Overview 2 Flashcards
Major risk factors for atherosclerosis? x4
Hypercholestrolaemia
Hypertension
Smoking
Diabetes
Outcome of the Framingham study? x2
Obesity is a risk for heart failure
Hypertension is a risk for CVD
Diabetes increases the risk of CVD by what amount?
Causes x3 increased risk of CVD
Metabolic syndrome is?
Syndrome including increased risk of CVD consisting of four particular factors
Four factors included in metabolic syndrome?
Insulin resistance/DM2
Abdominal obesity
Dyslipidaemia
Hypertension
Ethnicity most sensitive to the effects of obesity are?
South Asians
Major factor increasing insulin resistance/DM2 is?
Hypertriglyceridaemia/increased intracellular fatty acids
Rectors associated with increased transport of fatty acids is?
CD36
Effect of flavonoids on CVD?
Beneficial effect on MI and stroke
Flavonoids are found in what food groups? x3
Fruit
Veg
Tea
Two beneficial effects of flavonoids?
Reduces ROS
Reduces CVD
Effect of folate/B12 on CVD? x2
Reduces methionine and homocystokine - these are toxic and damage endothelial cells
SO reduces CVD
Effect of low birthweight on CVD?
Increased rate of CHD
Increased LDL
Increased fibrinogen
Increased BP
BMI of underweight?
<18.5
BMI of normal weight?
18.5-24.9
BMI of overweight?
25-29.9
BMI of obese?
> 30
BMI of morbidly obese?
> 40
Way to measure BMI?
Weight (kg) / height (m) squared
Healthy BMI of individuals may differ according to what factor?
Ethnicity
Alternative measurement for healthy weight x2 and why is this necessary?
Waist circumference
Waist/hip ratio
Can distinguish muscular people
Prevalence of obesity in Tower Hamlets when starting primary school?
One in eight
Prevalence of obesity in Tower Hamlets when leaving school (age 11)?
One in four
What percentage of weight issues are related to medications?
10-15%
Drugs causing weight issues x6
Mood stabilisers DM Corticosteroids Beta blocker Allergy relievers Drugs preventing seizures and migraines
The thrifty gene is?
Genes that predispose to obesity have a selective advantage in populations that previously experienced starvation
Two ethnicities mainly effected by the thrifty gene?
Asian
African
Gene associated with thrifty gene hypothesis?
CREBRF
Four features of syndromic monogenic obesity?
Mental retardation
Dysmorphic features
Organ specific abnormalities
OBESITY
Main site of adaptive thermogenesis?
Brown adipose tissue
Effect of brown adipose tissue on obesity?
Protection against obesity
Effect of white adipose tissue on obesity?
Increased rates
Apple/pear shape - which has greater risk of weight-related health problems and why?
Apple shape - more visceral fat
Obesity related diseases could cut the lifespan by how many years?
11
Main drug used to treat obesity?
Orlistat
Action of orlistat?
Lipase inhibitor - reduces the amount of fat absorbed from food that is eaten
What must first be undertaken prior to surgery for weight loss?
Weight management course - diet and nutrition, fitness and exercise
Indications for surgery in those that are obese? x2
Morbid obesity (BMI >40) Or BMI > 35 and obesity related complications once conventional medical treatments have failed
Three surgery types for the treatment of obesity?
Restrictive procedures - gastric band
Malabsorptive procedures
Restriction plus malabsorption
Problems associated with malabsorptive procedures to cause weight loss? x3
Cause nutrient deficits and malnutrition and also dumping syndrome
Functions of the hypothalamus x7
Pituitary function Feeding - appetite and satiety Stress response Water balance Sleep-wake cycle Thermoregulation Emotions
Six hormones released by the anterior pituitary
Growth hormone TSH LH FSH PRL ACTH
Two hormones released by the posterior pituitary
Oxytocin
AVP/ADH
Blood comes to the anterior pituitary via which artery?
Superior hypophyseal
What travels from the hypothalamus to the anterior pituitary via the superior hypophyseal artery?
Hormones
Pituitary gland sits in?
