Endocrinology and toxicology

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corbin19
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16603
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Endocrinology and toxicology
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2010-04-29 10:54:31
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endocrinology and toxicology for MLT
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  1. These act in conjunction with nervous systems to maintain a state in the body which functions optimally and is disease free.
    Hormones
  2. These are chemical substances produced and secreted into the blood by an organ or tissue, and has a specific effect on target tissue.
    Hormones
  3. Hormones affect the body as a _______.
    Whole
  4. What are the three chemical types of hormones?
    • Steroids
    • Protein
    • Amine
  5. Steroid hormones are produced in what three places?
    • Adrenal gland
    • Gonads
    • Placenta
  6. These are lipid soluble hormones synthesized from cholesterol
    Steroidal hormones
  7. What is the plasma half life of steroidal hormones?
    60-100min
  8. What are the two types of protein hormones?
    • Peptide hormones
    • Glycoprotein hormones
  9. These hormones are synthesized as prohormones.
    Peptide hormones
  10. These hormones are composed of alpha- and beta- chains.
    Glycoprotein hormones
  11. These are water soluble hormones that are produced, then stored and released as needed.
    Protein hormones
  12. These hormones have properties intermediate to steroids and proteins.
    Amines
  13. These amines behave like protein hormones.
    • Epinephrine
    • Noepinephrine
  14. Thes amines behave like steroid hormones
    • Thyroxine(T4)
    • Tiiodothyronine(T3)
  15. These hormones are thought to produce effects via interaction with receptor on outer surface of cell membranes.
    Protein hormones
  16. This acts a second messenger by translating hormone binding into cellular action
    (cAMP)
  17. Cellular action in protein hormones ceases rapidly after loss of _______.
    Stimulus
  18. These hormones pass through cell membrane and interact with an intracellular receptor.
    Steroid hormones
  19. This is the portion of the brain located in walls and floor of third ventricle, directly above pituitary gland.
    Hypothalamus
  20. What are five hypothalamus associated disorders?
    • Tumors
    • Inflammatory/degenerative processes
    • Congenital problems
    • Growth failure in emotionally deprived children
    • Anorexia nervosa
  21. This protein hormone is produced by the anterior pituitary gland and is involved in cell division, protein synthesis, and bone growth.
    Growth hormone (GH)
  22. What are three conditions that would cause a decrease in adult growth hormone?
    • Decreased muscle mass
    • Increased body fat
    • Decreased bone density (osteoporosis)
  23. This protein hormone is produced in the anterior pituitary gland and is involved in milk production.
    Prolactin (PRL)
  24. After delivery prolactin levels can reach what levels?
    200-300 ng/mL
  25. This peptide hormone is produced in the posterior pituitary and stimulates water reabsorption by kidneys.
    ADH (vasopressin)
  26. This peptide hormone is produced in the posterior pituitary and stimulates uterine muscle contraction.
    Oxytocin
  27. To produce these two hormones the thyroid gland actively acquires iodine.
    • Triiodothyronine (T3)
    • Thyroxine (T4)
  28. These two amide hormones are produced in the thyroid. They stimulate O2 consumption and metabolic rate in tissue.
    • Triiodothyronine (T3)
    • Thyroxine (T4)
  29. This peptide hormone is produced in the thyroid and lowers blood calcium levels.
    Calcitonin
  30. What is the most useful test for assessing thyroid function?
    TSH
  31. Serum total T3, rT3, and T4 levels are usually measured by which two assays.
    • Radioimmunoassay (RIA)
    • Chemiluminometric assay
  32. When the eyes protrude because of edema in eye socket tissues in cases of hyperthyroidism or Graves’ disease it is called what?
    Exophthalmic goiter
  33. How many parathyroid glands do most people have?
    Four
  34. This peptide hormone is produced in the Parathyroid and raises blood calcium levels.
    PTH
  35. These are paired organs located atop upper pole of each kidney.
    Adrenal glands
  36. This part of the adrenal gland is linked to sympathetic nervous system.
    Adrenal medulla
  37. This part of the adrenal gland is composed of three layers each responsible for different hormones.
    Adrenal cortex
  38. These amine hormones are produced in the adrenal medulla and are released in emergency situations.
    • Epinephrine
    • Norepinephrine
  39. This steroid hormone is produced in the adrenal cortex; it raises blood glucose levels and stimulates the breakdown of protein.
    Cortisol
  40. This steroid hormone is produced in the adrenal cortex; it is used to reabsorb sodium and excrete potassium.
    Aldosterone
  41. This steroid hormone is produced in the adrenal cortex; it stimulates reproductive organs and brings about sex characteristics.
