test #17 4.5 Flashcards
what converts NE to E
PNMT, phenylethanolamine-N-methyltransferase
dopa stands for..
dihydroxyphenylalanine
how does cortisol affect epinephrine secretion?
adrenal venous drainage cortex inwards. cortisol produced in fasiculata will travel into adrenal medulla –> increase expression of gene encoding PNMT.
MAO converts..
epinephrine and NE to dihydroxymandelic acid
COMT converts..
epinephrine to metanephrine. norepinephrine to normetanephrine
Rh- women are treated with what 28 wks into gestation & immediately after? why?
treat with IgG against Rh (D) antigen. RhoGAM. stops mother from mounting immune response to Rh+ baby. small amounts, so IgG does not travel transplacentally & hurt baby.
RhoGAM is.. goal of therapy?
IgG against Rh (D) antigen. prevent mom from EVER mounting an immune response to Rh factor. Abs cover fetal erythrocytes & mom will sequester in spleen.
what type of immune response is mounted when Rh- mom exposed to Rh antigen in baby? what happens in subsequent pregnancy?
after transplacental fetomaternal hemorrhage, mom will mount maternal Ab response, form memory B-lymphocytes. subsequent prengnancies, Rh+ fetus at risk for hemolytic disease of newborn (erythroblastosis fetalis). maternal IgG anti-Rh antibodies cross placenta, enter fetal circulation, massive hemolysis of fetal erythrocytes.
IgG or IgM in RhoGAM? why?
IgG! while IgM is good for promoting agglutination of foreign cells, this isn’t so useful bc of low concentration of fetal cells in maternal circulation. IgG does not cause significant transplacental fetal hemolysis bc so little given.
somatostatin decreases secretion of.. (5)
(1) secretin (2) CCK (3) glucagon (4) insulin (5) gastrin. insulin is inhibited far more than glucagon. net = hyperglycemia.
somatostatin inhibits secretion of both glucagon and insulin. which is inhibited more?
insulin inhibited more. net effect: HYPERGLYCEMIA
secretin
adjust secretions from stomach and pancreas (affects environment of duodenum). S cells in crypts of Lieberkuhn in duodenum. also helps regulate duodenal pH (increase bicarb secretion in duodenum and inhibit acid secretion from stomach)
somatostatin analogues..
octreotide and lanreotide
deltaF508 mutation causes… (2) problems in CFTR
(1) abnormal protein folding and (2) failure of glycosylation. = absent from exocrine ductal cells.
protein abnormality of Friedreich’s ataxia? important for which 2 things. at what level is this gene affected.
frataxin gene: codes for mitochondrial protein, important for (1) respiratory fxn and (2) iron homeostasis. GAA repeat disruptions TRANSCRIPTION
inflixamab
monoclonal Ab that irreversibly binds to & inhibits TNF-alpha
what enzyme is exclusively expressed in inflammatory cells?
COX-2
allopurinol
xanthine oxidase inhibitor
APML is what type of AML?
M3 type
what suggests good prognosis in ALL (children)?
presence of CD10 antigen (CALLA)
causes of low glucose, high insulin, high c-peptide?
excess sulfonylurea & meglitinide use (stimulates insulin secretion). note: somatostatinoma inhibits insulin far more than glucagon.
sulfonylurea & meglitinide?
insulin secretagogues
differentiate factitious hypoglycemia (sulfonylurea/meglitinide use) from insulinoma
urine hypoglycemic agent screen
presentation of glucagonoma (3)
(1) hyperglycemia (2) anemia (3) necrolytic migratory erythema (raised erythematous rash affecting face, groin, and extremities.