Our Clues 14 Flashcards

(50 cards)

1
Q

Periods of rapid growth?

A

0-2 years
4-7 years
Puberty
Pregnancy

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2
Q

What is the only protein hormone that has a nuclear membrane receptor?

A

Thyroid hormone
T3

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3
Q

Dx of (say one at a time):
antimicrosomal antibody
thyroid peroxidase antibody
antithyroglobulin antibody

A

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

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4
Q

How does T4 become metabolically active?

A

Converted to T3 by 5’-deiodinase which is in the liver.
It has a beta receptor located on it.

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5
Q

Dx of hypothyroidism
- incr TRH
- incr TSH
- decr T3/T4

A

Primary hypothyroidism
(d/t thyroid problem)

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6
Q

Dx of hypothyroidism
- incr TRH
- decr TSH
- decr T3/T4

A

Secondary hypothyroidism
(d/t pituitary problem)

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7
Q

Dx of hypothyroidism
- decr TRH
- decr TSH
- decr T3/T4

A

Tertiary hypothyroidism
(d/t hypothalamus problem)

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8
Q

Dx of T cell and macrophages chewing away at the thyroid and usually self-resolving

A

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

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9
Q

Dx of antibodies against TSH receptor

A

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

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10
Q

Dx of one area of iodine uptake in the thyroid?
(one hot nodule)

A

Plummer’s syndrome
- MCC of hyperthyroidism after 50 years

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11
Q

Dx of Hyperthyroidism
- decr TRH
- decr TSH
- incr T3/T4

A

Primary Hyperthyroidism
(d/t thyroid problem)

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12
Q

Dx of Hyperthyroidism
- decr TRH
- incr TSH
- incr T3/T4

A

Secondary Hyperthyroidism
(d/t pituitary problem)

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13
Q

Dx of Hyperthyroidism
- incr TRH
- incr TSH
- incr T3/T4

A

Tertiary Hyperthyroidism
(d/t hypothalamus problem)

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14
Q

What drugs block peroxidase?

A

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

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15
Q

What is the MOA of atypical antipsychotics?
(same for all)

A

Block
- Dopamine 4 receptors
- 5-HT receptors

Used for:
- side effects
- extrapyramidal side effects

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16
Q

Side effects of atypical antipsychotics:
Clozapine

A

agranulocytosis
seizure

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17
Q

Side effects of atypical antipsychotics:
Olanzapine

A

weight gain
obesity

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18
Q

Side effects of atypical antipsychotics:
Risperidone

A

incr prolactin
galactorrhea

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19
Q

Side effects of atypical antipsychotics:
Quetiapine

A

sedating
cataracts

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20
Q

Side effects of atypical antipsychotics:
Ziprasidone

A

incr QT interval
weight gain

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21
Q

Growth Hormone
- Made by
- Stimulus
- Inhibition
- Where it goes
- What it does
- 2nd messenger

A
  • 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
22
Q

Antidiuretic Hormone
- Made by
- Stimulus
- Inhibition
- Where it goes
- What it does
- 2nd messenger

A
  • 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
23
Q

Dx of:
- normal plasma volume
- decr plasma osmolarity
- decr plasma Na
- incr urine Na
- incr urine osmolarity

A

SIADH
- cells are sensitive to pressure
- causes
1) pain
2) incr ICP
3) hypoxic lung disease
4) drugs
5) cancer

24
Q

What is produced by the supraoptic nucleus?
What is produced by the paraventricular nucleus?

