Monday Wk 3 Endo 3 Flashcards
SGLT2 is __ affinity and __ capacity transport protein in the PCT
SE include urinary tract and genital __ infections
may cause symptomatic __
avoid in pt w __ impairment
waist greater than 102 cm in men, 88 cm in females assc w inc risk of insulin __ and diabetes, w C__
__ is necessary for internal male genitalia, spermatogenesis, male differentiation, and puberty
__ is important for external genitalia, inc prostate, male pattern hair
__ is necessary for endometrial prolif, developing ovarian granulosa cells, breast develop
low, high
mycotic
hypoTN
renal
resistance, CAD
Testosterone
DHT
estrogen
5AR type 1 present in postpubescent __
type 2 present in __
def 5AR type 2 dec conversion of __ to DHT in genitals
leads to normal _ genitals due to testosterone, but lack of __ genitalia
male P__, often becomes more male at puberty as __ aids in masculinization
may have small __ and hypospadius at birht
def of \_\_ results in dec cortisol and sex steroids w inc MC pt has \_\_ retention w HTN and female type genitals
A__ def presents w virilazion of females, but normal males
skin gonads Testosterone internal, external pseudohermaphroditism, 5AR t 1 phallus
17hydroxylase
sodium
aromatase
__ T3 is completely from peripheral conversion
by giving pt T3, TSH will be __
this leads to low __ and therefore __
bc it has short half life, avoid L__ T3
androgen use leads to __ Hct, __ LDL, and __ HDL
pt has A/H/male pattern __
females may get O/C
boys w testicular A__ and infertility
depression and H__ and aggressive
may see breast __ or gynecomastia
__ voice and premature epiphyseal cosure
reverse
suppressed
T4, rT3
Liothyronine
inc, inc, dec
acne, hirsutism, baldness
oligomenorrhea, clitormegaly
atrophy
hypomania
atrophy
deep
CDI causes hyperosmotic volume __
dec volume of __/__
could be seen in dehydration and profuse __
hemorrhage/diarrhea causes loss of __ fluid
referred to as isosmotic volume __
less aldo causes loss of __ and ECF volume
low osmolarity of ECF shifts free water to __ causing expansion
hypertonic saline causes volume __
high osmolarity draws water to __ further inc volume
polydipsia/SIADH causes __ retention, thus expanding ICF but dec __
contraction
ICF/ECF
sweating
ECF
contraction
NaCl
inc
expansion
ECF
water, osmolarity
TZD are similar to __ that activate PPAR receptors
strong lowering of __ levels
Gynecomastia has ductal epithelial \_\_ and stromal fibrosis due to dec \_\_ in CKD/hypogonad inc \_\_ in cirrhosis/obesity dec androgen prodxn in _ ags/K dec converstion to DHT by \_\_ inhibition of androgen receptors ie S/B
in pt w androgen deprivation therapy, tx w T__ to act as estrogen receptor antag in the breast
fibrates
TG
hyperplasia androgens estrogen GnRH, ketoconazole 5AR inhibs spironolactone, bicalutamide
tamoxifen
AGE can lead to accumulation/deposition of __ in blood vessel walls and inflam cell invasion leading to atherosclerosis and microangiopathies
Polyol pathway __ leads to osmotic/oxidative stress w impending neurologic damage
in hypergly states, __ reductase converts glucose to sorbitol faster than metab allows
Muscarinic M3/Glucagon/B2 adrenergic/GLP all are stimulated to release __
A2/somatostatin are stimulated to inhibit __ release
A2 predomiates over B2, but w blocker, __ release can occur
LDL
overactivity
aldose
insulin
insulin
insulin
redistribution of fat from extremities to trunk known as Lipo__ or __
common SE of ___
lipoatrophy leads to loss of __ from face, extremities
usually seen in __ RTI like stavudine/ziduvidine or __ inhibitor use
later leads to __ fat deposition
leads to metabolic __
McArdle Dz GSD type \_\_ def in M\_\_ an isozyme of glycogen phosphorylase dec breakdown of \_\_ during exercise, w poor exercise \_\_ and muscle cramps, R\_\_
Glycogen phosphorylase cleaves A__ glycosidic linkages, releasing G1P
occurs until __ residues left
then glucosyltransferase cleaves outer __ resideues and transfers to nearby branch
a 1, 6 glucosidase removes __ branch, producing free glucose
atrophy/dystrophy HAART subq fat nucleoside protease central abnormalities
