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Flashcards in Random Organ systems - endo Deck (105)
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1

What is the function of CRH of HPA? clinical notes?

increase ACTH, MSH, Beta-endorphin

CRH is decreased in chronic exogenous steroid use

2

What is the function of Dopamine of HPA? clinical notes?

decrease prolactin

Dopamine antagonists (antipsychotics) can cause galactorrhea

3

What is the function of GnRH of HPA? clinical notes?

increase FSH & LH

regulated by prolactin;
Tonic GnRH suppresses HPA axis
Pulsatile GnRH leads to puberty & fertility

4

What is the function of Prolactin of HPA? clinical notes?

decreases GnRH

Pituitary prolactinoma leads to amenorrhea & osteoporosis

5

What is the function of somatostatin of HPA? clinical notes?

decrease GH & TSH

Analogs used to treat acromegaly

6

What is the function of TRH of HPA?

increase TSH & prolactin

7

Name the neuroendocrine glands controlled by the medulla

Posterior pituitary => ADH & OT
Adrenal medulla => catecholamines
Hypothalamus => releasing hormones

8

What increases or decreases cholesterol desmolase action to convert cholesterol to pregnenolone?

increases => ACTH
decreases => ketoconzale

9

WRT calcium homeostasis, an increase in pH will cause what Sx?

increase in pH leads to increase affinity of albumin (neg charge) to bind to Ca+ causing hypocalcemia symptoms of cramps, pain, paresthesias, carpopedal spasm

10

What endocrine signaling pathways use cAMP?

FLAT ChAMP
FSH; LH, ACTH, TSH
CRH, hCG, ADH (V2 receptor), MSH, PTH
calcitonin, GHRH, glucagon

11

What endocrine signaling pathways use cGMP?

ANP & NO (EDRF) => think vasodilators

12

What endocrine signaling pathways use IP3?

GOAT HAG
GnRH, Oxytocin, ADH (V1 receptor), TRH;
Histamine (H1-receptor), AT-II, Gastrin

13

What endocrine signaling pathways use steroid receptor (intracellular action)?

VETTT CAP
Vit D, Estrogen, Testosterone, T3/T4;
Cortisol, Aldosterone, Progesterone

14

What endocrine signaling pathways use intrinsic tyrosine kinase?

MAP kinase pathway => think growth factors

Insulin, IGF-1, FGF, PDGF, EGF

15

What endocrine signaling pathways use receptor associated tyrosine kinase?

JAK/STAT pathway => think acidophiles & cytokines
PIG

Prolactin, Immunomodulators, GH

IL-2, IL-6, IL-8, IFN

16

Steroid hormones are lipophilic & bound to SHBG. Describe the increase & decrease in SHBG in men & women

men=> increase SHBG lowers free testosterone causing gynecomastia

women=> increase SHBG is found in OCPs & pregnancy but free estrogen is unchanged;
decreased SHBG raises free testosterone leading to hirsutism

17

What does T3/T4 do to the heart?

increases B1 receptors leading to increased CO, HR, SV, contractility

18

What does T3/T4 do to the BMR?

increases BMR via increase in Na/K ATPase activity causing more O2 consumption, increased RR & body temp

19

What causes a decrease in TBG? increase in TBG?

hepatic failure;

pregnancy or OCP use along w/ estrogen

20

What converts T4 to T3 in the periphery?

5'-deiodinase

21

What is the role peroxidase of thyroid hormones?

Peroxidase responsible for oxidation & organification of iodide; couples MIT & DIT

22

What is the Wolff chaikoff effect?

excess iodine temporarily inhibits thyroid peroxidase leading to decreased T3/T4 production

23

Differentiate the Rx used for hyperthyroidism

Propylthiourcil inhibits both peroxidase & 5'-deiodinase

Methimazole inhibits peroxidase only

24

Treatment for prolactinoma

DA agonists => bromocriptine or cabergoline

25

Tx for acromegaly

Try to resect
If not cured then octreotide (somatostatin analog) or pegvisomant (GH receptor antagonist)

26

Differentiate DI based on water restriction test

Central DI will show > 50% increase in urine osmolarity

Nephrogenic DI while show no change in urine osmolarity

27

Tx for central DI

Intranasal DDAVP & hydration

28

Tx for nephrogenic DI

HCTZ, indomethacin, amiloride;
Hydration

29

What are secondary causes of Nephrogenic DI?

hypercalcemia; lithium, demeclocycline (ADH antagonist that is former antibiotic rarely used)

30

What can cause SIADH?

Ectopic ADH from small cell lung CA;
CNS d/o or head trauma;
Pulmonary disease;
Drugs => cyclophosphamide