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UWORLD Endocrine Review

Quiz yourself by thinking what should be in each of the black spaces below before clicking on it to display the answer.
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Question
Answer
show Medullary Thyroid Cancer  
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show Medullary Thyroid Cancer  
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show MEN2A and MEN2B  
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Medullary Thyroid cancer develops amyloid deposits, thus, it stains:   show
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show Gynecomastia  
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show 1. Increased Estrogen to Androgen ratio 2. Ductal Epithelial Hyperplasia and stromal fibrosis  
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show Liver cirrhosis, Obesity, CKD, hypogonadism, 5-a-reductase deficiency.  
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To what drugs is the development of gynecomastia associated?   show
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show Visceral Obesity  
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Visceral obesity is an indicator of:   show
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TPO is + for:   show
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Which are the two most common INCRETINS?   show
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Are incretins dependent or independent of serum glucose levels?   show
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GI hormone released by gut mucosa after the ingestion of a rich glucose meal that increases insulin release?   show
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What are the two main causes of Hypothyroidism?   show
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What are examples of conditions that may provoke Hypothalamic Hypothyroidism?   show
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Sheehan Syndrome is a common cause of:   show
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Mass lesions on the Pituitary are known to cause:   show
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Low level of hormones released by the pituitary cause deficiency in:   show
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show Hypotension, decreased weight, and hypoglycemia  
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Hypothyroid patient presents with:   show
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show amenorrhea; infertility; libido; infertility  
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show 17-hydroxyprogesterone into 11-deoxycortisol; Cortisol  
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Decreased levels of CORTISOL in 21-(OH) deficiency lead to:   show
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show Z. RETICULARIS, which causes increased levels of Androgens  
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show 21-(OH) deficiency  
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show All of them due to increased levels of MSH as it is coproduced with ACTH  
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show Hypertension  
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show virilization in females  
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DECREASED renin activity is seen in which adrenal deficiency?   show
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In congenital adrenal deficiencies the Blood pressure and the [K+] are ____________________________ proportional.   show
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show Insulin; macrosomia; Hypertrophic; HYPOGLYCEMIA  
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show Aphasia, growth retardation, and POLYCYTHEMIA.  
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show The mother created a state of chronic hyperglycemia, which caused the fetus to create an constant hyperinsulinemic environment, which is not compensated at birth.  
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Di George Syndrome:   show
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show 1. Chovek Sign (twitch of nose and lips) 2. Trousseau sign (carpal spasm)  
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Absent Thymic shadow, low levels of T-cells and cleft lips are key characteristics of:   show
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Sulfonylureas MoA?   show
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Where does the sulfonylurea bind in the Pancreatic B-cell?   show
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The attachment of Sulfonylurea to ATP- dependent K+ channel causes _____ ____________, leading to subsequent exocytosis of ___________.   show
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show Glyburide, Glipizide and Glimepiride  
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1st generation Sulfonylureas?   show
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What is a common side effect of ALL sulfonylureas?   show
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show Disulfiram-like effects  
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show Hypoglycemia  
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show Injectables; Exenatide and Liraglutide  
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show DPP-4 inhibitors  
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show TRIGLYCERIDE; ADIPOSE; INSULIN  
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show LIPASE  
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GLYCEROL is broken down in the _______________ by __________ __________, into Glycerol-3-P which then becomes DHAP, which produces _________ via ________________ and __________ via ________.   show
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Hyperthyroidism causes the upregulation of ___ -receptors expression, leading to INCREASED ___________________ effect.   show
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show 1. minimize the ADRENERGIC effects 2. inhibit 5'-monoiodide, thus decreasing the conversion of T4 into T3.  
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Beta-blockers in Hyperthyroid patients cause a decrease in T___ production by inhibiting _________________________.   show
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show Papillary Thyroid cancer  
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Large cells with nuclei, containing finely dispersed CHROMATIN, giving an empty or "ground-glass" appearance, and intranuclear inclusions, is the histology seen in?   show
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"Orphan-Annie eyes" histological description is seen in what type of thyroid cancer?   show
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show Papillary  
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Laminated Calcium deposits seen in certain malignancies?   show
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What are the 2 most common causes of DI?   show
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show Inadequate pituitary secretion of ADH  
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Nephrogenic DI is due to inability of the collecting duct to respond to _______________.   show
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Administration of analogous ADH produces a positive response in what type of Diabetes Insipidus?   show
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Post-Pituitary damage produces ___________________ __________ DI.   show
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show Hypothalamic nuclei damage.  
