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Endocrine Flashcards

1
Q

Thyroid development

A

Thyroid diverticulum arises from floor of primitive pharynx and descends into neck.
Connected to tongue via thyroglossal duct
Thyroglossal duct disappears –> foramen cecum
Thyroid follicular cells derived from endoderm

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2
Q

Most common ectopic thyroid tissue site

A

tongue –> hypothyroidism

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3
Q

Thyroglossal cyst

A

anterior midline nech mass
moves with swallowing or protrusion of tongue
Remnant thyroglossal duct

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4
Q

Anterior pituitary

A

Secretes FSH, LH, ACTH, TSH, prolactin, GH, B endorphin

Derived from oral ectoderm

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5
Q

Posterior Pituitary

A

store and release vasopressin and oxytocin (made in hypothalamus and transported to posterior pituitary via neurophysins)
Derived from neuroectoderm

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6
Q

Adrenal Cortex

A

Mesoderm
Glomerulosa- Ang II regulates, release aldosterone
Fasciculata- regulated by ACTH and CRH, release cortisol
Reticularis- regulated by ACTH, and CRH, releases DHEA

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7
Q

Adrenal Medulla

A

Neural crest
Chromaffin cells
regulated by preganglionic sympathetic fibers
release epinephrine and norepinephrine

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8
Q

ADH level in DI

A

decreased in central DI

increased/normal in nephrogenic DI

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9
Q

CRH

A

Hypothalamus

increase ACTH, MSH, B endorphin

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10
Q

Dopamine

A

Hypothalamus

decrease prolactin, TSH

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11
Q

GHRH

A

Hypothalamus

increase GH

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12
Q

GnRH

A 
Hypothalamus
release FSH and LH
Suppressed by hyperprolactinemia
tonic GnRH --> suppress axis
pulsatile GnRH --> puberty and fertility
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13
Q

MSH

A

Hypothalamus

increase melanogenesis by melanocytes

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14
Q

Oxytocin

A

Hypothalamus

Cause uterine contractions during labor. Milk letdown reflex in response to suckling

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15
Q

Prolactin

A 
Anterior PItuitary
Decrease GnRH
stimulate lactogenesis, inhibit ovulation and spermatogenesis
Excess --> decreased libido
Inhibited by dopamine
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16
Q

Pituitary prolactinoma

A

amenorrhea, osteoporosis, hypogonadism, galactorrhea

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17
Q

Somatostatin

A

Hypothalamus

Decrease GH and TSH

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18
Q

TRH

A

Hypothalamus

increase TSH and prolactin

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19
Q

Growth Hormone

A

Anterior Pituitary
Linear growth and muscle mass somatomedin C secretion (liver). Increases insulin resistance
Secretion increase during exercise, deep sleep, puberty, hypoglycemia, CKD
Secretion decrease by glucose, somatostatin, somatomedin

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20
Q

Acromegaly/ gigantism

A

Acromegaly (adults) Gigantism (children)
Excess GH secretion
T(x) somatostatin analog, surgery

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21
Q

ADH

A

Synthesized in hypothalamus and stored in posterior pituitary
regulates blood pressure and serum osmolality via regulation of aquaporin channel insertion in principal cells of renal collecting duct.

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22
Q

Thyroid Hormone

A

produces T3 (active) and T4 (inactive) – thyroid follicles
Inhibited by glucocorticoids, B-blockers and PTU
Brain maturation, bone growth, B adrenergic effects, increase BMR, increase glycogenolysis and lipolysis, stimulate surfactant synthesis in babies

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23
Q

Wolff-Cahikoff effect

A

excess iodine turns off thyroid peroxidase –> decreased T3/T4 production

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24
Q

Increased TBG

A

in pregnancy, OCP use –> increase total T3/T4

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25
Q

Decreased TBG

A

in steroid use and nephrotic syndrome

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26
Q

Parathyroid Hormone

A

Chief cells of parathyroid
Increase free calcium in blood and GI via bone resorption and reabsorption in DCT. Increase calcitriol production by activating 1a hydroxylase in PCT
Stimulated by RANKL-RANK interaction
Secreted when low serum calcium and magnesium
Inhibited when high serum phosphate

