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Flashcards in Endocrine Deck (120):
1

decrease protein synthesis

glucocorticoiss

2

IP3 mechanism

GnRH, TRH, oxytocin, vasopressin V1R

H1, ATII, Gastrin

3

TK mechanism

intrinsic (MAPK):

receptor-associated (JAK/STAT):


insulin, IGF-1, PDGF, FGF

GH, prolactin, IL, G-CSF, EPO

4

cAMP mechanism

FSH
LH
ACH
TSH

ADH V2R, glucagon, calcitonin, PTH, hCG, MSH, GHRH, CRH

5

vasopressin from

hypothalamic SON

6

estriol from

placenta

7

estrone from

adipose

8

estrogen in males from

testes

9

steroid hormone receptors

cytoplasm

10

GH regulation

inhibited by pregnancy, glucose, obesity, SS

stimulated by sleep, estrogen, endogenous opioids, low glucose, sleep, exercise, puberty

11

ADH regulation

stimulated by nicotine, opiates

inhibited by ethanol, atrial natriuretic factor, low osmolarity

12

FSH, LH regulation

inhibin ---] FSH
progesterone/estrogen --] LH

13

POMC precursor for

ACTH
lipotropin
MSH
B-endorphin

14

Addison's

primary adrenal insufficiency

hypotension, low Na, high K

15

somatostatin analogs

octreotide, somatostatin LAR, lanreotide-P

use for thryotropinoma, acromegaly
carcinoid syndrome, VIPoma

if need to reduce splanchnic circulation for varicose, ulcers

16

Sheehan syndrome

secondary hypothyroidism
rare hyponatremia
amenorrhea, agalactorrea

from pituitary necrosis

17

3-B-hydroxysteroid dehydrogenase deficiency

Early death, Na loss in urine

No gluco/mineralocorticoids
No sex steroids

18

17-a-hydroxylase deficiency

phenotypic female unable to mature
hypertension

increased mineralocorticoids
no sex steroids or cortisol

19

21-a-hydroxylase deficiency

masculinized with hypotension
salt wasting
high ACTH

increased sex steroids
no cortisol or mineralocorticoids

20

11-beta-hydroxylase deficiency

masculinized with hypertension

increased sex steroids
weak mineralicorticoid deoxycorticosterone
no cortisol, corticosterone, aldosterone

21

BAM CUSHINGOID

Buffalo hump
Anemia, Amenorrhea**
Moon face
Crazy
Ulcers
Skin
HTN**
Infection
Necrosis femoral head**
Glaucoma
Osteoporosis
Immunosuppressed
Diabetes**

22

Conn syndrome

Primary hyperaldosteronism

HTN, low renin
low K, acidosis

23

treat hyperaldosteronism

spironolactone
eplerenone

24

treat pheo

phenoxybenzamine
phentolamine

25

treat Graves disease

methimazole (block DIT)
-if 2nd-3rd trim
-get aplasia cutis

PTU (block T4 to T3, block DIT)
-if 1st trim
-get liver and agranulocytosis

26

increase thyroid binding globulins

pregnancy and OCP

27

hyperthyroidism after IV contrast use

Jed-Baselow phenomenon

28

HLA B35

subacute thyroiditis

29

Hashimoto HLA's

HLA DR5
HLA B5

30

Papillary thyroid cancer

RET, BRAF, NRTK1, tobacco, radiation
Orphan Annie nuclei
psammoma bodies

31

follicular thyroid cancer

RAS
PA8-PPAR1

32

medullary thyroid cancer

TK, RET

33

GLUT2

small intestine
liver, B cells, renal

34

DM1 HLA

HLA DR3-DQ2
HLA DR4-DQ8

35

glargine

24 hr insulin

36

glulisine

ultra short insulin

37

aspart

ultra short insulin

38

glargine

24 hr insulin

39

NPH

18 hr insulin, peak at 6 hr

40

regular insulin peak

3 hr

41

DPP-4 inhibitors

saxagliptin

good for elderly/organ dysfunction

42

GLP-1 agonists

dulaglutide

cause acute pancreatitis

43

SGLT-2 inhibitors

empagliflozin

44

a-glucosidase inhibitors

miglitol and acarbose

less gut digestion, diarrhea
miglitol is hepatotoxic

45

inhibit PPARy-receptor

pioglitazone
rioglitazone

edema and hepatotoxicity
good for renal dysfunction

46

sulfonylureas require

good renal function

47

obesity cancers

non-Hodgkin
multiple myeloma

48

leptin

inhibits lateral hypothalamus
stimulates ventromedial

49

lipodystrophy

from low leptin
from protease inhibitors

50

drugs causing weight gain

mirtazepine
progestins
insulin, sulfonylureas, TZD's
atypical antopsychotics

51

for metabolic syndrome Dx

TAG >150
HDL 130/85
waist >35 female
glucose >100, >140

52

hypercalcemia causes are:

vitamin A intoxication
thiazide diuretics
granulomatous disease increase vit D
PT adenoma/hyperplasia
breast metastasis to bone
multiple myeloma

