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Farias-Test II

Farias-Test II Drug Actions Spring 2007

Alpha Cells Glucagon
D cells Somatostatin
Beta Cells Insulin, Amylin
Proteases Typsinogen, Chymotrypsinogen, Procarboxypeptidase (digest proteins and peptides)
Lipases Triglycerides into monoglycerides and free fatty acids
Amylases hydrolyze starch into maltose
insulin glucose into live, muscle, and adipose tissue
glucagon inc. glycogenolysis, gluconeogenesis, and lipolysis
Somatostatin supress release of pancreatic hormones, GI homrones, GH, and TSH
Amylin slows gastric emptying, promotes satiety, and regulates glucagon secretion
acute pancreatitis clinical syndrom of acute inflammation and destructive auto digestion of pancreas and extrapancreatic tissue
Acute Pancreatitis etiology Alcohol, Biliary tract obstruction, viral or bacterial, trauma, familiar
acute pancreatitis pathophysiology mild no hemmorrhage, infiltraiton of neutrophills, swelling of pnacrease, suppuration
acute pancreatits severe massive necrosis, liquefaction, avscess, hemorrhage, pancreatic ascites, fat necrosis
acute pancreatitis clinical manifestations pain, severe, deep, constant, N/V, Fever, Shock, coagulopathy, metabolic irregularities (acidodis, hyperkalemia, hypocalcemia), jaundice
Kalikrien edema inflammation
chymotrypsin activation edema vascular damage
elastase activation vascular damage, hemorrhage
phospholipase A2 activation coagulation, necrosis
lipase fat necrosis
Chronic Pancreatitis relapsing; inflammatoiin of parenchyma, progressive destruction of acini, ductule stenosis, dilation, fibrosis
chronic pancreatitis etiology alchol, long term obstruction of pancreatic duct, autoimmunity, idiopathic
chronic pancreatitis pathophysiclogy scaring, fibrosis, shrinkingi, stenosis, dilation of ducturles, lymphocyctic infiltrate, increase ductlin permeability due to chronic inflammation, inc. free radicals, toxic metabolites, lysosomal activity
chornic pancreatitis manifestations sever ab. pain, N/V, weight loss, steatorrhea, hyperglycemia, jaundice
pancreatic insuffienciency maldigestion resulting from disorders interfering with effective pancreatic enzyme activity
pancreatic insufficiency etiology chronic pancreatitis, cystic fivrosis, surgery, increased gastreic acid, hyperlipidemia
pancreatic insuffieciency pathophysiology fat melabsorption, decrease in lipase of bicarbonate
pancreatic insuffienciency clinical manifestation steatorrhea, diarrhea, hypoclacemia, nephrolithiasis, Wieght loss, edema/ascites
diabetes mellitus acute manifestation hyperglycemia, hypoglycemia, glucosuria, polyuria, polydipsia, pholyphagia, diabetic ketoacidosis, hyperosmolar coma
DM clinical chronic manifestations blindness, nephropathy, atherosclerosis, endotherlial dysfunction, hypertension, neuropathy, diabetic foot ulcers, infections
throid hormone increase activity of metabolic enzymes and NA/K atpases, o2 consumption, protein catabolism-adult, anabolism-children, normla development of NS
parathyroid hormone inc. vit. D synthesis, renal calcium adsorption, born resortion, increase plasma calcium levels
Graves disease manifestations nervouseness, irritability, alertness, muscular weakness, palpitations, tachycardia, DEC. TSH; INC T4, metabolic rate, exophtalmos, optic nerve pressure -> blindness
Hashimotos Thyroiditis myxedema (skin irritation), hyothermia, DEC. basla metabolic rate, mental retardation in children, slow thinking, ataxia, forgetfulness, lethargy in adults, bradycardia, INC TSH; DEC T4
Hyperparathyroidism excess PTH secretion and hypercalcemia
hyperparathyroidism etiology adenoma, idiopathic, iatrogenic
hyperparathyroidism pathiophysiology-primary excess autonomous produciton and release of PTH by PTH gland
