Endo 1 Flashcards
how will TBG T3 T4 look like in a woman who is taking post menopausal hormone replacement
Estrogen increases TBG
increases TOTAL T3 T4
normal free T3 T4
euthyroid hyperthyroxinemia
total is high cause most of t3 t4 is bound to ybg
undergo nuclear translocation to act on zinc finger proteins and ultimately alter targeted-gene expression.
vitamin D3
steroids
estro
progestro
increase peripheral sensitivity to insulin by binding to and stimulating the activity of nuclear transcription factors called peroxisome proliferator–activated receptors.
thiazolinadones
glitazones
SE edema weight gain hepatotoxic and CI in heart failure as increase risk of MI
what drug do u give prior to pheochromocytoma ressection
irreversible alpha antag
SE can be miosis or pupillary constriciton
antidiabetic meds that decrease glucagon release
eexanetide pramlintide
GLP1 analogues
pancreatitis and hyhpoglycemoa
FSH works on?
granulosa cells to make estrogen
what would be the immediated effects of OCP that cause low FSH
low esttogen in follicular phase
essential amino acid to make thyroid hormones
tyrosine
arginine is a precursor of
NO
creatinien
urea
tryptophan precursor for
niacin (b6) and serotonin (bh4 and b6)
Glucagon and epinephrine act via the Gs pathway, leading to an increase in protein kinase A levels which in turn increases
fructose 2,6 bisphosphate
dysfunctional signal recognition particle (SRP).
Where is this signal sequence most likely located?
The signal peptide that sends a protein into the (endoplasmic reticulum) ER during translation is composed of a series of hydrophobic amino acids found at the N-terminus of the protein, and is recognized by the signal-recognition particle (SRP).
tumors of the adrenal medulla in adults and are derived from chromaffin cells, which arise from
neural crest
Pheochromocytomas may be associated with germline mutations such as those responsible for
MEN2A, MEN2B, von Hippel–Lindau disease, and neurofibromatosis type 1.
responsible for ADH production.
The supraoptic nucleus of the hypothalamus
he lateral nucleus of the hypothalamus is thought to be
hunger center” of the brain. Damage to this area leads to anorexia and starvation,
in hypoglycemia wat happens to glucose uptake into b celll
still takes place
glut 2 is insulin inependnt
what is neurophysin 1 used for
transport of oxytocin from paraventricular nucleus
ADH is transported by
neurophysin II
post pituitary hormones are made in
supraoptic nucleus … paraventricular nucleus
what is the treatment in primary hyperaldosteronism
spirinolactone
inhibits aldosterone
hypokalemai is mostly assoc with which type of acid base imbalacnce
metabolic alkalosis due to increased H+ secretion
how does spironolactone cause gynecomastia
en because it decreases testosterone production, increases peripheral conversion of testosterone to estradiol, and displaces estradiol from sex hormone-binding globulin
Hyperuricemia has been associated with use of
thiazide diuretics
ototoxicity (diuretic)
loop
Examples of hormones that act through the GPCR and cAMP-mediated signal transduction
FSH/LH, TSH, ACTH, ADH, PTH, and glucagon, calcitonin
Atrophy of pancreatic tissue with dystrophic calcification
chronic pancreatitis
Periportal inflammation and necrosis with ballooning degeneration of hepatocytes
hepatitis A
The classic triad of ascending cholangitis
right upper quadrant pain
fever
jaundice
recurrent yeast infections, hyperglycemia, low insulin and C-peptide levels, as well as a family history of gestational diabetes
maturity onset diabetes of ypung
due to glucokinase gene modification
glucokinase turns glucose into glucose 6 phosphate and promotes glycolysis —– more ATP made —- closees the K+ channels and insulin is secreted
17 alpha hydroxylase def
the only CAH to have a sex hormone def
so no testosterone …. female charactersitsics
first trimester pregnant girl
hyperthyroidism
txt?
PTU
methimazole is CI in first trimestwr
ethanol intoxication …. NAD NADH ratio
in ethanol metabolism NAD is used to make NADH
so NADH;NAD ratio is high …. stops gluconeogenesis tooooo
insulin and growth hormonesacts through which kind of cell surface receptor
tyrosine kinase
at risk for non hodgkin lymphoma
hypothyroid patients
complications of graves if not treated
fractures — high level of thyroxin increases osteoclast activity
life threatening thyroid storm
fetal hyperthyroidism
glycoprotein hormone that is secreted from the interstitial cells of the kidney to increase RBC production. Upon erythropoietin binding to its receptor (EpoR), intracellular nonreceptor tyrosine kinases transduce signals via the JAK-STAT pathway.
erythropoetin
DKA triggers
infection
steroid use
no insulin
right adrenal vein vs left
The right adrenal vein drains directly into the IVC
Left drains into renal vein first
The adrenal medulla secretes catecholamines (epinephrine, norepinephrine, and dopamine) in response to
direct stimulation by preganglionic sympathetic neurons. These neurons use the neurotransmitter acetylcholine
deficiency of debranching enzyme
cori disease
milder form of von gierke disease
hypoglycemia and normal lactate levels
serine/threonine kinase receptor
transforming growth factor-beta is an example of a molecule that has its action mediated by a receptor serine/threonine kinase.
graves disease nodular or diffusely enlarged thyroid
also what type of antibodies
diffusely enlarged
anti TSH
21 vs 11 hydroxylase def
syncopal episodes can be distinguishing factor
wont occur in 11 …. coz of 11 deoxycortisone
bblocker overdose treatment
glucagon
Beta blocker overdose can present with symptoms of cardiogenic shock, including pale and cool extremities, bradycardia, and hypotension.
what is the mechanism of red palms in liver cirrhosis
hyperesterinism
like testicular atrophy, gynecomastia, spider angiomas loss of hair
disulfiram-like reaction secondary to ethanol consumption at a cocktail party.
diabetic patient
first degree sulfonylurea
chlopropamide
tolbutamide
ic SBLA cancer syndrome: Sarcoma, Breast, Leukemia, and Adrenal gland cancers.
li fraumeni
p53
normally a tumor suppressor
vongierke
glucose 6 phosphatase def
severe hypoglycemia
increaed triglycerides
increased lactic acid
cori disease
debranching enzyme
NO LACTIC ACID buildup
manifest at birth with symptoms of vomiting, hypotonia, and hypotension.
catecholamine synthesis problem
dopamine B hydroxylase def
Increased levels of calcitonin are expected in patients with which type of cancer
medullary thyrooid cancer
Tall, crowded follicular epithelial cells with scalloped colloids
graves disease
Lymphocytic infiltrate with occasional germinal center formation
postpartum thyroiditis
Thyroid tissue replaced with inflammatory infiltrate
reidel thyroiditis
fibrosis may etend to nearby tissues
w inflammatory infiltrate with multinucleated giant cells
subacute thyroiditis
viral
self limiting
increased ESR CRP
HLADR5 increases risk of
HASHIMOTOOOOO
76-year-old patient is found to have a large thyroid mass with pleomorphic spindle cells on biopsy. An x-ray also reveals metastasis to the lungs. This patient’s large mass is consistent histologically and clinically with a very aggressive tumor. The posterior spread and subsequent metastatic spread, along with his presenting symptoms, point to a diagnosis o
ANAPLASTIC CARCINOMA
poorly differentiated, pleomorphic cells on histology.
follicular thyroid carcinoma i
DISTANT hematogenous metastasis
polygonal to spindle-shaped cells with granular cytoplasm in an amyloid-filled stroma.
medullary thyroid carcinoma
