Flashcards in UWorld Incorrect Deck (13):
presentation of hyperparathyroidism
Osteitis fibrosa cystica is the most characteristic skeletal manifestation of primary hyperparathyroidism.
-subperiosteal erosions affecting phalanges of the hand
-salt and pepper skull
-Brown tumor bone cysts
how does epinephrine get made?
from norepinephrine by PNMT (phenylethanolamine-N-methyltranfserase) whose transcription is increased by cortisol which is highly present b/c venous drainage of adrenal cortex goes through adrenal medulla.
function of MAO
metabolizes epinephrine and norepinephrine to dihydroxymandelic acid
function of COMT
metabolizes epinephrine to metanephrine
metabolizes norepinephrine to normetanephrine
insulin and glucagon affect glycolysis and gluconeogenesis how?
Glucagon phosphorylates the bifunctional enzyme (PFK2/fructose 2,6-bisphosphatase). This inactivates kinase and activates phosphatase.
Insulin dephosphorylates the bifunctional enzyme (PFK2/Fructose 2,6-bisphosphatase). This activates kinase and inactivates phosphatase.
treatment of hirsutism in PCOS
work by suppressing LH secretion from pituitary decreasing ovarian androgen production. also increases Sex hormone binding globluin synthesis by the liver
next line is antiandrogens like 5alpha-reductase inhibitors (finasteride) and testosterone receptor antagonists (spironolactone)
Seizures (major cause of death and morbidity)
Tachyarrhythmias (but not QT prolongation)
hematemesis and melena (upper GI bleeding) b/c iron directly toxic to gastric mucosal cells)
beta blocker toxicity
treat with glucagon (b/c increases intracellular cAMP and cardiac contractility)
general supportive care
Naloxone/Naltrexone/Nalmefene are opioid antagonists you can use
liver dmg after a latent period
NAC is treatment by glutathione donor
MAOI used when
Treatment resistant depression