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Second yaaa > endocrine > Flashcards

endocrine Flashcards

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1
Q

which of the two renal veins is the longer and more significant?

A

left renal vein

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2
Q

what do the pancreatic delta cells secrete and what is its function?

A

somatostatin - inhibits release of insulin + glucagon

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3
Q

what do the pancreatic F cells secrete and what is its function?

A

pancreatic poly peptide - inhibits exocrine function of pancreas

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4
Q

which enzyme converts glycogen to glucose and is inhibited by insulin?

A

glycogen phosphorylase

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5
Q

which enzyme converts glucose–6-phosphase to glycogen and is inhibited by glucagon?

A

glycogen synthase

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6
Q

which enzyme converts glucose to glucose-6-phosphase?

A

hexokinase

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7
Q

which enzyme converts TAG to glycerol + fatty acids?

A

hormone sensitive lipase

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8
Q

describe osmotic diuresis

A

Osmotic diuresis is increased urination due to the presence of certain substances in the fluid filtered by the kidneys.

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9
Q

how do biguanides (metformin) work?

A

by inhibiting G6Pase (G6Pate->Fructose6Pate) & PEPCK (oxaloacetate -> phosphoenolpyruvate)

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10
Q

how do sulphonylureas work?

A

inhibiting ATP sensitive K+ channels

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11
Q

which enzyme converts inactive I- into the active I+ in the thyroid follicle cells?

A

thyroid peroxidase

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12
Q

oeripherally, how is T3 formed?

A

by 5’ deionisation of T4

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13
Q

how does I- enter the thyroid follicle from the capillary?

A

along with Na+ via a TSH-sensitive ion pump

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14
Q

what is the main cause of hypER thyroids and what are the signs and symptoms?

A 
Grave's disease (hypER =gRavEs)
weight loss
hypertension
heat intolerance
Grave's opthalmology
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15
Q

what is the main cause of hypO thyroids and what are the signs and symptoms?

A 
Hasimoto's Disease
weight gain
cold intolerance
menorrhagia
goitre possible
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16
Q

what is the drug of choice for Grave’s disease and it’s mechanism of action?

A

carbimazol (a thionamide)

inhibit’s thyroid hormone synthesis by blocking the action of thyroid peroxidase

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17
Q

what is the drug of choice for Hashimoto’s disease

A

Thyroxine replacement therapy for life (levothyroxine)

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18
Q

what are the 4 borders of the femoral traingle?

base, medial border, lateral border, apex

A

base: inguinal ligament
medial border: lateral border of adductor Magnus muscle
lateral border: sartorius muscle
apex: where sartorial crosses medial border

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19
Q

where on the body can GLUT-2 transporters be found?

A

liver, pancreatic beta cell, small intestine, kidney

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20
Q

where on the body can GLUT-4 transporters be found?

A

skeletal and cardiac muscle, adipocytes

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21
Q

where on the body can GLUT-1 transporters be found?

A

every cell

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22
Q

what are hexokinases I-III inhibited by?

A

G6P

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23
Q

what is the committed step for glycolysis?

A

phosphofructokinase

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24
Q

are hexokinase reactions reversible or irreversible?

