Monday Wk 3 Endo 1 Flashcards

1
Q

Familail D__ type 3 hyperlipoproteinemia
see X__ and premature __/__ disease
inherited __, most severe w other cx affecting lipoprotein metab

deficient in apoE3 and __
responsible for binding __/__ to receptors
w/out it, chylo/VLDL cannot be removed, thus blood shows high levels of __/__

Familial chylo__ syndrome type 1
defect in lipoprotein __ or ApoC2
inc levels of C__
see acute __ w lipema retinalis and eruptive __

A

dysbetaliporproteinemia
xanthomas, CAD/PVD
AR

apoE4
VLDL/TG
cholesterol, TG

micronemia
lipase
chylomicrons
panc, xanthomas

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2
Q

familial hypercholesterolemia type 2 A is defect in __ receptor or ApoB100
inc level of __
see premature _, tendon __ and xanthelasma

Familial hyperTG (type 4) is poly__ defect
inc __
assc w CAD and P and DM

ApoA1 req for conversion of cholesterol to \_\_ by LCAT
def in ApoA1/LCAT results in low \_\_ and inc cholesterol
A

LDL
LDL
CAD, xanthomas

genic
VLDL
panc

HDL
HDL

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3
Q

normal thyroid follicles w colloid indicates lingual __
__ gland formed from outpoching of pharyngeal __ and descends to __ neck
lowest part forms __ w rest forming the thyroglossal duct
can be found anywhere along descent due to failed __
enlargement leads to __ sx exp w inc thyroid stim

thyroid formed by fusion of thyroid follicular cells and parafollicular __ cells
w lingual thyroid, __ does not occur

metabolism of ethanol by alcohol/aldehyde dehydro consumes __ inc NADH/NAD+ ratio
as a result, all pathways req __ are inhibited

A
thyroid
thyroid, epithelium
lower anterior
thyroid
migration
obs

C
fusion

NAD+
NAD+

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4
Q

thyroid follicle cells take up inorganic __ against conc gradient using __ iodide symporter
iodide released into follicular lumen and converted to iodine by thyroid __
then binds t__ residues (Organification) in TG to form MIT/DIT
coupled to form __/__
follicles engulf __ via pinocytosis, hormones removed and TG is released

M/P are thioamide drugs
inhibit thyroid __ responsible for iodine __ and coupling
PTU dec peripheral conversion of __ to __
M__ does not

P/P are comp inhibs of Na/Iodide symporter

A
iodide, Na
peroxidase
tyrosine
T4/ T3
pinocytosis
Methimazole, PTU
peroxidase
organification
T4 to T3
methimazole

perchlorate, pertechnecate

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5
Q

small amnts of panc __ can leak into panc capillaries, metabolizing TG to __
this causes a __ effect on panc w inc TG levels

pt w hypoThyroid has __ TSH, __ T4 and usually __ T3

heparain admin inc __ activity
thus, if low after admin, think familial __ syndrome

Glucose diffuses across cell membranes via __ mediated transport for facilitated diffusion
GLUT enzymes are stereo__ for D-glucose
GLUT4 is found in __ muscle and Adipocytes
stored in __ vesicles, and binds to surface w high insulin
__ aids in export of glucose from liver/SI/kidney into circ
helps to control __ sec by panc

A

lipase, FFA
toxic

high, low, normal

LPL
chylomicronemia

carrier
selective
skeletal
cytoplasmic
GLUT2
insulin
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6
Q

PPP is main source of __
necessary for cells w high __ stress to maintain integrity
organs such as L/AC involved in FA/cholesterol/steroid synth
resp burst via __ oxidase

G6PD generates NADPH and R5P via __ rxns
nonoxidative reactions produce __

pt w thioamides and fever/sore throat, oral ulcers, signs of infections need __ count and discontinued drug
both M/P have risk of __

PTU can be used in thyroid storm due to inhibition of __ conversion of T4-T3
M is preferred due to severe __ risk w PTU

Avoid __/__ NSAIDs as they can displace T4 from TBG

A

NADPH
oxidative
liver/adrenal cortex
NADPH

oxidative
energy

WBC
agranulocytisis

peripheral
hepatotoxicity
ibuprofen/aspirin

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7
Q

Central DI is due to damage to the __ w low ADH prodxn
synthesized in P/S nuclei of hypothalamus
can have __ dysfxn, but this will resolve w time

anterior pituitary releases hromones from __ eminence via hypothalamic/hypophyseal portal vssels

majority of thyroid hormones are bound to __ w some to transthyretin/albumin
inc __ raises TBG levels, w reduction in free T4
this causes transient inc in __ prodxn to saturate TBG, w inc total T4
free T4 remains __ and pt is euthyroid

A

hypothalamus
paravent, supraoptic
PP

median

TBG
estrogen
thyroid hormone
normal

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8
Q

pt w longterm GC use has __ of entire HPA axis
see bilateral cortical __
stopping GC can result in life threatening adrenal __
inc risk for C__

most prostate cancer is __ dependent
rx w surgical __ or pharm suppression of __ prodxn
L __ is GnRH analog
initially causes rise in __ and testosterone, but over time leads to dec __ by Leydig cells

