what degrade triglylerides during fasting☆hormone sentitive lipase
+ stress hormone(catecholamines, glucagons, ACTH)
- insulin endocrinologyUWorld HirotoShishido
β2 receptor effect
what should be careful about with the patient who has both DM and hypertension(protein kinase A blocks ☆myosin light chain kinase in smooth muscle)
smooth muscle cells relaxation
bronchodilation
decrease GI motility
¥decrease uterine tone
secretion of aquaous humor
increase cellular K+ uptake(↓serum pottacium)
☆increase insulin(⇔α2)
☆increase glucose via liver
☆release of glucagon via pancreous
deficient enzyme in maturity-onset diabetes of the young(MODY)
characteristics(若年発症成人型糖尿病)
glucokinase(production of glucose-6-phosphatase from glucose)
mild hyperglycemia that often worsens with pregnancy-induced insulin resistance
☆can maintain very good glycemic control with dietary modification only
patients with MODY are typically younger and nonobese, and the condition is nonprogressive, even without the treatment
not associated with an elevated risk of long term diabetic complications endocrinologybiochemistryUWorld HirotoShishido
counseling on the patents with insulin-induced weight gainReview for changes in diet
☆Ask about hypoglycemic symptoms(may cause patients to attempt to suppress feelings of hypoglycemia)
mechanism of correction of metabolic acidosis by kidney・Increased HCO3- reabsorption
・Increased H+ secretion
・Increased acid buffer excretion: In order to facilitate excretion of much larger amounts of acid, the kidney utilizes acid buffers to trap H+ without markedly lowering urinary pH. The 2 most important acid buffers in urine are ☆hydrogen phosphate (HPO4 2-) and ammonia (NH3). renalendocrinologyUWorld HirotoShishido
hormones which use cGMP for signaling pathwayBAD GraMPa
immunologic/nervous side effects of corticosteroids☆neutrophilia (demargination of neutrophils previously attached to the vessel wall→ neutrophil recruitment to fight infection in tissues is decreased)
areas particulary susceptible to neuropathic ulcersare points of localized pressure created by a shoe or weight-bearing bones of the foot (eg, ☆plantar surface of the first metatarsal head)
A wound in this area often goes unnoticed (due to lack of pain sensation and being hidden by socks orshoes) and can develop into a nonhealing foot ulcer. cardiologyendocrinologyUWorld HirotoShishido
pseudohypothyroidism☆end-organ resistance to PTH
(psudopsudohypoparathyroidism dose not have this resistance but has the same physical findings)
where is preproinsulin synthesized?/
where is it accumulated with the patients with deletion in signal sequences which can be recognized by signal recognition particles(SRPs)RER
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
from what amino acid is thyroid hormone made?Phenylalanine is a precursor to tyrosine, and tyrosine residues are needed to create thyroid hormone biochemistryendocrinology HirotoShishido
