Question Clues - Endocrineology Flashcards
What does Thyroid Peroxidase (TPO) and Thymosin do?
Help T-Cells Mature
What does vasoactive intestinal peptide (VIP) do?
Inhibits secretin, motilin, and CCK and open sphincters.
How does a VIPoma present?
Watery Diarrhea
How does a somatostatinoma present?
Constipation
What are the hormones with disulfide bonds?
“PIIG” - Prolactin, Insulin, Inhibin, GH
What hormones have alpha subunits?
Lh, FSH, TSH, and Beta-HCG (Hints the HCG Diet)
What hormones produce Acidophilus?
“GAP” GH, Acidophilus, and Prolactin - Pink on stain
What hormones produce Basophils?
“B FLAT” - Purple on stain - Basophils, FSH, LH, ACTH, and TSH
What hormones are released from the posterior pituitary?
ADH (supraoptic nucleus), Oxytocin (paraventricular nucleus) by the neurophysins
What is seen in Hashimoto’s Thyroiditis?
Antimicrosomal antibody and Anti-TPO antibody
What is the mechanism of Action of Insulin?
Pushes K+ into the cells,
Liver: Increases glucose storage as Glycogen, Increases triglyceride Synthesis.
Muscles: Increases protein and glycogen synthesis
Adipose Tissue: Improves triglyceride storage by activating lipoprotein lipase, and decreasing circulating free fatty acids
What are the indications for insulin?
DM Type one and two, Hyperkalemia, Stress induced hyperglycemia, gestational Diabetes
What is the adverse effect of insulin?
Hypoglycemia
What are the short acting insulin drugs?
Aspart and Lispro
What is the rapid acting insulin drugs?
Regular insulin
What is the intermediate acting insulin drugs?
NPH and Lente
What are the long acting insulin drugs?
Ultralenta, Glargine, and Protamine Zinc
What is the mechanism of action of Sulfonylureas?
Closes K+ Channel in the pancreatic cell membrane, reduces K+ efflux & increases CA++ influx, and cell depolarize to increase the secretion of insulin.
What are the indications for sulfonylureas?
NIDDM (Type 2 DM)
What is the adverse effects of sulfonylureas?
Hypoglycemia, GI Distribance, muscle weakness, mental confusion, sulfa allergy
Function of what cells is necessary for the action of Sulfonylureas?
Requires some islet cell function so the drug is used less in Type 1 DM
What are the first generation sulfonylureas?
Chlorpropamide and Tolbutamide
What are the adverse effects for the first generation sulfonylureas?
Disulfiram like effects
What are the second generation sulfonylureas?
Glyburide, Glimepiride, and Glipizide
What is the mechanism of action of biguanides?
Decreases gluconeogenesis, increase glycolysis, and increase peripheral glucose intake (insulin sensitivity)
What are the indications for biguanides?
First line therapy in Type 2 DM
What are the adverse effects of biguanides?
Lactic acidosis (contraindicated in renal failure). Also stop use in patients undergoing studies using contrast.
What is the Biguanides drug?
Metformin
What is the mechanism of action of Glitazones/Thiazolidinedione’s?
Increase insulin sensitivity in peripheral tissues. Transaction modulation by PPAR-gamma in nucleus.
What are the indications for Glitazones/Thiazolidinedione’s?
NIDDM. (Type 2)
What are the adverse effects of Glitazones/Thiazolidinedione’s?
Weight gain, edema, hepatotoxicity, increase LDL and triglycerides, and contraindicated in CHF.
What are the Glitazones/Thiazolidinedione’s drugs?
Pioglitazone and Rosiglitzone
What is the mechanism of action of Alpha-Glucosidase Inhibitors?
Inhibits intestinal brush border Alpha-Glucosidases, Delays sugar hydrolysis and Glucose absorption from the gut, Decreases postprandial hyperglycemia.
What are the indications for alpha-glucosidase inhibitors?
NIDDM (Type 2)
What is the adverse effect of alpha-glucosidase inhibitors?
Gi disturdances and may reduce absorption of Iron
What are the alpha-glucosidase inhibitors?
Acarbose and Miglitol
What is the mechanism of action of Mimetics?
Decrease Glucagon
What is the indication for mimetics?
NIDDM (Type 2)
What are the adverse effects of mimetics?
Hypoglycemic, Nausea, and Diarrhea
What is the mimetic drug?
Pramlintide
What is the mechanism of action of GLP-1 analogs (Glucangon like peptides)
Increase insulin and decrease glucagon release
What is the indication for a GLP-1 analog?
NIDDM (Type 2)
What are the adverse effects of GLP-1 analogs?
Nausea, Vomiting and Pancreatitis
What are the GLP-1 analog drugs?
Exenatide and Liraglutide
What is the mechanism of action of Growth Hormone?
Stimulates liver production of insulin-like growth factors and gastric emptying
What are the indications for GH?
GH deficiency in children, Turner syndrome, and burn victims.
What is the mechanism of action for Octreotide? (synthetic analog of Somatostatin)
Decrease release of GH, Gastrin, CCK, Carcinoid, VIP, Glucagon, and Insulin.
What are the indications for Octreotide?
Acromegaly; Glucagonoma; Insulinoma’ Carcinoid syndrome
What are the indications for Oxytocin?
Induces labor and Controls uterine hemorrhage
What is the mechanism of action of Desmopressin (DDAVP) / ADH?
Recruits water channels to Luminal Membrane in collecting duct
What are the indications for Desmopressin (DDAVP) / ADH?
Antidiuresis and Central DI
What are the adverse effects of Desmopressin (DDAVP) / ADH?
Over hydration and allergic reaction
What is the mechanism of action of Propylthiouracil and Methimazole?
Inhibits peroxidase enzyme in thyroid and decreases synthesis of thyroid hormones
What is the indication for Propylthiouracil and Methimazole?
Hyperthyroidism
What are the adverse effects of Propylthiouracil and Methimazole?
Agranulocytosis, skin rash, and aplastic anemia
What is the mechanism of action of Levothyroxine (T4) / Triiodothyronine (T3)?
Thyroxine Replacement.
What are the indications for Levothyroxine (T4) / Triiodothyronine (T3)?
Hypothyroidism and Myxedema
What are the adverse effects of Levothyroxine (T4) / Triiodothyronine (T3)?
Tachycardia, heat intolerance, tremors, and arrhythmias
What is the mechanism of action of Demeclocycline?
ADH anatagonist
What is the indication for Demeclocycline?
SIADH
What is the adverse effects of demeclocycline?
Nephrogenic DI, Photosensitivity and abnormalities of Bone and Teeth
What is the mechanism of action of Glucocortocids?
Decrease production of Leukotrienes and prostaglandins by inhibiting phospholipase A2 and expression of COX-2
What are the indications for glucocorticoids?
Addison’s disease; inflammation; immune suppression; asthma
What are the adverse effects of glucocorticoids?
iatrogenic Cushing’s Syndrome
What are the glucocorticoid drugs?
Hydrocortisone, triamcinolone, dexamethasone, prednisone, beclomethasone