What effect does lithium have on Na level?
it decreases it by displacing it
3 drugs for prolactinemia?
GH for Dwarfism?
Coniviptan blocks what?T
3 strategies for osteoporosis?
Primary cause of parathyrodism?
- 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
- 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
ADH and Oxytocin production
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?
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?
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?
Cortisol production inhibitor used to diagnose ACTH deficiency?
Somatostatin analog for tx of carcinoid, gastrinoma, glucogonoma, acromegaly?
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
atrophy of ant. pit due to decreased perfusion during labor
Tx for Hyperparathyrodism?
- Bisphosphoates--drugs ending in DRONATE
bisphosphonate for Pagets
Recombinant PTH for Osteoporosisn?
Tx for Hypercalcemia?
- IV saline
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?
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?
what do u measure to see thyroid levels?
Highly sensitive TSH is done when?
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?
Tx for hyperthyrodism?
- 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?
What is give after radiation exposure?
WhAT 6 drugs prevent conversion of T4 to T3?
Therapy for Thyrotoxicosis?
Tx for Toxic Multinodular Goiter/Plummer dz?
- radioactive Iodine
- destroy thyroid cells
MOA of Iodine?
stops releae of thyroid hormone
Pretibial myxedema is what thyroid disorder?
Tx for Hypothyrodism?
What abs are seen in Hashimotos?
Cretinism is associated with what congenital disorder/
What condition can give you coma?
hypo or hyperthyrodism?
- give IV and levothyroxine
Subacute thyroditis follows what?
What disorder presents with hyper then hypothyrodism?
In what thyroid condition do you get high ESR?
2 examples of suppressing adenomas from making too much hormone?
- pit. cushings
What happens in a dexamethsone test to cortisol/acth with high dose?
if pituitary tumor?
Small cell carcinoma?
- pituitary--low cortisol/acth
- adrenal--low acth, high cortisol
- small cell carcinoma--high acth, high cortisol
Drugs used for Cushings?
- Aminoglutethimide--stops desmolase
- Metyrapone--blocks 11 beta hydroxylase
- Trilostane--3 beta hydroxylase
Hyperpigmentation of skin in what endocrine disorder?
Short acting glucocorticoid?
Intermediate acting Glucocorticoids?>
Long acting Glucocorticoids?
Second line replacement for Addisons?