    Sex hormones
  42. This syndrome can be caused by and adrenal cortex tumor.
    Cushing syndrome
  43. Hormonal secretions by the anterior pituitary are all _______ hormones.
    Protein
  44. This peptide hormone is produced by the anterior pituitary; it stimulates the adrenal cortex.
    Adrenocorticotropic hormone (ACTH)
  45. This protein hormone is produced in the anterior pituitary; it is involved in cell division, protein synthesis, and bone growth.
    Growth hormone
  46. This protein hormone is produced in the anterior pituitary; it is involved in milk secretion.
    Prolactin (PRL)
  47. These glycoproteins are produced in the anterior pituitary; they are involved in egg and sperm production.
    Gonadotropics (FSH, LH)
  48. This glycoprotein is produced in the anterior pituitary; it stimulates the thyroid.
    Thyroid stimulating hormone (TSH)
  49. Pituitary tumors cause ________ secretion.
    Increased
  50. Where are the Islets of Langerhans located?
    Pancreas
  51. What are the three cell types in the Islet of Langerhans and what do they secrete.
    • Alpha- secrete glucagon
    • Beta- secrete insulin
    • Delta- secrete somatostatin
  52. This protein hormone is produced in the pancreas and lowers blood glucose levels.
    Insulin
  53. This protein hormone is produced in the pancreas and raises blood glucose levels.
    Glucagon
  54. These steroid hormones are produced in the ovaries and stimulate female sex characteristics.
    • Estrogens
    • Progesterone
  55. What hormones does the placenta secrete?
    • Estrogen
    • Progesterone
    • Wide variety of protein hormones
  56. This steroid hormone is secreted by the testes and stimulates male sex characteristics.
    Androgens (testosterone)
  57. This classic hormone methodology is cumbersome and expensive; it requires a host organism.
    Bioassay
  58. If the binding reagent is an antibody, the assay is ___________.
    Immunoassay
  59. If the binding reagent is a transport protein, the assay may be called _____________.
    Competitive protein binding assay
  60. If the binding reagent is a receptor, the assay is ________.
    Receptor assay
  61. What is the simplest way to identify an assay?
    By the label used
  62. What is the most commonly used immunoassay?
    ELISA
  63. This type of immunoassay utilizes radio-labeled hormone as tagged hormone.
    RIA
  64. In this immunoassay, the antibody is labeled instead of hormone.
    IRMA
  65. In this immunoassay, enzyme tag is used vice radioactive label.
    ELISA
  66. What are the two purposes of drug monitoring?
    • ID non-compliance
    • Ascertain effectiveness of dosage
  67. What are the four general processes that a body has to handle a foreign compound?
    • Absorption
    • Distribution
    • Metabolism
    • Excretion
  68. What are the three routes for absorption?
    • Orally
    • Rectally
    • Parenterally (IV, IM)
  69. What are two factors for optimum utilization in absorption?
    • Route of administration
    • Is drug utilized as is or as metabolite
  70. Body interprets drug as __________.
    Foreign material
  71. Insoluble drugs are converted to soluble by what organ?
    Liver
  72. Under normal renal performance, most drugs and their metabolites are excreted in ______ via the ______.
    • Urine
    • Kidneys
  73. ________ have little capacity to eliminate drugs.
    Neonates
  74. This will affect drug disposition due to hormonal changes and increased fluid volume.
    Pregnancy
  75. What are three diseases that can affect drug disposition?
    • Hepatic function
    • Cardiac capacity
    • Renal function
  76. What admin data is needed for drug testing procedures (5)?
    • Pt name, SSN, DOB, sex
    • Date/time of last dose
    • Date/time of collection
    • Amount of last dose
    • Name of drug
    • Pt diagnosis
  77. What are three appropriate samples for drug testing?
    • Non-hemolyzed serum
    • Non-hemolyzed plasma (red/dark blue top)
    • Urine
  78. This is collected prior to dose when drug concentrations are lower.
    Trough
  79. This is collected after dose (60 min) when drug concentrations are higher.
    Peak
  80. How long after a dose is a sample collected for peak testing?
    60 min
  81. Most drugs/metabolites are stable for several days at what temperature?
    Room temp
  82. This methodology detects a wide variety of drugs.
    Thin layer chromatography (TLC)
  83. This methodology is better for ID of drugs than TLC.
    Gas Chromatography (GC)