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1. Beta-Oxidation of Fatty Acids 2. TCA cycle 3. Carboxylation of Pyruvate (Gluconeogenesis)   show
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Processes occuring in the CYTOSOL:   show
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show Transketolase and Vitamin B1 as cofactor.  
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Where does the 1st step in STEROID synthesis occur? all subsequent steps are done in what organelle?   show
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show Well developed Smooth Endoplasmic reticulum. (SER)  
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show Adrenal glands, gonads, adn liver  
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Cells that produce steroids:   show
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show High levels of ACTH  
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show 1. Adrenal adenoma 2. Adrenal malignancy 3. Exogenous glucocorticoid intake (MC) (person with chronic inflammatory disease)  
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Suppressed levels of ACTH after High dose Dexamethasone Test, indicative which probable causes?   show
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show Ectopic ACTH production (malignant tumor)  
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What is the most common Ectopic ACTH secreting tumor?   show
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show Pyruvate Dehydrogenase Complex Deficiency  
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In Pyruvate Dehydrogenase complex deficiency, the patient is unable to convert ____________________ into __________________.   show
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show Purely Ketogenic amino acid diet  
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Which are the purely Ketogenic amino acids?   show
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show 1. Cushing Disease --> Pituitary ACTH hypersecretion 2. Ectopic ACTH secretion --> secretion of ACTH paraneoplastic  
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What is the ACTH-INDEpendent cause of Cushing Syndrome?   show
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show ACTH-dependent Cushing Syndrome changes at tissue level  
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At time of GLUCOSE DEPLETION, the body uses which substance to create energy?   show
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________________ metabolism occurs in the ________________ in times of prolonged ________________.   show
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Which cells are not able to use Ketones for energy at all and why?   show
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show No, the brain cell will only take up ketone for energy in cases in extreme cases.  
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show FRUCTOKINASE  
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show HEXOKINASE; Glycolysis  
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Deficiency of _________________ leads to development of Severe Fructose inherited intolerance.   show
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What is the clinical presentation of Fructose Intolerance?   show
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show PRE-PRO-INSULIN; Rough Endoplasmic Reticulum; N-terminal  
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What is the role of PRP (signal peptide protein)?   show
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show Insulin; C-peptide; Equivalent; secretory granules  
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Defective Lipoprotein Lipase leads to development of?   show
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show Chylomicrons  
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show 1. ACUTE PANCREATITIS episodes 2. Lipemia retinalis 3. Eruptive Xanthomas  
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show Familial Hypercholesterolemia  
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show 1. LDL receptor 2. ApoB-100  
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show 2A; LDL receptor; ApoB-100  
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show Type 2A Familial Hypercholesterolemia  
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Patient with premature atherosclerosis, TENDON XANTHOMAS, and xanthelasmas, suspect of?   show
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show Type 3 Familial Hyperlipoproteinemia  
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show Familial Dysbetalipoproteinemia  
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show Accumulation of: 1. Chylomicrons 2. VLDL remnants Defective ApoE (3 &4)  
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show Familial Hypertriglyceridemia  
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Accumulation of VLDL only, is seen in Type _______ hyperlipoproteinemia.   show
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Tuberoeruptive and palmar xanthomas are characteristic of?   show
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What are the xanthomas manifested or characteristic of Type 3 Hyperlipoproteinemia?   show
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What Familial Hyperlipoproteinemia has LDL and VLDL accumulated?   show
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show Type 2A is mainly LDL receptor deficient and accumulates LDL, while Type 2B has LDL receptor and ApoB-100 defective and accumulates LDL and VLDL  
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______________ deficiency, has low CORTISOL and excessive release of _________________. The best treatment is __________________ corticosteroids, in order to suppress ______________ production.   show
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show Decreased androgen production, which manifests with a DELAY in SEXUAL development.  
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show MEN 2B  
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show 1. Oral/ Mucosal Neuromas 2. Medullary Thyroid cancer 3. Pheochromocytoma  
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show MEN2B  
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show Cytoplasm  
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show CORTISOL; Cytoplasm; Nucleus  
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show NUCLEUS; Cytoplasm; Nucleus: transcribed (transcription); glucose  
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show High levels of Hepatic GLUCOSE synthesis --> Hyperglycemia.  
