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PP Clues 1 Flashcards

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1
Q

CCK:
- Made by
- Stimulus
- Inhibition
- Where it goes
- What it does
- 2nd messenger
- Misc syndromes

A

Made by: I cells in duodenum
Stimulus: food (especially fats)
Inhibition: incr pH (alkalosis)
Where it goes: pancreas (digestive enzyme) + gallbladder (bile)
Function: fat + protein digestion
2nd messenger: IP3/DAG
Misc: reason for RUQ pain in gallbladder disease after fatty meal; decr CCK release; if TPN: incr risk of gallstones

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2
Q

Secretin:
- Made by
- Stimulus
- Inhibition
- Where it goes
- What it does
- 2nd messenger

A

Made by: S cells in duodenum
Stimulus: decr pH
Inhibition: incr pH
Where it goes: Paracrine = duodenum
Function: stimulates production of bicarb from pancreas and inhibits gastrin + gastric motility
2nd messenger: cAMP

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3
Q

What pancreatic hormone has no known function?

A

Pancreatic polypeptide

From F cells

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4
Q

Hormone that inhibits peristalsis and hunger

Secreted where?

A

Leptin
Secreted by stomach and adipose

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5
Q

Hormone that promotes hunger and food intake

Secreted where?

A

Ghrelin

GHRRR when you’re hungry

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6
Q

Gastrin:
- Made by
- Stimulus
- Inhibitor
- Where it goes
- What it does
- 2nd messenger
- Misc syndrome

A

Made by: antrum of stomach
Stimulus: incr pH
Inhibitor: decr pH
Where it goes: parietal cells of the stomach (mostly body)
Function: production of HCl and intrinsic factor
2nd messenger: calcium
Misc: gastrinoma, incr gastrin; ulcers all the way down ileum

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7
Q

Glucagon:
- Made by
- Stimulus
- Inhibitor
- Where it goes
- What it does
- 2nd messenger
- Misc syndrome

A

Made by: alpha cells of pancreas
Stimulus: hypoglycemia, stress
Inhibition: hyperglycemia
Where it goes:
- adrenal cortex for Gluconeogenesis
- liver for Gluconeogenesis and ketogenesis
- adipose tissue for lipolysis
Function: gluconeogenesis, Glycogenolysis, ketogenesis, lipolysis
2nd messenger: cAMP
Misc: glucagonoma (incr glucose, incr lipids, incr ketones)

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8
Q

Timeline of stress hormones
- immediately
- 20 minutes
- 2–4 hours
- >24 hours

A

Immediately: epinephrine
- stimulates glycolysis, Glycogenolysis, gluconeogenesis

20 min: glucagon

2–4 hours: cortisol
- incr glucose by protein breakdown

> 24 hours: growth hormone
- incr glucose by proteolysis

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9
Q

Places that store glycogen(s)

A

1) skeletal muscle
2) liver
3) adrenal cortex
4) heart
5) intestine wall

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10
Q

Dx if increased levels of VMA, HVA, or metanephrines
OR
BP drops quickly after phentolamine

A

Pheochromocytoma or neuroblastoma

VMA -> breakdown of Epi
HVA -> breakdown of dopamine
Metanephrines -> breakdown of norepinephrine
Phentolamine is a short-acting alpha blocker

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11
Q

Dx of dancing feet and dancing eyes in a child

A

Neuroblastoma

Dancing feet -> hypsarrhythmia
Dancing eyes -> opsoclonus

Most common abdominal mass in children

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12
Q

Dx of intermittent palpitations, HTN, diaphoresis, and HA

A

An excess of NE and Epi causes sympathetic overdrive
- Pheochromocytoma
- Neuroblastoma
-> hypsarrhythmia (dancing feet)
-> opsoclonus (dancing eyes)
-> most common abdominal mass in children

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13
Q

Epinephrine:
- Made by
- Stimulus
- Inhibitor
- Where it goes
- What it does
- 2nd messenger

A

Made by: adrenal medulla
Stimulus: ACh, stress or hypoglycemia
Inhibitor: hyperglycemia
Where it goes: liver and adrenal cortex
(Only places w/ glucose-6-phosphatase)
Function: gluconeogenesis and Glycogenolysis
2nd messenger: cAMP

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14
Q

2 organs that conduct gluconeogenesis

A

Liver
Adrenal cortex

(Only places that have the enzyme glucose-6-phosphatase)

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15
Q

MOA of Flutamide

A

Blocks DHT receptors
- treatment of prostate cancer only

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16
Q

MOA of Finasteride

A

Blocks 5-alpha reductase

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17
Q

Management of increased cortisol:
- low dose dexamethosone
-> suppression?
-> no suppression?
-> incr ACTH?
-> decr ACTH?

