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Common causes of dec. Mg2+
- alcohol abuse
↧ serum Mg2+ -->
↧↧ serum Mg2+ -->
↧ serum Mg2+ --> ↥ PTH secretion
↧↧ serum Mg2+ -->↧ PTH secretion
Ghrelin increase secretion of
(“dancing eyes-dancing feet”) in Neuroblastoma
- from neural crest cells; Homer-Wright rosettes characteristic.
- Occurs anywhere along the
- sympathetic chain.
- Most common presentation is abdominal distension and a firm, irregular
- mass that can cross the midline.
- Can also
- present with opsoclonus-myoclonus syndrome (“dancing eyes-dancing feet”).
What is Necrosis~
Non-programmed·cell death = noisy, inflammation, nucleus destroyed first
What is Apoptosis?
Programmed cell death = quiet, no inflammation, nucleus guides it => destroyed last
What is Pyknosis?
Nucleus turns into blobs "pick blobs"
What is Karyohexis?
What is Karyolysis?
What is a Somatotrope?
What is a Gonadotrope?
What is a Thyrotrope?
What is a Corticotrope?
What is a Lactotrope?
What receptors do protein hormones use?
Cell membrane receptors
What receptors do steroid hormones use?
Nuclear membrane receptors
What are the steroid hormones?
- "PET CAD"
- Note: thyroid hormone acts like a steroid
- Vit D
What does Endocrine mean?
Secretion into blood
What does Exocrine mean?
Secretion into non-blood
What is Autocrine?
Works on itself
What is Paracrine?
Works on it's neighbor
What is Merocrine?
Cell is maintained => exocytosis
What is Apocrine?
Apex of the cell is secreted
What is Holocrine?
The whole cell is secreted
What organs do not require insulin?
- Cardiac, Cornea
- Exercising muscle
What does GnRH do?
Stimulates LH, FSH
What does GRH do?
What does CRH do?
What does TRH do?
What does PRH do?
What does DA do?
What does SS do?
What does ADH do?
Conserves water, vasoconstricts
What does oxytocin do?
Milk letdown, baby letdown
What does GH do?
lGF - 1 release from liver
What does TSH do?
T,,T~ release from thyroid
What does LH do?
Testosterone release from testis , E2 and Progesterone release from ovary
What does FSH do?
Sperm or egg growth
What does PRL do?
What does ACTH do?
Cortisol release from adrenal gland
What does MSH do?
What are the stress hormones?
- Epi: immediate
- Glucagon: 20min
- Insulin: 30min
- ADH: 30min
- Cortisol: 2-4hr
- GH: 24 hr
What does ADH do?
What is Diabetes Insipidus?
Too little ADH =>urinate a lot
What is Central DI?
Brain not making ADH
What is N ephrogenic DI?
Blocks ADH receptor, can be caused by Li and Domecocycline
What does the Water Deprivation test tell you?
- water deprivation => DI
- concentrates 25%
What is SIADH?
Too much ADH => expand plasma vol => pee Na
What is the difference b/w DI and SIADH?
- DI has dilute urine,
- SIADH has concentrated urine
What is Psychogenic Polydipsia?
Pathologic water drinking => low plasma osmolarity
What does Aldosterone do? R e absorbs N a , secretes H • / K+
Reabsorbs Na, secretes H+/K+
What is a Neuroblastoma?
Adrenal medulla tumor in kids, dancing eyes/feet, secretes catecholamines
What is a Pheochromocytoma?
Adrenal medulla tumor in adults, 5 P's
What does the Zona Glomemlosa make?
What does the Zona Fasiculata make?
What does the Zona Reticularis make?
What is Conn's syndrome?
High Aldo (tumor), Captopril test makes it worse
What does ANP do?
Inhibits Aldo, dilates renal artery (afferent arteriole)
What does Calcitonin do?
Inhibits osteoclasts => low serum Ca2+
What is MEN I?
"Wermer's": Pancreas, Pituitary, Parathyroid adenoma (high gastrin) "PPP"
What is MEN II?
"Sipple's": Pheo, Medullary thyroid cancer, PTH
What is MEN III?
"MEN IIB": Pheo, Medullary thyroid cancer, Oral/GI neuromas
What docs CCK do?
Gallbladder contraction, bile release
What does Cortisol do?
Gluconeogenesis by proteolysis => thin skin
What is Addison's disease?
- Autoimmune destruction of adrenal cortex=>
- hyper-pigmentation, INC ACTH
What is Waterhouse Friderichsen?
What is Cushing's syndrome?
High cortisol (pituitary tumor or adrenal tumor or small cell lung CA)
What is Cushing's disease?
High ACTH (pituitary tumor)
What is Nelson's syndrome?
Hyperpigmentation after adrenalectomy
If the low-dose dexamethasone test suppresses, what does that tell you?
Normal, obese, or depressed
If the low- dose dexamethasone test does not suppress, what does that tell you?
Cushing's => do high dose test
If the high-dose dexamethasone test suppresses, what does that tell you?
Pituitary tumor => ACTH (call brain surgeon)
If the high-dose dexamethasone test does not suppress, what does that tell you?
