endocrine1 Flashcards
Down syndrome assoc w what endocrine abnormality
hypothyroidism
Lab values in Primary Hyperaldosternoism
Na
K
HCOe
Normal Na, Decreased K, increased HCO3
which fat correlates strongly w insulin resistance
visceral fat: measure wast circumference
insulin resistance: what are dyslipidemia values
high TG, low HDL;
LDL do not increase w insulin resistance
two treatments of Nephrogenic diabetes insipidus
thiazide diuretics (induce mild hypovolemia, increasing prox tubule sodium and water reabsorption) or indomethacin (decerease synthesis of Prostgalndins, which inhibit ADH)
rapid withdrawal of corticosteriods
adrenal insufficiency
FGF23 inhibts what activity
1-alpha hydroxylase
which hormone responsible for spermatogenesis
FSH
GLUT family tranport proteins steroselective for
D-glucose
zinc deficiency symptoms
erythematous skin lesions, hypogonadism, impaired taste and smell, night blindness, impaired wound healing.
Kallman syndrome associated with which amenorrhea
primary
remember secondary is normal mesntruation in puberty followed by menstrual dysrgulation
hot flashes in what hormone deficiency
estrogen
A boy with 21 hydroxylase deficiency; excess testosterone. how to treat
treat with glucocorticoids to cause ACTH supppression; this reduces excess androgen production
21 hydroxylase defiency; virizilating effects in amles are due to
DHEA and androstenedione; not testosterone
long term use of glucocorticoids leads to what
bilateral adrenocortical atrophy
Digeorge syndrome results from
maldevelopment of third (affewcts inferior parathyroid and thymus) and fourth (affects superior parathyroid) pharyngeal/branchial pouches. Consequent parathyroid and thymic hypoplasia:
Chvostek’s sign
twitch of nose and lips when tapping on facial nerve
infant unusual flexion of left wrist and thumb and extension of fingers w blood pressure measurement
trousseau sign
failure of anteiror neuropore to close
anencepahly
invaginated oral ectoderm that develops into anterior pituitary
rathke pouch
depression on tongue that represents embrylogical remnant of superior end of obliterated thyrglossal duct
foramen cecum
hypertelorism, short palpebral fissures, micrognathia, bifid uvula, cleft palate
digeorge syndroem
external branch of what nerve is at risk of injury during thyroidectomy due to proximity to superior thryoid artery and vein
superior laryngeal nerve
external branch superior laryngeal nerve innervates what muscle
cricothyroid muscle
remaining laryngeal muscles innervated by
recurrent laryngeal nerves which also provide snesory innervation to larynx below vocal folds
why are pt’s taking exogenous insulin vulnerable to exercise induced hypoglycemia
insulin continue to be rleeased from injection site despite falling glucose levels in exercise
hypokalemia symptoms
paresthesias and muscle weakness
diarrhe and flushing seen in
carcinoid syndrome: derived from neuroendcorine cells of GI tract
nephrogenic DI resistance to ADH in the
kidneys
how is damage to hypothalamus different than posterior pituitary in DI
damage to hypothalamus: permanent central DI because damage to hypothalamic nuclei results in loss of vasopressinergic neruons
In posterior pituitary: transeitn central DI: hypothalamic nuclei are intact and axonal regeneration and hypertrophy allow adquate ADH release into circulation
Fusion is joining of cell lines; mature thryoid is formed by fusion of thyroid follicular cells and parafollicular C cells
true
lingual thyroid contains no
C cells due to failure of migration
insulin resistance in adipose cells hinders antilipolytic effects of insulin: this leads to
lipolysis and release of free fatty acids. which also contribute to insulin resistance causing acanthosis nigricans (sign of insulin resistance)
to diagnose inflammatory myosiits you need
muscle biopsy: polymyositis, dermatomositis
what is CK in lambert eaton and myastehnia gravis
NORMAL
what is CK in hypothyroid myopathy
ELEVATED
RET proto oncogene codes for a membrane bound
membrane bound tyrosine kinase receptor
Lmyc
small cell lung cancer
large, overlapping nuclei containing sparse finely disperesed chromatin
numerous intranuclear inclusion bodies and grooves
Papillary carcinoma
colloid containing microfollicles
benign follicular adenoma
which hyperlipoproteinemia is associated with acute pancreatitis
familial chylomicronemia syndrome
defect in familial chylomicronemia syndrome
lipoprotein lipase; APoC II
acute pancreatitis, lipemia retinalis (milky-appearing retinal vasculature) and eruptive xanthomas (small yellowish papules surrounded by erythema on extensor surfaces)
familial chylomicronemia syndorme
which inflammatory cell in sarcoidsois express 1 alpha hydroxylase
macropahges
lymphoplasmacytic infiltrate w active germinal centers
hashimoto’s
generalized hyperpigmentation: addison’s disease
feedback inhibiton of POMC. as a result POMc cleavage products: including ACTH and MSH secreted in excess. MSH increased melanin synthesis
metabolic acidosis winter
PaCo2 = 1.5 (serum HCO3) + 8 +/- 2
In DKA, low serum bicarbonate due to ketoacidsosi reduces amt of HCO3 filtered by kidney.