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show Anastrozole and Letrozole  
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show Aromatase  
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______________________ is enzyme that carries the conversion of ______________________ into ________________.   show
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show ER-2 + Breast cancer  
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Cholesterol is converted into Pregnenolone in the ________________, and all subsequent steps in Estrogen synthesis occur in the _____________________________.   show
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What is the most important INSULIN stimulator?   show
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Glucose in Pancreatic B-cell undergoes _____________________ to produce _________, which then binds to the _______________________.   show
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show Optic Chiasm; Lower; Posterior  
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show Elevated Insulin with DECREASED C-peptide  
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If insulin and C-peptide are both elevated, and there is a Positive drug assay, suspect?   show
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show Produces Elevated Insulin and Elevated C-peptide, with negative drug assay.  
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Injectable Insulin does NOT increase ____________________   show
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Initially, the Increase in Estrogen during pregnancy will lead to a ______________ free ______.   show
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show TBG: T4: T4; bound-T4; TRH; T4.  
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What enzyme converts Testosterone into DHT>   show
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What is DHT's role?   show
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A male patient with 5-alpha-reductase deficiency will show:   show
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show 1. HYPOSPADIAS 2. Small phallus  
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show Finasteride  
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By which GLUT is glucose taken into the cell in muscle cells and adipocytes?   show
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Which GLUT is INSULIN dependent?   show
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show GLUT 1, 2, 3, and 5  
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show INCREASES; GLUT 1, 2, 3, 5  
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What is the MCC of Adrenal Insufficiency?   show
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What are some common triggers/situations/events that lead to an adrenal crisis?   show
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show Low Cortisol, Low CTrH, and low ACTH  
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Patient with decreased cortisol, ACTH and CTrH, is about to enter the OR for cholecystectomy. What is a common cause for the patients laboratory results?   show
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Conversion of Oxaloacetate into PEP by using PEP carboxykinase (PEPCK)   show
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show GTP is the cofactor used by PEPCK in GLUCONEOGENESIS  
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From which cycle is the GTP used in Gluconeogenesis originated?   show
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What hypothalamic hormone inhibits Prolactin?   show
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Dopamine inhibitors may cause:   show
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show TRH and VIP  
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Haloperidol is a ________________ inhibitor that may cause:   show
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show HSP: IgA and C3  
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Hepatitis C   show
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show Small Vessel Vasculitis that affects most evidently the skin  
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Skin lesions (multiple red dots) + arthralgias + recent treatment with a Beta-lactam, and the patient got symptoms resolved spontaneously.   show
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Conn's Syndrome:   show
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What is the MCC of Conn's Syndrome?   show
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Patient presents with HTN, low serum[K+], pH higher than 7.45, muscle fatigue and paraesthesias, with abdominal CT showing abnormally large adrenal gland. Dx?   show
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Elevated plasma Aldosterone and Low plasma RENIN activity. Dx?   show
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The muscle weakness and paresthesias seen in Conn's Syndrome, are due to:   show
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show Secondary Hyperaldosteronism  
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Baby presents with Enlarged fontanelle, Protruding tongue, and Umbilical hernia, and mother states is hard to feed. PE shows mild jaundice. Dx?   show
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show 1. Enlarged Fontanelle 2. Protruding tongue 3. Association with UMBILICAL hernia  
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The brain, kidneys, intestines, liver and RBCs use what type of GLUT transporters?   show
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show GLUT-1  
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GLUT-2 is used by:   show
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show Placenta; Neuronal; 3  
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GLUT-5 is used by:   show
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show Insulin-INDEPENDENT GLUT  
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Insulin-Dependent GLUT   show
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show Increase BONE RESORPTION to increase serum Calcium  
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PTH acts INDIRECTLY on_______________________ and DIRECTLY on the ________________________.   show
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Osteoblasts have ____________ receptors   show
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The binding of PTH and osteoblast leads to:   show
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show RNK-L; Osteoclasts; Resorption  
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show product from PTH and Osteoclast interaction. Associated with elevated levels of PTH and low level of serum Calcium.  
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show Aspart, Lispro, and Glulisine  
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Regular Insulin's effect is completely gone after how many hours approximately?   show
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show Detemir insulin actions act up to 24 hours, while NPH's act up to 18 hours.  
