histopathology of
①Hashimoto thyroiditis
②Riedel thyroiditis
③de Quervain thyroiditis
④Graves disease①☆lymphoid aggregates with germinal centers
Hurthle cells(Askanazy or oxyphil cells)=enlarged ephthelial cells with eosinophilic cytoplasm and prominent nucleoli are commonly seen
②thyroid replaced by fibrous tissue and inflammatory infiltrate
effects of insulin on GLUT-4 proteinphosphorylation of ☆serine and threonine residues of insuline receptor leads to insulin resistance
(phosphorylation can be induced by ☆TNF-α, catecholamines, glucocorticoids, and glucagon)
☆increased translocation of the transporters to the cell membrane (this process is activated by PI3K pathway)
→ increase glucose uptake endocrinologyUWorldUWorld SIM2 HirotoShishido
familial hypocalciuric hypercalcemia
pathophysiologyhigher serum calcium levels are required to suppress the secretion of PTH
→mild asymptomatic hypercalcemia, reduced urinary excretion of calcium, normal high or mildly elevated PTH
noninsulin antidiabetic agents whose side effect is weight loss☆★GLP-1 agonist(cause incretin stimulated insulin release following oral consumption of glucose, independent of IV glucose)
→☆delayed gastric emptying
(¥liraglutide, exenatide)
physiologic insulin secretion1-2 hr peak
no LAG
Lispro, Aspart, Glulisine
(→ regular(2-4hr) available ☆iv, im → NPH(4-12hr)→detemir(3-9hr, lasts up to 24hr)→)
glarGINE→no peak(long acting, lasts about 24hr)
insulin degludec, concentrated glargine with duration of action>24hr
physiologic insulin secretion can be approximated by a combination of ☆long-acting and rapid-acting insulin analogs (ie, basal-bolus regimen).
(glargine once daily plus lispro before each meal) endocrinology卒試UWorld HirotoShishido
medications which increase endogenous insulin secretionsulfonylureas
endocrine hormones which are related to nonreceptor tyrosine kinasenonreceptor
Janus kinase2/signal transducers and activators of transcription(JAK/STAT pathyway)
☆doesn't have intrinsic kinase domain on the receptor
glucagon
signal pathwayG-protein-coupled receptor (GPCR) that activates adenylyl cyclase to produce an increase in intracellular ☆cAMP endocrinology HirotoShishido