Sella turcica
Enlargement of pituitary gland causes which deficit most commonly?
Bitemporal hemianopia
Bitemporal hemianopia is?
Loss of vision in the lateral half of each eye
Cause of bitemporal hemianopia is?
Compression of the optic chiasm
Hypothalamic hormone causing release of growth hormone?
GHRH - growth hormone releasing hormone
Hypothalamic hormone causing release of thyroid stimulating hormone TSH?
Thyroid releasing hormone
Hypothalamic hormone causing release of prolactin?
Thyroid releasing hormone
Hypothalamic hormone causing release of ACTH? x2
AVP and CRH
Hypothalamic hormone causing release of FSH? x2
Kisspeptin
Gonadotrophin releasing hormone GnRH
Hypothalamic hormone causing release of LH? x2
Kisspeptin
Gonadotrophin releasing hormone GnRH
Thyroid releasing hormone is secreted from where?
Hypothalamus
Thyroid releasing hormone causes the release of which two hormones from the pituitary gland?
TSH
Prolactin
Hypothalamic hormone somatostain inhibits the release of which pituitary hormones? x2
Growth hormone
TSH
Hypothalamic dopamine hormone inhibits the release of which pituitary hormone? x1
Prolactin
Growth hormone causes the release of what from where?
IGF-1 from the liver
TSH causes the release of what from where?
T3 and T4 from the thyroid gland
Prolactin has an effect where? x2
Mammary glands
Immune system
ACTH releases what from where
Glucocorticoid cortisol from the adrenal gland
Cortisol is released fro which part of the adrenal gland?
zona fasciculata
FSH and LH release what from where?
Ovaries - oestrogen and progesterone
Testes - testosterone
Negative feedback of thyroid hormone works via which two pathways?
Thyroxine on TSH - pituitary gland
Thyroxine on TRH - hypothalamus
Thyroxine is T4 or T3?
T4
Primary underactivity is?
Damage to the target organ so lack of production of the target hormone
Secondary underactivity is?
Damage to the pituitary gland - lack of production of the pituitary hormone AND the target hormone
Primary underactivity of thyroid - lack of which hormone?
T4/T3
Secondary underactivity of thyroid - lack of which hormone?
TSH AND T4/T3
Hormone that can also stimulate the release of GHRH and GH?
Ghrelin
Pituitary hormone that has circadian rhythm is?
Growth hormone GH
GH relation to puberty?
Increased release during puberty
Inheritance of McCune-Albright syndrome?
Mosaic mutation
NOT inherited
Mutation associated with McCune-Albright syndrome?
R201
Diagnostic criteria for McCune-Albright syndrome?
Fibrous dysplasia
Cafe au lait spots
Endocrine dysfunction
Four examples of endocrine dysfunction in McCune-Albright syndrome?
Precocious puberty
Hyperthyroid goitre
Adrenal hyperplasia
Somatotroph hyperplasia
What is the main pathology of McCune-Albright syndrome?
Excess release of growth hormone
Excess levels of cortisol results in what condition?
Cushing’s syndrome
Persistently low levels of cortisol results in what condition?
Addison’s disease
What are the two types of Cushing’s syndrome?
ACTH independent
ACTH dependent
Causes of ACTH independent Cushing’s syndrome? x2
Adrenal hyperplasia
Adrenal tumour
Essentially increased adrenal release of cortisol
Cortisol is released from which part of the adrenal gland?
Zona fasciculata of the adrenal cortex
Cause of ACHT-dependent Cushing’s syndrome?
Pituitary adenoma causing excess release of ACTH
Kisspeptin stimulates the release of?
GnRH
GnRH stimulates the release of?
Oestrogen/progesterone
Testosterone
Oestrogen has a negative feedback effect on what?
On kisspeptin
Breast/prostate cancer - why treat with long acting GnRH analogue?
To activate receptor desensitisation
Which receptor type do you want to desensitise with long acting GnRh analogues?
G-protein coupled receptors
Oxytocin released during which two physiological actions?