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27
Q

Calcium Homeostasis

A

High pH –> albumin binds for Ca2+ –> decreased ionized Ca2+ –>cramps, pain, paresthesias –> increase PTH
Low pH –> albumin binds less Ca2+ –> increase ionized Ca2+ –> low PTH

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28
Q

Calcitonin

A

Parafollicular cells of thyroid
Decrease bone resorption
regulated by increase serum Ca2+ –> increase calcitonin secretion

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29
Q

Glucagon

A

a cells of pancreas
promotes glycogenolysis, gluconeogenesis, lipolysis, ketogenesis. Elevates blood sugar levels to maintain glucose
Secreted when hypoglycemic
Inhibited by insulin, hyperglycemia and somatostatin

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30
Q

Insulin synthesis

A

Preproinsulin (RER of pancreatic B cells) –> proinsulin (stored in secretory granules) –> insulin and C peptide

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31
Q

Insulin Functions

A

bind insulin receptors (TK) –> glucose uptake
increase glucose transport to skeletal muscle and adipose tissue, increase glycogen/ TAG synthesis
DOES NOT CROSS PLACENTA

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32
Q

Insulin dependent glucose transporters

A

GLUT4- adipose tissue, striated muscle, exercise

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33
Q

Insulin independent glucose transporters

A 
GLUT1- RBC, brain, cornea, placenta
GLUT2- B islet cells, liver, kidney, GI
GLUT3- brain and placenta
GLUT5- spermatocytes, GI
SGLT1/2- kidney, small intestine
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34
Q

Insulin Regulation

A

Glucose enter B cells –> increase ATP from metabolism –> close K+ channels and depolarize B cell membrane –> VGCC open –> Ca2+ influx –> insulin exocytosis
increase insulin response with oral glucose via GLP1 or GIP, B2
decrease with a2

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35
Q

17a hydroxylase deficiency

A 
increase mineralcorticoids
Decrease K+
Increase BP
Decrease Cortisol
Decrease sex hormones
decrease androstenedione
XY ( ambiguous genitalia, undescended testes) XX (lack secondary sexual development)
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36
Q

21 hydroxylase deficiency

A 
decrease mineralcorticoids
increase K+
decrease BP
Decrease Cortisol
increase sex hormones
increased renin activity, increased 17 hydroxyprogesterone
Salt wasting in infancy
XX (virulization)
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37
Q

11B hydroxylase

A 
decrease aldosterone
Decrease K+
Increase BP
Decrease Cortisol
increase sex hormones
decrease renin activity
HTN, precocious puberty in infancy
XX (virilization)
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38
Q

Cortisol

A

Adrenal zona fasciculata
increase appetite, BP, insulin resistance, gluconeogenesis
Decrease fibroblast activity, inflammatory and immune response, bone formation
regulated by CRH (hypothalamus) –> ACTH (anterior pituitary) –> adrenal cortex

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39
Q

Ghrelin

A

stimulate hunger and GH release.
Produced by stomach –> lateral area of hypothalamus
Sleep deprivation, fasting and Prader Willi syndrome –> increase ghrelin production

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40
Q

Leptin

A

Satiety hormone
Produced by adipose tissue –> ventromedial area of hypothalamus
Mutation –> central obesity
sleep deprivation or starvation –> decrease leptin production

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41
Q

Endocannabinoids

A

Act on cannabinoid receptor in hypothalamus and nucleus accumbens –> increase appetite

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42
Q

Signaling pathway of steroid hormones

A

Circulate bound to specific binding globulins to increase solubility
Men: increase SHBG lowers free testosterone –> gynecomastia
Women: decrease SHBG raises free testosterone –> hirsutism
Increased estrogen –> SHBG