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Insulin receptor shows:   show
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show 1. Hypoglycemia 2. Lipodystrophy 3. Hypersensitive reactions  
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show Increase glucose store as GLYCOGEN  
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show Insulin actions in the MUSCLE  
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How is fat affected upon contact with Insulin release:   show
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show SHORT; NPH  
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What is a desired or advantageous side effect of Metformin:   show
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What are the MoA of Metformin?   show
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Biguanide   show
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show Mitochondrial matrix  
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Transported used by Fatty Acids to move across the membrane   show
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show Malonyl-CoA  
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show Malonyl-CoA; Fatty acids; carnitine acyl-transferase  
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show 1. Major product of the de Novo FA synthesis first step 2. Inhibits carnitine acyltransferase --> no Fatty acid across membrane of the mitochondria.  
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show Endometriosis  
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show ADHESIONS; scarring; Fallopian: INFERTILITY  
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show Fibroids, Adenomyosis, and Endometrial cancer/hyperplasia.  
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show Fibroids  
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Fibrinoid key features:   show
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Pelvic examination demonstrates a bulky, globular, and tender uterus, and a 7 month Hx of dysmenorrhea. Dx?   show
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What is a common risk Hx for a patient to develop Endometrial carcinoma>   show
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69 yo female complains of vaginal bleeding. Her last menses was over 10 years ago. She has a indicates past gastric bypass surgery 20 years ago, and hysterectomy at age 21. Dx?   show
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show Endometrial carcinoma/hyperplasia  
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show Fibroids have enlarged uterus. Adenomyosis have bulky, globular and tender uterus Endometrial cancer have a NON-tender uterus.  
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show Metabolic acidosis  
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What is adenomyosis?   show
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show Fruity; breath ; urine  
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Sudden onset of polyuria, polydipsia, volume depletion and fruity odor in breath. Dx?   show
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show respiratory alkalosis; HYPERVENTILATION  
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show Adrenal hemorrhage or infarct, and acute onset of illness or surgery.  
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show The use of glucocorticoids; Dexamethasone  
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Thyrotoxicosis labs show:   show
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show Thyrotoxicosis  
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How is the histology of Exogenous Hyperthyroidism described:   show
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Thyroid tissue biopsy demonstrates LYMPHOCYTIC infiltrate with GERMINAL centers.   show
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show Mixed; Multinucleated Giant cells  
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show Tall, columnar epithelium with scalloped margins of colloid.  
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What are zinc-motifs?   show
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show chains of amino acids, which mostly include Cysteine and Histidine, around central Zinc atom  
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show Cysteine and Histidine  
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show Zinc - motifs  
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Which autoimmune conditions have higher risk of developing in a patient with DM type 1?   show
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show HLA-2  
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show 1. HYPOnatremia 2. HyperKalemia and Hyperchloremia 3. Non-anion gap metabolic acidosis  
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Addison's Disease is also classified as:   show
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Addison's Disease has __________________ gland dysfunction, leading to decreased levels of both, ________________ and ____________________.   show
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show Hypotension  
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show MSH; HYPERPIGMENTATION  
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show Waterhouse-Friedshensen Syndrome  
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__________________________ is often caused by __________________ by N. _____________, __________, or _______________________ shock. It causes adrenal gland ________________________.   show
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Main differences between PRIMARY and SECONDARY adrenal gland insufficiency?   show
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show Tertiary  
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show LH: secretes Testosterone  
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By what cell is Testosterone secreted?   show
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Testosterone is secreted by Leydig cells in the testes by stimulation of which Pituitary hormone?   show
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show Inhibin B  
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show Hypothalamus: Pituitary gland  
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show FSH; Pituitary gland  
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show Anti-cancer  
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Which are the two main cancer in which T-cells and NK cells act upon or attack?   show
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-- B-cell -- No memory -- Short duration -- NO immunogenicity in infancy   show
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show + B/T-cell immunity (Humoral and Cellular) + Memory + Long Duration + Immunogenicity in infancy  
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show Receiving PREFORMED antibodies -- Rapid onset and short half-lives (3 weeks)  
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Examples of passive immunization   show
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show Exposure to foreign antigens  
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What type of immunity has a slow onset and creates memory?   show
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Natural infections, vaccines, toxoids   show
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Preformed antibodies, may be given to a patient that had recent exposure to which toxins or infections? What is the main benefit?   show
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show Epinephrine  
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show Vasodilation, increased vascular permeability, and bronchoconstriction.  