Giving birth
Milk ejection
Vasopressin is otherwise known as?
ADH
Lack of ADH causes which condition?
Diabetes insipidus
Three features of diabetes insipidus
Massive thirst
Polyuria
Nocturia
Nocturia is?
Waking at night to void urine
Two groups of micronutrients are?
Organic - vitamins
Inorganic - trace elements
Four fat soluble vitamins?
A
D
E
K
Four water soluble vitamins?
B
Folate
Biotin
C
Fat/water soluble vitamins - which can be stored?
Fat soluble
Fat/water soluble vitamins - which is excreted in urine?
Water soluble
Presentation of lack of calcium? x3
Osteoporosis
Parastehesis
Muscle spasms
Presentation of lack of phosphorus?
Bone pain Pseudofractures Proximal muscle weakess Rickets/short stature Neurological complications
Presentation of lack of Iron?
Anaemia
Presentation of lack of Selenium?
Cardiomyopathy
Presentation of lack of Zinc?
Growth retardation Alopecia Dermatitis Diarrhoea Congenital malformations
Presentation of lack of Copper?
Growth retardation
Source of calcium?
Dairy products
Source of phosphorus?
Seeds and nuts
Lentils
Soya
Source of iron?
Red meat
Dark vegetables
Watermelon
Source of selenium?
Seafood
Red meat
Cereal
Source of zinc?
Meat
Shellfish
Nuts
Legumes
Source of copper?
Shellfish Liver Nuts Legumes Bran Offal
Malnutrition contributes to what proportion of child deaths worldwide?
1/3
Kwashiorkor is due to?
Lack of protein and sufficient carbs
Masasmus is due to?
Lack of all nutrient groups
Number of adults in UK that are malnourished?
2 milllion
Presentation of vitamin A deficiency?
Xeropthalmia
Presentation of vitamin D deficiency?
Rickets
Osteomalacia
Presentation of vitamin E deficiency?
Peripheral neuropathy
Presentation of vitamin K deficiency?
Coagulopathy
Presentation of vitamin C deficiency?
Scurvy
Presentation of vitamin B1 deficiency?
Beri beri
Presentation of vitamin B2 deficiency?
Angular stomatitis
Presentation of vitamin B3 deficiency?
Pellagra
Presentation of vitamin B6 deficiency?
Neuropathy
Anaemia
Presentation of vitamin B12 deficiency?
Anaemia
Presentation of vitamin folate deficiency?
Anaemia
Vitamin B1 also known as?
Thiamine
Vitamin B3 also known as?
Niacin
Vitamin D2 known as and source?
Ergocalciferol - plant sources
Vitamin D3 known as and source?
Cholecalciferol - synthesised in the skin
Four lifestyle factors causing reduced levels of vitamin D?
Obesity
Smoking
Alcohol
Exercise
Target level of vitamin D in patients is?
> 75nmol/l
What is osteomalacia?
Reduced bone strength
What is rickets?
Osteomalacia in children- expansion of the growth plate
Gait of someone with osteomalacia described as?
Waddling gait
Two types of thiamine deficiency?
Wernicke’s encephalopathy
Korsakoff’s psychosis
Where is B1/thiamine absorbed?
Jejunum
Commonly see B1/thiamine deficiency in? x2
Malignancy
Alcohol deficiency
Three other conditions B1/thiamine deficiency si seen in?
Anorexia/weight loss
Cognitive impairment
Muscle weakness - proximal
Proximal muscle weakness means that what movement is often difficult?
E.g. getting up from a chair
What is thiamine specifically required for, biochemically?
For the removal of pyruvate from the Kreb’s cycle
Lack of thiamine results in what biochemically?
Build up of pyruvate and hence, build up of lactic acid - death of neurones
Function of thiamine
Conversion of pyruvic acid to acetyl-coA
Beri-beri is caused by?
Thiamine B1 deficiency
The two types of beri-beri are?
Wet
Dry
Dry beri-beri causes?
Sympathetic peripheral neuropathy
Wet beri-beri causes?