53

primary hyperparathyroidism

proximal muscle weakness
itchy
keratitis
HT
uremia
polydipsia
osteitis fibrosa cystica
OA
peptic ulcers
pancreatitis

54

osteitis fibrosa cystica

radial middle phalanges
tapered distal clavicle
salt and pepper skull
bone cysts
brown tumors of long bones

55

hypocalcemia causes are:

Albright hereditary osteodystophy
-short, obese, short 3/4th digits, OFC

DiGeorge, acute pancreatitis

56

secondary hyperparathyroidism

low Ca
high Ph

high alkphos

possibly from low vitamin D
usually chronic renal failure

57

acromegaly

cardiac failure
large tongue
secondary DM from gluconeogenesis

58

treat SIADH

demeclocycline

59

hypercalcemia
hypocholesterolemia
hyperglycemia
afib

hyperthyroidism

60

arrhythmia
hyperthermia
vomiting
hypovolemic shock

thyroid storm

61

Hurthle cells

Hashimoto - eosinophilic, lining of follicle

62

achlorhydria
cholelithiasis
steatorrhea

somatostatinoma - low gastrin/CCK

63

VIPoma symptoms

hypokalemia
achlorhydria
watery diarrhea

64

causes of Addison's

TB = worldwide
lung/other metastatic cancer
autoimmune

65

pheo syndromes

NF1
VHL
MEN2A/2B

66

basophils in pituitary

FSH
LH
ACTH
TSH
"B-FLAT"

67

cornea GLUT

GLUT1

68

insulin effects

increases kidney Na retention
increases uptake of K, AA

69

prolactin regulation

TRH increases

70

tesamorelin

GHRH analog
for HIV associated lipodystrophy

71

somatomedin C

IGF1

72

ghrelin changes

increase with Prader Willi
increase with sleep loss
made by stomach

73

V1 receptor

BP via ADH

74

ADH regulation

osmoreceptors in hypothalamus

75

increase in 17-OH-progesteron

21-hydroxylase deficiency

76

calcium homeostasis

40% on albumin - increase with higher pH
45% free ionized

77

increases macrophage CSF and RANKL

PTH

78

very low serum Mg

decreases PTH

79

V1 ADH type

IP3

80

H1 R type

IP3

81

IGF1 type

TK to MAPK

82

GH type

RTK to JAK/STAT

83

Aldosterone type

intracellular R

84

ATII type

IP3

85

V2 ADH type

cAMP

86

TRH type

IP3

87

Vit D type

intracellular R

88

prolactin type

RTK to JAK/STAT

89

GnRH type

IP3

90

oxytocin type

IP3

91

T3 helps in

brain maturation

92

metyrapone stimulation test

blocks 11-deoxycortisol to cortisol
no compensatory increase in ACTH with adrenal insufficiency

93

opsoclonus myoclonus

neuroblastoma - Nmyc

HVA and VMA, bombesin, neuron enolase

94

90% pheos are

benign unilateral adrenal non-calcifies in adults

95

pheo syndromes

NF1
VHL

96

Hurthle cells

Hashimoto, near germinal centers

97

jaw pain and ESR high

de Quervain subacute thyroiditis

98

IgG4 related

autoimmune pancreatitis
retroperitoneal fibrosis
noninfectious aortitis
Riedel (rock) thyroiditic

99

fever, diarrhea, tachyarrhythmia, high ALP

thyroid storm
give propranolol, PTU, prednisolone

100

Ligated inferior thyroid artery

Cut recurrent laryngeal nerve

101

lymphatic invasion thyroid cancer

hematogenous invasion thyroid cancer

papillary - irradiation, BRAF, RET

medullary

102

Ca levels in hyperparathyroidism

low with secondary
- hyperP in renal failure, hypo P usually

high with primary

high with tertiary
- chronic renal disease causes high PTH

103

hypocalciuric hypercalcemia

PT cell Ca receptor defect
mild hypercalcemia
increased/normal PTH

104

increased ALP, cAMP in urine

hyperparathyroidism

105

pegvisomant

GH receptor antagonist for acromegaly

106

DI labs

urine gravity 290

central - >50% increase urine osmolal with vasopressin

107

low aldosterone

SIADH

108

treat SIADH

conivaptan
tolvaptan
demeclocycline

109

most common death in diabetes

MI from large vessel disease

110

severe glucose intolerance

type 1 DM

111

IAPP deposits

type 2 DM

112

most common ketone body

BHB

113

changes in diabetic ketoacidosis

leukocytosis
heart failure
cerebral edema
low bicarb
mucormycosis - Rhizopus

114

dermatits
hyperglycemia
DVT
depression

glucagonoma

115

high urine 5-HIAA

carcinoid syndrome

116

carcinoid syndrome 2/3

2/3 are non-metastatic, single, with no second malignancy

usually SI

117

treat carcinoid

octreotide

118

positive secretin stimulation test

Zollinger Ellison
may be in MEN1
no inhibition of gastrin release

119

MEN1 gene

menin tumor suppressor

120

PTU SE`

liver failure
ANCA+ vasculitis

use in first trimester