DD6 Glucocorticoids Flashcards

1
Q

Do mineralcorticoids or glucocorticoids have inflammatory action?

A

Glucocorticoids

-steroidal anti inflammatory drug

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2
Q

3 modes of regulation by HPA axis?

A
  1. Diurnal rhythm
  2. Negative feedback
  3. Stress
    - overrides (-) feedback→ Anterior pituitary release ACTH → cortisol release (glucocorticoid)
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3
Q

How does negative feedback regulate HPA axis?

A

a) Circulating corticosteroids → regulates (neg feedback) on hypothalamus and pituitary → ↓ ACTH release + steroidogenesis

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4
Q

How does stress regulate HPA axis?

A

a) Stress ( ie: Hemorrhage, severe infection, surgery, hypoglycemia, cold, pain, fear (anything stressful really)) → override (-) feedback

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5
Q

What are glucocorticoid (cortisol) metabolic effects on carbohydrate?

A

­increase gluconeogenesis
increase ­ blood glucose
increase ­ insulin

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6
Q

What are glucocorticoid (cortisol) metabolic effects on protein?

A

decrease protein synthesis
increase aa
net transfer of AA from muscle to bone

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7
Q

What are glucocorticoid (cortisol) metabolic effects on fat?

A

increase lipolysis

increase free fatty acids

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8
Q

What are mineralocorticoid (aldosterone) effects on kidney?

A

increase Na reabsorption
increase blood volume
increase BP

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9
Q

What is the most commonly used glucocorticoid for steroid burst therapy? 2nd?

A

1st: prednisone
2nd: methylpresnisone

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10
Q

What is a potent anti-inflammatory glucocorticoid used for treating cerebral edema?

A

Dexamethasone (decadron)

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11
Q

What is the most potent anti inflammatory glucocorticoid agent?

A

Dexamethasone (decadron)

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12
Q

Iatrogenic Cushing’s syndrome

A

caused by too much glucocorticoids:
diabetes-like state (hyperglycemia),
protein wasting (muscle),
lipid deposition (weight gain)

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13
Q

Mineralocorticoid effects

A

Salt and water retention
edema
increased blood pressure,
hypokalemia

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14
Q

Virchows triad

A

3 factors that promote thrombosis (blot clot)

  1. Abnormal blood flow
  2. Endothelial injury
  3. Hypercoagulability
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15
Q

Left sided system emboli

what does it affect?

A

arterial

-can affect any organ (mostly leg or brain)

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16
Q

Right sided system emboli

what does it affect?

A

Venous

- lungs (PE)

17
Q

How is septic shock different from Cardiogenic and hypovolemic?

A

Septic shock = immensely elevated inflammatory mediators

increased blood flow vs not enough flow.

18
Q

Infarcts

A

(areas of necrosis) caused by ischemia.

19
Q

White infarcts

A

arterial blockage

-heart, kidney, spleen

20
Q

Red infarcts

A

venous blockage

- lung, liver, intestine

21
Q

Single or duel blood supply:
White infarcts
Red infarcts

A

White: Single blood supply

Red: duel blood supply
- harder to infarct

22
Q

DIC

A

disseminated intravascular coagulation

clotting and bleeding at same time

23
Q

Congestion

A

pathologic accumulation of blood

24
Q

Hemorrhage

A

blood outside vasculature

25
Q

Vegetation

A

infected mass - growth of bacteria

26
Q

Dysplasia

A

Disordered growth - hallmark of premalignant neoplasia

27
Q

Neoplasia

A

new formation of cells - pathologic and irriversible

28
Q

What term is synonymous with tumor?

A

Neoplastic

29
Q

Benign neoplasm:

  • epithelial tissue etiology -
A

aden-oma
papill-oma

-benign “oma”

30
Q

Benign neoplasm:

  • mesenchymal tissue etiology -
A

oste-oma
chondr-oma
fibr-oma

-benign “oma”

31
Q

Malignant neoplasm:

  • epithelial tissue etiology -
A

adenocarcinoma

-malignant carcinoma

32
Q

Malignant neoplasm:

  • Mesenchymal tissue etiology -
A

osteo-sarcoma
chondro-sarcoma
fibro-sarcoma

-malignant sarcoma

33
Q

Malignant neoplasm:

  • hematopoietic tissue etiology -
A

lymphoma (lymph node)

leukemia (bone marrow)