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43
Q

SIADH

A

Excessive free water retention
Euvolemic hyponatremic
cerebral edema, seizures
Urine osmolality > serum osmolality
Caused by ectopic ADH, head trauma, pulmonary disease, drugs
T(x): fluid restriction, salt tablets, ADH antagonists

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44
Q

Central DI

A

via pituitary tumor, autoimmune, trauma, surgery
decreased ADH
>50% increase in urine osmolality after administration of ADH analog
T(x) Desmopressin, Hyration

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45
Q

Nephrogenic DI

A

Hereditary
Normal/increased ADH levels
no change in urine osmolality with ADH administration
T(x): HCTZ, indomethacin, amiloride, hydration, salt restriction

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46
Q

Sheehan’s syndrome

A

Hypopituitary
ischemic infarct of pituitary after postpartum bleeding
Presents as failure to lactate, no period, cold intolerance

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47
Q

Empty sella syndrom

A

Hypopituitary
atrophy or compression of pituitary
common in obese women
associated with idiopathic intracranial HTN

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48
Q

Pituitary apoplexy

A

Hypopituitary
sudden hemorrhage of pituitary gland in presence of pituitary adenoma
presents with sudden onset of severe HA, visual impairment, bitemporal hemianopia, diplopia (CN III)

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49
Q

Acromegaly

A

Excess GH in adults
via pituitary adenoma
Large tongue with deep furrows, deep voice, large hands and feet, coarsening facial features with age, frontal bossing
Increased risk of colorectal polyps and cancer
D(x): increased serum IGF1, failure to suppress GH following oral glucose tolerance
T(x): resect, octreotide, DA agonist

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50
Q

Hypothyroidism

A

cold intolerance, decrease sweating, weight gain, hyponatremia
coarse brittle hair, diffuse alopecia, nonpitting edema, periorbital edema, constipation, decreased appetite, proximal muscle weakness, decreased libido and infertility, lethargic, brady
Increase TSH, decreases T3 and T4, hypercholesteremia

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51
Q

Hyperthyroidism

A

Heat intolerance, increased sweating, weight loss, pretibial myxedema, exophthalmos, diarrhea, osteoporosis and increase fracture, decreased libido and infertility, hyperactive, tachy
decreased TSH, increased T3 T4, decreased LDL, HDL and cholesterol

52
Q

Hashimoto Thyroiditis

A

Hypothyroidism
Autoimmune with antithyroid peroxidase and antithyroglobulin Ab.
Associated with HLA DR3, DR5
incrased risk of NHL
Hurthle cells, lymphoid aggregates with germinal centers
Moderately enlarged, nontender thyroid

53
Q

Postpartum thyroiditis

A 
Hypothyroidism
self limited
up to 1 year after delivery
Women are euthyroid following resolution
Thyroid is painless and normal size
Lymphocyteic infiltrate with occasional germinal center formation
54
Q

Congenital hypothyroidism

A

Hypothyroid
Ab mediated maternal hypothyroidism, thyroid dysgenesis, iodine deficiency
Pot bellied, pale, puffy faced, protruding umbilicus, protuberant tongue, poor brain development

55
Q

Subacute granulomatous thyroiditis

A

Hypothyroidism
self limited following flu like illness
granulomatous inflammation
increase ESR, jaw pain, tender thyroid

56
Q

Riedel thyroiditis

A

Hypothyroidism
Thyroid replaced by fibrous tissue and inflammatory infiltrate.
IgG4 related systemic disease
fixed, hard, painless goiter

57
Q

Graves Disease

A

Hyperthyroidism
IgG –> TSH receptors on thyroid (goiter), dermal fibroblasts (pretibial myxedema) and orbital fibroblasts (exophthalmos)
Activate T cells –> release inflammatory cytokines
Presents during stress
Associated with HLA DR3 and B8
tall, crowded follicular epithelial cells, scalloped colloid

