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Repro/Endo FInal > midterm physio deck 2 > Flashcards

midterm physio deck 2 Flashcards

1
Q

thyroid

A

thyroid develops from oral endoderm and travels down from foramen cecum

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2
Q

parathyroid development

A

inferior glands form from 3rd pharyngeal pouchsuperior glands form in 4th pharyngeal pouch, then detach and migrate inferiorly and medially

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3
Q

thyroid gland has no ________ but has many __________

A

glands; blood vessels

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4
Q

thyroid functional unit

A

follicle = filled w colloid (thyroglobulin) and lined by thyrocytes (follicular epithelium)

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5
Q

thyroid is the only endocrine gland to…

A

store hormone extracellularly in inactive form (thyroglobulin)

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6
Q

thyroglobulin iodination

A

2 tyrosines are iodinated and coupled to form thyroxine (t4)

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7
Q

thyroxine (thyroid hormone) synthesis

A

-thyroglobulin exocytosed into follicle-iodide transported into cell, oidized to iodine and released into follicle-1 or 2 iodine molecules are added to tyrosineson thyroglobulin (organification), catalyzed by thyroid peroxidase in the presence of hydrogen peroxidet3 = MIT + DIT (mono and di ioidothyronine)t4 = DIT +DITts/t4 are formed by oxidative coupling of 2 iodinated tyrosyls near each other — one donates and the other accpts iodotyrosyl; the acceptor remains attached to thyroglobulint3 is active

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8
Q

thyroid parafollicular cells (c cells)

A

next to follicles; neural crest originsecrete calcitonin

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9
Q

can you live without parathyroid glands?

A

absence is fatalyou need parathyroid

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10
Q

parathyroid gland cell types and their jobs

A

chief cells make PTHoxyphils are eosinophilic due to lots of mitochondria (job unknown)

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11
Q

PTH

A

stimulates bone resorption to increase serum caalso retains ca in the kidney and gutstored by chief cells and released when ca is low–works through its receptor on osteoblasts to make RANKL –> this stimulates osteoclasts formation and increased absorption in intestines and kidney

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12
Q

normal range of serum calcium

A

8.5-10.250% is free and 50% is bound to protein

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13
Q

vitD and PTH roles in ca regulation

A

vit D increases intestinal absorptionPTH causes bone resorption, increases vit D activation, and increases renal Ca absorption

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14
Q

how are changed in levels of blood Ca sensed?

A

detected by the calcium sensing receptor (CaSR) on the chief cells

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15
Q

Parathyroid Hormone Paradox

A

injectable PTH stimulates bone formationcontinuous levels of PTH leads to bone loss while intermittent short bursts can be anabolic for boneintermittent PTH favors osteoblasts; continuous favors osteoclasts

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16
Q

how osteoblasts influence osteoclasts

A

PTH causes osteoblasts to produce RANKLRANKL binds to RANK on osteoclasts and activates them

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17
Q

OPG

A

osteoprotegerinOPG binds RANKL and inhibits osteoclast activation (in absence of PTH)opg increases in response to estrogen (inhibits osteoclasts)opg decreases in response to PTH

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18
Q

RANKL

A

binds rank on osteoclastsmade by osteoblasts in response to PTHdecreased by estrogen

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19
Q

denosumab

A

antiresorptive drug that is sn antibody against RANKLused to treat post-menopausal osteoporosis; increases BMD

20
Q

estrogen and testosterone have what effect on bones?

A

stimulate bone formation! (decrease in osteoclasts)

21
Q

hyperparathyroidism causes

A

excess PTH –> osteoporosis

22
Q

how does lack of Ca cause convulsions

A

NMJ is more permeable to ions and readily depolarizes –> convulsions/tetany

23
Q

1-hydroxylase

A

forms bioactive vitamin DPTH increases 1-hydroxylase levels

24
Q

ca absorption in the intestine is directly dependent on_______ and indirectly on ________

A

directly on bioactive vit Dindirectly on PTH which forms the vit D

25
Q

ca and phosphate: bone/intestine vs kidneys

A

in bone/intestine phosphate and go same directionbut in kidney, ca and phosphate go opposite directtions(PTH retains Ca and excretes phosphate)

26
Q

where is ca [ ] higher :1) bone or plasma?2) extra cellular or intracellular

A

1 - plasma; hydroxyapatite has los solubility2 - extracellular; gradient allows it to act as a diffusible messenger to bind regulatory proteins

27
Q

CaM

A

calmodulinsca binding proteins that transduce ca signalslocated in cytoplasm, membranes and organelles; also aids in mitotic spindleundergo transformational change when bound to ca ; can bind up to 4 cahigh affinity and specificity

28
Q

calcitriol

A

active vit D3 (1,25 - OH2D3)

29
Q

vit D biosynthesis

A

cholesterol –> 7-dehydrocholesterolphotochemically converted to pre-vitamin D3isomerizes to cholecalciferol (D3)opens B ring to form a sterolhydroxylation at 25 (liver) by 25 hydroxylase–> 25-OHD3hydroxylation at 1 (kidney) by 1-hydroxylase–> 1,25-OH2D3

30
Q

1-hydroxylase

A

only in the kidney (inner mito membrane)so the kidney is the only site 1,25 vit D can be madephosphate depletion activates 1-hydroxylationhyperphosphatemia inhibits itinduced by hypocalcemia/PTH

31
Q

can you make 1,25-OH2D3 after renal failure or bilateral nephrectomy?

A

no; kindeys are the only place where 1-hydroxylase is

32
Q

how does decline in estrogen affect vit D?

A

–> lowers 1 hydroxylaseless 1,25 OH2D3–> post menopausal osteoporosis

33
Q

24-hydroxylase

A

24 hydroxylase is in the kidney24 hydroxylation results in 24,25 OH2D3 which is inactiveinduced in hypercalcemia; suppressed by hypocalcemia

34
Q

PTH has no direct effect on

A

intestine

35
Q

blood ca and calcitonin are ____ related

A

directly

36
Q

osteoporosis vs osteopenia

A

osteoporosis = BMD more than 2.5 std dev below meanosteopenia = between -1 and -2.5

37
Q

osteoporosis vs osteomalacia

A

OP = bone volume is reduced but mineralization is normalOM = abnormal mineralization

38
Q

ca and vit D supplements can cause

A

constipation

39
Q

risk of estrogen therapy for osteoporosis

A

breast cancer, thromboembolism, stroke. MI

40
Q

drug of choice for bad osteoporosis?

A

bisphosphonatesalendronate or risedronatenot absorbed well - so take w water and remain upright for 30 min

41
Q

risk of alendronate

A

esophagitis, esophageal ulcer

42
Q

SERMs

A

selective estrogen receptor modulatorsRALOXIFENE - used for osteoporosis
less BMD improvement than bisphosphonates**reduces MI and cancer risk though!!

43
Q

who should not use SERMs?

A

pregnant womenit is teratogenic!!!

44
Q

salmon calcitonin

A

analgesic effect for osteoprosis fractures

45
Q

pattern of ca and phos in PTH mediated disease

A

ca increases and phos decreases or vv

46
Q

pattern of ca and phos in vitD mediated disease

A

ca and phos go in same direction

47
Q

stones bones abd groans and psych moans

A

hypercalcemia

Repro/Endo FInal (23 decks)

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