Hyperparathyrodism pathophysiology-secondary defect outside glands, sever calcium or vit. d deficiency; chronic renal failur, dec. calsium reabsorption, skeletal resistance to PTH
hypoparathyroidism low PTH secreation and hypocalcemia
hypoparathyroidism etiology uncommon, truama, surgical damage, autoimmunity
hypoparathyroidism clinical manifestations confusion, weakness, mental retardation, tetany, seizure, CHF, enamel hypoplasia of teeth
Asthma airway inflammation and airflow obstuction and bronchial hyperresponsiveness
asthma etiology most common, 3-5%, hyper-immune response, increased reactivity of airway, triggers: histamine, cold, polution, viruses, allergens, genetic
asthma clinical manifestations cough, wheezing, dyspnea, tachypnea, tachycardia, hypoxemia, bronchial hyper-responsiveness, poor performance on pulmonary function test
Chronic bronchitis air inflammation and airflow obstruction
chronic bronchitis etiology cigarrettes, irritants: ozone, coal burning
chronic bronchitis clinical manifestations wheezing, CRACKLES, dyspnea, PULMONARY HTN, poor performance on pul. perf. test., hypoxemia, polycythemia
Emphysema decreased recoil tension, expiration more work, trouble getting air out
emphysema etiology cigarettes, genetics (alpha 1 proteatse inhibitor deficiency, alpha-1 antitrypsin deficiency
emphysema CM NO PRODUCTIVE COUGH, dyspnea, decreased beath sounds, HYPER INFLATION, tachycardia, hypoxemia, poor pef. pul. funct. test, HYPERCAPNIA, polycythemia
Pulmonary Fibrosis scarring of lung parenchyma (air trouble in and out)
plumonary Fibrosis Etiology chornic inflammation of alveolar walls, diffuse and professive severe fibrosis, recruitment and activation of inflammatory cells, cigarette smoke main cause
pulmonary fibrosis CM NONPRODUCTIVE COUGH, tachypnea, INSPIRATORY CRACKLES, pulmonay HTN, SMALL VOLUME, hypoxemia, hypercapnia,
Pulmonary Edema accumulation of excess fluid in the extravascular space
Pulmonary Edema CM-cardiogenic dyspnea, non-productive cough, ORTHOPNEA, SHALLOW TACHYPNEA, hypoxemia, wheezing, INSPIRATORY CRACKLES, increase hyrostatic pressure, protein poor edema fluid
Pulmonary Edema CM-non cardiogenic mechanical ventailation, may lead ot pulmonary fibrosis, protein rich edema fluid, normal hydrostatic pressure
Pulmonary Embolism venous thrombi from legs migrate to lung circulation
pulmonary embolism secondary to disease, virchow's triad of risk factors
virchows triad of risk factors, statis of blood, injury to vessel wall, increased clotting
pulmonary embolism CM dyspnea, PLEURITIC CHEST PAIN, HEMOPTYSIS, SYNCOPE, swollen, tender, warm, red calf, abnormal ECG.
Alzheimers degernerative disease of brain with insidious onset of dementia
alzheimse Pathophsyiology plaque build up-amyloid b-peptide, presenilin mutaitons, apo-lipoprotein E, neurofibrillary tangles, astrocytosis, microglial proliferaiton, neuronal loss
Alzheimers Disease CM dementia, 5-10 years, memory loss, impairment of learning, spatial disorientation, aphasia, anomia
Parkinsons disease progessive degenerative neurological disease
parkinsons disease Pathophysiology degeneration of dopamine cells in SN, lewis bodies, abnormal protein degreadation, oxidative stress
parkinsons disease CM bradykinesia, freezing, involuntray movements, motor fluctuations, postural instability, orthostatic hypotension, rigidity,tremor
Epilepsy disorder of recurrent seizures
epilepsy-pathophysiology after brain lesion, abnormal calcium currents, GABA dyscuntion, paroxysmal disturbances, synchronous discharge of cortical neurons
epilepsy-CM-partial seizures small brain lesion, concious or unconcious
epilepsy-CM absences staring in childhood, brieg loss of conciousness, slight head movement, spacing out, alert after seizure
Epilepsy CM tonich clinic seizures loss of conciousness, tonich limb and back, confusion after regain conciousness