58
Q

Toxic Mandibular goiter

A 
Hyperthyroidism
focal patches of hyperfunctioning follicular cells distended with colloid working independently of TSH
Increase release of T3 and T4
Hot nodules
Not malignant
59
Q

Thyroid Storm

A

Hyperthyroidism
worsen in acute stress
agitation, delirium, fever, diarrhea, coma, tachy
T(x): B blockers, propylthiouracil corticosteroids, potassium iodide

60
Q

Jod Basedow phenomenon

A

Hyperthyroidism
Iodine induced
Iodine deficiency and autonomous thyroid tissue is made iodine replete (after iodine IV contrast or amiodarone use)

61
Q

Causes of goiter

A

Smooth/diffuse –> graves, Hashimoto, iodine deficiency, TSH secreting pituitary ademona
Nodular –> toxic multinodular goiter, thyroid adenoma, cancer, cyst

62
Q

Thyroid adenoma

A

Benign solitary growth
nonfunctional (does not cause hyperthyroidism)
absence of capsular or vascular invasion

63
Q

Thyroid Cancer

A

D(x) fine needle aspiration
T(x) thyroidectomy
complications of surgery –> hypocalcemia, transection of recurrent laryngeal N, injury to the external branch of the superior laryngeal N

64
Q

Papillary Carcinoma

A

Excellent prognosis
empty appearing nuclei with central clearing, psammoma bodies, nuclear grooves. increased risk with RET/PTC rearrangements and BRAF mutations, childhood irradiation
Palpable LN

65
Q

follicular Carcinoma

A

Good prognosis
invade thyroid capsule and vasculature
uniform follicles, hematongenous spread
Associated with RAS mutations and PAX8-PPARy translocations

66
Q

Medullary Carcinoma

A

From parafollicular C cells
produce calcitonin, sheets of polygonal cells in an amyloid stroma
Associated with MEN2A ad 2B

67
Q

Undifferentiated/ Anaplastic Carcinoma

A 
older patients
rapidly enlarging neck mass
compressive symptoms
Poor prognosis
Associated with TP53 mutation
68
Q

Hypoparathyroidism

A

tetany, hypocalcemia, hyperphosphatemia
Chovstek sign- tap facial N –> facial muscles contract
Trousseau sign- occlusion of brachial A with BP cuff –> carpal spasms

69
Q

Pseudohypoparathyroidism Type 1A

A

AD
maternally transmitted mutations (GNAS1 inactivating mutation via imprinting) - encode Gs protein a subunit–> inactivate adenylate cyclase when PTH binds to its receptor –> end organ resistance to PTH
Albright hereditary osteodystrophy (short stature, round face, subQ calcifications)
Increase PTH, low Ca2+, high phosphate

70
Q

Pseudopseudohypoparathyroidism

A

AD
paternally transmitted mutations (imprinted GNAS gene) but no end organ resistance to PTH
Albright hereditary osteodystrophy
normal PTH, Ca2+, phosphate

71
Q

Vitamin D Deficiency

A

decrease Ca2+
decrease phosphate
increase PTH

72
Q

Hypoparathyroidism

A

decrease Ca2+
increase phosphate
decrease PTH

73
Q

Secondary Hyperparathyroidism (CKD)

A

decrease Ca2+
increase phosphate
increase PTH

74
Q

Pseudohypoparathyroidism

A

decrease Ca2+
increase phosphate
increase PTH

75
Q

Hyperphosphatemia

A

decrease Ca2+
increase phosphate
increase PTH

76
Q

Primary hyperparathyroidism

A

via parathyroid adenoma or hyperplasia
Hypercalcemia, hypercalciuria, polyuria, hypophosphatemia, increase PTH, ALP and urinary cAMP
bone pain, weakness, constipation, ab/flank pain, neuropsychiatric disturbances