__ def presents w intro of fructose into the diet (HFI)
V and hypoGly w intracellular accumulation of __
depletes inorganic __ inhibiting glycogenolysis/gluco
FtT/HSM/J w liver/renal failure
tx w removal of __ from diet

F__ is AR do of impaired fructose metabolism
released into __

A

suppression
atrophy
insufficieny
CAD

androgen
orchiectomy, testosterone
Leuprolide
LH, prodxn

Aldolase B
fructose 1 phos
phosphate
jaundice
fructose

fructokinase
urine

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9
Q

__ stim test can indicate HPA integrity
metyrapone blocks __synth by inhibiting 11B hydroxylase
converts 11deoxycortisol to __ in ZF
does not inhibit __ so it should be high if HPA works
inc levels of __ and 17OHCS in urine

Metyrapone also blocks __ synthesis, but 11-deoxycortisone has some __ activity, so RAAS is not affected

TPO catalyzes __ of Iodide to Iodine, iodination of TG __ residues, and coupling rxn for __/__
antibodies seen in __ dz

A
metyrapone
cortisol
cortisol
ACTH release
11-deoxycortsol

aldosterone
MC

organification
tyrosine, T4/T3
Hashimoto

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10
Q

Carbamezeipine/Cyclophosphamide, SSRI can all cause __
ADH/oxytoxcin synth by M_ neurons in hypothalamus
packaged into vesicles and travel via __ transport to PP (N__)
terminate in __ bodies in vesicles w neurophysins involved in postranslation processing/stabilization
hormones/ neurphysin secreted into __ vein & systemic circ

Regular insulin has \_\_ effect after ingestion
does not work w \_\_ peak in BG
due to d\_\_/hexdimer formation
\_\_ acting insulin overcomes this 
L/A/G are preferred for post prandial

G__ is long acting and does not have peak
crystallizes in _ tissue
D__ is long acting w FA side chain
lasts around __ hrs

A
SIADH
magnocellular
anterograde axonal
neurohypophysis
herring
hypophyseal
delayed
postprandial
dimer
rapid
lispro, aspart, glulisine

glargine
subQ
detemir
24

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11
Q
Subacute granulomatos thyroidits onset after \_\_ illness
\_\_ thyroid enlargement
transient \_\_ sx
inc ESR/CRP but \_\_ radioiodine uptake
inflamm infiltrate w macros and \_\_ cells
Hashimoto aka chronic \_\_ hypothyoid
\_\_ etiology
painless thyroid \_\_
always \_\_ thyroid
positive \_\_ antibody
lymph infiltrate w well developed \_\_
\_\_ cells aka eosinophilic epithelial cels

Papillary thyroid ca hs branching __ structures w concentric Ca (psammoma body)
see follicular __ w nodular enlargement

__ thyroiditis caused by fibrosis of thyroid gland
gland is __ and nontender

A
viral
painful
hyperthyroid
dec
giant
lymphocytic
AI
enlarge
hypo
TPO
germinal centers
hurthle

papillary
hyperplasia

reidel
hard

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12
Q

in acid __ def (pompe dz), glycogen will accumulate in __

caracts cause loss of __ reflex
seen w age, excessive __ exposre, DM and __ use
DM has saturation of __ pathway, as sorbitol builds up and cannot be converted to __ by sorbitol dehydro
accumulates in lens/retina, K and PN
results in o__ stress, w hydrobic lens fibers __ w opacification

glucose converted to sucrose by __ reductase

A

maltase, lysosomes

red
sun, GC
polyol
fructose
kidney, PN
oxidative
degen

aldose

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13
Q

TZD cause fluid retention by inc sodium reabsorption in renal __
worse when given w __

agranulocytosis can occur w __

flesh colored nodules on lips/tongue are likely mucosal __
unencapsulated, thick proliferations of __ tissue
can also see intestinal __ w MEN2B

RER produces secretory/lysosomal/integral membrane __
w posttranslation mod, they are passed to __ via COP 2 coated transport vesicles

SER necessary for steroid/__ biosynth
well developed in steroid porducing cells like __/_/__

A

collecting tubules
insulin

SFU

neuromas
neural
ganglioneuromas

proteins
golgi

phopsholipid
adrenals, gonads, liver

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14
Q

pt w severe hypoTN, refractory shock, ab pain, vomiting, weak, fever most likely has __ crisis
commonly seen w __ cx in setting of stressors
tx w fluid __ and __ admin

__ disease is AR due to sphingomyelinase def
accumulating sphingomyelin causes large, foamy cells w __
pt has neurologic __ and cherry red macula

inc risk of rare gene defects in pop known as __ effect
lost genetic varability w conceiving in ___

A

adrenal
AI
resus, GC

NP
HSM
degeneation

founder
community

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15
Q

__ dz is caused by bglucocerebrosidase def
__ accumulates
HSM, pancytopenia and __ pain

__ is def in a l iduronidase
__/__ sulfate accumulate
leads to dysostosis multiplex w enalrged __ and abnroaml __/__ and corneal clouding