Cardiac complications - enlarged heart, tachycardia, peripheral oedema
Neurological conditions
Triad of signs in Wernicke’s/Korsakoff’s are?
Horizontal nystagmus
Opthalmoplegia
Cerebellar ataxia
Mental impairment also
Vitamin B3/Niacin deficiency causes?
Pellagra
Three causes of vitamin B3 deficiency?
Vegetarianism
Alcoholism
Other vitamin deficiency states
Early symptoms of pellagra are? x6
Loss of appetite Generalised weakness Irritability Abdominal pain Vomiting Bright red glossitis
Late signs of pellagra? x6
Casal's necklace Vaginitis Oesophagitis Diarrhoea Depression Seizures
The four D’s of late pellagra are?
Dermatitis
Diarrhoea
Dementia
Death
Why does Casal’s necklace occur around the neck?
Area typically exposed to sunlight
Vitamin B12 also known as?
Cobalamin
What percentage of B12 is absorbed?
50%
How is vitamin B12 excreted?
In the urine or the bile
Four conditions B12 deficiency may be seen in?
Inadequate intake - vegans
Disorders of the terminal ileum
Inadequate production of IF
Defective release of cobalamin from food c
Common treatment for the prevention of refeeding syndrome is?
Pabrinex
Three types of transplant rejection are?
Hyperacute
Acute
Chronic
Hyperacute rejection occurs how soon after transplant?
Minutes to hours
Acute rejection occurs how soon after transplant?
One week to six months after
Chronic rejection occurs how soon after transplant?
Months to years after
Acute rejection is mediated through what?
Immune-mediated damage
Acute cellularly mediated rejection involves which cell types? x3
CD4+ T-lymphocyte
CD8+ T-lymphocyte
Macrophage
Acute antibody mediated rejection involves which cell type?
B-lymphocyte - antibodies
Two types of acute rejection are?
Cellularly mediated
Antibody mediated
Primary target in acute antibody mediated rejection is?
Endothelium of arteries and capillaries
Three criteria for acute AMR is?
Evidence of acute renal injury on histology
Evidence of antibody activity e.g. CD4 staining
Circulating anti-donor antibodies
What is the cause of hyperacute rejection?
Preformed antibodies due to prior pregnancy, transplant or transfusion
Ig commonly associated with hyperacute rejection is?
IgM
Other than immunology/rejection - three other reasons a graft may fail are?
Damaged prior to transplantation
Surgical complications
Recurrence of the original disease
How can you prevent hyperacute rejection?
Screen for the presence of pre-formed antibodies
Four consequences of ischaemia in transplant rejection?
Upregulates adhesion molecules
Increases adhesion of leucocytes
Increases non-specific damage
Increases acute rejection
Four factors to prevent chronic rejection?
Choose best possible organ
Minimise surgical damage
Minimise acute rejection
Minimise drug toxicity
Just anterior to the infundibulum is?
Optic chiasm
Just posterior to the infundibulum is?
Pituitary gland in sella turcica
Pituitary tumour pressing on central part of the optic chiasm causes which visual field defect?
Bitemporal hemianopia
Anterior and posterior clinoid processes are located where?
Laterally - anterior and posterior to the sella turcica
Clivus of the sphenoid bone is?
Between the sella turcica and the foramen magnum
V1 opthalmic exits through which foramina?
Superior orbital fissure
V2 maxillary exits through which foramina?
Foramen rotundum
V3 mandibular exits through which foramina?
Foramen ovale
Flashcards of foramina of the skull!!
Flashcards of foramina of the skull!!
Embryology of the kidney - the mesonephric duct is also known as?
Wolffian duct
Paramesonephric duct is also known as?
Mullerian duct
Mesonephric (wolffian)/paramesonephric (mullerian) - which is male and which is female?
Mesonephric - male
Paramesonephric - female
Paramesonephric duct goes on to form?
Oviduct
Mesonephric duct does on to form?
Uretic duct
How many embryonic kidneys are there?
Three
What are the three stages of kidney development?
Pronephric
Mesonephric
Metanephric
So the metanephric kidney develops from what?