77
Q

Osteitis fibrosa cystica

A

cystic bone spaces filled with brown fibrous tissue
Due to high PTH
Primary Hyperparathyroidism

78
Q

Secondary Hyperparathyroidism

A

secondary hyperplasia due to decrease Ca2+ absorption or increased phosphate
CKD
hypocalcemia, hyperphosphatemia, high ALP and PTH
Renal osteodystrophy –> bone lesions

79
Q

Tertiary Hyperparathyroidism

A

Refractory hyperparathyroidism resulting from CKD

HIGH PTH and calcium

80
Q

Familial hypocalciuric hypercalcemia

A

Defective G coupled Ca2+ sensing receptors in multiple tissues
High Ca2+ –> suppress PTH
Excess renal calcium reabsorption –> mild hypercalcemia and hypocalciuria with normal/high PTH

81
Q

Diabetes Mellitus

A

polydipsia, polyuria, polyphagia, weight loss, DKA (type 1), hyperosmolar hyperglycemia (Type 2)
complications: diffuse thickening of BM in small vessels –> retinopathy, microaneurysms, glaucoma, nephropathy, CKD. Large vessel atherosclerosis, CAD, peripheral vascular occlusive disease, gangrene. Osmotic damage –> cataracts and neuropathy
D(x): HbA1c >6.5%, fasting blood glucose >126, 2 hour oral glucose tolerance >200

82
Q

Type 1 DM

A 
autoimmune T cell mediated destruction of B cells. 
Insulin always needed in T(x)
<30 years
Weak genetic predisposition
Associated with HLA DR4, DR3
Severe glucose intolerance and high insulin sensitivity
common DKA
Islet leukocytic infiltrate
83
Q

Type 2 DM

A 
increase resistance to insulin
Sometimes need insulin
>40 years
Associated with obesity and genetic predisposition
Rare DKA
IAPP deposits
84
Q

DKA

A

Insulin absent ketones present (B hydroxybutyrate > acetoacetate)
Deadly
deliriumm Kussmael respirations, abdominal pain, dehydration, fruity breath
Hyperglycemia, increase H+, low bicarb, increase urine and blood ketones, leukocytosis, Normal/high K+, decrease insulin and acidosis
complications: mucormycosis, cerebral edema, cardiac arrhythmias, HF
T(x): IV fluids, insulin, K+

85
Q

Hyperosmolar hyperglycemic state

A

insulin present, ketones absent
profound hyperglycemia –> excessive osmotic diuresis –> dehydration and increased serum osmolality
elderly Type 2 DM that can’t drink
Thirst, polyuria, lethargy, focal neuro deficits, seizures
Hyperglycemia, increased serum osmolality, normal pH, no ketones, Normal/ high serum K+
Complications: death, coma
T(x): IV fluid, insulin and K+

86
Q

Cushing

A

increased cortisol
Exogenous –> low ACTH –> bilateral adrenal atrophy
Primary adrenal adenoma, hyperplasia –> low ACTH –> atrophy of adrenal gland NOT involved
ACTH secreting pituitary adenoma, paraneoplastic ACTH secretion –> bilateral adrenal hyperplasia
high cholesterol, urinary free cortisol, skin changes (striae, thinning), HTN, immunosuppression, neoplasm, growth retardation, hyperglycemia, amenorrhea, moon facies, buffalo hump, osteoporosis
Tests: high free cortisol on 24 hour urinalysis, increase late night salivary cortisol, no suppression with dexamethasone test

87
Q

Nelson Syndrome

A

enlargement of pre-existing ACTH secreting pituitary adenoma after bilateral adrenalectomy for refractory Cushing disease –> high ACTH, mass effect
T(x): transsphenoidal resection, post op pituitary irradiation for residual tumor

