physiology- Lopez Flashcards
21b enzyme def presentation
most common
salt wasting
precocious puberty
virilizsation
main binding proteins of thyroid hormones
TBG (made in liver)
transthyretin
albumin
short term actions on bone of PTH
bone formation via direct action on osteoblasts
PTH on kidney and urinary cAMP
increases urinary cAMP
inhibitory or stimulatory factor of insulin secretion?
diazoxide
inhibitory
only time phosphate and calcium increase or decrease together is when and is it increase or decrease
Vitamin D deficiency
both decrease
inhibitory or stimulatory factor of insulin secretion?
cortisol
stimulatory
what enzyme converts cholesterol to pregnenoone
cholesterol desmolase
11b enzyme def presentation
virilization
TRH works on what pituitary target
thryotrophs–> TSH
lactotrophs–> prolcatin
cAMP in urin in vit D def
increased in urine
pseudohypoparathyroidism phenotype
short stature short neck obesity subcut calcification short metatarsals and metacarpals
pseudohypoparathyroidism
PTH/Ca2+/Pi/Vitamin D
PTH = increased
Ca2+ = decreased
Pi = increased
vitamin D = decreased
inhibitory or stimulatory factor of insulin secretion?
exercise
inhibitory
prolactinoma associated with what
mechanism?
hypogonadism and galactorrhea
-prolacting inhibits secretion of LH and FSH by directly inhibiting hypothalamus release of GnRH
inhibitory or stimulatory factor of insulin secretion?
glucagon
stimulatory
vitamin D on ca2+ and Pi in intestine
increase absorption of both by increaseing calbindin expression
effect of glucagon on blood level of glucose, FAs, and ketoacids
all increased
pseudohypoparathyroidism type 1a
exogenous PTH and cAMP (urinary)
defective Gs in bone and kidney
AD disorder
exognenous PTH does not increase urinary cAMP
vitamin D on bone
sensitizes osteoblasts to PTH
regulates osteoid production and calcification
secondary hyperparathyroidism and cause
increased PTH due to low calcium in blood
renal failure
vitamin D deficiency
where does T4 and T3 negatively feedback on
anterior pituitary only
2 principal nuceli innervate the posterior lobe
supraoptic and paraventricular
what cytokines released from osteoblasts stimulate osteoclasts
IL-6
RANK ligand
m-CSF to make osteoclast precursors
vitamin D on kidney
promotes Pi reabsorption by proximal nephrons (stimulates NPT2a expression)
where in kidney is calcium reabsorbed from stimulation of PTH
-where is Pi reabsorption inhibited
TAL and distal tubule
proximal nephrons (repress NPT2a)
negative feedback of cortisol works where
hypthalamus–>no CRH
AP–>no ACTH
secondary adrenal insufficiency from what and levels of CRH,ACTH,cortisol
exogenous glucocorticoid drugs
all levels decreased
inhibitory or stimulatory factor of insulin secretion?
GIP
stimulatory
inhibitory or stimulatory factor of insulin secretion?
obesity
stimulatory
presentation of 17a hydroxylase deficiency
ambiguous genitalia
undescended testes
lack of 2ndary sex development
sodium below what in SIADH causes what symptoms
120
hyponatermic encephaolapthy
the connections between the hypothalamus and the anterior lobe are
neural and endocrine
rickets type 1 cause
decreased 1a-hydroxylase
pituitary failure of FSH/LH
infertility
hypogonadism
reduced sperm
menstrual irregularity
what increases the activity of the enzyme that creates active vitamin D and what is the enzyme and where is this done
decreased calcium
increased PTH
decreased phosphate
enzyme is 1a hydroxylase (CYP1a) and converts 25 OH cholecalciferol to 1,25 oh-cholecalciferol
renal proximal tuibule
causes of nephrogenic DI
lithium
polycystic kidney diseaes
sickle cell anemia
long term action on bone of PTH
bone resoprtion, indirect from action on osteoblasts which secrete cytokines to activate osteoclasts
inhibitory or stimulatory factor of insulin secretion?
vagal stimulation; Ach
stimulatory
associated conditions with DM1
autoimmune thyroid disese
celiac disease
addison’s diseaes
in pts with primary hyperparathyroidsm they excrete excessive amounts of
pi, cAMP, Ca2+
inhibitory or stimulatory factor of insulin secretion?
a adrenergic agonists
inhibitory
associated conditions with DM2
obesity
lipid abnormalities
PCOS
NAFLD
effect of increased vitamin D (1,25) and increased calcium pathway on pth
increased calcium sensed by CaSR which is Gq signaling to inhibit PTH and increase CaSR gene
Vitamin D does same through intracellular receptor
supraoptic nuclei neurons
ADH
the connections between the hypothalamus and posterior lone are
neural
paraventricular nuclei neurons
oxytocin
rickets type II cause
decreased vitamin D receptor
familial hypocalciuric hypercalcemia
PTH/serum calcium/urine calcium/ Pi/ vitamin D
this is defect in CaSR
AD
PTH = N/increased serum calcium = increased urine calcium = decrased Pi = N vitamin D = N
