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Flashcards in Endocrine Deck (74):
1

What test should you order before giving metformin

Creatine test

2

What happens to pro insulin in the RER

It is added to three disulfide bonds and transported to the Golgi and packed into secretary granules

3

The cleavage of what by endopeptidases in the secretory granules results in the formation of insulin and c peptide

Pro insulin

4

Uptake of cholesterol happens how

Receptor mediated endocytosis (mediated by LDL receptor)

5

How does glucose get into cells

Facilitated diffusion with the use of GLUT transporters

6

medullary thyroid carcinoma has increased levels of what

calcitonin

7

what are the gremlin mutations seen in MEN 2

RET

8

Marfanoid, mucosal neuroma, pheochromocytoma, medullary thyroid carcinoma?

MEN 2B

9

medullary thyroid carcinoma, pheochromocytoma, parathyroid hyperplasia

MEN 2A

10

hyperparathyroidism, pituitary tumor
and pancreatic tumor

MEN 1

11

RAS mutations are found in what

follicular thyroid cancer and some follicular adenomas

12

what is the treatment for CAD

giving low doses of cortisol to suppress ACTH secretion

13

what is the best marker test for hypothyroidism

high TSH ( this will be high before you see low T3 and T4)

14

why does the metabolism of alcohol for long periods of time cause hypoglycemia

Alcohol DH and Acetaldehyde DH reduce NAD to NADH and this increases the NADH/NAD Ratio, making impossible for reactions that need NAD to work, such as gluconeogensis

15

what binds to potassium in the pancreas to release insulin

ATP

16

protein defect in familial Chylomicronemia Syndrome

Lipoprotein Lipase and ApoC-2

17

major manifestations of Familial Chylomicronemia Syndrome

Acute Pancreatitis
Eruptive skin Xanthomas

18

protein defect in familial hypercholesterolemia

LDL receptor
APOB-100

19

manifestations in familial hypercholesterolemia

premature coronary artery disease

20

protein defect in familial dysbetalipiproteinemia

ApoE

21

manifestation in familial dysbetalipiproteinemia

premature coronary artery disease

22

protein defect in familial hypertriglyceridemia

ApoA-V

23

what is lipoprotein lipase usually bound too

heparin sulfate

24

milky appearing renal vascular is seen in familial chylomicronemia syndrome and is called what

lipema retinalis

25

what are the carrier proteins for OCT and ADH

neurophysins

26

what is the signaling pathway that GH uses to release IGF-1 from the liver

Jak Stat Pathway

27

what is it called when there is an aldosterone secreting tumor and there is a rise in sodium and a fall in hydrogen and potassium

Conn syndrome

28

DKA can cause something in patients that is associated with the respiratory alkalosis they experience to combat the acidosis

respiratory failure

29

biopsy of subacute granulomatous thyroiditis

multinuclear giant cels with lymphocytic infiltration

30

biopsy of papillary thyroid cancer

branching papillary structures with concentric calcifications

31

biopsy of the tall cell type papillary thyroid cancer

follicular hyperplasia lined by tall epithelial cells usually in older people

32

biopsy of Reidel Thyroiditis

extensive fibrosis of the plan that extends into surrounding tissue

33

biopsy of Hashimoto

diffuse painless gland enlargement with mononuclear parenchymal infiltration with well developed germinal centers

34

what is usually the main cause of hyperaldosteronism

bilatera adrenal hyperplasia

35

main clinical features of hyperaldosteronism

hopkalemic alkalosis
muscle weakness and paresthesias
hypertension

36

what is aldosterone escape

this is when there is a high HTN because of the salt retention so the GFR increases and so there is never a fluid over load seen in hyperaldosteronism

37

somatostatinomas inhibits what

insulin
cholecystokinin
gastein
glucagon
g.i motility

38

signs of VIPoma

watery diarrhea, hypokalemia and impaired gastric acid secretion

39

brown tumor bone cyst in the long bones, salt and pepper skull and subperiosteal erosions in the phalanges of the hands are all sign of what disease

osteitis fibrosa cystica

40

what is the classic finding in hypothyroidism associated with the slow reabsorption of calcium by the SR causing the muscle to round when you tap on it

myoedema

41

what do bile acids do in reference to cholesterol

it causes depletion of bile acids so that there has to be an upregualtion of 7 alpha hydroxyls which converts cholesterol to bile acids