5
myophosphorylase
glycogen, tolerance, rhabdo
a 1 4
4
3
remaining
muscles do not have glucose __, thus must use G6P for contraction
fructose is absorbed in GI tract via __ and phosphorylated to F1P by fructokinase
if pt is deficient (EF) __ takes over forming F6P
SE of glucocorticoid use include __ ulcer and GI bleed due to dec PG
psychosis esp w hypo__
sleep __
inc __ prodxn in lungs
causes __ of PMN, making it difficult to fight infections
leuks/monos, baso, eosinophils will be __
6 phosphatase
GLUT5
hexokinase
peptic
mania
disturbs
surfactant
demargination
low
failure of menarche before 15 is __ amenorrhea
cessation of menstruation in premen women who previously had menses is __ amenorrhea
2ndary amenorrhea assc w __ body weight, strenuous __, and Lanugo
results in Fxnal Hypothalamic amenorrhea, due to low __ levels which stop pulstalie GnRH
__ is most important stimulator of insulin, entering via GLUT2
goes through CAC to form __ which binds to K channel
normally it is open, allowing __ of K
w ATP, channel closes and membrane __ w opening of voltage gated __ channels
results in __ release
primary
secondary
low, exercise
leptin
glucose ATP, efflux depolarizes Ca insulin
pt w mutation that dec insulin release from K ATP dependent channels needs tx w __
F26BP stimulates __ in glycolysis
inhibits __ in gluconeogenesis
insulin upregulates __ to form F26BP
this stimulates __ and inhibits gluco
statins prevent conversion of HMG CoA reductase to __ acid
inc LDL receptor __ allows intrahepatic cholesterol levels to remain normal, but blood levels be low
SFU
PFK1
F16BPase
PFK2
glycolysis
mevalonic
recycling
VB7 is __ used in pyruvate carboxylase conversion of pyruvate to oxaloacetate
VB7 def can be seen in poor diet or inc raw __ consumption due to biotin binding avidin
pt presents w AMS, myalgias, chronic __ changes like macular dermatitis and met acid
pyruvate dehydro req T, R, N, P, L as cofactors
converts pyruvate to __
biotin
egg whites
dermatologic
thiamine, riboflavin, niacin, panthothenic acid, lipoic acid
acetyl coa
polyuria polydipsia could be Diabetes __/__, or primary psychogenic
PP presents w __Na and low urine osmolarity
urine osmolarity rises w __ deprivation
at 510, admin of __ does nt improve
tx w dec __ intake
tx of NDI uses thiazide diuretic to reduce __ and promote Na/water reabsorpton in __ tubule
mellitus, insipidus hypo water ADH water
volume, proxmal
pt w pyruvate dehydro def has inc __ then shunted toward latate via lactate __
can lead to life threatening __
tx w k__ diet, low in carbs high in __/__
stops __ and instead body uses KB for fuel
L/L are exclusively ketogenic AA
never will produce _ as all others can
pt presents w __ sx
pyruvate, dehydro LA ketogenic fat/protein glycolysis
leucine, lysine
glucose
neuro sx
Ammonia is breakdown of __ converted to urea in UC
combination of HCO3, NH3 and ATP catalyzed by carbamoyl phosphate __ to yield carbamoyl phosphate
CP combines w __ to yield citrulline via OTC
citrullin becomes Argininosuccinate and then A__
stimulated by N-acetyl__
pt w OTC def has inc __ and __ acid
hyperammonemia can be __ emergency w episodes of vomiting/confusion/coma
Tachypnea also occurs w hyper__ and resp alkalosis
AA synthestase ornithinne arginine glutamate
CP, orotic
metabolic
ventilation
17a hydroxylase is present in __ glands and gonads
def leads to low A/E/C but normal MC
inc ACTH stimulates __ leading to high levels
17A hydroxylase converts pregnenolone to 17__
also progesteroe to 17__
males present phenotypically __ due to lack of virilizing androgens
females appear __
at puberty
lack of __ hormones leads to abnormal SSC
inc MC levels leads to HTN, hypo__ and low __
adrenal
androgens, estrogen, cortisol
MC
hydroxyprenenolone hydroxyprogesterone female normal sex
K, renin
bile acid binding resins like C/C/C dec enterohepatic recirc
this leads to inc prodxn of __ and hypertriglyceridemia
G__ caused by inc GH in kids
acts as growth __ and stress hormone
effects due to __ release by liver, activating JAK/STAT path