true;
decreased urinary bicarb loss bc acidosis causes a compensatory increase in renal tubular H+ secretion by a-intercalated cells in collecting duct, promtoing bicarbonate reuptake
how does TNFa induce insulin resistnace
through activation of serine kinases which phosphorylate serine residues on beta subunits of IR and IRS1; inhibitng tyrosine phosprplyation of IRS-1 by IR and subsequently hindering downstream signaling: resulting in resistance
brown adipose tissue found
in neonates: contains several intracytoplasmic fat droplets and many more mitochondria than white adipose cells; used for heatproduction; gives it its brown color (mitochondria) function to produce heat by uncoupling ox phosphorualtion w protein thermogenin
glucagon increases serum glucose by increasing hepatic
glycogenolysis and gluconeogenesis
bony enlargement of hands and feet
gigantism (new shoes needed each month).
this is not seen in klinefleter or marfan
Laron dwarfism
defects in GH receptor: decreased linear grwoth, high serum GH concentrations and low IGF1
why do pt’s w type i dm have low ciruclaing levels of islet amyloid polypeptide
bc: type 1 extensive beta cell destruction: so cant produce the amyloid!
SIADH caused by what drugs
carbamazepine, cyclophsophamide, SSRI
in sites other than epiphyseal growth plate: the effect of estrogen on bone is
anabolic bc estrogen increases osteoblastic one depostion and decreases osteoclastic bone resorption
somatotroph pit adenoam
growth hormone
corticotroph pituitary adenoma
cushing disease
testoterone exogenously inhibits
GnRH
name for islet amyloid polypeptide
amylin
Intellectual disability, gait or posture abnromality, eczema, musty body odor
PKU
Autosomal recessive
preproinsulin syntehsized in
RER
cleaveage of presignal:
proinsulin
proinsul stored in
secretory granules; then exoctyossi after cleavage of proinsulin
what cleaves proinsulin into insulin and c peptide
endopeptidases in secretory granules
stored in granules until extruded in equal amounts
insulin and c peptide
98% of body’s potassium is stored
intracellulary
Calcium sensing recetpros are what type of receptors
G protein coupled receptros
PTH causes osteoblasts to increase production of
RANKL and M-CSF
stimulates osteoclastic precurosesr to differentiate into bone resorbing mature osteoclasts
PTH also decrease OPG
hba1c levels affected by alterations in RBC survival; conditions that increase RBC turnover (hemolytic anemia) wil cause
falsely low hba1c levels
DERMAL accumulations of macropahges containing cholesterol and triglycerides
xanthelasmas
Could be type 4 or 5 hyperlipidemia
I- to I2 is
oxidationto iodine
iodine reacts w tyrosine residues in thryglobulin to form MIT and DIT
iodination
peripheral conversion catalyzed by (t4-t3)
iodothyronine deiodinase
aldosterone secretes
potassium and hydrogen ions
LH function in women
decrease ovarian androgen production
increase sex hormone binding globulin syntehsis by liver decrease free testotsteorne levels
eflornithine
topical orinthin decarboxylase inhibitor used to decrease rate of facial hair growth
electron dense membrane boudn secretory granules
adrenal medulla: pheochromocytoma
functional hypohtalamic amenorrhea leptin leveels
decreased
SIADH has what type of hyponatremia
euvolemic
remember; increased water reabosrptioN: hypervolemia: supppress RAAS; increase natiruiess: low sodium thus; euvolemic hyponatremia
Craniopharyngiomas have three components
solid, cystic, calcified
insulin increases reabsorption of
sodium
insulin suppresses glucagon by
directly acting on alpha cells; preventing glucagon from intefering w glucose lowering action of insulin
if you have decreased cortisol levels ; what does that do to insulin
decreased cortisol levels lead to lower insulin requirements in pt’s w aadrenal insufficiency
adrenal insuffiency labs
hyponatremia
hyperkalemia
hyperchloremia
non anion gap metabolic acidsosi
decreased H+ excretion; causing non agion gap met acidosis: low Hco3 levels; leading to compensatory increase in Cl reteion to matinatin electrical neutrality of eCF.
definition of azoospermia
no sperm
seen in klinefelter’s and CF
endogenous testoerone prodcution
LH FSH, testosterone sperm coutn?
LH low
FSH normal
elevated testoterone
low sperm count bc local androgen c oncentriosn in seminiferous tubule are suboptimal for spermatogenesis
cryptochordism
LH, FSH, testosterone , sperm levels
normal LH and testoerone, elevated fSH, low sperm count
seminiferous tubules damaged: thus elevated FSH levels
Ledyig cells are preserved
AP and posteiro pituitary lie in the
sella turcica
metabolism of ehtanol by alchol dehdyrgonease and aldehyde dehdyrogenase does what to nadh
reduces NAd to nadh ; increasing nadh/nad+ ratio
inhibiitng other pathwyas requiring nad+; including reactions required for gluconeneogesnsi
disorganized lamellar bone in mosaic pattern
paget
normal calcium and phosphours
osteoid matrix accumulation around trabeculae
vitamin D deficiency
histo: excessive unmineralized osteiod w widened osteoid seamas: low urinary calcium
spongiosa filling medullary canals w no mature trabeculae
osteopetrosiss
subperiosteal resoprtion with cortical thinning
Primary hyperparathyroidism
you cans ee peptic ulcer diseae in primary hyperprathyroidism
true
osteoporosis vs primary hyperparaythyroidsm osteoporosis
osteoporiss: trabecular thinning w fewer interconnections]]
PHPT: affects cortical (comapct) bone of appendicular skeleton (pectoral girdle, pelvic girdle, limbs)
cortical thinning: subperiosteal erosisons