A

Low dose = 0.5 mg IV Q6x4
-> suppression: physiologically normal
-> no suppression: Cushing’s
-> incr ACTH: small cell lung cancer or pituitary adenoma
-> decr ACTH: adrenal adenoma

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18
Q

Management of incr cortisol:
- high dose Dexamethasone
-> suppression?
-> no suppression?

A

High dose = 1 mg IV Q6x4
-> suppression: pituitary adenoma
-> no suppression: small cell lung cancer

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19
Q

Bone Terminology:
- incr scarring

A

Osteosclerosis

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20
Q

Bone Terminology:
- Inflammation of bone causing scarring

A

Osteitis fibrosis cystica

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21
Q

Bone Terminology:
- incr osteoclastic activity w/ incr alkaline phosphatase

Study These Flashcards
A

Osteitis deformans
(Paget’s disease)

22
Q

Bone Terminology:
- decr osteoclastic activity which obliterates bone marrow

23
Q

Dx of DEXA scan with T-score >-2.5

Study These Flashcards
A

Osteopenia
- decr bone density could be matrix or mineralization
- combo of osteoporosis and osteomalacia

24
Q

Dx of:
- decr bone density
- decr bone matrix
- DEXA scan with T-score <-2.5

Study These Flashcards
A

Osteoporosis
- in menopause: decr estrogen -> loss of osteoclastic inhibition, loss of matrix