The mesonephric kidney
Which of these three embryonic kidneys goes on to be the functional kidney?
Metanephric kidney
Metanephric kidney is developed from which two structures?
Uteric bud (mesonephric duct) Metanephric bud
Metanephric bud is derived from where?
The mesenchyme
The uteric bud develops into which part of the kidney?
The collecting system - pelvis, calyces, collecting ducts, ureters
The metanephric bud develops into which part of the kidney
Excretory system of the kidney i.e. the nephron - glomerulus, capsule, convoluted tubules, loop of Henle
Development of the kidney starts at which vertebral level?
S1
Final location of the kidney is at which vertebral level?
T12
Failure of the kidney to ascend to position is known as?
Ectopic kidney
What happens to the renal arteries as the kidney ascends to position?
Renal arteries continually degenerate and regenerate
What is kidney agenesis?
Failure of the kidney to form - unilaterally OR bilaterally
Kidney agenesis is associated with which mutation?
Defect in uteric bud formation
Uteric bud develops from what?
Mesonephric duct
Will the baby survive in bilateral agenesis?
No
Effect of bilateral agenesis on the amniotic fluid?
Reduced amniotic fluid
Reduced amniotic fluid is known as?
Oligohydramnios
Two birth defects developing from bilateral agenesis are?
Failure of lung development
Club foot
Bifid ureter is?
Ureter splits into two OR duplicate ureter
What is an ectopic kidney?
When the kidney remains in the pelvic region - does not asence
What is a pancake kidney?
When the kidneys come together and fuse as one - does not then ascend
Type of ectopic kidney
Is a pancake kidney functional?
Yes
What is a horseshoe kidney?
Kidneys fuse in pelvic region and form singe U shape
Type of ectopic kidney
Is a horseshoe kidney functional?
Yes
What is a polycystic kidney?
Kidneys develop fluid filled cysts
Inheritance of polycystic kidney is?
Autosmal dominant OR autosomal recessive
Prevalence of kidney failure in those with polycystic kidneys is?
50% kidney failure by the age of 60
Two histological changes in kidney cysts?
Change in epithelium to secretory
Increased proliferation of the cyst epithelium
Arcuate blood vessels are between what?
Between the cortex and the medulla
Stages of the renal arteries
Renal artery - segental artery - interlobar arteries - arcuate arteries - interlobular arteries
Which of the renal arteries bend around the medullary pyramids?
The arcuate arteries
Renal corpuscle is what?
Bowman’s capsule and glomerular capillaries
Vascular pole of the renal corpuscle is?
Site of afferent and efferent arterioles
Urinary pole of the renal corpuscle is?
Where the proximal convoluted tubule begins
Podocytes are which layer of the Bowman’s?
Visceral layer of Bowman’s capsule
Channel protein located in the proximal convoluted tubule is?
Na+/K+ ATPase
What is reabsorbed in the proximal convoluted tubule and how much? x6
Water - 70-80% Na+ - 70-80% Cl- - 70-80% Amino acids - 100% Glucose - 100% Bicarbonate - small amount
How can you differentiate between proximal and distal convoluted tubules histologically?
The PCT will have many microvilli sticking out into the lumen whereas the DCT will have a much clearer lumen
Epithelium of thin limb of loop of Henle?
Simple squamous epithelium
Epithelium of thick limb of loop of Henle?
Simple cuboidal epithelium
Functions of the distal convoluted tubule x2
Reabsorotion of water via ADH
Electrolyte and acid base balance - Na+, K+, H+
Juxtaglomerulosar cells are located where?
Afferent arterial
Juxtagomerulosa senses what? secretes what?
Changes in BP
Secretion of renin
Macula densa sense what?
Decreased Na+ content of distal tubule
Function of collecting duct? x2
(Similar to DCT)
Final concentration of urine - ADH
Electrolyte and acid-base balance - aldosterone
Muscle of internal sphincter of bladder is?
Smooth muscle
Renal corpuscles are located in which part of the kidney?
