Monday Wk 3 Endo 3 Flashcards

1
Q

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

A

low, high
mycotic
hypoTN
renal

resistance, CAD

Testosterone
DHT
estrogen

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

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

A
skin
gonads
Testosterone
internal, external
pseudohermaphroditism, 5AR t 1
phallus

17hydroxylase
sodium

aromatase

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

__ 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

A

reverse
suppressed
T4, rT3
Liothyronine

inc, inc, dec
acne, hirsutism, baldness
oligomenorrhea, clitormegaly
atrophy

hypomania
atrophy

deep

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

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 __

A

contraction
ICF/ECF
sweating

ECF
contraction

NaCl
inc

expansion
ECF

water, osmolarity

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

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

A

fibrates
TG

hyperplasia
androgens
estrogen
GnRH, ketoconazole
5AR inhibs
spironolactone, bicalutamide

tamoxifen

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

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

A

LDL
overactivity

aldose

insulin
insulin
insulin

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

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

A
atrophy/dystrophy
HAART
subq fat
nucleoside
protease
central
abnormalities

5
myophosphorylase
glycogen, tolerance, rhabdo

a 1 4
4
3
remaining

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

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 __

A

6 phosphatase

GLUT5
hexokinase

peptic
mania
disturbs

surfactant

demargination

low

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

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

A

primary
secondary

low, exercise
leptin

glucose
ATP, efflux
depolarizes
Ca
insulin
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

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

A

SFU

PFK1
F16BPase

PFK2
glycolysis

mevalonic
recycling

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

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 __

A

biotin
egg whites
dermatologic

thiamine, riboflavin, niacin, panthothenic acid, lipoic acid
acetyl coa

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

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

A
mellitus, insipidus
hypo
water
ADH
water

volume, proxmal

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

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

A
pyruvate, dehydro
LA
ketogenic
fat/protein
glycolysis

leucine, lysine
glucose

neuro sx

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

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

A
AA
synthestase
ornithinne
arginine
glutamate

CP, orotic
metabolic
ventilation

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

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 __

A

adrenal
androgens, estrogen, cortisol
MC

hydroxyprenenolone
hydroxyprogesterone
female
normal
sex

K, renin

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

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

A

cholestyramine, colestipol, colesevelam
TG

gigantism
promotr
IGF1
bone, cartilage, skeletal muscle, soft tissue

linear
hands/feet, prognathism
height

IGF1
high

17
Q

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

A

21 Hydroxylase
ambig

11 b hydroxylase
retention

corticosterone, cortisol
androgen

17a hydroxylase

18
Q

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__

A

androgen, DHT
androgen

PCOS
OCP
SHBG
acne, alopecia, insulin
weight loss

eflornithine

metformin

19
Q

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

A

benign

vasc/capsular

B oxidation
Acyl coa
carnitine
asx
catabolism

FADH2, NADPH
acetyl coa

20
Q

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

A

gonadism
postmen

mass

Kallman
placode
KAL1, FGFR1
lip/palate

enlargement

21
Q

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

A/B
binds, TK
GLUT4

serine/threonine
tyrosine

22
Q

__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___

A
somatostatin
CCK
secretin
Delta
glucagon
seminiferous
low
low
high
gynecomastia

limbs, sperm, hair

cryptorchidism

23
Q

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

A

glucose, cholesterol, calcium
hyperPTH

inhibin B, Androgen binding
FSH, testosterone

ACTH
dexamethasone

insufficiency

morning

lost

night