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Part of eukaryotic DNA that closely resembles bacterial DNA, and codes for proteins, tRNA, and rRNA
Mitochondrial DNA
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Histology of thyroid: mononuclear, parenchymal infiltration with well-developed germinal centres
Hashimoto's
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Glucocorticoids increase protein synthesis in what organ?
Liver (to make gluconeogenesis to increase BG)
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Consequences of hyperaldosteronism (Conn syndrome)
- Increased Na+ retention and K+ excretion (hypokalemia)
- Metabolic alkalosis
- can cause muscle weakness and paresthesias
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Cushing's syndrome skin manifestations
- Easy bruising
- Inhibited collagen and matrix GAG formation
- Thinner, weaker skin and connective tissue
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Increase in which blood cell with Cushing's
- Neutrophils due to demargination of cells previously attached to the vessel wall
- All other cell lines decrease
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How does TNF-a decrease insulin's action?
Activates serine and threonine kinases, which phosphorylates IRS-1 residues. This prevents tyrosine IRS-1 phosphorylation by insulin
catcecholamines, glucocrticoids, and glucagon do the same thing to cause insulin resistance
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Initial commited step of gluconeogenesis
pyruvate to oxaloacetate, and then OAA to phosphoenylpyruvate
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Phosphonylpyruvate requires the phosphorylation of GTP. What step in the Kreb cycle makes it?
succinyl coA to succinate
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Kallmann syndrome, deficiency of what peptide hormone
Absence of GnRH released from the hypothalamus
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Histology of medullary thyroid carcinoma
Polyglonal cells with amyloid deposits from the parafollicular cells (calcitonin)
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Histology of papillary thyroid cancer
Psammomma bodies
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Sheehan syndrome decreases what hormones
Panhypopituitarism (multiple hormones) due to necrosis of the anterior pituitary
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What enzyme elevation can be the first manifestation of hypothyroidism besides the thyroid hormones
creatine kinase (hypothyroid myopathy)
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Thyrotoxicosis, increased ESR, tenderness over the thyroid gland, reduced iodide uptake
- deQuervain's thyroiditis
- Granulomas
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High blod glucose levels in pregnancy cause what to the fetus
- Can cross the placenta, causing islet cell hyperplasia
- Hyperinsulinemia causes a big head
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Metformin is contraindicated in what situations
Renal failure, liver dysfunction, CHF, alcoholism, sepsis
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In a 95% CI, mean +-SD range is from 200-240. How many people lie above 240 in a sample of 400?
2.5% on each side, 2.5% x 400 = 10 people
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Menotropin (human menopausal gonadotropin) acts like FSH or LH
- FSH
- formation of a dominant ovarian follicle
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Increased AFP levels
- Made by fetal liver, GI tract and yolk sac (early gestation only)
- Dating error (under-estimation of gestational age)
- NTD
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Increased estriol levels
- Placental and fetal abnormalities
- intrauterine growth retardation
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Person exposed to radioactive iodide. Treatment
- Potassium iodide
- prevents thyroid absorption of the chemical by competitive inhibition
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Which drugs can improve exopthalmos in Grave's disease
- High-dose glucocorticoids (e.g. prednisone) as they decrease inflammation and extraocular volume
- (doesnt work with anti-thyroids)
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Difference between Conn syndrome and diuretics in metabolic alkalosis
- Conn syndrome: hypokalemia and normal sodium
- Diuretics: hypokalemia and hyponatremia
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Functions of thyroid peroxidase
- 1. oxidation to organic iodide
- 2. binding to tyrosine residues on TBG
- 3. forms mono-tyrosine which can make di-tyrosine to make T3 and T4
nb secretion of TSH controls all else
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How do sulfonylureas work?
- Inhibit K+ATP channels
- Keeps the channels closed so it causes a depolarization, allowing Ca+2 to enter the cells
- This causes exocytosis of insulin
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Anorexia nervosa and amenorrhea
Loss of pulsatile secretion of GnRH from the hypothalamus which decreases FSH and LH
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Features of Laron dwarfism
- Defective GH receptors
- High GH hormone levels
- Decreased linear growth (due to decreased IGF-1 from the liver)
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Three domains of G protein receptors
Examples of such receptors
- Extracellular: ligand-binding
- Transmembrane: a-helices with hydrophobic AA (valine, isoleucine, methionine, phenylalanine)
- Intracellular: G protein activation
TSH, LH, and FSH
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Affects of PPAR-gamma regulators (e.g. glitazones)
- Increases insulin sensitivity (decreases insulin resistance)
- Increases GLUT-4
- Increases FA transport protein
- (regulates F.A. storage and glucose metabolism)
- Increases adiponectin levels
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Most common tumor of the pituitary (cell type)
Most abundant cell of the pituitary
- Pituitary adenoma: prolactinoma - lactotrophs
- Somatotrophs (GH stimulators)
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Where is rRNA made?
Nucleolus
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Which AA can be given safely to a patient with pyruvate DH deficiency?
- Lysine and Leucine (ketogenic)
- will not increase lactate levels as PDH patients will have lactic acidosis
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Function of aspartate
- Acidic
- made from asparagine
- transaminated with a-ketoglutarate to make glutamate and oxaloacetate (intermediate for TCA cycle)
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How does insulin promote glycolysis?
- Activates PFK-2 (dephosphorylates it), which converts F6P to F2,6.BP
- F2,6BP then activates PFK-1, which converts F6P to F1,6BP
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Role of neurophysins
- Post-translational processing of oxytocin and ADH
- Made in the hypothalamic nuclei and released into circulation from axon terminals in the posterior pituitary
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Confirmatory test for menopause
- FSH level will be increased
- (LH also increases but occurs later in menopause)
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Drug that competes with testosterone and DHT for androgen receptors
- Flutamide
- (does not affect testosterone production by Leydig cells)
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Drug that decreases steroid hormones in adrenals and gonads
Ketoconazole (weak anti-androgen affect)
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If a reaction has a negative free E change, what will the concentrations of products and reactants be? And equilibrium constant?
[products] > [reactants]
K >1
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1st step of vitamin D synthesis
- Liver
- cytochrome P450 25-hydroxylase
- converts cholecalciferol to 25-hydroxycalciferol
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which hormones increase BG levels
- TSH (increases glucose absorption in the gut)
- Increasing insulin resistance to tissues:
- GH
- cortisol
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Patient presents with hyper-thyroid symptoms and now develops delirium, abdominal pain, and vomiting
Dx and consequences
- Thyrotoxicosis crisis (abrupt onset)
- stressors induced: infection, childbirth
- consequences: thyroid storm: CHF, pulmonary edema, death
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Grave's and Hashimoto's - type of hypersensitivity?
- Grave's: Type II HS (non-cytotoxic)
- Hashimoto's: Type IV HS (cell-mediated cytolysis)
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Function of KI and perchlorate in treatment of thyroid disease
Inhibits the Na+/iodide symporter (uptake of iodine)
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Insulin increases fat storage by activating what enzyme
Acetyl-coA carboxylase
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Affects of glucagon on glycogenolysis
Glucagon - cAMP - PKA - glycogen phosphorylase kinase to make glycogen phosphorylase (RLS of glycogenolysis)
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Tx for 2nd hyper-PTH that occurs with renal failure
- Cincalcet (increases Ca+2 sensitivity on chief cells of the PTH gland to extracellular Ca+2)
- Decreases PTH hormone release
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