-
What effect does lithium have on Na level?
it decreases it by displacing it
-
3 drugs for prolactinemia?
- bromocriptine
- pergolide
- cerbergoline
-
GH for Dwarfism?
somatotropin
-
-
-
Coniviptan blocks what?T
Tolvaptan?
-
Entrapment neuropathy?
carpal tunnel
-
3 strategies for osteoporosis?
- bisphosphonates
- somatoropin
- relexifine
-
Primary cause of parathyrodism?
Secondary?
- adenoma
- low calcium--> high calcium
-
What is the diff in phosphoate homeostasis with PTH and vit D?
- PTH--increases po4 exrection in kidney
- Vit D--increase po4 absorption in intestine
-
PTH function?
- increases Ca and Po4 resorption from bone
- increases Ca absorptionin kidney
- increases PO3 excretion in kidney
- activates vit D--which absorbs ca and po4 in intestine
-
SIADH tx?
- demeclocycline
- Coniviptan
- Tolvaptan
-
ADH and Oxytocin production
- supraoptic
- paraventricular
-
Tx for pit adenoma?
- bromocriptine to stop prolactin
- octeotride---somatostatin analog to stop GH
-
In case of hypo. ant. pit what HR decreases first and which one should be treated first?
- GnRH goes down first--sexual dysfunction
- ACTH def. must be treated first with cortisol to maintain sugar and BP
-
Tx for lithium induced DI?
ameloride
-
DI tx?
hydrochlorothiazide
-
Somatostatin has 3 inhibitory roles what are they?
What secretes it?
- Hypothalamus--inhibit GH and TSH
- D cells of pancreas-stop insulin, glucagon, enzymes
- GI mucosa--gastrin, pepsinogen
-
ADh vasoconstriction via what receptor?
V1
-
Measurment of GH can be done by looking at what?
somatomedin c /IGF-1
-
In normal PTs what effect does glucose have on GH?
- low glucose--high GH
- high glucose--low GH
-
GH receptor for acromegaly?
pegvisomant
-
Cortisol production inhibitor used to diagnose ACTH deficiency?
Metyrapone
-
Somatostatin analog for tx of carcinoid, gastrinoma, glucogonoma, acromegaly?
octerotride
-
5 releasing HR from Hypothalamus?
-
How do diagnose GH deficiency with insulin?
give insuling-->low sugar--> GH levels should rise
-
3 Causes for hypo. ant. pit?
- post partum hemorrhage
- inflammation--encephalitis, sarcoidosis
- pit. apoplexy--hemorrhagic infarct due to pit. adenoma
-
V1 acts thru what receptor?
Gq via ip3 and DAG
-
Sheehans?
atrophy of ant. pit due to decreased perfusion during labor
-
Tx for Hyperparathyrodism?
- calcitonin
- Bisphosphoates--drugs ending in DRONATE
-
Risedronate?
bisphosphonate for Pagets
-
Recombinant PTH for Osteoporosisn?
Teriparatide
-
Tx for Hypercalcemia?
- IV saline
- Furosemide
- Calcitonin
- Pamidronate
-
what are the levels of Ca and PO4 in pseudoparathyrodism?
what causes it?
- ca and po4 are low
- renal failure and low vit d cause it
- all due to defective pTH receptors
-
Hypcalcemia does what do the QT interval?
prolongs it--torsaides the point? yup
-
T3 or T4 is predominatly active?
T3
-
-
What 2 conditions elevate TBG and total t4 but free t4 is normal?
What 3 conditions decreaese TBG and total t4 but free T4 is still normal?
- pregnancy and tamoxifen--due to estrogen
- nephrotic syndrome and androgens
-
What index do we look at to see normal thyroid levels?
FT4 index
-
what do u measure to see thyroid levels?
tsh
-
Highly sensitive TSH is done when?
hyperthyrodism
-
What do you treat? Hyperthyrodism, or hypothyrodism?
when do u do radioactive uptake?
- Treat Hypothyrodism
- Radioactiv Uptake in Hyperthyrodism
-
-
RAIU is low/
someone is ingesting thyroid hormone
-
what one is used in pregnancy?
methimazole or propylthiouracil?
propylthiouracil
-
Tx for hyperthyrodism?
moa?
- propylthiouracil
- methimaozle
- block oxidation of iodine
- block coupling of iodine to tyrosine
-
High dose of propylthiouracil does what?
prevent conversion of T4 to T3
-
Inhibitors of iodine uptake?
- thyocyante
- perchlorate
- pertechnate
-
What is give after radiation exposure?
KI
-
WhAT 6 drugs prevent conversion of T4 to T3?
- glucocoritcoids
- propranolol
- lithium
- amiodarone
- propylthiouracil
-
Therapy for Thyrotoxicosis?
- Iodine
- PTU
- propranolo
- dexamethasone
-
Tx for Toxic Multinodular Goiter/Plummer dz?
MOA?
- radioactive Iodine
- destroy thyroid cells
-
MOA of Iodine?
stops releae of thyroid hormone
-
Pretibial myxedema is what thyroid disorder?
Graves
-
Tx for Hypothyrodism?
- levothyroxine
- levothyroinine
- Liotrix
-
What abs are seen in Hashimotos?
anti-microsomial/thyroglobulin
-
Cretinism is associated with what congenital disorder/
umbilical hernia
-
What condition can give you coma?
hypo or hyperthyrodism?
- hypo
- give IV and levothyroxine
-
Subacute thyroditis follows what?
viral illness
-
What disorder presents with hyper then hypothyrodism?
-
In what thyroid condition do you get high ESR?
Subacute thyroditis
-
2 examples of suppressing adenomas from making too much hormone?
- prolactinoma
- pit. cushings
-
What happens in a dexamethsone test to cortisol/acth with high dose?
if pituitary tumor?
adrenal tumor?
Small cell carcinoma?
- pituitary--low cortisol/acth
- adrenal--low acth, high cortisol
- small cell carcinoma--high acth, high cortisol
-
Drugs used for Cushings?
anti-cortisol?
- Aminoglutethimide--stops desmolase
- Metyrapone--blocks 11 beta hydroxylase
- Trilostane--3 beta hydroxylase
-
Adrenocortical Insufficiency?
Addisons
-
Hyperpigmentation of skin in what endocrine disorder?
Addisions
-
Short acting glucocorticoid?
Hydrocortizone--mineralocorticoid action
-
Intermediate acting Glucocorticoids?>
- Prednisone
- Prednisolone
- Methylprednisilone
-
Long acting Glucocorticoids?
Dexamethasone
-
Second line replacement for Addisons?
Fludrocortizone
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