88
Q

Adrenal insufficiency

A

inability of the adrenal gland to generate enough glucocorticoids and/or mineralcorticoids for the body
weakness, fatigue, orthostatic hypotension, muscle aches, weight loss, GI disturbances
T(x): glucocorticoids/mineralcorticoids

89
Q

Primary adrenal insufficiency

A

decreased gland function –> low cortisol, low aldosterone –> hypotension, hyperkalemia, met acid, hyperpigment
Acute: sudden onset, shock
Chronic: Addison disease (adrenal atrophy via autoimmune)
Waterhouse Friderichson syndrom: acute due to adrenal hemorrhage via N. meningitidis, DIC, shock

90
Q

Secondary Adrenal insufficiency

A

Seen with low pituitary ACTH production.

NO skin hyperpigmentation or hyperkalemia

91
Q

Tertiary Adrenal Insufficiency

A

Seen in patients with chronic exogenous steroid use, precipitated by abrupt withdrawal
aldosterone synthesis unaffected

92
Q

Hyperaldosteronism

A

HTN, low/normal K+, met alk, secondary causes edema

93
Q

Primary Hyperaldosteronism

A

Adrenal adenoma or bilateral adrenal hyperplasia
high aldosterone, low renin
Treatment resistant HTN

94
Q

Secondary Hyperaldosteronism

A

Renovascular HTN, JG cell tumors and edema

95
Q

Neuroendocrine Tumors

A

GI, pancreas, and lungs. Thyroid and adrenals

T(x): resection, somatostatin analogs

96
Q

Neuroblastoma

A

Tumor of adrenal gland in children (<4years)
Originated from NCC on the sympathetic chain
abdominal distention and firm irregular mass that can cross midline
Hgih HVA and VMA in urine. Homer Wright rosettes
Associated with N myc

97
Q

Pheohromochytoma

A

Tumor of adrenal gland in adults
Derived from chromaffin cells
Associated with germline mutations NF1, VHL, RET
Secrete epinephrine, NE and DA –> episodic HTN
EPO –> polycythemia
high catecholamines and metanephrines
T(x) irreversible a antagonists then B blockers

98
Q

MEN 1

A

Pituitary tumors
Pancreatic endocrine tumors
Parathyroid adenomas
Associated mutation in MEN1, angiofibromas, collagenomas, meningiomas

99
Q

MEN 2A

A

Parathyroid hyperplasia
Medullary thyroid carcinoma
Pheochromocytoma
Associated with RET mutation

100
Q

MEN 2B

A

Medullary thyroid carcinoma
Pheochromocytoma
mucosal neuromas
Associated with marfanoid habitus and RET gene mutation

101
Q

Insulinoma

A

Tumor of pancreatic B cell –> high insulin –> hypoglycemia
Whipple triad: low blood glucose with resolution of symptoms after normalization of glucose levels
high C peptide
Associated with MEN 1
T(x): surgery

102
Q

Glucagonoma

A

Tumor of pancreatic a cells –> high glucagon
Dermatitis, Diabetes, DVT, declining weight, Depression, Diarrhea
T(x): octretide, surgery

103
Q

Somatostatinoma

A

Tumor of pancreatic delta cells –> high somatostatin –> low secretion of secretin, cholecystokinin, glucagon, insulin, GIP
Present with diabetes, steatorrhea, gallstones, achlorydia
T(x): surgery, somatostatin analogs for symptom control

104
Q

Carcinoid syndrome

A

Arise from neuroendocrine cells (intestine and lung)
Prominent rosettes, chromogranin A + and synaptophysin +
secrete 5HT –> recurrent diarrhea, wheezing, right sided heart valvular disease
T(x): surgery, somatostatin analog for symptom control

105
Q

Zollinger Ellison Syndrome

A

gastrin secreting tumor of pancreas or duodenum
Acid hypersecretion–> recurrent ulcers in duodenum and jejunum
Ab pain, diarrhea
+ secretin stimulation test (gastrin remain elevated)
Associated with MEN 1`

