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Flashcards in Endocrine Deck (163):
1

which adrenergic receptors increase hepatic glucose output

beta 2 and 3

2

alpha 1 receptor works by which second messanger

IP3, Ca (Gq)

3

alpha 2 receptor works by which second messanger

Gi : decrease cAMP

4

beta1 receptor works by which second messanger

Gs increase cAMP

5

beta2 receptor works by which second messanger

Gs increase cAMP

6

alpha 1 prefers which adrenergic ligand

NE

7

alpha 2 prefers which adrenergic ligand

NE

8

which adrenergic receptor inhibits insulin release

alpha 2

9

beta 1 prefers which adrenergic ligand

NE=E

10

beta 2 prefers which adrenergic ligand

E

11

beta 3 prefers which adrenergic ligand

NE

12

where do you find beta 2 receptors

GI, urinary, adipose, liver, skeletal muscle, alpha cells in pancreas, bronchiole

13

where do you find beta 1 receptors

heart

14

where do you find alpha receptors

veins, lymph, beta cells in pancreas

15

beta3 receptor works by which second messanger

Gs increase cAMP

16

disease: high circulating catecholamines causing headache, palpitations, HTN, sweat, tachycardia

pheochromocytoma

17

disease: high cortisol, low ACTH

cushing syndrome (spontaneous or drug induced cortisol excess)

18

disease: high cortisol, high ACTH

cushing disease (pituitary adenoma)

19

how to distinguish cushing disease from syndrome

dexamethasone suppression test

20

osteoporosis, poor wound healing, virilization, HTN, round face, buffalo torso

cushing

21

treatment for cushings

ketoconozole, metyrapone

22

why do we get HTN with high cholesterol

alpha 1 stimulation causes vasoconstriction

23

disease: hypoglycemia, hypotension, hyperkalemia, acidosis, decreased hair and libido, hyperpigmentation

addisons

24

what will cortisol, CRH, ACTH look like in secondary adrenocortical insufficiency

low cortisol, high CRH, low ACTH

25

disease: primary adrenocortical insufficiency

addisons

26

why do we get hyper pigmentation with addisons

increased ACTH with alphaMSH can't stimulate adrenal cortex (cuz its messed up) but the MSH produces discoloration

27

disease: primary hyperaldosteronism

conn syndrome

28

disease: hypervolemic, hypernatremic, HTN, low K, low H (alkalosis)

Conn syndrome

29

how do you treat conn syndrome

spironolactone (aldosterone antagonist)

30

disease: overproduction of mineral corticoids can occur when we have deficiency in which enzyme

17alpha hydroxylase

31

disease: cannot synthesize gluco or mineral corticoids so we get excess androgens leading to urinary ketosteroids and sterility

21 beta hydroxylase deficiency

32

a deficiency in which enzyme along the steroid hormone synthesis pathway would lead to HTN

11 beta hydroxylase

33

a deficiency in which enzyme along the steroid hormone synthesis pathway would lead to Hypotension

21 beta hydroxylase

34

angiotensin II stimulates what enzyme

aldosterone synthase

35

what regulates secretion of cholesterol desmolase

ACTH

36

what enzyme is needed to convert cortisol to the less active corticosterone after binding mineral corticoid receptors

beta hydroxysteroid dehydrogenase

37

who secretes PTH

chief cells

38

who secretes calcitonin

C parafollicular cells

39

oxytocin and ADH are stored in these enlarged axon terminals

herring bodies

40

glial cells of neurohypophysis

pituicytes

41

pineal gland secretory function is mediated by what type of receptor

beta adrenergic

42

what do F cells in pancreas secrete

pancreatic polypeptide

43

what do delta cells secrete in pancreas

somatostatin and gastrin

44

what do catecholamines and thyroid hormones have in common

derived from tyrosine (amine hormones)

45

POMC neurons make what kind of hormone

ACTH, MSH

46

what stimulates GH release

low glucose, GHRH, estrogen, testosterone, exercise, stress, sleep, alpha adrenergic agonist

47

Somatomedin C is also called

IGF1

48

GH directly affects what organs

skeletal muscle, adipose, liver

49

what does GnRH do

stimulates anterior pituitary to make LH and FSH

50

GH has indirect anabolic affect via what mediator

somatomedins made in liver

51

the hypothalamus releases what product that inhibits GH secretion from anterior pituitary

somatostatin

52

what test is performed to confirm diagnosis of GH excess (acromegaly)

administer oral glucose-- should suppress GH levels and if they remain high we know there is exogenous GH secretion

53

how does prolactin suppress ovulation

inhibit GnRH

54

what stimulates prolactin release

TRH

55

what inhibits prolactin release

dopamine

56

3 sources of dopamine which inhibits release of prolactin

posterior pituitary, hypothalamus, non lactotroph cells of anterior pituitary

57

how does ADH increase peripheral resistance

binds V1 receptors increasing intracellular ca++ and contraction of SM in arterioles

