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Endocrine Flashcards

0
Q

Pituitary

A

Releases follicle SH

Stimulates ovaries/testes

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1
Q

Hypothalamus

A

Releases Gonadotropin RH

Stimulate pituitary

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2
Q

Best predictor of menstruation onset

A

Weight

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3
Q

Peripheral early puberty

A

Decrease in GnRH

Results in shorter adult height

Treat with hormones that reduce estrogen/androgen (GnRH analog/antagonist)

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4
Q

Childhood obesity appetite suppressant

A

Phentermine
Orlistat: saturated lipstatin, inhibit lipases. Give multivitamin b/c less absorption of fat soluble vit.

Sibutramine inhibit 5HT,NE, reuptake
Mazindol inhibit NE

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5
Q

Satiety

A

Ghrelin increases hunger (inhibit)
Leptin decreases hunger

hypothalamus

Serotonergic

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6
Q

Anorexia nervosa

A

High cortisol, low 5HT, NE

Fluoxetine

Olanzapine atypical antipsych
Risperidone

Calcium vitD for bone health

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7
Q

Bulimia

A

Dehydration
Electrolyte imbalance

Fluoxetine
TCA
BZD
Ondansetron for N/V

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8
Q

Bone remodeling

A

Clast : chip
Blast : build

10 years to remodel entire skeleton

Constantly remodel BMUnits

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9
Q

Rank ligand

A

matures osteoclasts

Stimulated by PTH to increase calcium

OPG suppresses maturation

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10
Q

Calcium

Ionized=active

A

Most abundant mineral in human body

For neurotransmission
Muscle contraction
Bone formation

Regulated by parathyroid gland and VitD

Kidney, intestine, bone major organs involved in calcium-mineral processes

Affected by albumin, pH

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11
Q

Hypercalcemia >10.5

Primary hyperPTH

Confusion, dehydration, kidney stones

A

Fluids and loop diuretics
(Furosemide, bumetanide)

N-Biphosphonate: ARBZ
Have PCP backbone, inhibit FPPS and osteoclastgenesis

Non-N containing ECT- compete with ATP in osteoclasts, decrease resorption

Can give corticosteroids

May be due to lithium toxicity

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12
Q

6) Calcitonin

A

Produced in thyroid

Opposes parathyroid and reduces blood calcium

Negative feedback from high Ca levels

3rd line: only decreases vertebral fractures

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13
Q

Hypocalcemia <9

A

Hypoparathyroidism, vit D deficiency

CaCO3 give with meals

CaCitrate with or within meals

Cardio and muscle weakness, brittle hair, hand spasm

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14
Q

Active Vit D3

A

125 cholecalciferol or calcitriol

2 hydroxylase (renal) steps to add OH

Promotes Ca absorption
And reabsorption in kidney

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15
Q

Osteoporosis

Reassess BMD every 2 years
Height every year
DXA scan to monitor drug therapy
Non-pharm tai chi, exercise

A

Teriparatide (PTH)

Intermittent daily for treatment

For women with high risk of fracture

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16
Q

Antiresorptive agents

A

Biphophonates
Calcitonin
Estrogen replacement

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17
Q

Parathyroid hormone

Regulate ECF calcium

A

Increase bone resorption
GI Ca absorption (due to increased calcitriol production)
Kidney reabsorption (increase Ca transport proteins)

Increase RANKL osteoclastgenesis

Intermittent injections build bone

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18
Q

5) Denosumab

Refractory to biphosphonates

A

Inhibit RANKL to suppress osteoclastgenesis

Decrease risk of non vertebral and hip fractures

May cause hypocalcemia
Avoid if renal impairment

19
Q

Compact bone

A

For strength

20
Q

Trabecular/cancellous

A

Metabolically active

21
Q

Osteoid

22
Q

Mineral

A

Calcium, phosphorus

Hydroxyapatite

23
Q

Corrected calcium

A

Measured Ca + 0.8(4-albumin)

24
Osteomalacia
Defective bone mineralization VitD deficiency Softening of bones Rickets in children, reduced renal hydroxylase activity, bowing Elevated PTH in response and elevated alkaline phosphatase (high bone turnover) Phenytoin, phenobarbital
25
Osteoporosis Diagnose with DEXA X-ray for women >65, men >70 BMD t score <-2.5 FRAX 10 year risk score
Fragility of bone decreased amount of bone, but normal cellular composition Increased osteoclast activity Menopause, aging, white, dementia, smoking alcohol Decline of estrogen Hip fracture is most serious Corticosteroids, aluminum, lithium
26
Primary hyperparathyroidism labs Causes hypercalcemia
High serum Ca Low serum phosphate (excretion inc) High PTH HypoPTH: opposite and low Mg
27
Solidarity adenoma
Single PTH gland enlarged Benign
28
PTH hyperplasia
All four glands enlarged Cancer PTHrP
29
Pagets disease
Resorption with abnormal repair Elevated alkaline phosphatase
30
Renalosteodystrophy
Bone mineral abnormality with renal failure Lack of kidney hydroxylase causing decreased production of 125 Vit D (calcitriol)
31
Secondary hyper PTH
Response to hypocalcemia to normalize Ca
32
Tertiary hyperPTH
Hypertrophy parathyroid due to secondary PTH | and uncontrolled PTH secretion causing hypercalcemia
33
Calcium VitD supplementation
800 vit D, 1200 calcium in men and women >70 Women >50 need 1200 calcium Space calcium from iron zinc, levothyroxine by at least 2 hours Caution, increased risk of MI
34
1) Alendronate ARBZ
Take in morning with water, without food Decreases hip,spine, and vertebral fractures Max 5 year treatment
35
2) Risedronate
Decreases vertebral and non-vertebral fractures
36
3) Ibandronate (boniva) All of these biphosphonates can help those expected to take corticosteroids >1 year
Only decreases vertebral fractures
37
4) zoledronic acid
Prevent new fractures in patients with recent low trauma hip fracture Decreases vertebral, non vertebral, and hip fractures
38
Osteonecrosis of the jaw
Due to biphosphonates Treat with chlorhexidine mouth rinse 1-3 weeks of antibiotics Prevent with dental hygiene DC biphosphonates after 5 years
39
Estrogens with/without progestin
Approved for prevention of osteoporosis
40
Phenobarbital
Enzyme inducer Decrease vit D levels
41
Delayed puberty
Give low dose estrogen/testosterone
42
Lithium
Increases set point of calcium levels
43
Osteoporosis risk factors
Low weight, female, Asian, white Smoking, pregnant, menopause Corticosteroids, aluminum PPI decrease calcium absorption No exercise
44
Duavee
CEE estrogen + bazedoxifine Estrogen agonist in tissue Antagonist in uterus Decreases risk of endometrial hyperplasia

Pharmacy (63 decks)

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