneoplastic syndrome

23

Pregnancy, Hormone replacement therapy, and OCPs effect on Thyroid Hormones

Increased TBG (thyroid binding globulin) so total T3 and T4 are increased but free is normal

24

Hypothyroidism

May have myopathy with myoedema (bump rises when muscle tapped with a reflex hammer), will have elevated CK

25

DKA

HYPERkalemia because potassium inside cells is low (K+ normally taken up with glucose) and potassium outside is normal or increased (potassium sent out of cells), total potassium is low because of lose K+ in urine; sodium is low
- Tx: must replace potassium

26

Complete androgen insensitivity syndrome

X linked mutation, breast development and bind pouch vagina, cryporchid testes (karyotype is XY)

27

Papillary Thyroid Cancer

MC; orphan annie eyes, psamomma bodies, internuclear grooves and inclusions
- Don't confused with Follicular Adenoma or Carcinoma

28

Anorexia and GnRH

Lose pulsatile secretion of GnRH → amenorrhea and osteoporosis (if long-term)

29

Transient vs Permanent Central DI

- Isolated damage to posterior pituitary → transient central DI
- Damage to the hypothalamic nuclei will be permanent

30

Intrinsic Tyrosine Kinase

insulin and growth factors (eg. FGF, EDGF, etc)
- MAP kinase

31

Receptor- Associated Tyrosine Kinase

growth hormone, prolactin, cytokines
- JAK/STAT

32

C-peptide

Formed from pro-insulin (cleaved off) and packed into a secretory granule with insulin (equimolar concentration)
- Not present with exogenous insulin

33

IGF-1

Produced by liver due to GH stimulation

34

Insulin Activates:

- Directly activates glycogen synthase
- Indirectly inactivates glycogen phosphorylase (via protein phosphatase 1)

35

Thyroid Hormone increases ________ in Heart

B1 receptors

36

Thyroid Receptors in _______

Nucleus (unlike most steroid hormone receptors which are cytoplasmic)

37

Hypothyroidism

- Hypercholesterolemia (due to downregulation of LDL receptors)
- Also an increased risk of non-hodgkins
- Hurthle cells; follicles (germinal centers)

38

DeQuervain vs Reidel

- DeQuervain: post-viral hypothyroidism (painful), jaw pain
- Reidel (fibrosing) is not painful

39

Jod Basedow Phenomenon

Thyrotoxicosis if patient with iodine deficiency is given iodine

40

Tx for Growth Hormone excess

If it is not cured by resection:
- Pegvisomant (GH receptor antagonist) or octreotide (somatostatin analog)

41

__________ is given intravenously to treat DKA

Regular insulin
- onset 30 min
- peaks at 2-4 hours
- lasts 5-8

42

HPA Axis Suppression by Exogenous Steroids

All 3 parts are suppressed (hypothal, pituitary, and adrenals) which means that CRH, ACTH, and cortisol will be low in an adrenal crisis if steroids are stopped abruptly

43

Klinefelters: Gonadotropins and Hormones

High LH and FSH
Low testosterone
Azoospermia
Hyalinized semeniferous tubules

44

hCG and TSH

similar in structure so patients with testicular germ cell tumors or gestational trophoblastic disease may develop high hCG that can stimulate TSH receptors and cause hyperthyroidism

45

Proptosis w/ Graves

Due to increased GAGs (glycosaminoglycan) depositing by orbital fibroblasts --> edema and enlargement of extraocular muscles

46

Metryapone

Inhibits 11 B hydroxylase
- Decreases cortisol synthesis and if HPA axis is intact ACTH should increase

47

Uniform polygonal or spindle-shaped cells w/ extracellular amyloid deposits (stains with Congo red)

Medullary Thyroid cancer
- extracellular amyloid deposits formed by calcitonin released from neoplastic parafollicular C-cells

48

Beta-blocker use with Thyrotoxicosis

Decreases Sympathetics
Also decreases rate of peripheral T4 conversion to T3

49

TNFa induced insulin resistance

due to activation of serine kinase (which phosphorylates insulin receptor)