Our Clues 14 Flashcards
(50 cards)
Periods of rapid growth?
0-2 years
4-7 years
Puberty
Pregnancy
What is the only protein hormone that has a nuclear membrane receptor?
Thyroid hormone
T3
Dx of (say one at a time):
antimicrosomal antibody
thyroid peroxidase antibody
antithyroglobulin antibody
Hashimoto’s Disease
- most common cause of primary hypothyroidism
- T cell and macrophage infiltration of thyroid
- incr risk of lymphoma due to defective T cells
How does T4 become metabolically active?
Converted to T3 by 5’-deiodinase which is in the liver.
It has a beta receptor located on it.
Dx of hypothyroidism
- incr TRH
- incr TSH
- decr T3/T4
Primary hypothyroidism
(d/t thyroid problem)
Dx of hypothyroidism
- incr TRH
- decr TSH
- decr T3/T4
Secondary hypothyroidism
(d/t pituitary problem)
Dx of hypothyroidism
- decr TRH
- decr TSH
- decr T3/T4
Tertiary hypothyroidism
(d/t hypothalamus problem)
Dx of T cell and macrophages chewing away at the thyroid and usually self-resolving
Subacute Thyroiditis/de Quervain’s disease
- Granulomatous attack
- started by viral infection
- very painful from inflammation
- incr T4/T3
- decr TSH
- decr RAIU uptake
- incr thyroglobulin
Dx of antibodies against TSH receptor
Grave’s Disease
- stimulates receptor
- MCC of hyperthyroidism before 50 years
- symmetrical enlargement of the thyroid (goiter)
- exophthalamous due to granulomatous infiltration
- symmetrical iodine uptake
Dx of one area of iodine uptake in the thyroid?
(one hot nodule)
Plummer’s syndrome
- MCC of hyperthyroidism after 50 years
Dx of Hyperthyroidism
- decr TRH
- decr TSH
- incr T3/T4
Primary Hyperthyroidism
(d/t thyroid problem)
Dx of Hyperthyroidism
- decr TRH
- incr TSH
- incr T3/T4
Secondary Hyperthyroidism
(d/t pituitary problem)
Dx of Hyperthyroidism
- incr TRH
- incr TSH
- incr T3/T4
Tertiary Hyperthyroidism
(d/t hypothalamus problem)
What drugs block peroxidase?
Used to treat hyperthyroid:
PTU (= propylthiouracil)
- blocks peripheral conversion of T4 to T3
- DOC
- can be used in pregnancy
Methimazole
- inhibits release of T3/T4
- crosses placenta, not used in pregnancy
What is the MOA of atypical antipsychotics?
(same for all)
Block
- Dopamine 4 receptors
- 5-HT receptors
Used for:
- side effects
- extrapyramidal side effects
Side effects of atypical antipsychotics:
Clozapine
agranulocytosis
seizure
Side effects of atypical antipsychotics:
Olanzapine
weight gain
obesity
Side effects of atypical antipsychotics:
Risperidone
incr prolactin
galactorrhea
Side effects of atypical antipsychotics:
Quetiapine
sedating
cataracts
Side effects of atypical antipsychotics:
Ziprasidone
incr QT interval
weight gain
Growth Hormone
- Made by
- Stimulus
- Inhibition
- Where it goes
- What it does
- 2nd messenger
- Made by: anterior pituitary
- Stimulus: stress, growth
- Inhibition: somatostatin
- Where it goes:
during stress to liver
during growth to bone - What it does
stress - catabolic: stimulates gluconeogenesis via proteolysis
growth - anabolic: stimulates IGF only after 1st REM - 2nd messenger
stress - cAMP
growth - tyrosine kinase
Antidiuretic Hormone
- Made by
- Stimulus
- Inhibition
- Where it goes
- What it does
- 2nd messenger
- Made by: hypothalamus
(stored in posterior pituitary) - Stimulus: incr osmolarity
- Inhibition: decr osmolarity
- Where it goes:
collecting duct of kidney (V2 receptors)
blood vessels (V1 receptors) - What it does
1) opens aquaporins causing reabsorption of H2O
2) vasoconstriction
3) release vWF, Factor V, Factor VIII - 2nd messenger: IP3/DAG
Dx of:
- normal plasma volume
- decr plasma osmolarity
- decr plasma Na
- incr urine Na
- incr urine osmolarity
SIADH
- cells are sensitive to pressure
- causes
1) pain
2) incr ICP
3) hypoxic lung disease
4) drugs
5) cancer
What is produced by the supraoptic nucleus?
What is produced by the paraventricular nucleus?
SAD POX
supraoptic
- 80% ADH
- 20% oxytocin
paraventricular
- 80% oxytocin
- 20% ADH