A

SAD POX

supraoptic
- 80% ADH
- 20% oxytocin

paraventricular
- 80% oxytocin
- 20% ADH

25
Oxytocin - Made by - Stimulus - Inhibition - Where it goes - What it does - 2nd messenger
- Made by: hypothalamus (stored in posterior pituitary) - Stimulus suckling of the nipple distention of uterus (labor) - Inhibition No suckling relaxation of the uterus - Where it goes: breast and uterus - What it does: smooth muscle contraction - 2nd messenger: IP3/DAG
26
What is the alkaline tide?
1) Gastrin touches parietal cell 2) Absorbs H2O and CO2 3) Produces H2CO3 with carbonic anhydrase to break it down 4) HCO3- will leave cell, Cl- into cell 5) H+ and Cl- inside cell (high pH) goes into stomach (low pH) via ATPase (3 H+ out, 2 K+ in) 6) incr HCl signals Chief cells
27
Gastric Ulcers - Location - Etiology - S&Sx - Cancer risk - Blood type
- Location: antrum of stomach - Etiology: 70% H. pylori - S&Sx: Pain worse with eating - Cancer risk: 20% - Blood type: type A
28
Duodenal Ulcers - Location - Etiology - S&Sx - Cancer risk - Blood type
- Location: 2nd part of duodenum - Etiology: 95% H pylori - S&Sx: Pain worse 30-40 min after eating - Cancer risk: 1% - Blood type: type O
29
Dx of Apo B48 missing
Abetalipoproteinemia Bassen-Kornzweig Syndrome - low chylomicrons - decr fat absorption - neuro, adrenal, adipose problems
30
The metanephros develops into what?
The kidney proper all the kidney structures up to and including the distal convoluted tubules (DCTs)
31
The mesonephros develops into what?
Mesonephros = Wolffian duct (present in males only) Gives rise to genitalia in males: - testis - seminal vesicles - vas deferens - epididymis
32
The paramesonephros develops into what?
Paramesonephros = Müllerian ducts Gives rise to genitalia in females: - ovaries - fallopian tubules - uterus - upper vagina
33
The urogenital sinus develops into what? (males)
prostate prostatic urethra bulbourethral glands
34
The urogenital sinus develops into what? (females)
lower vagina labia minora
35
The urogenital tubercle develops into what? (males)
penis
36
The urogenital tubercle develops into what? (females)
clitoris
37
The labia scrotal swellings develop into what? (males)
scrotum
38
The labia scrotal swellings develop into what? (females)
labia
39
Describe the Renin-Angiotensin-Aldosterone system
1) Low volume sensed by JG apparatus 2) Renin released to plasma and goes to the liver 3) Angiotensinogen is converted to AT1 by renin 4) AT1 goes to the lungs 5) AT1 is converted to AT2 by ACE 6) AT2 vasoconstricts all vessels, stimulating release of Aldosterone - pee out H+/K+, reabsorb Na+ - ADH (reabsorb water)
40
What are the (3) anatomic narrowings of ureters?
Uretero-pelvic junction -> largest stones Mid-ureter -> as ureter goes over the iliac bone Uretero-vesical junction
41
What is the makeup of struvite stones and MCC?
Also called staghorn calculus or triple phosphate stones - calcium phosphate - magnesium phosphate - ammonium phosphate MCC -> UTI from Pseudomonas & Proteus
42
What is the only kidney stone not visible on x-ray?
Uric acid stones - MCC: dehydration - Most patients have normal serum uric acid - associated with rapid cellular death states b/c purines (A & G) break down into uric acid
43
Prostate pathology and associated lobe - BPH - Adenocarcinoma
BPH -> transition zone (MCC of hydronephrosis in men) Prostatic adenocarcinoma -> posterior lobe (peripheral zone)
44
The ureteric bud develops into what?
collecting duct major & minor calyces papilla hilum ureters ureteric bud must contact the metanephros or kidney won't develop
45
Dx of cresence scarred glomeruli
Overall term is rapidly progressive glomerulonephritis (RPGN) #1 cause -> Goodpasture's #2 cause -> Wegener's (granulomatosis with polyangiitis)
46
MOA of digoxin
- cardiac glycoside - directly inhibits the Na/K ATPase - incr vagal tone -> decr SA node and AV node
47
BUN is associated with what part of the kidney
efferent arteriole (b/c it's secreted) Normal BUN: 10-20
48
Creatinine is associated with what part of the kidney
afferent arteriole (b/c it's filtered) Normal Cr: <1.2
49
Location of GLUT 1
RBCs BBB kidney
50
Location of GLUT 2
liver pancreatic beta cells renal PCT