-
Common causes of dec. Mg2+
- diarrhea,
- aminoglycosides,
- diuretics,
- alcohol abuse
-
↧ serum Mg2+ -->
↧↧ serum Mg2+ -->
PTH?
↧ serum Mg2+ --> ↥ PTH secretion
↧↧ serum Mg2+ -->↧ PTH secretion
-
Ghrelin increase secretion of
-
opsoclonus-myoclonus syndrome
(“dancing eyes-dancing feet”) in Neuroblastoma
-
Neuroblastoma characteristic
- Originates
- 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?
Nucleus fragments
-
What is Karyolysis?
Nucleus dissolves
-
What is a Somatotrope?
GH
-
What is a Gonadotrope?
LH, FSH
-
What is a Thyrotrope?
TSH
-
What is a Corticotrope?
ACTH
-
What is a Lactotrope?
PRL
-
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
- Progesterone
- E2
- Testosterone
- Cortisol
- Aldo
- 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?
- "BRICKLE"
- Brain
- RBC
- Intestine
- Cardiac, Cornea
- Kidney
- Liver
- Exercising muscle
-
What does GnRH do?
Stimulates LH, FSH
-
What does GRH do?
Stimulates GH
-
What does CRH do?
Stimulates ACTH
-
What does TRH do?
Stimulates TSH
-
What does PRH do?
Stimulates PRL
-
What does DA do?
Inhibits PRL
-
What does SS do?
Inhibits GH
-
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?
Milk production
-
What does ACTH do?
Cortisol release from adrenal gland
-
What does MSH do?
Skin pigmentation
-
What are the stress hormones?
- Epi: immediate
- Glucagon: 20min
- Insulin: 30min
- ADH: 30min
- Cortisol: 2-4hr
- GH: 24 hr
-
What does ADH do?
Concentrates mine
-
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?
Aldosterone "salt"
-
What does the Zona Fasiculata make?
Cortisol "sugar"
-
What does the Zona Reticularis make?
Androgens "sex"
-
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?
Adrenal hemorrage
-
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?
Gluconeogenesis, glycogenolysis
-
What does Erythropoietin do?
Makes RBCs
-
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?
childhood acromegaly
-
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?
Milk production
-
What does PTH do?
Chews up bone
-
What does Vit. D do?
Builds bone
-
What do parathyroid chief cells secrete?
PTH
-
What do stomach chief cells secrete?
Pepsin
-
What is the difference between Norepinephrine and Epinephrine?
- NE: Nemotransmitter
- Epi: Hormone
-
What is 1° hyperparathyroidism?
Parathyroid adenoma
-
What is 2° hyperparathyroidism?
Renal failure
-
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?
Thyroidectomy
-
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?
Growth, differentiation
-
What disease has Exophthalmos?
Grave's
-
What disease has Enophthalmos?
Horner's
-
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?
Hyperthyroid adenoma
-
What is Plummer-Vinson syndrome?
Esophageal webs
-
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?
Watery diarrhea
-
How does a SSoma present?
Constipation
-
What are the hormones with disulfide bonds?
- "PIGI"
- • 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
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