Endocrine
Terms
-
Ant pit acidophils make
-
GH, prolactin
"Throw acid in GP's face"
- a-glucosidase inhibitors
-
Acarbose, Miglitol
Inhibit brush border sugar hydrolysis
-
Addison's signs/sx
- hypotension, skin hyperpigmentation, weakness, vomitting, diarrhea, sweating
- all hormones are down except prolactin is increased?
- Hypothalmus lesion or pit stalk is severed
- Alpha subunit
-
common to TSH, LH, FSH, hCG
B-unit differentiates them
-
Amine hormones are derived from?
-
Tyrosine
Thyroid, epi, norep
-
Ant pit is derived from?
-
oral ectoderm
- anti-microsomal Abs
-
result of thyroid destruction in hashimoto's
anti-thyroglobulin too
- Biguanide
-
Metformin
decrease gluconeogenesis
-
bone disease of primary hyperparathyroid
-
osteitis fibrosa cystica (von recklinhausen's)
cystic bone lesions (painful) filled w/ brown fibrous tissue
-
bone disease of renal failure
-
renal osteodystrophy
- Causes of galactorhea
-
prolactinoma
Antipsychotics (DA antagonists)
Hypothyroid
-
causes of hypercalcemia
-
Ca, Hyperparathyroid, Iatrogenic, Multiple myeloma, Paget's, Addison's, Neoplasms, ZE, Excess Vit D, Excess Vit A, Sarcoid
CHIMPANZEES
-
causes of hypoparathyoid
-
Presents w/ signs of hypocalcemia (Chvosteck, Trouseau)
surgical damage of parathyroid, Di George
-
conn's syndrome
-
primary hyperaldosteronism
-
control of prolactin
-
DA is increased by prolactin and inhibits release from ant pit.
TRH stimulates release from ant. pit and is inhibited by T4.
- Cushing's syndrome, key findings
-
HTN, hyperglycemia, truncal obeisity, osteoporosis, amenorrhea, etc.
- distinguish Addison's from secondary cause
- Addison's has hyperpigmentation from MSH from excess ACTH production from POMC
-
Drugs that cause nephrogenic DI
- Li, demeclocycline (tetracycline used to tx SIADH)
-
endocrine uses of octreotide
-
acromegaly, carcinoid, gastrinoma, glucagonoma
- functions of T3
-
Brain maturation
Bone growth
Beta-adrenergic effect
BMR increase (Na/K ATPase)
-
germinal centers in thymus
-
myasthenia gravis
produce the Abs that attack the ACh receptors
Can also see thymomas (less common)
-
germinal centers in thyroid gland
- hashimoto's
- Glitazones
-
Pioglitazone, Rosiglitazone, (Troglitzone off market)
Increase target cell response to insulin
SE:Fluid retention-->don't give to CHF pt's
-
glucocorticoid mechanism
-
decrease leukotriene production by inhibiting phospholipase A2 and expression of COX-2
- High dose dexamethasone suppression
-
ACTH producing tumor in pit = cushing's DISEASE
-
HLA type in DMI
-
HLA-DR3 and 4
- HLA type in Hashimoto's
- HLA Dr3, Dr5
- Insulin
-
short: lispro, regular
intermediate: NPH, Lente
Long: Glargine, ultra-lente
-
Ketoconazole and steroids
-
supresses hormone synth
- low dose dexamethasone suppression
-
healthy and normal
- masculinized female newborn
-
21OHase deficiency, decreased aldo and cortisol, hypotension, increased ACTH
HTN w/ 11OHase defeciency
-
Medullary thyroid cancer
-
cells are neural crest origin (same as pheo)
produce calcitonin that becomes amyloid
-
Men I
-
(Wermer's)
Parathyroid tumor, Pancreatic tumor, Pituitary tumor
- MEN IIa
-
(Sipple's)
Pheo, mudullary thyroid, parathyroid
ret proto-oncogene
Presentation: Kidney stones and ulcers
-
MEN IIb
-
Pheo, mudullary thyroid, intestinal nueromas
ret proto-oncogene
- pancreas endo cell types a, b, d
-
a=glucagon
b=insulin
d=somatostatin
-
Pharm tx of pheo
- phenoxybenzene (irreversible b-adrenergic blocker)
- phenotypically female newborn w/out physical development
- 17OHase deficiency, hypertension
-
Post pit is derived from?
- neuroectoderm
- pseudohypoparathyroid
-
kidney unresponsive to PTH
short stature, short 4th/5th digits
-
PTU, methimazole
-
inhibit iodination and condensation
skin rash, agranulocytosis, aplastic anemia
-
ret proto-oncogene
-
gain of function = hirchsprung's
loss of function = MEN I and IIa
- siburtamine
-
sympathomimetic serotonin and norep reuptake inhibitor
-
steroid hormones are derived from?
-
Cholesterol
- subacute thyroiditis
-
self-limited HYPOthyroidism
Can by hyperthyroid early on
Tender thyroid gland
- sulfonylureas
-
Tolbutamide, chlopropamide: (disulfiram effect)
Glyburide, Glimepiride, Glipizide
Block K+ channel-->depolarize cell-->increase insulin release
-
Ts for SIADH
-
demeclocycline, H20 restriction
-
Tx for agromegaly
- Octreotide
-
Tx for carcinoid sydnrome
- octreotide
-
Tx for DI
-
central: intranasal desmopressin
nephrogenic: HCTZ, indomethacin, amiloride
-
Used to tx increased prolactin secretion
- DA antagonists (bromocriptine)
- what is dexamethasone
-
cortisol analog
- which tissues don't need insulin to take up Glu?
-
Brain and RBCs
have GLUT1 trasporter