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Endocrine

First Aid Q&A: Endocrine (Pharm heavy)

QuestionAnswer
What is the mechanism of goiter formation in Grave's disease? TSH receptor stimulation by thyroid stimulating immunoglobulins (TSI's) leads to glandular hyperplasia and enlargement
What other autoimmune diseases are associated with Grave's disease? pernicious anemia and DM type I
Idiopathic replacement of thyroid and surrounding tissue with fibrous tissue resulting in dysphagia, stridor, dyspnea, and hypothyroidism. Diagnosis? Riedel's thyroiditis
Are thyroid adenomas usually solitary nodules or multiple nodules and are they hyperfunctioning or nonfunctional? Usually solitary nonfunctional nodules
What is a struma ovarii? Ovarian teratoma which is capable of producing thyroid hormone
Diarrhea, weight loss, and hyperglycemia that does not respond to oral hypoglycemic agents. Also painful, pruritic erythematous papules that blister, erode, and crust over noted around mouth. Diagnosis? Glucagonoma; associated with necrolytic migratory erythema (skin rash)
Hypersecretion of T4 from ectopic gland can result in what menstrual abnormalities? amenorrhea and oligomenorrhea
Accumulations of mesangial matrix in glomeruli. Kimmelstiel-Wilson nodules; often accompanied by increased basement membrane thickness
These sensory receptors are responsible for transducing vibratory, pressure, and tension sensation. Pacinian corpuscles
Sensory receptors are responsible for conveying sensation of light touch. Meissner's corpuscles
Type 2 diabetic complains of vomiting, headache, dizziness, blurry vision, difficulty breathing after attending a cocktail party. Skin is notably flushed. What is the likely medication which caused these symptoms? Diabetic med that causes Disulfiram-like reaction; First generation sulfonylurea (Tolbutamide, chlorpropamide)
What is the blood supply for the pancreas? Superior pancreaticoduodenal arteries are supplied by gastroduodenal artery off celiac trunk; Inferior pancreaticoduodenal arteries are supplied by superior mesenteric artery
What is the treatment for acromegaly? Octreotide; somatostatin analog that acts anterior pituitary to suppress GH secretion
What is the treatment for BPH? Finasteride; 5alpha reductase inhibitor which suppresses conversion of testosterone to dihydrotestosterone
What is the drug used to treat infertility, prostate cancer, and uterine fibroids? Leuprolide; GnRH analog
What is somatrem? somatotropin, or growth hormone analog
What is the effect of hypoglycemia on GH? GH is critical in stress response and acts to decrease glucose uptake by cells and increase lipolysis to raise blood sugar.
What is the mode of inheritance of pseudohypoparathyroidism? Autosomal dominant with genetic imprinting; maternal is associated with renal involvement whereas paternal is usually just skeletal abnormalities with a PTH responsive kidney
What is the mechanism of action of insulin? insulin binds receptor, receptor autophosphorylates, generation of tyrosine kinase which participates in intracellular signaling cascade
This DM drug decreases hydrolysis and absorption of disaccharides and polysaccharides at the intestinal brush border. Acarbose; alpha glucosidase inhibitor (SE's include cramps, diarrhea, and flatulence)
DM drugs that act via stimulation of insulin secretion by the pancreas. Sulfonylureas (chlorpropamide, tolbutamide, glipizide, glyburide, glimepiride)
DM drugs that sensitize peripheral tissues to insulin. Glitazones (SE hepatotoxic)
Defect in fibroblast growth factor receptor 3 results in this condition. Achondroplasia; short limbs with normal sized head and trunk
Defective dihydrotestosterone receptor results in men affected by this syndrome. Testicular feminization syndrome (XY appearing female)
Into what veins do the adrenal glands drain? Right adrenal --> IVC; Left adrenal --> left renal vein
34 yro african american female presents with cramps that worsen during menstrual cycle, with periods lasting longer than 7 days. Ultrasound shows multiple masses on patients uterus. Diagnosis? Leiomyoma or fibroids
Hyperfunctioning nodular goiter causing hyperthyroidism. Diagnosis? Plummer's disease
A tan man with diabetes. Diagnosis? Hemochromatosis; micronodular pigment cirrhosis leading to diabetes, hemosiderin deposition leading to skin pigmentation
What is the inheritance pattern for MEN? Autosomal dominant
Patient being treated for hypothyroidism complains of sore throat, rashes, metallic taste in mouth, and ulcerations of mucous membranes. What is the drug causing these symptoms? Oral iodide
This hyperthyroid drug inhibits peroxidase. propylthiouracil
Why would a diabetic patient being treated for hypertension be at increased risk for hypoglycemia? Because the response to hypoglycemia (tachycardia, diaphoresis, tremor, and anxiety) is mediated by sympathetic tone. If the patient is on a beta blocker for HTN, then these symptoms may be masked.
What is the major side effect of metformin? Lactic acidosis, an anion gap metabolic acidosis
Competitive inhibitor of testosterone used in the treatment of prostate carcinoma. Flutamide
What HLA's are associated with DM type I? HLA-DR3 and HLA-DR4
Demeclocycline and lithium can effect kidneys resulting in this condition. Nephrogenic diabetes insipidus
What are the two first generation sulfonylureas? Tolbutamide, chlorpropamide
What are the second generation sulfonylureas? Glyburide, glimepiride, glipizide
What is the mechanism of action of sulfonylureas? Close potassium channel to depolarize cell triggering insulin release via Calcium influx
What is believed to be the primary effect of metformin? Decrease gluconeogenesis
What is the mechanism of action of acarbose? inhibit intestinal brush border alpha-glucosidase
This drug inhibits pancreatic lipase. Orlistat
Sympathomimetic serotonin and norepinephrine reuptake inhibitor used to treat obesity. Sibutramine
This drug inhibits organification and coupling of thyroid hormone synthesis. Propylthiouracil
Created by: rahjohnson