Myasthenia Gravis autoimmune disorder or neuromuscular transmission
myasthenia gravis-pathophysiology Ab formed against nicotine receptors, less nicotine recptions, stufcutally deficient synaptic clefts
myasthenia gravis CM fluctuating fatige, weakenss that gets better with rest, mild to severe weakness in ocular and skeletal muscles
MS autoimmune disorder of demylination
MS-pathophysiology T&B cell immunity involved, CNS demylination, relapsing vs. chronic
MS-CM visual loss, extra-ocular movement, parathesias, loss of senation, weakness, dysarthria, spasticity, ataxia, bladder dysfunction
hypothalamic insuffieciency anterior pituitary trophic hormones
hypothalamic insufficiency Etiology developmental, traumatic, neoplastic, inflammatory, vascular, infection
hypothalamic insuffienciency-pathophysiology PROP-1 mutation, TF mutations -> deficiency GH, PRL, TSH, gonadotropin
hypothalamic insuffieciency-CM Kallman, Laurence-Moon-Bardet-Beidl, Frolich, Prader Willi
Kallman syndrome defective GnRH color blindness, nerve eagness, cleft palate, low FSH, LH
Laurence-Moon-Bardet-Beidl syndrome mental retardation, obesity, hexadactyly, brachydactyly, retinal degeneration (blind before 30)
Frolich syndrom hypothalmic lesions, central hypogonadism, hyperphagia, obesity
Prader Willi Syndrome mental retardation, hyperphagia, obesity, TII diabetes, muscle hypoonia, multiple somatic defects
Anterior Pituitary Hyperprolactinemia hypersecretion of prolactin; most common
Hyperprolactinemia-etiology pituitray adenoma, pregnancy, lactation, radiation, trauma, systemic disorders (renal failure, hypthyroidism, cirrhoisis, epileptic seizures)
Hyperprolactinemia-CM amenorrhea, galactorrhea, diminished libido or visual loss, PRL lvls >1000 ug/L
Anterior Pituitary-Growth hormone disorders hyper or hyposecreiton of GH
pituityar dwarfism anterior pituitary, short stature, high pitch voice, hypoglycemia, GHRH receptor mutations, growth hormone insensitivity, GH respons <7 ug/L
Anterior Pit-Acromegaly GH hypersecretion, acral bony, voice deepening, oily skin, arthropathy, kypohosis, muscle weakness, fatigue, GH supress less 1ug/L challenged with glucose, surgery is only option
Anterior Pit-Adrenocorticotropin hormone disorder hyper or hyposecretion of ACTH
ACTH deficiency Anter. pit hypo; surgery, supression of HPA axis, ademnoma, low serum corticsol, fatigue, weakness, anorexia, nausea, vomiting, hypoglycemia
cushings disease ant. hormone, pit corticotrop adenoma, iatrogenic, ectopic tumor secreting ACTH; thin brittle skin, cetnral ovesity, HTN, plethoric moon faces, purple striae, diabetes, osteoporisis, leukocytosis, lymphopenia, eosinopenia, immune supression, DXM diagnosis
Ant. Pit.-FSH and LH gonadotropin
gonadotorpin deficiency kallman syndrom, DAX1 gene mutation, stress, anorexia, starvations, extreme exercise, amenorrhea, infertility, decresed libido, dec. muscle mass, reduced body hair
gonadotropin producing adenoma FSH, LH, optic X pressure, menstrual disturbances, ovarian hyperstimulation
Ant-Pit. TSH hormone def. low basal TSH, altered biological activity, low thyroid hormone, pituity hypothyroidism, TRH increase TSH 2-3 times
TSH secreting adenoma rare, large, locally invasive, thyroid goiter, hyperthyroidism, high TSH and T4, positive MRI
syndrome inappropraite vassopressin secretion acute inflammation and destructive auto digestion of the pancreas and extra pancreatic tissue
inappropriate vasopressin secretion-etiology primary: agenesis destruciton of neurohyphpysis, Xq28 gene disruption, secondary: excessive intake of fluid, polydipsia
vasopressin secretion-pathophysiology decresase urin concentraiton, diabetes insipidus
vasopressin secretions-CM decreased vasopression secretion, nocturia, enuresis, polyuria
Created by: Alexia4