Extra Cards Flashcards
Hypothyroidism and LDL levels
Thyroid hormone serves to increase these receptors. However, when thyroid hormone is decreased, as it is in hypothyroidism, the number of LDL receptors on the liver surface and the ability to clear out cholesterol are both decreased, which leads to increased cholesterol.
Why does Cushings cause obesity
Further the high cholestrol, triglycerides and LDL confirm the obesity (fat gain) due to the increased metbaolism this causes an increased appetite and typically with chsuings there is a craving for salty and sweet foods. The weight gain is also present because in Cushings there is elevated leptin levels which inhibits the starvation mode, and tus signalling to the brain to intake more food,
analyse this for VP
Urine porphyrin/creatinine ratio: 146.1 nmol/mmol (<28)
Faecal porphyrins: 459 nmol/g dry weight (<130)
Faecal coproporphyrin III/I ratio: 4.0 (<2.0)
Red blood cell porhyrins: 231 nmol/L (<11.2
Urine porphyrin/creatinine ratio: 146.1 nmol/mmol (<28)
Faecal porphyrins: 459 nmol/g dry weight (<130)
Faecal coproporphyrin III/I ratio: 4.0 (<2.0)
Red blood cell porhyrins: 231 nmol/L (<11.2)
To get an accurate diagnosis: need to use blood, urine and faecal screens.
Faecal porphyrins: Screen for Acute, differeniate
Urine porphyrin: VP causes an increase in PBG, not to the same level as AIP, and therefore during an acite attack the pBG will decrease faster (back to normal) than AIP. However, the urine test is critical because during an acute attack the PBG will be high, just not as high. If the attack is missed, then the urine will still have an increased level of prop causing VP
RBC: Porphyrins help form many important substances in the body. One of these is hemoglobin. VP is an inherited porphyria resulting in the accumulation of protoporphyrins in red blood cells that causes acute, painful photosensitivity and thus increase in RBC porphyrins.
Faecal coproporphyrin III/I ratio: Increased Copro to Copro 3 is for VP while increase in copro 1 is for AIP
why is 17hydroxyprogesterone elevated in 21H deficency
elevation of 17-hydroxyprogesterone (17-OHP), the main substrate for the enzyme 21H.