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What is the virulence factor of Strep Pyogenes?   show
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show Group A strep (S. pyogenes)  
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Pentad of; 1 Fever, 2 pharyngitis, 3 Strawberry-tongue, 4 sand-paper like skin rash, 5 circumoral pallor, describes the clinical manifestation of?   show
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Infection of S. pyogenes, with or without development of Scarlet Fever, predisposes a higher risk for development of what 2 other conditions?   show
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Patient with Kawasaki Disease has a higher risk of development of _____________________________.   show
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show C1 deficiency, which is a common cause of Angioedema  
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The conversion of Kininogen to Bradykinin in C1 deficiency, is done by:   show
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show Bradykinin; Angioedema; C1 esterase inhibitor  
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show ACE INHIBITORS as these increase Bradykinin levels as a side effect, furthering the angioedema.  
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show Dominant  
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show Gastrinoma  
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Pancreatic tumor, rarely seen in MEN1, characterized by electrolyte abnormalities and watery diarrhea?   show
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show Medullary  
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show MEN2A & MEN2B  
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show MEN1  
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show MEN2A  
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MEN 2B   show
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show MEN 2B  
🗑
show Sarcoidosis and other granulomatous diseases activate MACROPHAGES, which then express 1a-HYDROXYLASE, which leads to synthesis of 1,25-(OH)2 Vit D and Hypercalcemia  
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What GI autoimmune disorder is a cause of Secondary Hyperparathyroidism?   show
🗑
Celiac Disease impairs the absorption of fat-soluble vitamins, such as Vitamin _______, which leads to: ______________ serum __________ and _____________ serum ____________, and __________ serum _______.   show
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Low vitamin D has:   show
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show Increased androgens enhance early linear growth.  
🗑
show Low doses of EXOGENOUS corticosteroids to suppress excessive ACTH and reduce stimulation of Adrenal cortex.  
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show Ambiguous genitalia  
🗑
Increased numbers of catecholamines:   show
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Leydig Cell Hyperplasia:   show
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show Pituitary adenoma  
🗑
show Pituitary adenoma  
🗑
What is the key characteristic of MCAD deficiency?   show
🗑
show Beta-Fatty Acid oxidation in the mitochondria  
🗑
show 1. HYPOKETOTIC HYPOGLYCEMIA 2. Seizures and sudden death  
🗑
Fatty acid disorder that presents with Hypoketotic Hypoglycemia, muscle weakness, CARDIOMYOPATHY, and hypertriglyceridemia.   show
🗑
show Mitochondria; Cytoplasm  
🗑
Patient recently diagnosed with depressive disorder, complains of weakness, very concentrated urine, Dx?   show
🗑
Most common malignancy associated with development of SIADH?   show
🗑
show 100 mOsm/Kg  
🗑
1. Ectopic ADH (small cell lung ca) 2. CNS disorder/Trauma (meningitis, SAH) 3. Pulmonary disease 4. Drugs (cyclophosphamide, SSRIs)   show
🗑
Peripartum hemorrhage causing ischemic necrosis, is known as?   show
🗑
show Mother's delay to lactate, due to Prolactin deficiency.  
🗑
show During pregnancy there is an increase n estrogen due to enlargement of pituitary gland, but there is NO proportional blood supply to the gland enlargement.  
🗑
Another name for De Quervain's Thyroiditis?   show
🗑
show viral infection  
🗑
Is de Quervain's thyroiditis painful?   show
🗑
show 1. Transient Hyperthyroid symptoms 2. Increased ESR and CRP 3. Decreased in radioiodine uptake.  
🗑
show Hashimoto's Thyroiditis  
🗑
Hurthle cells are seen in histology of _____________________________.   show
🗑
show Hurthle cells  
🗑
show Inhibition of radioactive iodine.  
🗑
show In nuclear accidents in order to prevent radiation-induced thyroid carcinoma  
🗑
Development of Cushing's that ACTH's and Cortisol production is only suppressed by High-dose Dexamethasone test?   show
🗑
show ACTH cannot be suppressed with low or high dexamethasone tests.  
