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Second yaaa > endocrine > Flashcards

endocrine Flashcards

1
Q

which of the two renal veins is the longer and more significant?

A

left renal vein

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2
Q

what do the pancreatic delta cells secrete and what is its function?

A

somatostatin - inhibits release of insulin + glucagon

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3
Q

what do the pancreatic F cells secrete and what is its function?

A

pancreatic poly peptide - inhibits exocrine function of pancreas

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4
Q

which enzyme converts glycogen to glucose and is inhibited by insulin?

A

glycogen phosphorylase

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5
Q

which enzyme converts glucose–6-phosphase to glycogen and is inhibited by glucagon?

A

glycogen synthase

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6
Q

which enzyme converts glucose to glucose-6-phosphase?

A

hexokinase

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7
Q

which enzyme converts TAG to glycerol + fatty acids?

A

hormone sensitive lipase

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8
Q

describe osmotic diuresis

A

Osmotic diuresis is increased urination due to the presence of certain substances in the fluid filtered by the kidneys.

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9
Q

how do biguanides (metformin) work?

A

by inhibiting G6Pase (G6Pate->Fructose6Pate) & PEPCK (oxaloacetate -> phosphoenolpyruvate)

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10
Q

how do sulphonylureas work?

A

inhibiting ATP sensitive K+ channels

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11
Q

which enzyme converts inactive I- into the active I+ in the thyroid follicle cells?

A

thyroid peroxidase

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12
Q

oeripherally, how is T3 formed?

A

by 5’ deionisation of T4

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13
Q

how does I- enter the thyroid follicle from the capillary?

A

along with Na+ via a TSH-sensitive ion pump

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14
Q

what is the main cause of hypER thyroids and what are the signs and symptoms?

A 
Grave's disease (hypER =gRavEs)
weight loss
hypertension
heat intolerance
Grave's opthalmology
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15
Q

what is the main cause of hypO thyroids and what are the signs and symptoms?

A 
Hasimoto's Disease
weight gain
cold intolerance
menorrhagia
goitre possible
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16
Q

what is the drug of choice for Grave’s disease and it’s mechanism of action?

A

carbimazol (a thionamide)

inhibit’s thyroid hormone synthesis by blocking the action of thyroid peroxidase

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17
Q

what is the drug of choice for Hashimoto’s disease

A

Thyroxine replacement therapy for life (levothyroxine)

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18
Q

what are the 4 borders of the femoral traingle?

base, medial border, lateral border, apex

A

base: inguinal ligament
medial border: lateral border of adductor Magnus muscle
lateral border: sartorius muscle
apex: where sartorial crosses medial border

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19
Q

where on the body can GLUT-2 transporters be found?

A

liver, pancreatic beta cell, small intestine, kidney

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20
Q

where on the body can GLUT-4 transporters be found?

A

skeletal and cardiac muscle, adipocytes

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21
Q

where on the body can GLUT-1 transporters be found?

A

every cell

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22
Q

what are hexokinases I-III inhibited by?

A

G6P

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23
Q

what is the committed step for glycolysis?

A

phosphofructokinase

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24
Q

are hexokinase reactions reversible or irreversible?

A

irreversible

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25
Q

what is the function of PEPCK?

A

converting oxaloacetate into PhosphoEnolPyruvate

26
Q

what type of receptors are glucagon receptor?

A

G protein coupled receptors

27
Q

what are incretins?

A

GI hormones that increase insulin secretion (GLP-1, DPP-4)

28
Q

how do SGLT-2 inhibitors work?

A

reduce hypERglycaemia by inhibiting renal re-uptake of glucose from filtrate by SGLT-2

29
Q

how is Hyperosmolar hyperglycaemic State different to DKA?

A 
DKA:HHS
short history:inisidious history
no residual insulin:residual insulin
usually young T1DM:usually older T2DM
patient usually alert:patient usually drowsy
30
Q

in normal renal glucose handling, how much glucose is reabsorbed by SGLT2 in the PCT?

A

90% (remaining 10% by SGLT1)

31
Q

which enzyme hydrolyses TAG to chylomicrons/VLDL and which one re-esterifies it to TAG?

A 
lipoprotein lipase (LPL)
Diacylglycerol acyl transferase (DGAT)
32
Q

above which dose does metformin begin giving major GI sx

A

2g

33
Q

what does maolnyl CoA do?

