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110 Cards in this Set
- Front
- Back
anterior pituitary hormones secreted by acidophils
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GH, PRL
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anterior pituitary hormones secreted by basophils
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FSH, LH, ACTH, TSH (B-FLAT)
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insulin-dependent glucose transporter
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GLUT4
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glucose transporter on RBCs and brain
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GLUT1
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glucose transporter on adipose and skeletal muscle
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GLUT4
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insulin-independent (concentration sensing) glucose transporter
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GLUT2
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glucose transporter on B-islets, liver, kidney, and small intestine
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GLUT2
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What hormones trigger insulin release?
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GH, EPI, NE, glucagon
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Does alpha or beta adrenergic stimulation trigger insulin release?
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beta agonists trigger insulin release
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What hormones suppress insulin release?
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cortisol, somatostatin, alpha2 agonists
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How to B-islets regulate insulin release?
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increased glucose --> increased ATP --> closes K+ channels --> depolarization --> insulin release
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What is the effect of insulin on the kidneys?
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induces Na+ retention
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What is the effect of insulin on the plasma K+ concentration?
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reduces it, by inducing cellular K+ uptake
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In addition to stimulating release of TSH, TRH increases release of ___?
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PRL
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In addition to inhibiting PRL release, somatostatin inhibits the release of ___ and ___.
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GH, TSH
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How does PRL inhibit the secretion of LH and FSH?
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By inhibiting the secretion of GnRH.
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17a-hydroxylase deficiency: ___ mineralocorticoids, ___ cortisol, ___ adrenal androgens.
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high mineralocorticoids, low cortisol, low adrenal androgens
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Clinical presentation of 17a-hydroxylase deficiency?
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hypertension and hypokalemia (from excess aldosterone); hypocortisolism; XY pseudohermaphrodite, XX w/o secondary sex characteristics (from decreased adrenal androgens)
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What is the most common congenital adrenal hyperplasia?
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21-hydroxylase deficiency
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21-hydroxylase deficiency: ___ mineralocorticoids, ___ cortisol, ___ adrenal androgens.
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low mineralocorticoids, low cortisol, high adrenal androgens
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Clinical presentation of 21-hydroxylase deficiency?
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hypotension, hyperkalemia, high renin, volume depletion (from low aldosterone); hypocortisolism; XY precocious puberty, XX pseudohermaphroditism
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11B-hydroxylase deficiency has ___ aldosterone, ___ 11-deoxycorticosterone, ___ cortisol and ___ adrenal androgens.
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low aldosterone, high 11-deoxycorticosterone, low cortisol, and high adrenal androgens
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Clinical presentation of 11B-hydroxylase deficiency?
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hypertension (from high 11-deoxycorticosterone); XY precocious puberty; XX pseudohermaphroditism
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How does cortisol maintain blood pressure?
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by increasing the expression of alpha 1 receptors on arterioles
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What cells secrete PTH?
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Chief cells of the parathyroid gland.
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How does PTH stimulate bone reabsorption?
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By increasing osteoblasts' production of M-CSF and RANK-L, which activates osteoclasts.
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What is the effect of increased PTH secretion on serum Mg2+?
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decreases Mg2+
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What is the overall effect of PTH on serum phosphate?
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decreased, because PTH decreases phosphate reabsorption in the kidneys (which outweighs the phosphate gained from bone breakdown)
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What is the overall effect of vitamin D on serum phosphate?
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increases, because it increases reabsorption by the kidneys. This counterbalances PTH's decrease of serum phosphate.
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What hormones signal through cAMP (hint: FLAT CHAMP).
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FSH, LH, ACTH, TSH; CRH, hCG, ADH (V2R), MSH, PTH
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second messenger of FSH signal
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cAMP
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second messenger of LH signal
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cAMP
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second messenger of ACTH signal
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cAMP
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second messenger of TSH signal
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cAMP
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second messenger of CRH signal
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cAMP
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second messenger of hCG signal
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cAMP
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second messenger of ADH (V2R) signal
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cAMP
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second messenger of MSH signal
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cAMP
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second messenger of PTH signal
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cAMP
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What hormones signal though cGMP?
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The vasodilators: ANP, NO
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second messenger of nitrous oxide signal
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cGMP
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second messenger of ANP signal
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cGMP
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What hormones signal through IP3/Ca2+? hint: GOAT HAG
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GnRH, Oxytocin, ADH (V1R), TRH, histamine (H1), angiotensin II, gastrin
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second messenger of GnRH signal
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IP3/Ca2+
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second messenger of oxytocin signal
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IP3/Ca2+
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second messenger of ADH (V1R) signal
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IP3/Ca2+
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second messenger of TRH signal
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IP3/Ca2+
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second messenger of histamine (H1) signal
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IP3/Ca2+
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second messenger of angiotensin II signal
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IP3/Ca2+
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second messenger of gastrin signal
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IP3/Ca2+
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Which steroid binds its receptor in the nucleus instead of the cytoplasm?
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T3/T4
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Which hormones signal through an intrinsic tyrosine kinase, via the MAP-K pathway?
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insulin, IGF-1, FGF, PDGF
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signal mechanism for insulin
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intrinsic tyrosine kinase, MAPK
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signal mechanism for the growth factors IGF-1, FGF, PDGF
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intrinsic tyrosine kinase, MAPK
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What enzyme converts T4 to T3, and where is this enzyme located?
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5' deiodinase, in the target cell
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What is the Wolff-Chaikoff effect?