58

disease: large volume of dilute urine excreted and high osmolarity of body fluids-- fixed with ADH analogue

central DI

59

disease: large volume dilute urine excreted and high osmolarity of body fluids and high ADH

nephrogenic DI

60

MOA for nephrogenic DI

V2 defect

61

nephrogenic DI can occur secondary to what

lithium use, polycystic kidney disease, sickle cell anemia

62

how to treat nephrogenic DI

thiazide diuretics: inhibit Na reabsorb from PCT

63

disease: dilute body fluids, hyponatremia, high concentration of urine

SIADH

64

disease: enlargement of pituitary during pregnancy leads to infarction and hypopituitism

sheehan syndrome

65

what enzyme activates a GPCR by making the GDP GTP

GEF

66

what enzyme deactivates GPCR by hydrolyzing GTP

GAP

67

what are the ligands for RTKs

growth factors

68

inactive versus active form of insulin

hexamer: inactive
monomer: active

69

end result of RAS dependent insulin action

upreg glucokinase

70

end result of RAS independent insulin action

move GLUT4 to membrane (and activate glycogen synthase)

71

insulin resistance may happen because PKB does not activate to insert GLUT4 into PM's. this could be because ___ gets phosphorylated at the wrong spot (ser/thr instead of tyr)

IRS1 and IRS2

72

epinephrine encourages what pancreatic secretion

glucagon (stress can cause DKA because E also inh insulin)

73

when we have no more glycogen, ___ stimulates gluconeogenesis

cortisol

74

estrogen binds ___ which is a HAT loosening DNA allowing transcription

SRC1

75

estrogen antagonists like ___ are going to activate HDAC to tighten chromatin

tamoxifen

76

conversion from T4 to T3 requires what enzyme

deiodinase

77

what enzyme hydrolyzes bonds to release MIT and DIT from TG allowing them to combine and form thyroid hormones

lysosomal proteases

78

MIT and DIT interact with ___ in the thyroid epithelial cell to produce tyrosine and thyroglobulin

intrathyroidal deiodinase

79

deficiency in intrathyroid deiodinase mimics what other condition

I- deficiency

80

who does I- get to lumen

pendrin + peroxidase

81

drug that blocks NIS

perchlorate and thiocynate

82

drug that blocks peroxidase

PTU

83

high levels of I- inhibit organification and synthesis of thyroid hormones (peroxidase aint working)

wolff chaikoff effect

84

what causes high TBG

pregnancy

85

thyroid hormone encourages synthesis of

NaK ATPase, beta adrenergic receptors, lysosome enzymes

86

to convert carotene to vitamine A we need what hormone

thyroid hormone

87

disease: antibodies destroy or block thyroid hormone synthesis by blocking peroxidase resulting in hypothyroid with goiter

autoimmune thyroiditis

88

disease: hypothyroidism in mother during pregnancy leads to this in baby

cretinism

89

disease: antibody stimulates TSH receptors

graves disease

90

disease: protruding eyeballs, periorbital edema, elevated thyroid hormone, goiter

graves

91

disease: impaired synthesis of thyroid hormones due to TG or TPO antibodies

hashimoto disease

92

disease: iodide deficiency in developing baby

cretinism

93

most common hyperthyroidism cause

graves

94

can you have goiter with i deficiency

yes- low T3/T4 stimulates TSH release

95

disease: new bones fail to mineralize so we get bending and softening

osteomalacia

96

disease: hyperreflexia, muscle twitching, tingling

hypocalcemia

97

disease: decrease QT interval, constipation, lack apetite, hyporeflexive, coma

hypercalcemia

98

academia leads to what ca++ related condition

H displaces Ca from albumin and you get increase in free ionized ca

99

chromic hypomagnesemia in alcoholics inhibits synthesis storage and secretion of what

PTH

100

how does vitamin D increase calcium reabsorption in GI tract

synthesis of calbindin which increases the absorptive capacity of GI epithelial cells so we can bring more into blood

100

how does PTH increase Pi excretion

inhibits NPT (NaPi cotrasport) in PCT

101

whats the job of osteoprotegrin

bone formation (inactivate osteoclast)

102

where does ca reabsorption take place in a kidney stimulated by PTH

TAL, distal tubule

103

what does estrogen do to [ca]

stimulate intestinal and renal absorbtion

105

what regulates activity of 1alpha hydroxylase

activated by PTH
inhibited by Ca

105

disease: stones, bones, groans

primary hyperparathyroidism

106

what are vitamin D levels like in someone with parathyroid adenoma

increased PTH causes lots of vitamin D activation so levels are HIGH

107

disease: renal failure or vitamin D deficiency leads to low ca

secondary hyperparathyroidism

108

in secondary hyperparathyroidism what are the Pi levels like

DEPENDS on the cause
vitamin D deficient: low Pi levels
renal failure: high Pi levels (cannot excrete)