- • Adrenal adenoma => Cortisol (call general surgeon)
- • Small cell lung cancer=> ACTH (call thoracic surgeon)
What are the survival hormones?
- Cortisol: permissive under stress
- TSH: permissive under normal
What does Epinephrine do?
What does Erythropoietin do?
What does Gastrin do?
Stimulates parietal cells => IF, H+
What does Growth hormone do?
Growth, sends somatomedin to growth plates, gluconeogenesis by proteolysis
What is a Pygmie?
No somatomedin receptors
What is Achondroplasia = Laron Dwarf?
Abnormal FGF receptors in extremities
What is a Midget?
DEC⇩ Somatomedin receptor sensitivity
What is Acromegaly?
Adult bones stretch "my hat doesn't fit", coarse facial features, large furrowed tongue, deep husky voice, jaw protrusion,↑IGF-1 b/c of GH tumor
What is Gigantism?
What does GIP do?
Enhances insulin action→postprandial hypoglycemia
What does Glucagon do?
Gluconeogenesis, glycogenolysis, lipolysis, ketogenesis
What does Insulin do?
Pushes glucose into cells
What is Type I DM?
Anti-islet cell Ab, GAD Ab, Coxsackie B, low insulin,DKA, polyuria, polydipsia, polyphagia
What is Type II DM?
Insulin receptor insensitivity, high insulin, HONK coma, acanthosis nigricans
How does DKA present?
Kussmaul respirations, fruity breath (acetone), altered mental status
What is the Dawn phenomenon?
Morning hyperglycemia 2° to GH
What is the Somogyi Effect?
Morning hyperglycemia 2° to evening hypoglycemia
What is Factitious Hypoglycemia?
Insulin injection (↑INC insulin, ⇩DEC C-peptide)
What is an Insulinoma?
Tumor (⇧INC insulin, ⇧INC C-peptide)
What is Erythrasma?
Rash in skin folds, coral-red Wood's lamp
What is Syndrome X = Metabolic Syndrome?
"Pre-DM"→ HTN, dyslipidemia, hyperinsulinemia, acanthosis nigricans
What are foot ulcer risk factors?
- • DM/ Glycemic control
- • Male smoker
- • Bony abnormalities
- • Previous ulcers
What conditions cause weight gain?
- • Obesity
- • Hypothyroidism
- • Depression
- • Cushing's
- • Anasarca
What does Motilin do?
stimulates segmentation (1o peristalsis, MMC)
What does Oxytocin do?
Milk ejection, baby ejection
What does PRL do?
What does PTH do?
Chews up bone
What does Vit. D do?
What do parathyroid chief cells secrete?
What do stomach chief cells secrete?
What is the difference between Norepinephrine and Epinephrine?
- NE: Nemotransmitter
- Epi: Hormone
What is 1° hyperparathyroidism?
What is 2° hyperparathyroidism?
What is Familial Hypocalciuria Hypercalcemia?
↓DEC Ca excretion
What if both serum Ca and PO4 decrease?
Vit D deficiency
What if serum Ca and PO4 change in opposite directions?
- PTH problem
- • High Ca → hyperPTH
- • Low Ca → hypoPTH
What is the most common cause of 1° hypoparathyroidism?
What is Pseudohypoparathyroidism?
Bad kidney PTH receptor,↓ DEC urinary cAMP
What is Pseudopseudohypoparathyroidism?
G-protein defect, no Ca2+ problem
What is Hungry Bone syndrome?
Remove PTH → bone sucks in Ca2+
What does Secretin do?
Secretion of bicarb, inhibit gastrin, tighten pyloric sphincter
What does Somatostatin do?
Inhibits secretin, motilin, CCK
What do T3 and T4 do?
What disease has Exophthalmos?
What disease has Enophthalmos?
What are the Hyperthyroid diseases and their descriptions ?
- •Grave's-Exophthalmos, pretibial myxedema, TSHr Ab
- • DeQuervain's- Viral, painful jaw
- • Silent thyroiditis- Post-partum
- • Plummer's-Benign adenoma, old person
- • Jod-Basedow-Transient hyperthyroidism due to ↑I
What are the Hypothyroid diseases and their descriptions?
- • Hashimoto's- Antinucrosomal Ab = TPO Ab
- • Reidel's struma- Woody neck
- • Cretin- Freaky features, hypothyroid Mom and Baby
- • Euthyroid sick syndrome- Low T3 syndrome
- • Wolff-Chaikoff- Transient hypothyroidism.
What is Plummer's syndrome?
What is Plummer-Vinson syndrome?
What does Testosterone do?
Makes external male genetalia
What does Mullerian Inhibiting Factor do?
Makes internal male getutalia
What do TPO and Thymosin do?
Help T cells mature
What does VIP do?
Inhibits secretin, motilin, CCK
How does a VIPoma present?
How does a SSoma present?
What are the hormones with disulfide bonds?
- • PRL
- • Insulin
- • GH
- • Inhibin
Which hormones have the same a subunits?
What hormones produce acidophils?
What hormones produce basophils?
- "B FLAT"
- • FSH
- • LH
- • ACTH
- • TSH