Renal cortex
What are the only arteries that go into the renal cortex?
Arcuate arteries
The colon is what?
Large intestine
What is Hirschsprung’s disease?
Dilation of the large intestine (megacolon) causing obstruction in infant
Three symptoms of Hirschsprung’s disease?
Failing to pass meconium within 48 hours
Swollen belly
Vomiting green fluid i.e. bile
Four muscles of the pelvic floor?
Levator ani - pubococcygeus, iliococcygeus, ischiococcygeus
Puborectalis
Internal/external anal sphincters - which is voluntary and which is involuntary?
Internal - involuntary
External - voluntary
Internal/external anal sphincters - which is stimulated first?
External - voluntary and then the involuntary opens
Which pelvic floor muscle forms a U shaped loop?
Puborectalis
Where does the puborectalis form a loop from and to?
Loop that slings around the rectum TO the pelvis
Puborectalise supports which anal sphincter?
External - closure
Function of puborectalis?
Maintain angle between anal canal adn rectum
Nervous innervation of continence is via (and nerve roots)?
S2, S3, S4 (keeps the 3 P’s off of the flood - penis, poo, pee)
Pudendal nerve
Innervation of external anal sphincter is via?
Inferior rectal nerves from pudendal nerve
Innervation of internal anal sphincter is via? x2
Hypogastric nerves L1, L2 - sympathetic
Pelvic nerves S2-S4 - parasympathetic
Three components essential for foecal continence
Internal anal sphincter
External anal sphincter
Puborectalis muscle
Which two structures make up the anorectal angle?
Puborectalis muscle
External anal sphincter
What is meant by reservoir continence?
The ability of the rectum to retain stool
What is meant by rectal compliance?
The elastic component of the rectum that allows it to stretch/expand
Function of the IAS?
Responsible for closure of the rectum and the maintenance of the resting pressure
Function of the EAS?
Squeezing and the pressure during contraction
What is the rectoanal inhibitory reflex (RAIR)?
Reflex enabling you to relax your IA sphincter and empty the rectum
What initiates RAIR?
Progressive rectal filling
What is the valsalva manouvre?
Person holds breath and forcibly tries to exhale a closed glottis - pushing down to excrete foecal matter
What does the valsalva manouvre result in?
Increases the abdominal pressure
Closing reflex of the rectum involves which sphincter?
EAS
Two groups constipation effects the most?
Females
Elderly
What is foecal incontinence?
Involuntary passage of rectal content - gas or stool
What is passive incontinence?
When the IAS is not working - you have no idea that you are passing stools until you feel it
What is urge incontinence?
When the EAS is not working - feel immediate urgency to pass stool but do not make it to the toilet in time
When are cortisol levels the highest?
Morning
When are cortisol levels the lowest?
Evening
Normal plasma cortisol levels are in the range of?
30-100ug/100ml
What can cause cortisol levels to increase?
Stress
What is Hans Selye’s general adaptation syndrome?
Following acute stress there is chronic stress and then there is exhaustion and pathogenic stress
Drug given to patients to increase cortisol levels is?
Cortizone
Name some side effects of long term cortisol treatment
Oedema Weight gain Glaucoma Hypertension Insomnia Depression Thrombosis
Two forms of glucocorticoid receptor is? How do these differ?
Alpha - binds steroid
Beta - does not bind steroid
Two ways in which glucocorticoid receptors can work are?
Genomic - slow - acting on the DNA
Non-genomic - fast - not acting on the DNA but on the receptors
Three types of stress causing a release of glucocorticoids x5
Metabolic disturbance Tissue damage Infection Fluid loss Neural disturbance
Why can steroid treatment not be suddenly stopped?
Patient stops producing steroid when on treatment - must slowly lower the dose
Most of the calcium in the blood is in what form?
Bound to albumin
Calcium is bound to albumin at the expense of?
H+
Changes to albumin bound calcium in acidosis?
Acidosis - less calcium bound to albumin so more H+ can be bound
SO more ionise calcium in teh blood
Changes to albumin bound calcium in alkalosis?
