Endo II

Question 1

ADH

Answer 1

synthesized supraoptic nuclei

-released posterior pituitary

Question 2

V2 receptor

Answer 2

for ADH - regulate serum osmolarity

mutation - nephrogenic DI

Question 3

V1 receptor

Answer 3

for ADH - regulate blood pressure

Question 4

nephrogenic DI

Answer 4

mutation V2 receptor

Question 5

central DI

Answer 5

ADH level decreased

Question 6

cholesterol desmolase

Answer 6

stimulated by ACTH
-convert cholesterol to pregnenolone

pregnenolone - start substrate for adrenal steroids

Question 7

ketoconazole

Answer 7

inhibit cholesterol desmolase

less cholesterol to pregnenolole

Question 8

17a hydroxylase deficiency

Answer 8

excess aldosterone

• low cortisol
• low sex hormones

increase BP and hypoK - aldosterone effect

decreased androstenedione

Question 9

boy with 17a hydroxylase deficiency

Answer 9

ambiguous genitalia
undescended testicles

HTN, hypoK

Question 10

girl with 17a hydroxylase deficiency

Answer 10

lack secondary sex development

HTN, hypoK

Question 11

21 hydroxylase deficiency

Answer 11

low aldosterone

• low cortisol
• hgh sex hormone

decreased BP and hyperK - lack of aldosterone

labs - increased renin and increased 17-hydroxyprogesterone

MC

Question 12

girl with 21 hydroxylase deficiency

Answer 12

virilization and precocious puberty

low BP and hyper K - low aldosterone

low cortisol

Question 13

11-B hydroxylase deficiency

Answer 13

low aldosterone - but elevated 11-deoxycorticosterone (weak mineralocorticoid)

decreased cortisol
increased sex hormone

HTN and hypoK

decreased renin activity

Question 14

girl with 11-B hydroxylase deficiency

Answer 14

virilization

Question 15

aromatase

Answer 15

convert testosterone > estrogen

Question 16

5-a reductase

Answer 16

convert testosterone > DHT

Question 17

reactivation of TB and candida

Answer 17

exogenous corticosteroids

block IL-2 production

Question 18

cortisol activity

Answer 18

upregulate a1 receptors - HTN
increased insulin resistance
gluconeogenesis, lipolysis, proteolysis
striae - decreased fibroblasts
decreased inflammation
decreased bone formation

Question 19

plasma Ca

Answer 19

majority ionized

bound to albumin and anions also

Question 20

increased pH

Answer 20

more affinity of albumin - more negative charge
-to bind Ca

get hypoCa - cramp, pain, paresthesia

Question 21

cholecalciferol

Answer 21

Vit D

D3 from sun exposure
D2 ingested from plants

Question 22

function of vit D

Answer 22

increased absorption of diet Ca and P

increased bone resorption - Ca and P increase

Question 23

24,25 D

Answer 23

• inactive storage vit D

Question 24

kidney and vit D

Answer 24

1-a hydroxylase - convert 25 to 1,25 (active)

negative feedback of 1,25 on its production

Question 25

PTH

Answer 25

increased Ca reabsorption decreased P reabsorption in kidney

Question 26

1,25 Vit D

Answer 26

increased absorption Ca and P in gut

Question 27

PTH

Answer 27

from chief cells of PTH

Question 28

PTH in kidney

Answer 28

more Ca reabsorption - DCT | less P reabsorption - PCT

Question 29

1-a hydroxylase

Answer 29

convert 25 D > 1,25 D stimulated by PTH -synthesized PCT

Question 30

PTH on bone

Answer 30

production of m-CSF and RANKL RANK-L - secreted by osteoblasts - binds RANK on osteoclasts -stimulate osteoclast activity

Question 31

sort of low Mg

Answer 31

stimulate PTH release

Question 32

very low Mg

Answer 32

inhibit PTH release

Question 33

calcitonin

Answer 33

from parafollicular C cells of thyroid decrease bone resorption of Ca

Question 34

hormones act through cAMP

Answer 34

``` FSH LH ACTH TSH CRH hCG ADH - V2 MSHR PTH calcitonin GHRH glugacon ```

Question 35

hormones act through cGMP

Answer 35

ANP BNP NO

Question 36

hormones act through IP3

Answer 36

``` GnRH oxytocin ADH - V1 TRH histamine - H1 ANG II gastrin ```

Question 37

hormone act through intrinsic tyrosine kinase

Answer 37

``` insulin IGF-1 FGF PDGF EGF ``` MAP kinase - growth factors

Question 38

hormone act through receptor associated tyrosine kinase

Answer 38

``` PRL GH G-CSF EPO thrombopoietin ``` JAK/STAT - acidophils and cytokines

Question 39

steroid hormones

Answer 39

circulate bound to binding globulin | -increase their solubility

Question 40

SHBG

Answer 40

sex hormone binding globulin men - lower free T women - decreased raises free T - hirsutism women - increased with OCP, pregnancy - free estrogen levels remain unchanged