  84. This methodology measures drugs simultaneously.
    HPLC
  85. This is the method of choice for drug testing.
    EIA
  86. This is an effective smooth muscle relaxant that stimulates CNS and increases respiratory rate.
    Theophylline
  87. What is the therapeutic and toxic range for Theophylline?
    • Therapeutic range: 10-20 ug/mL
    • Toxic: >25 ug/mL
  88. This drug improves cardiac contractions in CHF, 70% is absorbed orally.
    Digoxin
  89. How long after dosing of digoxin should a specimen be collected?
    8 hrs after
  90. Digoxin levels may rise ____ ng/mL in first eight hours.
    8-10
  91. What are the therapeutic and toxic ranges for digoxin?
    • Therapeutic: 0.8-2.0 ng/ml
    • Toxic : >3 ng/ml
  92. This drug is used to correct ventricular arrhythmias associated with MI, and also digitalis intoxication.
    Lidocaine
  93. What is the therapeutic and toxic range for lidocaine?
    • Therapeutic: 1.5-5.0 ug/ml
    • Toxic: .5.0 ug/ml
  94. This drug is used in the treatment and therapy of febrile seizures and neonatal seizures.
    Phenobarbital
  95. Which drug is tested based on the angle change of polarized fluorescence emitted by a fluorescent molecule?
    Theophylline
  96. What is the therapeutic range for Phenobarbital?
    15-40 ug/ml
  97. This is the primary drug in the treatment of absence (petit-mal) and myoclonic seizures.
    Valproic acid
  98. What is the therapeutic and toxic range for valproic acid?
    • Therapeutic: 50-100 ug/ml
    • Toxic: >100 ug/ml
  99. This multipurpose antibiotic is quickly diminished due to dose related toxicities primarily aplastic anemia.
    Chloramphenicol
  100. What is the therapeutic and toxic range for chloramphenicol?
    • Therapeutic: 10-20 ug/ml
    • Toxic: >25 ug/ml
  101. This antibiotic is effective against GPC/GPR, S. Epi, S. Aureus; it also prevents cell wall synthesis.
    Vancomycin
  102. What is the therapeutic range for vancomycin (peak and trough)?
    • Trough: 5-10 ug/ml
    • Peak: 30-40 ug/ml
  103. What are the toxic ranges for vancomycin (trough and peak)?
    • Trough: >20 ug/ml
    • Peak: >80 ug/ml
  104. Regular checking of __________ levels is used to alert exposed persons to any change in the level of this essential enzyme before it can cause serious illness.
    Cholinesterase
  105. Evaluation of this drug is used secondary to insecticide exposure.
    Cholinesterase
  106. What are the specimen requirements for cholinesterase?
    • Plasma (EDTA)
    • Spate plasma from cell immediately
  107. What is the normal reference value for cholinesterase?
    4,000-12,000 U/L
  108. To determine levels of ethanol in blood what is measured?
    NADH
  109. What is the methodology for ethanol testing?
    Reactive enzyme assay (REA)
  110. Ethanol tests are drawn using what tube?
    Sodium fluoride (gray top)
  111. Abuse of this commonly used analgesic leads to respiratory alkalosis.
    Salicylate
  112. What is the therapeutic and toxic range for salicylate?
    • Therapeutic: <30 mg/dL
    • Toxic: >30mg/dL
  113. This commonly used analgesic if not taken as directed could cause liver necrosis 3-4 days post OD.
    Acetaminophen
  114. The toxic agent in acetaminophen is the __________ not the parent drug.
    Metabolie
  115. What is the antidote for acetaminophen overdose?
    N-acetylcysteine
  116. What is the therapeutic and toxic range for acetaminophen?
    • Therapeutic: 10-25 mg/ml
    • Toxic: 100-250 mg/ml
  117. What are the four purposes of testing for drugs of abuse?
    • Pre-employment
    • Random testing
    • Employees exhibiting s/s of abuse
    • Forensics
  118. What are the two methods to screen for drugs of abuse?
    • EIA
    • FPIA
  119. What are the two methods to confirm drugs of abuse?
    • GC
    • MS
  120. What are the specimen requirements for drugs of abuse?
    Urine
  121. What are the initial and confirmatory test levels for marijuana?
    • Initial: 50 ng/ml
    • Confirmatory: 15 ng/ml
  122. What is the initial and confirmatory test level for cocaine?
    • Initial: 300 ng/ml
    • Confirmatory: 150 ng/ml
  123. What is the initial and confirmatory test level for opiate metabolite?
    • Initial: 300 ng/ml
    • Confirmatory: 300 ng/ml

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