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59 Cards in this Set
- Front
- Back
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Where is leptin from?
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fat cells
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What does leptin do?
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Appetite suppressor.
Wt. loss leads to leptin deficiency and increased appetite. |
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Where is adiponectin from?
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fat cells
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What does adiponectin do?
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stimulates fatty acid oxidation.
Liver: Decreases fatty acid influx, decreases trigyceride content; glucose production - protects from metabolic syndrome |
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Where is ghrelin from?
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empty stomach before a meal
arcuate nucleus of hypothalamus |
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What does Ghrelin do?
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appetite stimulator (orexigenic effect)
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Where is peptide YY from?
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ileum and colon
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What does peptide YY do?
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Satiety signal
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What does free IGF-1 cause?
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fetal macrosomia
Promotes cancer growing, aging |
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What does the increased estrogen in hyperinsulinemia cause?
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promotes endometrial and breast cancer
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What is metabolic syndrome?
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HTN + DM + high cholesterol
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Which cancers are strongly associated with obesity?
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Colon cancer
Endometrial cancer Prostate cancer Esophogeal Adenocarcinoma Gallbladder cancer Renal cell carcinoma |
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What is panniculitis?
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bacterial infection extending to subQ tissues of abdominal fat apron
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What is a diabetic HbA1C?
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>6.5%
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What is considered a diabetic fasting glucose level?
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=/>126
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Which drugs can cause secondary DM?
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glucocorticoids
protease inhibitors thiazides Beta andrenergic agonists |
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What are the genetic indications of Type I DM?
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HLA-DR3
HLA-DR4 CTLA-4 |
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What are the 3 mechanisms that interact to make DM-I?
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beta cell destruction (autoimmune)
Genetic susceptibility (HLA-DR3, HLA-DR4, CTLA-4) Environmental factors (viruses, drugs, etc) |
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What is the defect in MODY-2?
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Glucokinase deficiency - leads to increased blood glucose threshold for insulin release from the beta cells
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What are the mechanisms of vascular disease in DM?
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formation of advanced glycation end products (AGE)
Activation of protein kinase C Intracellular hyperglycemia with disturbances in polyol pathway |
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What do AGE's have to do with DM?
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AGE's are resistant to proteolytic digestion and are involved in atherogenesis, microangiopathy (nephropathy and retinopathy)
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What does activation of PKC in DM do?
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results in increased VEGF (diabetic retinopathy)
among others Prothrombotic (increased PAI - inhibitor of fibrinolysis) |
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What does the polyol pathway have to do with DM?
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involved in metabolic pathway in tissues that does not require insulin for glucose transport:
- nerves, lenses, blood vessels Increases susceptibility to oxidative stress (free radical injury) Major pathway of glucose neurotoxicity |
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What is the specific lesion of the kidney for DM?
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Kimmelstiel Wilson lesion
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What is Whipple's Triad? What malignancy is it related to?
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Insulinomas
1. hypoglycemia 2. CNS sx: confusion to unconsciousness 3. Attacks precipitated by fasting, exercise; relieved by glucose |
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What is Zollinger Ellison Syndrome?
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gastrin-producing tumor
may be in duodenum, peripancreatic tissue or pancreas |
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What is the weird symptom in a somatostatinoma?
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hypochlorhydria
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What lab(s) reflect glomerular function?
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GFR and protein in the urine
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What lab(s) reflect tubular reabsorption (concentrating ability)?
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specific gravity
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Describe atheroslerotic retinopathy.
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silver wire arteries
hemorrhages |
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Describe HTNsive retinopathy.
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cotton wool exudates
flame-shaped hemorrhages papilledema |
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What will a CXR of a uremic pt show?
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hilar pneumonitis - "bat wing" opacity
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What is the abnormal histology that is seen in multicystic renal dysplasia?
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cartilage
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What condition is a complication/feature of Adult Polycystic Kidney Disease?
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Berry Aneurysm
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Word associations:
Patchy Ischemic Atrophy :: |
Benign Nephrosclerosis
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Word association:
Fibrinoid necrosis of arterioles :: |
Malignant hypertension/malignant nephrosclerosis
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What is the gross appearance of the kidney in malignant hypertension?
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flea-bitten appearance to kidney surface
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What is the microscopic appearance of the kidney in malignant hypertension?
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Onionskin hyperplasia
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What is the common Xray finding in fibromuscular dysplasia?
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beaded appearance of renal artery
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What is the characteristic finding in thrombotic microangiopathies?
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eosinophilic hyaline thrombi
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What factor is deficient in TTP?
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protease ADAMTS-13
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What renal lesion is seen in Sickle Cell?
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Papillary necrosis
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What are the associations of papillary necrosis of the kidney?
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SODA
Sickle cell Obstruction DM Analgesic nephropathy |
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What causes diffuse cortical necrosis?
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Follows septic shock*
obstetric emergencies (abruptio placenta) |
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What are the associations of cystine stones?
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liver disease
genetic defect in renal reabsorption of amino acids |
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What is Fanconi Syndrome?
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Acute lead poisoning in children (tubular damage: aminoaciduria, phosphaturia, and glycosuria)
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What is Minimata disease?
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CNS toxicity related to mercury poisoning - mad as a hatter!
- muscle tremors - dementia - gingivitis - cerebral palsy - mental retardation |
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Which renal cell carcinoma has best prognosis?
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chromophobe renal cell
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Which renal cell carcinoma has the worst prognosis?
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collecting duct (Bellini Duct) carcinoma
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Which renal cell carcinoma is the most common?
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clear cell carcinoma
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What is the classic triad for renal cell carcinoma?
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CVA pain
palpable mass hematuria |
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What are the 2 major histological characteristics of progressive renal damage?
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1. focal segmental glomerulosclerosis
2. Tubulointerstitial inflammation and fibrosis |
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Word association.
Rapidly Progressive GN :: |
Crescent
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Word association.
Membranous GN :: |
Subepithelial deposits
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What are Tamm-Horsefall proteins?
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eosinophilic hyaline casts - seen in acute kidney injury
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What distinguishes Tubulointerstitial Nephritis from glomerular disease?
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Absence of nephritic/nephrotic syndromes and presence of defects in tubular function
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What pathogen may cause pyelo in kidney allografts?
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Polyoma virus
tx = reduction in immunosuppression |
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What group of drugs cause acute drug induced interstitial nephritis?
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synthetic penicillins
sulfonamides |
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What complication may occur in a small percentage of analgesic nephropathy patients?
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Transitional papillary carcinoma
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