this stimulates cell growth in b/c/s/s
kids have rapid __ growth w weight gain, sweating, large H/F, thickened calvarium and P__
Acromegaly does not affect ___
Laron dwarfism has dec __ levels
GH is __, pt is short
cholestyramine, colestipol, colesevelam
TG
gigantism
promotr
IGF1
bone, cartilage, skeletal muscle, soft tissue
linear
hands/feet, prognathism
height
IGF1
high
low cortsiol/aldo w high testosterone/17OH prog has __ def
salt wasting and __ genitals in girls
dec cortisol/aldo, high Test/11-deoxycortisone is _ def
ambig genitalia in girls, but salt/fluid __ w HTN
cannot convert 11deoxycortisne to __ and 11dexoycortisol to __
bulid up of Aldo/cortisol precursors leads to __ excess
low cortisol/test, inc MC/corticosterone is __ def
all pt look __ w HTN
21 Hydroxylase
ambig
11 b hydroxylase
retention
corticosterone, cortisol
androgen
17a hydroxylase
hirsutism can be due to inc __ prodxn, inc DHT, or high sensitivity of hair follicles to __
virilization occurs w high __ levels, w clitoregaly, inc muscles, and voice deepening
usually due to P__ w high androgens
tx w __ that suppress LH release by pituitary
also inc __ synth by liver
may see A/A, menstrual irrgs, __ resistance and obesity
tx w W
Ornithine decarboxylase inhibs E dec rate of facial hair growth
Pt w PCOS and DM tx w M__
androgen, DHT
androgen
PCOS OCP SHBG acne, alopecia, insulin weight loss
eflornithine
metformin
most thyroid nocules are __ consisting of colloid, various follicles, and macros
distinguish benign FA from Follicular adenoca based on __/__ invasion and gene expression
pt w hypoketotic hypoGly has defect in FA \_\_ in mito most cmmonly due to \_\_ dehydro def presents similar to \_\_ def pt is \_\_ until prolonged fast avoid \_\_ and supplement w glucose
pt cannot produce __ and __ for ATP prodxn
cannot generate __ for KB
benign
vasc/capsular
B oxidation Acyl coa carnitine asx catabolism
FADH2, NADPH
acetyl coa
woman w prolactinoma may have hypo__, anovulation, and amenorrhea
sx of ___ state, leading to osteoporosis
men w galactorrhea likely have __ effect sx due to prolonged compression
pt w delayed puberty plus anosmia has __ syndrome
failure of GnRH neurons to migrate from olfactory __ to hypothalamus
may have __ mutation or mutation in __ gene
may also have cleft __/__
teste/breast __ are first sign of puberty in either sex
gonadism
postmen
mass
Kallman
placode
KAL1, FGFR1
lip/palate
enlargement
Insulin receptor has __/__ subunits
alpha __ insulin, beta has __ domains
upon binding, autophosphorylation occurs w phos of IRS1/2, pushing __ to CM
TNF/Catecholamines/GC/glucagon induce insulin resistance by actiating __/__ kinases
phos of serine residues on IR/IRS1 inhibits __ phosphorylation and downstream signaling
A/B
binds, TK
GLUT4
serine/threonine
tyrosine
__oma presents w hyper/hypoglycemia, steatorrheae, gallstones
gallstones from low __ stimulation of GB
steatorrhea due to low __ and dec motility
released from _ cells of panc
normally, insulin is more inhib than __ thus hyperGly dominates
Klinefelter syndrome has destrxn/hyalinization of __ tubules w small testes
serum inhibin is __ as a result of sertoli cell damage
Leydig cells dysfxn, leading to __ testosterone
LH/FSH are __ though
pt can have G due to high estrogen/aromatase
other findings include long __ and lack of __ w sparse body __
normal LH/testosterone but high FSH seen in C___
somatostatin CCK secretin Delta glucagon
seminiferous low low high gynecomastia
limbs, sperm, hair
cryptorchidism
thiazide diuretics can inc __/__/__
low PTH differentiates from primary __
sertoli cells necessary for __/__ protein release
spermatogenesis requires high __/__ to fxn
to dx cushing syndrome, measure __ levels then do __ suppression testing
ACTH stim test used for adrenal __
in normal indiv, serum cortisol is highest in __ and then drop
in cushing, rhythm is __
thus, measure cortisol at __ is a sensitive/sepcific test
glucose, cholesterol, calcium
hyperPTH
inhibin B, Androgen binding
FSH, testosterone
ACTH
dexamethasone
insufficiency
morning
lost
night