106
Q

Insulin prep

A

Bind insulin receptor

Adverse hypoglycemia, lipodystrophy, hypersensitivity, weight gain

107
Q

Biguanides

A

Increase insulin sensitivity
inhibit mGPD –> inhibit hepatic gluconeogenesis and glucagon
Increase glycolysis
Adverse: GI upset, lactic acidosis, vit B12 deficiency, weight loss

108
Q

Glitazones/ thiozolidinediones

A

Increase insulin sensitivity
Activate PPARy –> increase insulin sensitivity and adiponectin –> regulate glucose metabolism and FA storage
Adverse: weight gain, edema, HF, fractures
Delated onset

109
Q

Sulfonylurea

A

chlorpropamide, tolbutamide
Close K+ channels in pancreatic B cell membrane –> cell depolarize –> insulin release via calcium influx
Adverse: disulfiram like reaction, hypoglycemia

110
Q

Meglitinides

A

Nateglinide, repalglinide
Close K+ channels in pancreatic B cell membrane –> cell depolarize –> insulin release via calcium influx
Adverse: hypoglycemia

111
Q

GLP1 analog

A

Exenatide, liraglutide
decrease glucagon, decrease gastric emptying, increase insulin
Adverse nausea, vomiting, pancreatitis, weight loss, increased satiety

112
Q

DPP4 inhibitors

A

-liptin
inhibit DPP4 –> no GLP1 deactivation –> decrease glucagon, decrease gastric emptying, increase insulin
Adverse: respiratory and urinary infections, weight neutral, increased satiety

113
Q

Na-glucose co transporter 2 inhibitor

A

-fozin
block reabsorption of glucose in PCT
Adverse: glucosuria, hyperkalemia, weight loss

114
Q

a glucosidase inhibitor

A

acarbose, miglitol
inhibit intestinal brush border a glucoidases –> delated carb hydrolysis and glucose absorption –> low postprandial hyperglycemia
Adverse: GI upset, bloating

115
Q

Amylin analongs

A

Pramlintide
low glucagon release, low gastric emptying
Adverse: Hypoglycemia, nausea, high satiety

116
Q

Thionamides

A

propylthiouracil, methimazole
block thyroid peroxidase, inhibit oxidation of iodide –> inhibit thyroid hormone synthesis
Used in Hyperthyroidism. PTU in first trimester
Adverse: skin rash, agranulocytosis, aplastic anemia, hepatotoxicity.

117
Q

Levothyroxine, liothyonine

A

Hormone replacement for T4 and T3
used in Hypothyroidism, myxedema. abused for weight loss
Adverse: tachy, heat intolerance, tremors, arrhythmias

118
Q

Conivaptan, tolvaptan

A

ADH antagonists for SIADH

119
Q

Demeclocycline

A

ADH antagonist and tetracycline

for SIADH

120
Q

Desmopressin

A

Used in central DI, willebrand disease, sleep enuresis, hemophilia A

121
Q

GH

A

used in GH deficiency, turner

122
Q

oxytocin med

A

used to induce labor, control uterine hemorrhage

123
Q

Somatostatin

A

used in acromegaly, carcinoid syndrome, gastrinoma, glucagonoma, esophageal varices

124
Q

Flurocortisone

A

synthetic analog of aldosterine

used in mineralcorticoid replacement in primary adrenal insufficiency

125
Q

cinacalcet

A

sensitizes CaSR in parathyroid gland –> decrease PTH
used for secondary hyperparathyroidism in CKD, hypercalcemia in primary hyperparathyroidism or in parathyroid carcinoma
Adverse: hypocalcemia

126
Q

Sevelamer

A

nonabsorbable phosphate binder that prevents phosphate absorption from the GI tract
used in hyperphosphatemia in CKD
Adverse: Hypophosphatemia, GI upset

Step 1 (17 decks)

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