🗑
show Prolactinoma  
🗑
_________________ thyroid caner, is the most common type of thyroid cancer.   show
🗑
"Orphan Annie eyes" cytoplasm in thyroid cells, indicate   show
🗑
show Radiation Exposure  
🗑
RET/PTC rearrangements and BRAF mutations lead to increased risk of developing?   show
🗑
Follicular thyroid carcinoma has a ___________ prognosis. It invades the thyroid ___________________ and vasculatures, and is associated to _______ mutations and _________________ translocations.   show
🗑
show Medullary Thyroid cancer  
🗑
Medullary thyroid cancer cells stain + for ________________________.   show
🗑
RET mutations:   show
🗑
To what autoimmune condition is thyroid lymphoma associated?   show
🗑
What are common causes of Secondary Hyperparathyroidism?   show
🗑
show Causes of Primary Hyperparathyroidism  
🗑
show Anaplastic Thyroid cancer  
🗑
Thyroid malignancy with POLYGONAL or spindle shaped cells and + for calcitonin.   show
🗑
show Hyperglycemia  
🗑
show Glucogenic and glycogenic; Glucose  
🗑
An ________________________ effect is seen in glucocorticoid therapy.   show
🗑
What changes occur in adipose tissue in patient with glucocorticoid medications?   show
🗑
show Bone --> osteoporosis, Immune system --> suppression and T-cell apoptosis, Liver --> increased gluconeogenesis and glycogenesis, Skeletal muscle and Adrenal cortex --> atrophy, and the skin is thinning, striated adn impaired wound healing.  
🗑
What enzyme stimulates GLUCONEOGENESIS by increasing the activity of Pyruvate carboxylase?   show
🗑
show Hyper-adrenergic; Hypertension, palpitations, tachycardia, sweating, heat intolerance, tremor.  
🗑
show Beta-blockers to minimize adrenergic effects They do not work on exophthalmos  
🗑
What are 2 common medications used to treat Hyperthyroidism?   show
🗑
show Side effect of Methimazole and PTU  
🗑
___________________ is a teratogenic drug during the ________ trimester.   show
🗑
show Hepatic failure  
🗑
show Exophthalmos  
🗑
show Recurrent Laryngeal Nerve; Hoarseness  
🗑
show Cytosolic Acetyl-CoA carboxylase  
🗑
show Inhibition of B-oxidation of newly formed fatty acids  
🗑
show mitochondrial carnitine acyltransferase  
🗑
show Malonyl-CoA: REGULATOR ; Beta-oxidation of FA  
🗑
Events leading to Adrenal Crisis:   show
🗑
What situations are associated with increased stress leading to adrenal crisis?   show
🗑
show Increase the dosage of glucocorticoids  
🗑
Stimulation of orbital fibroblast by Thyrotropin receptor antibodies and cytokines released by T -cells, leads to development of?   show
🗑
What is the triad of symptoms seen in Grave's Ophthalmopathy?   show
🗑
show Glucocorticoids; Grave's Ophthalmopathy  
🗑
Which agents use Protein Kinase A, G-protein adenylate cyclase second messenger?   show
🗑
The _____ is the major product of the TH gland.   show
🗑
What is the active form of thyroid hormone?   show
🗑
T3:   show
🗑
show inactive form generated by peripheral conversion.  
🗑
show TSH, LH, and FSH.  
🗑
What are 3 major domains of G protein-coupled receptors?   show
🗑
show HYDROPHOBIC; Ala, Leu, Phe, Trp, Met, Pro, and Gly  
🗑
Tamoxifen is used in gynecomastia because?   show
🗑
show Familial Dysbetalipoprotenemia  
🗑
show 1. conversion of iodide --> iodine 2. Iodination of thyroglobulin tyrosinase residues and, 3. iodotyrosine coupling reaction that forms T3 and T4.  
🗑
show 1. Decrease hepatic synthesis of triglycerides and VLDL, 2. Reduce clearance HDL  
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hyperlipidemic drug that may cause GOUTY ARTHRITIS?   show
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show Pompe disease  
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Pompe's disease has deficiency of __________________________   show
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show Pompe Disease  
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Review the information in the table. When you are ready to quiz yourself you can hide individual columns or the entire table. Then you can click on the empty cells to reveal the answer. Try to recall what will be displayed before clicking the empty cell.
 
To hide a column, click on the column name.
 
To hide the entire table, click on the "Hide All" button.
 
You may also shuffle the rows of the table by clicking on the "Shuffle" button.
 
Or sort by any of the columns using the down arrow next to any column heading.
If you know all the data on any row, you can temporarily remove it by tapping the trash can to the right of the row.

 
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Created by: rakomi
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