A

irreversible

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25
what is the function of PEPCK?
converting oxaloacetate into PhosphoEnolPyruvate
26
what type of receptors are glucagon receptor?
G protein coupled receptors
27
what are incretins?
GI hormones that increase insulin secretion (GLP-1, DPP-4)
28
how do SGLT-2 inhibitors work?
reduce hypERglycaemia by inhibiting renal re-uptake of glucose from filtrate by SGLT-2
29
how is Hyperosmolar hyperglycaemic State different to DKA?
``` DKA:HHS short history:inisidious history no residual insulin:residual insulin usually young T1DM:usually older T2DM patient usually alert:patient usually drowsy ```
30
in normal renal glucose handling, how much glucose is reabsorbed by SGLT2 in the PCT?
90% (remaining 10% by SGLT1)
31
which enzyme hydrolyses TAG to chylomicrons/VLDL and which one re-esterifies it to TAG?
``` lipoprotein lipase (LPL) Diacylglycerol acyl transferase (DGAT) ```
32
above which dose does metformin begin giving major GI sx
2g
33
what does maolnyl CoA do?
inhibit FA oxidation
34
does inulin inhibit or promote lypolisis and how does it do this?
inhibit | stimulates breakdown of cAMP so NA can no longer stimulate lipolysis
35
does NA inhibit or promote lipolysis?
promote
36
which enzyme metabolises glucose to sorbitol?
aldose reductase
37
what do I+ and tyrosine form a complex with, in the synthesis of thyroxine (T4) and triiodothryonine (T3)
thryoglobulin
38
how do sulphonylureas work?
bind to receptor on beta cells, inhibit K(ATP) channels and permit increased insulin secretion -> increased circulating insulin
39
spironalactone?
anti aldosterone
40
what is the function of bisphosphonates?
reduce bone resorption by inhibiting osteoclasts
41
what effect do glucocorticoids (cortisol) have on bone volume?
decrease
42
what happens to the epithelium of follicular thyroid cells when it is stimulated?
becomes columnar and the lumen is depleted of colloid
43
list some of the main actions of thyroid hormone
``` inc bone turnover inc proteolysis inc lipolysis inc HR inc metabolic rate (glucose) ```
44
where does aldosterone act in the nephron?
principal cells of DCT + collecting duct (inc Na reabsorption + K excretion
45
what is SIADH (Syndrome of inappropriate anti-diuretic hormone) the opposite of?
diabetes insipidus
46
what effect does hypo/hypernatraemia have on the brain?
Na low ->water moves up to brain to bring up plasma osmolality brain swelling (cerebral oedema) seizure/death rapidly inc Na -> water leaves brain -> osmotic demyelination (often paralysed for life)
47
what is the rhyme to remember the clinical features of hypercalcaemia?
Moans (bone pain, muscle weakness) Bones (osteoporosis) Stones (renal) + Groans (constipation, pancreatitis, abdominal pain)
48
what are the functions of cortisol?
``` inhibit vit D production stimulate gluconeogenesis in the liver stimulate lipolysis suppress release of insulin immune suppression proteolysis ```
49
are all steroid hormones lipid soluble or insoluble? | same with water
lipid soluble (but not water soluble so have to be carried in blood))
50
blood supply to the adrenals
L+R superior, middle + inferior suprarenal arteries
51
venous drainage to adrenal gland
medullary vein (in centre) -> suprarenal veins ->IVC on right, L renal vein on L
52
describe the histology of each section of the adrenal gland
ZG - clusters of small cells. Fewer lipids than other layers ZF - Large cells arranged in cords ZR - smaller cells, haphazard arrangement Medulla - chromatin cells. Numerous capillaries + veins
53
what is the rate-limiting enzyme in cholesterol biosynthesis?
HMG-CoA Reductase
54
What is the rate-limiting step in the conversion of cholesterol to pregnenalone (first enzymatic step) and what is it carried out by?
transport of free cholesterol from cytoplasm into mitochondria (carried out by StAR
55
what is the function of 11B-HSDII (hydroxysteroid dehydrogenase)?
catalyses the conversion of active cortisol to inactive cortisone in selective tissues (eg. kidney) allowing aldosterone to function normally (as cortisol can bind to mineralocorticoid receptors and [cortisol]>>[aldosterone]
56
which 3 things stimulate the hypothalamus to secrete CRH?
illness, stress, time of day
57
which enzyme is lacking in congenital adrenal hyperplasia?
21-hydroxylase
58
what is the function of dexamethasone?
negative feedback a pituitary to inhibit ACTH release
59
what is primary aldosteronism?
like cushing's, but ACTH is normal, all just adrenal | - commonest secondary cause of hypertension, with hypokalaemia in up to 50%
60
what is tetany?
a condition marked by intermittent muscular spasms, caused by malfunction of the parathyroid glands and a consequent deficiency of calcium.

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