Firecracker Endo V Flashcards
D3 is converted to 25-OH-vit D3 by
hepatic 25-hydroxylase.
25-OH-vitD3 is converted to 1,25-OH2-vitD3 by
1-alpha-hydroxylase
What side effects are seen with the use of Orlistat?
steatorrhea and fecal urgency
–> coordinated increase in both [Ca2+] and [phosphate] in the ECF in order to form a solubility product that favors the mineralization of bone.
vitamin D
activates AMPK (AMP-activated protein kinase) → ↑ expression of orphan nuclear receptor SHP (small heterodimer partner) → inhibits expression of liver PEPCK and glucose-6-phosphatase, thus repressing hepatic gluconeogenesis. It also increases peripheral insulin sensitivity and utilization of glucose.
Metformin
1,25-OH2 vitamin D also inhibits its own production by inhibiting .
1α-hydroxylase
Improves insulin target sensitivity. It binds to PPAR-γ (peroxisome proliferator activating receptor-gamma), causing increased insulin receptor number and sensitivity, as well as decreased hepatic gluconeogenesis.
Thiazolidinediones: rosiglitazone, and pioglitazone
Side effects include hepatotoxicity and cardiovascular toxicity (i.e. crazy edema that can precipitate CHF). Absolute contraindication in pts with liver failure or CHF.
Thiazolidinediones: Commonly used medications include rosiglitazone, and pioglitazone
ANP, NO (EDRF) use what kind of signaling mechanism?
guanylate cyclase-cGMP mechanism
What are the common diagnostic tests in the work up of thyroid cancer?
- ultrasound
- FNA
- scintigram
scaly thickening and induration of the skin overlying the shins with nonpitting edema; this only occurs in 1-2% of patients with Graves
pretibial myxedema
In patients with liver or kidney disorder, D2 and D3 will be ineffective. In these cases, active metabolites (i.e. WHAT?) are available to compensate for inability to provide hydroxylation steps.
calcitriol
- Benzphetamine
- Phendimetrazine
- Diethylpropion
- Mazindol
- Phentermine
Sympathomimetics are prescribed for short-term weight loss
When leuprolide is given in a pulsatile fashion, it mimics physiological stimulation and can increase release of FSH, and LH. This is used to treat
infertility
At high levels, leuprolide acts as a superagonist, causing desensitization and decreased release of FSH and LH, resulting in chemical castration. This is particularly useful for the treatment of
hormone sensitive malignancies such as breast and prostate cancer, as well other conditions such as BPH, fibroids, and endometriosis.
What is the treatment of carcinoid syndrome?
Octreotide – somatostatin analogue;
Surgical resection and chemotherapy with 5-FU (fluorouracil) and doxorubicin
Where in the cell does a prohormone become a hormone?
Golgi apparatus
Name 2 short acting insulins
Regular, and Semilente
Has anti-diuretic properties similar to ADH, so can lead to hyponatremia and seizures. Can also cause subarachnoid hemorrhage. Note in pregnant patients, it can also cause uterine rupture!
Adverse effects of oxytocin
Name 2 intermediate acting insulins. What is their onset and duration of action?
Lente, Isophane (NPH)
GnRH, Oxytocin, ADH (V1 receptor), and TRH signaling mechanism
IP3-Ca2+
What is the treatment of secondary hyperparathyroidism?
Calcitriol (vitamin D) and phosphate binders such as aluminum hydroxide or calcium carbonate