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