Endocrine Review Hy

DIRECT ACTION: Insulin –(-)> Pancreatic Alpha Cells –> Decreases release of Glucagon

Hormone Sensitive Lipase

• Fed: ACTH / Epinephrine
• Fasting: Insulin

Infantile Parkinsonism

• Tyrosine ===

  TyrosineHydroxylase

  ===> DOPA

• Deficiency of TH => Infantile Parkinsonism

Acanthosis Nigrans sign of Insulin Resistance

• Inc FFA –(-)> insulin dependent glu update
• Obesity
• Sendantary lifestyle

CONCEPT: patients with Type1DM or chronic pancreatitis eventually may have higher hypoglycemic events

• Eventually pancreatic alpha cells get damanged –> Decreased Glucagon release –> Less production of Glucose!

Lisosomal disease:

• Adolecent, presenting with neuropathic pain in palms and soles
• less sweating
• This is Fabry’s disease
• Accumulation of Gb3 (ceremide trihexioside) in
  1. small nerves: sever distal extremety pain and swelling and distal loss of hot/cold temp
  2. vascular smooth muscle: angiokeratomas, telangiectasias
  3. angiokeratomas: non blanching, occur in clusters in buttocks, groin, umbelicus
  4. ADULTHOOD: (also CoD)
     • cardiac problems: (LVH)
     • cerebrovascular problems (TIA)
     • renal: glumurlus, distal tubule: proteinuria

GHRH –> GH(Apit) –> IGF-1(LIVER) –> Growth Effects (bone, cartilate, skeletal muscle, soft tissues

• GIGANTISM

Lady, wants to loose a ton of weight before marrige in a few weeks. What meds?

• Sympathomimmetics: only short term
• orlistat
• bupropion/naltrexone

Glucagonoma: What is the skin lesion?

• uw-id=585
• NECROLYTIC MIGRATORY ERYTHEMA
• blistering erythematic plaques with central clearing –> brown or bronze colored
• groin, face, extrimities

Female athelete –> Low BMI –> Less fat stores –> Reduced circulating Leptin –> Leptin –(-)> GnRH (pulsatile) –> Decrease FSH, LH –> Decreased Estrogen –> Amenorrhea

• LEPTIN inhibits GnRH
• Functionaly Hypothalamic Amennorhea (FHA)

Layers of Adrenal Cortex (Outer to Inner) –> G F R

• Outer layer tumor –> Hyperaldosteronism (Conn)
  • electrolyte imbalance –> parasthesias, muscle weakness

Conn vs Pheochromo (Both High BP)

• Conn: parasthesias, muscle wekaness, low Renin Activity
• pheochromo: High Renin Activity (stimulation!), techycardia, sweating, palpitations

Onset of Hashimotos –> 45-65 yrs

Hypercalcemia, Kidney stones, Constipation

• MEN 1 symptoms
• 3Ps
  1. Pancreatic
  2. Parathyroid
  3. Pituitary

Cortisol –(+)-> PMNT

• NE —

  PMNT

  –> Epi

• promoted by Cortisol
• lack of cortisol reduces Epi production
• expression of PMNT is upregulated by Cortisol (Permissive Action)

Loss of smell + gonadal dysgenesis = KALLMAN syndrome

• Loss of GnRH producing secretory neurons in Hypothalamus –> Decreasd LH/FSH
• Defective migration –> Olfactory placade