42

what is Proprotein Converts Subtilizing Kevin 9 (PCSK9)

it increases the degradation of LDL receptors

43

what drug is given to counteract PCSK9 and increase the availability of LDL receptors on the liver membranes, clearing ldl from the blood

Alirocumab ( monoclonal antibody)

44

drug used as an anti rejection drug that decreases the proliferation of T cells in the patient. can be used with mycophenalate or azathioprine

Tacrolimus

45

how does Epi increase Glucose

it limits glucose use by insulin dependent tissues as well as causing gluconeogenesis and glycogenolysis

46

mealtime insulin analogues have an amino acid substitution whre

at the c terminal end of the B chain

47

what tends to be elevates in males who only have one testicle and why

Inhibit B because there is not there are not enough Sertoli cells to produce it so FSH will be high because there is no negative feedback

48

in aa medical setting what is severe hypoglycemia usually treated with

intramuscular glucagon

49

why does the insulin Determi have a prolonged action

because it binds to lysine in the insulin molecule and binds to albumin so it can slowly dissociates

50

what can cause an increase in TBG which leads to an increase in thyroid hormone levels

estrogen

51

delayed puberty and anosmia ( can smell) are signs of what

Kallmann Syndrome

52

what is Kallmann Syndrome

results from he failure of GnRH secreting neurons to migrate from their origin in the olfactory placed to their normal anatomic location in the hypothalamus (mutation in KAL-1) there is central hypogonadism and anosmia

53

cushing syndrome and SLE both increase the chance for what

coronary artery disease

54

what could cause a unilateral atrophy of an adrenal gland

a contralateral cortisol producing tumor because it would decrease ACTH which would atrophy the adrenal that had no tumor

55

what do thyroid peroxidase do

they cause thyroglobulin iodination

56

what are the three effects of thyroid peroxidase

1. oxidation of iodide (iodide to iodine)
2. iodination of thyroglobulin
3. the coupling reaction between 2 iodized tyrosine resides

57

the uptake of iodide from the blood is blocked by what two things

perchlorate and pertechnetate

58

extracellular potassium levels that are high and intracellular levels that are low represent what

DKA

59

fever and sore throat in someone with Graves Disease who is treated with medical therapy should suggest what

thionamide (PPU and methimazole)drug use (Thionamide Induced Agranulocytosis)

60

main drug given for thyroid storm

PPU

61

what is a drug that is used to decrease the rate of facial hair growth by inhibiting ornithine decarboxylase which is used in DNA stabilization and repair

Eflornithine

62

how do chronically elevated free fatty acid levels contribute to insulin resistance

they impair insulin dependent glucose uptake and increase hepatic gluconeogenesis

63

describe the presentation of Metabolic syndrome

- elevated TG
- central obesity
- HTN
- high glucose
- low HDL

64

hypokalemia, hyperaldosteronima and late puberty are signs of

17-alpha hydroxyls def.

65

side chain cleave enzyme causes what

a decrease in all adrenal hormones because this stops the first step of cholesterol from becoming pregvnenlone

66

a male born with hypospaisias and a small penis is usually due to a lack of what

DHT

67

what is the enzyme that turns progesterone into 11-Deoxycorticosterone and 17-OH progesterone into 11-Deoxycortisol

21-hydroxylase ( the most common cause of CAD from bilateral adrenal insufficiency)

68

a high serum level of what is suggestive of 21 hydroxyls deficiency

17-hydroxyprogesterone

69

iv infusion of what drug treats DKA

regular insulin

70

a redistribution of fat from the face and extremities to the trunk "Lipoatrophy" is a common side effect of what treatment

highly active antiretroviral therapy (HAART)

71

what sulfonyureas have a better chance of giving someone hypoglycemia

Glyburide and Glimepiride (long acting)

72

what does metyrapone do

it blocks cortisol synthesis by inhibiting 11-b-hydroxylase which turns 11-deoxycortisol into cortisol, this will increase ACTH

73

how does TNF alpha induce insulin resistance

by activating serine kinases which then phosphorylate serine residues o beta subunits of IR and IRS-1

74

phosphorylation of serine and threonine residues that cause insulin resistance can be done by what things

- TNF-a
- catecholamines
- glucagon
- glucocorticoids