109

disease: low ca, low vitamin D, high serum Pi, muscle cramping, seizure, poor tooth development, mental deficit, intestinal malabsorbtion

hypoparathyroidism

110

disease: autosomal dominant inherited, Gs of PTH-R is broken leading to hypocalcemia and hyperphosphatemia

pseudohypoparathyroidism

112

what do glucocorticoids do to [ca]

inhibit absorption from kidney and intestine

113

disease: high PTH, low vitamin D, low ca, high Pi

pseudohypoparathyroidism

114

disease: PTHrp

humoral hypercalcemia of malignancy

115

what are vitamin D levels in humoral hypercalcemia of malignancy

low (this is the only difference from hyperparathyroid symptoms)

116

how to treat humoral hypercalcemia of malignancy

furosimide (increase ca excretion)
etidronate (inhibit bone resorbtion)

117

disease: autosomal dominant mistake in CaSR

hypocalcuric hypercalcemia

118

disease: deficiency in 1alpha hydroxylase

rickets type I

119

disease: deficiency in vitamin D receptor

rickets type II

120

disease: bone mass decreases

osteoporosis

121

treat for osteoporosis

PTH, estrogen, calcitonin, RANKL inhibitor

122

treat for rickets/osteomalacia

vitamin D, ca, sunlight

123

what brings glucose into beta cell to initiate insulin release

GLUT2

124

high levels of ATP in pancreatic beta cell causes what to happen

K channels close (depolarization)

125

an increase in intracellular ___ causes clathrin coated vesicles containing insulin to be released from beta cell

Ca

126

drugs that promote closure of ATP dependent K channels to increase insulin secretions in T2D

sulfonurea (tolbutamide, glyburide)

127

which tissues require insulin for effective glucose uptake (via GLUT4)

muscle, adipose, liver

128

insulin activates SREBP1c for what purpose

uptake more LDL's (to build more TAG's not break them down)

129

what does insulin release do to blood [k]

decrease

130

disease: autoimmune destruction of beta cells

type I diabetes

131

disease: progressive exhaustion of beta cells leading to insulin resistance

type II diabetes

132

medication for type II diabetics that sensitizes them to insulin

metformin

133

disease: patient has antibodies to GAD65, IA2, insulin autoantibody

type i diabetes

134

disease: patient has antibody that is antagonist against insulin

type ii diabetes (blocks insulin at target tissue)

135

while auto Ab's are found in type i diabetic patients, who is actually doing the most harm to beta cells

CTL's

136

what is the most common genotype mutation in type i diabetes patients

HLA: DQ2 or DQ8
DR3 or DR4

137

if you have this genotype you are said to have "protective" factor from developing type i diabetes

HLA DR2 DQ6

138

what viruses can cause direct or indirect (via molecular mimicry) development of T1D

mumps, rubella, CMV

139

what bacteria can cause harm to beta cells

streptozocin, bafilomycin a1

140

cell markers for treg

CD4+25+FOXP3+

141

disease: messed up FOXP3

IPEX

142

what kind of cell infiltrates adipose tissue in obese patients causing inflammation and eventually leading to insulin resistance

M1 macrophages (TNFalpha and IL1beta)

143

excess palmitate induces expression of TLR4 in beta cells which will release cytokines to attract ___ which are cells that cause harm to these cells

M1 macrophages

144

what gets released (at normal term birth) in order to stimulate surfactant production in newborn babies-- otherwise they get IRDS

glucocorticoids

145

enzyme that turns cortisol into cortisone so it doesn't overstimulate mineral corticoid receptors

11 beta hydroxysteroid dehydrogenase

146

why does real licorice give us HTN

it blocks 11 beta hydroxysteroid dehydrogenase allowing mineral corticoids AND glucocorticoids to raise BP

147

how does cortisol suppress immune function

inhibit NFKB by sequestering it
reduce IL2 synthesis
promote T cell apoptosis

148

enzyme required to make estradiol in the ovaries

aromatase

149

estradiol that gets circulated to the brain has what effect

down regulation of FSH and LH

150

gives breath a fruity smell in T1D

acetoacetate

151

disease: headache, weakness, diarrhea, arrhythmia, increase HR, vomitting, SOB with kussmaul

DKA

152

disease: parathyroid, pituitary, pancreas tumors

MEN1

153

disease: L dopa decarboxylase deficiency

this is in APUD cells -- MEN syndromes

154

most common parathyroid abnormality with MEN 1

hyper-- hyperplasia of all 4 glands

155

most common pancreas abnormality with MEN 1

gastrinoma

156

most common pituitary abnormality with MEN 1

prolactinoma

157

whats RET

protooncogene-- MEN2

158

whats menin protein

product of MEN1 gene (tumor suppressor)

159

disease: MTC and pheochromocytoma

MEN2

160

disease: MTC, pheochromocytoma, hyperparathyroidism

MEN 2a

161

what is unique to MEN2a

hyperparathyroid, cutaneous lichen amyloidosis

162

what is unique to MEN2b

mucosal neuroma, marfanoid habitus

163

disease: high E, high calcitonin, normal PTH

MEN 2b