A

inhibit FA oxidation

34
Q

does inulin inhibit or promote lypolisis and how does it do this?

A

inhibit

stimulates breakdown of cAMP so NA can no longer stimulate lipolysis

35
Q

does NA inhibit or promote lipolysis?

A

promote

36
Q

which enzyme metabolises glucose to sorbitol?

A

aldose reductase

37
Q

what do I+ and tyrosine form a complex with, in the synthesis of thyroxine (T4) and triiodothryonine (T3)

A

thryoglobulin

38
Q

how do sulphonylureas work?

A

bind to receptor on beta cells, inhibit K(ATP) channels and permit increased insulin secretion
-> increased circulating insulin

39
Q

spironalactone?

A

anti aldosterone

40
Q

what is the function of bisphosphonates?

A

reduce bone resorption by inhibiting osteoclasts

41
Q

what effect do glucocorticoids (cortisol) have on bone volume?

A

decrease

42
Q

what happens to the epithelium of follicular thyroid cells when it is stimulated?

A

becomes columnar and the lumen is depleted of colloid

43
Q

list some of the main actions of thyroid hormone

A 
inc bone turnover
inc proteolysis
inc lipolysis
inc HR
inc metabolic rate (glucose)
44
Q

where does aldosterone act in the nephron?

A

principal cells of DCT + collecting duct (inc Na reabsorption + K excretion

45
Q

what is SIADH (Syndrome of inappropriate anti-diuretic hormone) the opposite of?

A

diabetes insipidus

46
Q

what effect does hypo/hypernatraemia have on the brain?

A

Na low
->water moves up to brain to bring up plasma osmolality
brain swelling (cerebral oedema)
seizure/death

rapidly inc Na -> water leaves brain ->
osmotic demyelination
(often paralysed for life)

47
Q

what is the rhyme to remember the clinical features of hypercalcaemia?

A

Moans (bone pain, muscle weakness)
Bones (osteoporosis)
Stones (renal) +
Groans (constipation, pancreatitis, abdominal pain)

48
Q

what are the functions of cortisol?

A 
inhibit vit D production
stimulate gluconeogenesis in the liver
stimulate lipolysis
suppress release of insulin
immune suppression
proteolysis
49
Q

are all steroid hormones lipid soluble or insoluble?

same with water

A

lipid soluble (but not water soluble so have to be carried in blood))

50
Q

blood supply to the adrenals

A

L+R superior, middle + inferior suprarenal arteries

51
Q

venous drainage to adrenal gland

A

medullary vein (in centre) -> suprarenal veins ->IVC on right, L renal vein on L

52
Q

describe the histology of each section of the adrenal gland

A

ZG - clusters of small cells. Fewer lipids than other layers
ZF - Large cells arranged in cords
ZR - smaller cells, haphazard arrangement
Medulla - chromatin cells. Numerous capillaries + veins

53
Q

what is the rate-limiting enzyme in cholesterol biosynthesis?

A

HMG-CoA Reductase

54
Q

What is the rate-limiting step in the conversion of cholesterol to pregnenalone (first enzymatic step) and what is it carried out by?

A

transport of free cholesterol from cytoplasm into mitochondria (carried out by StAR

55
Q

what is the function of 11B-HSDII (hydroxysteroid dehydrogenase)?

A

catalyses the conversion of active cortisol to inactive cortisone in selective tissues (eg. kidney) allowing aldosterone to function normally (as cortisol can bind to mineralocorticoid receptors and [cortisol]»[aldosterone]

56
Q

which 3 things stimulate the hypothalamus to secrete CRH?

A

illness, stress, time of day

57
Q

which enzyme is lacking in congenital adrenal hyperplasia?

A

21-hydroxylase

58
Q

what is the function of dexamethasone?

A

negative feedback a pituitary to inhibit ACTH release

59
Q

what is primary aldosteronism?

A

like cushing’s, but ACTH is normal, all just adrenal

- commonest secondary cause of hypertension, with hypokalaemia in up to 50%

60
Q

what is tetany?

A

a condition marked by intermittent muscular spasms, caused by malfunction of the parathyroid glands and a consequent deficiency of calcium.

Second yaaa (6 decks)

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