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the transient decrease in T3/T4 after excessive ingestion of iodide due to inhibition of the iodide pump
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What is the mechanism of action of methimazole?
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inhibits thyroid peroxidase
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What is the mechanism of action of propylthiouracil?
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inhibits thyroid peroxidase AND 5' deiodinase
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What tumor is 10% malignant, bilateral, extra-adrenal, calcified, pediatric, and familial?
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pheochromocytoma
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What will you find in the urine of someone with a pheochromocytoma?
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increased vanillylmandelic acid
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What do you use to treat a pheochromocytoma (besides surgery)?
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alpha antagonists like phenoxybenzamine
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What will you find in the urine of someone with neuroblastoma?
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homovanillic acid from increased dopamine. DO NOT have increased VMA like pheo.
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What is the breakdown product of epinephrine?
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metanephrine
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What is the breakdown product of dopamine?
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homovanillic acid (HVA)
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What is the breakdown product of norepinephrine?
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vanillylmandelic acid (VMA)
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What type of thyroiditis occurs secondary to a flu-like illness and is painful and granulomatous?
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de Quervain's (subacute) thyroiditis
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What is Reidel's thyroiditis?
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replacement of the thyroid with fibrous tissue
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What is a thyroid storm?
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A complication of Graves' disease in which stress-induced catecholamine surge causes death by arrhythmia.
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What causes the Jod-Basedow phenomenon?
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Iodine repletion in an iodine-deficienct person can cause thyrotoxicosis.
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What is Chovstek's sign?
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tapping the facial nerve causes contraction of the facial muscles (a sign of hypocalcemia)
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What is Trousseau's sign?
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occlusion of the brachial artery with BP cuff causes carpal spasm (a sign of hypocalcemia)
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In primary hyperparathyroidism, calcium will be ___ while phosphate will be ___.
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Calcium is high, phosphate is low.
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In secondary hyperparathyroidism, calcium will be ___ while phosphate will be ___.
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Calcium is low, phosphate is high.
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What is another name for pseudohypoparathyroidism?
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Albright's hereditary osteodystrophy
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What is the inheritance pattern for pseudohypoparathyroidism?
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autosomal dominant failure of kidneys to respond to PTH
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What is the treatment for SIADH?
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demeclocycline, an ADH receptor antagonist
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Describe the potassium abnormality in DKA.
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Hyperkalemia with depleted intracellular K+ due to low insulin.
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What are the 3 neoplasias of MEN1?
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Parathyroid, Pituitary (prolactin, GH), Pancreas (gastrinoma, VIPoma, insulinoma)
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What are the 3 neoplasias of MEN2a?
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Parathyroid, Pheochromocytoma, Medullary thyroid carcinoma
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What are the 3 neoplasias of MEN2b, and what is the other physical finding?
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Pheochromocytoma, Medullary thyroid carcinoma, oral/intestinal ganglioneuromas, and Marfanoid habitus
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Which MEN syndromes include pheochromocytoma?
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MEN 2a and 2b
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What MEN syndromes include medullary thyroid carcinoma?
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MEN 2a and 2b (ret gene!)
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What MEN syndromes include hyperparathyroidism?
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MEN 1 and MEN 2a
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If regular insulin is short-acting, what are lispro and aspart?
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Rapid-acting
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If regular insulin is defined as short-acting, what is NPH?
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intermediate-acting
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If regular insulin is defined as short-acting, what are glargine and detemir?
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long-acting
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tolbutamide
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first generation sulfonylurea
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chlorpropramide
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first generation sulfonylurea
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glyburide
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second generation sulfonylurea
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glimopiride
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second generation sulfonylurea
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glipizide
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second generation sulfonylurea
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metformin
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biguanide
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What is the mechanism of action of sulfonylureas?
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Close the K+ channel in the B-cell membrane, so the cell depolarizes. Resulting Ca2+ release stimulates INCREASED INSULIN RELEASE.
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What is the mechanism of action of biguanides like metformin?
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INCREASED INSULIN SENSITIVITY via decreased gluconeogenesis, increased glycolysis, and increased peripheral glucose uptake.
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What is the mechanism of action of thiazolidinediones (TZDs)?
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INCREASE INSULIN SENSITIVITY via binding PPAR-gamma, a nuclear transcription regulator. Also INCREASE ADIPONECTIN.
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pioglitazone
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TZD
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rosiglitazone
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TZD
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acarbose
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alpha-glucosidase inhibitor
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miglitol
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alpha-glucosidase inhibitor
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Mechanism of alpha-glucosidase inhibitors?
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Inhibit intestinal brush border alpha-glucosidases, so decrease absorption of carbohydrates.
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Mechanism of action of pramintide?
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decreases glucagon secretion
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Mechanism of action of exenatide?
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GLP1 analogue that increases insulin release and decreases glucagon release
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exenatide
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GLP1 analogue
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Major side effect of first generation sulfonylureas?
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disulfiram-like rxn when combined w alcohol
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Major side effect of second generation sulfonylureas?
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hypoglycemia
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Major side effect of metformin?
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lactic acidosis
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Major side effects of TZDs?
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weight gain, edema, CHF, hepatotoxicity (CONTRAINDICATED IN CHF!!!)
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Major side effect of alpha-glucosidase inhibitors?
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diarrhea
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Major side effect of pramintide?
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hypoglycemia, n/v, diarrhea
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Major side effect of exenatide?
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n/v, pancreatitis
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