Endocrine Flashcards
17 alpha hydroxylase deficiency
Increased mineralcorticoids
Decreased cortisol and sex hormones
XY: pseudohermaphroditism
XX: lack secondary sexual characteristics
21 hydroxylase deficiency
Decreased mineralcorticoids and cortisol Increased sex hormones Increased 17-hydroxyprogesterone Salt wasting XX: virilization
11 beta hydroxylase deficiency
decreased aldosterone, cortisol
Increased sex hormone
Hypertension due to increased 11-deoxycorticosterone
XX: virilization
Cushing syndrome
Increased cortisol due to exogenous corticosteroids, primary adrenal adenoma, or ACTH secreting pituitary adenoma, ectopic tumor, or paraneoplastic (small cell lung)
Hypertension, weight gain, moon facies, osteoporosis, hyperglycemia
Low dose dex suppression:
Low ACTH, suspect adrenal tumor
High ACTH, suspect pituitary or ectopic tumor
High dose dex suppression:
Low ACTH, suspect pituitary tumor
High ACTH, suspect ectopic
Addison diesese
Adrenal insufficiency leading to deficiency of aldosterone and cortisol
Hypotension, hyperkalemia, hyponatremia
Hashimoto thyroiditis
Most common in iodine sufficient regions
Anti-thryoid peroxidase, antithyroglobulin antibodies
Hurthle cells on staining
Moderately enlarged non-tender thyroid
De Quervain (subacute) thryroiditis
Self-limited hypothyrodism following flu-like symptoms
Maybe hyperthyroid in the beginning
Shows granulomatous inflammation on staining
Increased ESR, jaw pain, very tender thyroid
Riedel thryroiditis
Thyroid replaced by fibrous tissue (hypothyroidism)
Fibrosis can extend to airway
Fixed, hard, and painless goiter, can resemble tumor
Central diabetes insipidus
Pituitary tumor, autoimmue, truam
Decreased ADH
Low urine specific gravity and high serum osmolarity
Water restriction test: increase in urine osmolarity after desmopressin
Treat w. DDAVP (ADH analog) and hydration
Nephrogenic diabetes insipidus
Hereditary ADH receptor mutation
Normal ADH
Water restriction test: no change in urine osmolarity after desmopressin
Treat w/ HCTZ and indomethacin
Biguanides (metformin)
Decrease liver gluconeogenesis Increase glycolysis Increase peripheral glucose uptake (increase insulin sensitivity) Can cause lactic acidosis Contraindicated in renal failure
Sulfonylureas (glyburide, glipzide)
Close K+ channel in beta cell membrane so cell depolarizes and triggers insulin release via increased Ca2+ influx
Glitazones (thiazolidinediones, pioglitazone)
Increase insulin sensitivity in peripheral tissue by binding to transcription regulator
Alpha glucosidase inhibitor (miglitol)
Inhibit intestinal brush border alpha glucosidase to delay sugar absorption
GLP-1 analogs (exenatide)
Increase insulin, decrease glucagon
