Firecracker Endo IV Flashcards
FSH, LH, ACTH, TSH use what kind of signaling mechanism?
adenylate cyclase - cAMP
CRH, hCG, ADH (V2), MSH, PTH use what kind of signaling mechanism?
adenylate cyclase - cAMP
calcitonin, GHRH, and glucagon use what kind of signaling mechanism?
adenylate cyclase - cAMP
Brain RBCs Intestines Cornea Kidneys Liver
6 examples of cells / tissues which do not need insulin or GLUT-4
Extends across midline, overlying the aorta, left renal vein, splenic vein and the end of the inferior mesenteric vein.
Body of pancreas
epigastric pain, diarrhea, steatorrhea, vomiting
Zollinger Ellison syndrome
stimulate insulin secretion by causing the closure of the ATP-sensitive K+ channels in β cells.
Sulfonylurea drugs such as tolbutamide or glyburide
GLUT-1 (insulin-independent) is constitutively expressed at high levels in cells with high glucose requirements, namely, [two cell types].
RBCs and brain
What effect does insulin have on renal sodium handling?
Insulin → ↑ Na+ retention by the kidneys.
In patients with Zollinger Ellison syndrome, where are the gastrinomas?
duodenum, pancreas
The [WHAT?] lies in the bed of the stomach behind the parietal peritoneum (secondarily retroperitoneal), except the tail, which lies within the splenorenal ligament.
pancreas
What duct drains the uncinate process and lower part of the head of the pancreas?
Accessory Pancreatic Duct
where does the Accessory Pancreatic Duct lead?
opens independently into the second part of the duodenum at the minor duodenal papilla.
What traverses the length of the pancreas and joins the common bile duct to form the ampulla of Vater (hepatopancreatic ampulla)?
Major pancreatic duct
What part of the pancreas lies in the curvature of the duodenum; traversed by the bile duct; hooklike uncinate process lies posterior to the superior mesenteric vessels?
Head
What part of the pancreas extends across midline, overlying the aorta, left renal vein, splenic vein and the end of the inferior mesenteric vein?
Body
What part of the pancreas entered the splenorenal ligament and terminates at the hilum of the spleen?
Tail
How does glucagon raise blood sugar levels?
↑ glycogenolysis
↑ gluconeogenesis
What part of the pancreas lies in curvature of the duodenum?
Head
_______ decreases the number of insulin receptors.
Obesity
_______ increases the number of insulin receptors.
Starvation
- Tachycardia
- Tremor
- Altered mental status
- Altered vision
- Sweating
- Anxiety or agitation
symptoms of hypoglycemia
At what serum [glucose] do symptoms of hypoglycemia generally appear?
<70 mg/dL
Heart failure, arrhythmias, cerebral edema, Mucor sinusitis (rapid fatal fungal infection)
most severe consequences of DKA
- Peptide hormone consisting of an A chain and B chain
- The two chains are linked by two disulfide bonds.
structure of insulin
How does the hypothalamus regulate anterior pituitary function?
Capillary involvement: hypothalamus releases stimulating/inhibiting hormones into capillaries that control anterior pituitary secretion
Describe Kussmaul respirations
(rapid and deep breathing),
Gastrin activates what cell types?
stomach parietal cells and enterochromaffin-like cells (secrete histamine)
Flushing of skin
Secretory (watery, voluminous) diarrhea
Abdominal cramps with nausea and vomiting
Bronchoconstriction/bronchospasm → wheezing
Tricuspid insufficiency or pulmonic valve stenosis (TIPS)
Symptoms that occur secondary to carcinoid neuroendocrine cells
Can you name 2 vasoactive substances responsible for causing symptomatic discomfort in carcinoid syndrome?
serotonin, kallikrein
1) Escaping hepatic degradation by virtue of its location (e.g. lung or liver)
2) Overwhelming the liver’s capacity to metabolize the vasoactive substance
2 mechanisms by which carcinoid tumors may become symptomatic
1) ↑ uptake of glucose by target cells
2) ↑ glycogen synthesis, and
3) ↓ gluconeogenesis.
how Insulin → ↓ blood glucose concentrations
DM is defined as 2hr oral glucose tolerance test over what measurement?
200
What drugs inhibit thyroid peroxidase?
propylthiouracil and methimazole.
MEN2b
Medullary thyroid carcinoma
Pheochromocytoma
Mucosal neuromas/Marfanoid habitus
sidebar: what is angioedema?
rapid swelling of nose, lips, tongue, mouth, and throat shortly after first dose of ace inhibitor
treatment for prolactinoma
1) Bromocriptine or cabergoline: dopamine agonists.
2) Transsphenoidal surgical resection for large tumors
why do dopamine antagonists (ex: antipsychotics) cause galactorrhea (loss of inhibition)?
Dopamine normally inhibits PRL release.
bromocriptine can be used for prolactinoma and?
parkinson’s
- Fever
- Painful thyroid
- Painful cervical lymphadenopathy
acute thyroiditis
Parathyroid hyperplasia
Pancreatic endocrine tumor
Pituitary adenoma
MEN1
What is a urinary degradation product of serotonin that is elevated in carcinoid syndrome?
5HIAA
What anions inhibit the Na-I transporter of thyroid follicular cells?
thiocyanate and perchlorate
Medullary thyroid carcinoma
Pheochromocytoma
Parathyroid hyperplasia
MEN2a
Step 1 of insulin secretion: 1) Glucose enters the pancreatic β cell through WHAT receptor by facilitated diffusion.
GLUT2
Step 2) of insulin secretion: Inside the cell, glucose is oxidized to ATP, which closes ATP-sensitive K channels on the plasma membrane. Closure of this K channel leads to membrane depolarization –>
, which then opens voltage-gated Ca2+ channels
Step 3 of insulin secretion: ↑ intracellular [Ca2+] leads to
exocytosis of insulin storage vesicles.
- May induce remission by blocking new thyroid hormone production via inhibition of the organification and coupling steps of thyroid hormone synthesis.
- PTU (not methimazole) also inhibits peripheral conversion of T4 to T3.
mechanism of Thioamides — e.g., PTU (propylthiouracil), methimazole:
What is the most common cause of renal papillary necrosis?
Diabetes mellitus (most common etiology of renal papillary necrosis)
Where are insulin and c-peptide stored after production?
secretion granules