__ dz is a galactosidase A def
G__ accumulates w neuropathc pain/angiokeratomas and organ involvement
inherited __

small stture, infertility, predisposition to malig w suc screen facial rash is __ syndomre
AR disorder w __ instability

A

gaucher
glucocerebrosiade
bone

hurler syndrome
heparan/dermatan
skull, ribs/vertebrae

Fabry
GB3
XLR

bloom
chromo

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16
Q

__ disease is AR def in neutral AA transporter
cannot transport neutral AA in __/__
trytophan is essential AA for N/S/M
conversion to Niacin is necessary for forming __ in redox rxns, thus def is problematic
pt has __ like skin rxns upon sun exposure and cerebellar __
dx w neutral ___
tx w high protein diet w __ supplementation

__ def can be seen as sore throat, stomatitis, glossitis, normocytic anemia and seborrheic derm
important in __ transport

A
Hartnup
SI, proximal tubules
niacin, serotonin, melatonin
NAD+
pellagra, ataxia
amino aciduria
niacin

Riboflavin
electron

17
Q

insulin is synth in panc b cells as ___insulin, and taken to RER by signal seq
converted to __ and taken to Golgi, and released in secretory granules
converted to mature __ and C peptide, secreted by B cells
C peptide does not undergo __ metabolism by liver as insulin does
can be measured for endogenous __ secreting capacity
M/S inc insulin sec, thus can upregulate __ sec

A
prepro
proinsulin
insulin
first pass
insulin
meglinities, SFU, C peptide
18
Q

GLP1 agonists E/L inc glucose dep __ sec, dec glucagon/gastric emptying
SE is P

DPP4 inhibs gliptins inc endo __ and __ levels
SE is N__

Biguanides like M__ stimulates __ to dec gluocse prodxn

BCAKD req T/L/C/F/N as cofactos

disorders of urea cycle req __ as essential AA
w hyperammonemia, arginine produces __ intermediates that lead to nitrogen disposal

A

exenatide, liraglutide
insulin
panc

GLP1. G1P
nasopharyngitis

metformin, AMPK

thiamine, lipoate, CoA, FAD, NAD

arginine
water soluble

19
Q

Primary hyperaldosteronism has bilateral adrenal __ or unilateral adrenal __
sx include HTN, hypokalemic __ w muscle weakness/paresthesias
does not have volume expansion due to aldo __

hypokalemia due to H secretion by __ cells
promotes __ reabsorption by basolateral HCO3/Cl exhanger
thus, __ levels are high

aldo escape means __/__ levels are normal
due to upregulated release of _ w natriruesis

well defined __ tumor of AC occurs, produces hormones depending on zone

MEN1 caused by mutation in __ gene for menin

A

hyperplasia, adenoma
alkalosis
escape

a intercalated
HCO3
HCO3

Na/volume
ANP

yellowish

MEN1

20
Q

Neurophysin 2 has binding site for __ and is involved in packaging/transport through RER/golgi
mutation can result in abnormal protein __ and removal, dec release
may lead to AD form of hereditary hypothalamic __

TRH stimulates release of __ and __

Screen for endogenous cushing w low dose __ suppression and late night salvary __ or 24hr urinary __
in normal pt, dexamethasone will suppress __/__

A

ADH
folding
CDI

TSH, prolactin

dexamethasone, cortiol, cortixol
ACTH, cortisol

21
Q

w pituitary overprodxn, cortisol is not suppressed w low D but is w __
ectopic ACTH prodxn will have high __ in response to dexa

cushing syndrome due to adrenal adenoma/carinoma or exogenous will have __ ACTH

Radioactive I131 is taken up by __ and results in radiation induced __thyroid or thyroid carcinoma
to tx, give ___prophylactically
Na/iodide symporter takes all forms of iodide, thus it can be __ inhibited

elevated serum iodide can also inhibit iodine __ via Wolff Chaikoff effet and reduce T4 release

A

high dose
ACTH

low

thyroid gland
hypo
KI
competitively

organification

22
Q

myoedema is focal __ of muscle following percussion in hypothyroid
seen w myalgias, __ muscle weakness and cramping
may precede hypothyroid, so get __ levels to dx

CKMB present in __ tissue
CKBB present in _ tissue
CKMM present in __ tissue

A

mounding
proximal
TSH

cardiac, CNS, skeletal muscle

23
Q

GC induced myopahty has proximal MW and __ w/out pain
__ extremities more involved
CK is __

Polymyalgia rheumatica has muscle pain and __
worse in __ and w activity
CK is __

Inflam myopathy (dermato/polymyositis) has skin \_\_ and inflam \_\_
CK is \_\_

Statin myopathy has proxmial muscle pain/weakness after using __
CK is __

A
arophy
lower
normal
stiffness, morning
normal

rash, arthritis
inc
statins
inc

24
Q

prolactin is neg regulated by __ binding D2 receptors on lactotrophs
positive reg via __/__ on lactotrophs
can be a result of __ lesion affecting the pituitary stalk

other hormones are __ by the hypothalamus
thus, damage results in __ levels

A

dopamine
TRH, VIP
sarcoid

stimulated
dec