More calcium bound to albumin for increased release of H+ SO less ionised calcium in the blood
Main role of calcium in cells?
Cell signalling
Majority of phosphate in the body is where?
85% body phosphate mineralised in bone
Calcium levels are controlled by which hormone?
Parathyroid hormone
Parathyroid glands develop from where embryologically?
Pharyngeal pouches
What are the cells responsible for the secretion of PTH?
Chief cells
Two cells of the parathyroid glands are?
Chief cells
Oxyphilic cells
What are the three types of hormone?
Peptide hormone
Steroid hormone
Amine hormone
What hormone type is thyroid hormone?
Peptide hormone
Pathway of thyroid hormone production?
Same way as insulin - pre, pro…
Major stimulus for the release of PTH is?
Low levels of ionised calcium
Low levels of ionised calcium causes what change to chief cells?
Hyperplasia of chief cells
Normal serum calcium levels are?
2.2-2.6
Three functions of the calcium sensing receptor?
Reduces PTH secretion
Increases the breakdown of stored PTH
Suppresses the transcription of the PTH gene
What type of receptor is the calcium sensing receptor?
G-protein coupled receptor
PTH has a role at which part of the kidney?
Distal tubule
What is the role of PTH at the distal convoluted tubule?
Increased reabsorption of calcium
Calcium reabsorption at the proximal convoluted tubule is dependent/independent of PTH?
Independent
What stimulates calcium reabsorption at the proximal convoluted tubule?
Voltage gradient
What stimulates calcium reabsorption at the loop of Henle?
Voltage dependent
What stimulates calcium reabsorption at the distal convoluted tubule?
PTH
What is Barter’s syndrome?
Mutation in the calcium channel of the loop of Henle
What is Gitelman syndrome?
Mutation in the Na+/Ca2+ channel of the kidney
Effect of vitamin D on the parathyroid gland is?
Reduces PTH transcription
Effect of vitamin D on bone is? x2
Reduces expression of type I collagen
Increases RANKL levels
What is FGF23?
Phosphatonin - hormone that reduces serum phosphate levels
Where is calcitonin produced?
Chief cells of the thyroid
Where are vitamin D2/D3 obtained from?
D2 - from vegetables
D3 - from meat
What is familial hypocalciuric hypercalcemia? FHH?
A mutation that inacivates CaSR
What happens in FHH?
Parathyroid cannot sense high calcium so PTH is not supressed by high calcium
CaSR in kidney not activated
Change in ion levels due to FHH is? x3
High serum Ca2+
Low urine Ca2+
High serum Mg
Pituitary adenoma is of the anterior or the posterior pituitary?
Anterior pituitary
Goitre of thyroid involves infiltration of what cell type?
Lymphocyte
Hashimoto’s thyroditis - what structure is formed histologically?
Lymphoid follicle
Hashimoto’s thyroditis - is this hyper or hypothyroidism?
Hypothyroidism
Grave’s disease - is this hyper or hypothyroidism?
Hypothyroidism
Hyperthyroidism has what effect n the sympathetic nervous system?
Overactivity of the sympathetic nervous system
Adrenal gland - cortex/medulla is brown or yellow?
Cortex - pale yellow
Medulla - brown
Two cell types in the parathyroid gland are?
Chief cells
Oxyphill cells
Most abundant cell type in the parathyroid gland is?
Chief cells
Cells of the thyroid gland are?
Follicular cells
Chief cells produce what hormone?
Parathyroid hormone
Parafollicular/C cells are in which gland?
Thyroid gland
Parafollicular/C cells produce what hormone?
Calcitonin
Which endocrine structure has a tricornate/three horned appearance?
Adrenal gland
Portal triad of the liver - which structure is teh largest?
Portal vein
Portal triad of the liver - which structure is the smallest?
Hepatic artery proper
Renal cell carcinoma tend to invade which renal structure?
Renal vein
What type of carcinoma is commonly found in teh kidney?
Transitional cell carcinoma
Renal corpuscles are only found in the cortex or in the medulla?
In the cortex
