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what symptoms have higher specificity for Graves disease ☆pretibial myxedema, proptosis(Graves orbitopathy)

Graves ophthalmopathy are not mediated by thyroid hormone or adrenergic stimulation and ☆do not respond to beta blockers. However, they are immune mediated, the manifestation usually respond to glucocorticoid therapy.

fibroblasts stimulated by TRAb secrete excess amount of ☆glycosaminoglycans (eg hyaluronic acid) along with adipogenesis, which expand ground substance of retro-orbital tissues
→desiccation(eg a sense of ☆grittiness), tearing
endocrinology UWorld UWorld SIM2 May 11, 2020, 10:29 PM   HirotoShishido

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lid lag a sign of ophthalmopathy caused by spasm of the smooth muscle portion of the levator palpebrae superioris due to sympathetic overactivity (as in from Graves hyperthyroidism).

Evaluated by instructing the patient to follow the examiner's finger as it moves downwards. Lid lag is present if the sclera can be seen above the iris as the patient looks down.
endocrinology Amboss level4 May 7, 2020, 4:24 AM   HirotoShishido

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what regulate the release of prolactin TRH→ ↑prolactin
dopamine→ ↓prolactin

(¥malignant PKU→ ↓dopamin→ hyperprolactinemia)
(☆hyperprolactinemia can be caused by the lesion in hypothalamus or pituitary lesion by the disruption of hypothalamic-pituitary axis)
endocrinology Amboss level4 UWorld May 1, 2020, 9:17 PM   HirotoShishido

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pancreatic islet cells α→ glucagon
β→ insulin
δ→ somatostatin
endocrinology Apr 14, 2020, 10:07 AM   HirotoShishido

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hormones which use cGMP for signaling pathway BAD GraMPa

Bnp, Anp, eDrf(NO)
GMP

ANP, BNP
afferent vasodilation+ efferent vasoconstriction→☆↑GFR
endocrinology UWorld Apr 14, 2020, 10:00 AM   HirotoShishido

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