Treatment:
- 1st = bisphosphonates
- 2nd = raloxifen or teriparatide

25
ANP: - Made by - Stimulus - Inhibition - Where it goes - What it does - 2nd messenger
Made by: right atrium, right ventricle, brain Stimulus: incr volume Inhibitor: decr volume Where it goes: kidney Function: dilates afferent renal artery, inhibits aldosterone 2nd messenger: NO (broken down by neprilysin) (BNP is brain version and made in right ventricle)
26
Somatostatin: - Made by - Stimulus - Inhibitor - Where it goes - What it does - 2nd messenger - Misc syndrome
Made by: D cells in the duodenum; delta cells in pancreas Stimulus: duodenal hormones Inhibition: incr pH Where it goes: Paracrine (duodenum) Function: purely inhibitory 2nd messenger: cAMP Misc: somatostatinoma -> can occur alone as part of MEN1; severe constipation
27
VIP: - Made by - Stimulus - Inhibition - Where it goes - What it does - 2nd messenger - Misc syndrome
Made by: Auerbach plexus in the duodenum Stimulus: duodenal hormones Inhibition: incr pH Where it goes: Paracrine (duodenum) Function: purely inhibitory 2nd messenger: cAMP Misc: VIPoma -> usually pancreatic tumor -> watery secretory diarrhea
28
GIP: - Made by - Stimulus - Inhibition - Where it goes - What it does - 2nd messenger - Misc syndrome
Made by: G cells in duodenum Stimulus: glucose Inhibitor: incr pH Where it goes: pancreatic islet cells Function: enhances insulin secretion, inhibits glucagon secretion 2nd messenger: cGMP Misc: dumping syndrome -> seen after gastric bypass causes osmotic diarrhea leads to DM T2
29
Motilin: - Made by - Stimulus - Inhibition - Where it goes - What it does - 2nd messenger
Made in: duodenum Stimulus: decr pH or small bowel distention Inhibition: incr pH Where it goes: Paracrine (duodenum) Function: - peristalsis, specifically segmentation - controls secondary peristalsis (= migrating myenteric complex = MMC) 2nd messenger: - IP3/DAG during meals - Ca/Calmodulin between meals
30
Decr response to edrophonium
Edrophonium MOA: AChE inhibitor Decr response: Lambert-Eaton
31
Incr response to edrophonium
Edrophonium MOA: AChE inhibitor Incr response: myasthenia gravis
32
Where does CMV remain latent?
Macrophages - most commonly picked up in blood transfusions and organ transplants
33
Where does EBV remain latent?
B cells
34
Dx of necrotizing glomuleronephritis
Wegener’s Granulomatosis w/ polyangiitis Anti-proteinase 3 = c-ANCA Incr bleeding time No change in platelets
35
Dx of positive anti-proteinase 3 (anti-PR3)
Wegener’s Granulomatosis w/ polyangiitis Anti-proteinase 3 = c-ANCA
36
Dx of positive anti-myeloperoxidase (anti-MPO)
Churg-Strauss Eosinophilic granulomatosis w/ polyangiitis Anti-MPO = p-ANCA
37
Bacteria causing bloody diarrhea (3)
Shigella (inflammatory) Yersinia (inflammatory) EHEC (non-inflammatory) (Inflammatory = pos leukocytes in stool)
38
Dx of stridor and barking cough AND/OR Steeple sign on neck film
Parainfluenza (80% - mild) RSV (15% - severe) - hospitalized Adenovirus Influenza virus
39
Dx associated with dermatitis herpetiformis? Antibody?
Celiac sprue Tissue transglutaminase (anti-TTG)
40
Dx of Port Wine stain
Can be normal and resolve shortly after birth OR Sturge-Weber - congenital anomaly of neural crest derivatives => capillary vascular malformations in CN V1/V2 distribution - angiomas in retina and brain
41
Dx of Café au lait spots
Can be normal and resolve shortly after birth Or rule out: - neurofibromatosis type 1 (AD, Chr 17) (Pigmented iris hamartomas, optic glioma, pheochromocytoma, seizures) - McCune Albright Syndrome (Gs protein activating mutation) (Unilateral café au lait spots & at least one endocrinopathy)
42
Dx of collection of melanocytes in sacral area
Mongolian spots - normal in people of color - typically self resolve after a couple months - or persists without complications
43
Dx of morbiliform rash (= flat, red/pink spots that merge and become raised)
Rubeola (2w measles) - 3 C’s: cough, coryza, conjunctivitis - Koplik spots - SSPE (= subacute sclerosing panencephalitis) Rubella (3d measles) - lymphadenopathy behind ears and neck
44
Dx that presents as RA but resolves 2 weeks later
Parvovirus B19 - fifth disease - aplastic anemia - red lacy rash appearance on cheeks (= slapped cheeks) Rubella (3d measles) - lymphadenopathy behind ears and neck - morbiliform rash
45
Dx associated with rash that presents as a red macule THEN clear vesicles THEN pustules and THEN scarring
Varicella Chicken pox Very itchy Incr risk of skin infection -> d/t scratching 1) staph aureus 2) strep pyogenes
46
Dx of painful ulcers in back of mouth, soles of feet, and palms
Coxsackie A Hand-Foot-Mouth disease
47
MCC of bacterial meningitis - 0-2 months - 2mo - 10y - 10-21 years - >21 years - immunocompromised
- strep agalactiae - strep pneumo - strep meningitis - strep pneumo - cryptococcus neoformans (presence of lymphocytes)
48
Common cold causes and how to differentiate
Rhinovirus -> nose only Coronavirus -> spring/summer Adenovirus -> fall/winter - conjunctivitis - swimming pool Herpesvirus -> attacks cornea and gums Influenza virus -> Nov-Feb; Cryoglobulinemia Parainfluenza -> barking cough
49
Identify the meningitis: 1) pos proteins, neutrophils, decr glucose 2) pos proteins, T cells and macrophages, decr glucose 3) pos proteins, T cells and macrophages, norm or elev glucose
1) Bacterial - strep pneumo - strep agalactiae - N meningitidis 2) TB/Fungal - coccidiodomycosis - cryptococcus neoformans 3) Viral (aseptic) - enterovirus - picorna
50
Viral causes of encephalitis
Arboviruses - Birds -> Mosquito -> Human - St Louis encephalitis - Equine Eastern Encephalitis *more E’s = more fatal Herpesvirus - prefers temporal lobe

PP Clues (31 decks)

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