Unit 7 SIGs Cases 1-6 | Baamboozle - Baamboozle | The Most Fun Classroom Games!

Describe the physiology of achieving and maintaining erection (U7W3 SIGS 7.3b).

parasympathetic-> release acetylcholine-> incr endothelial nitric oxide-> activates guanylate cyclase-> incr cGMP-> decr intracell. free Ca2+-> sm. muscle relax

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Rationalize the use of 24-hour urine free cortisol (UFC), late-night salivary cortisol and the low-dose overnight dexamethasone suppression test (DST) in the screening for Cushing syndrome. (SIGs 7.2b)

24 hour: cortisol over time (most accurate); late-night: cortisol usually lowest then; Low dose dexameth.: should suppress cortisol (high= cushing)

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Contrast primary and secondary hypogonadism and correlate them to low testosterone. (SIGS 7.3b)

Primary: issue w/ gonads-> decr. testosterone production; Secondary: issue w/ ant. pituitary-> decr. LH & FSH production

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Explain how hypercortisolism led to the development of thin extremities and easy bruising (Wild Card WFA 7.3)

Glucocort-protein metabolism: decr protein synthesis& incr protein breakdown;Chronic + ->lean muscle loss;cortisol inhibits fibroblast prolif & collagen->bruise

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thief

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rocket

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rocket

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baam

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Evaluate lifestyle and integrative approaches to bone health, including vitamins, minerals, specific medicinal foods (fish; soy; tea), weight-bearing exercise, and mind-body techniques.

See image

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Contrast alterations in blood and urine levels of calcium, phosphate, vitamin D, and alkaline phosphatase in hyper- and hypoparathyroidism. (SIGS 7.1a)

Hypo: Ca+ low, Vit. D. low, alk phos low, phosphate high, PTH low ;hyper: Ca+ high, Vit D high, alk phos high, phosphate low, PTH high

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Describe the role of Sertoli cells in providing immune protection to the developing sperm (Wild card WFA 7.3)

Sertoli cells protect germ cells by forming the so-called blood-testis barrier with tight junctions between adjacent Sertoli cells.

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Describe the effect of an anterior pituitary adenoma on regulation of the hypothalamic-pituitary (HP) axis (SIGS 7.1b).

producing tumors = effects of the overproduced hormone, smaller size (i.e. prolactinoma); non-producing tumors = mass effects, larger size

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Describe the clinical features of symptomatic male hypogonadism (U7W3 SIGS7.3b).

decreased libido, fewer spontaneous erections, fatigue, hot flashes, depressed mood, difficulty w/ concentration, decr. muscle mass

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seesaw

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fairy

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gift

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lifesaver

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Review pharmacological agents to manage osteoporosis in patients with hyperparathyroidism and hypoparathyroidism. (SIGS 7.1a)

hyper: bisphosphonate (pyrophosphate analogs that bind to hydroxyapatite binding sites to reduce bone resorption); Hypo: teriparatide- promotes bone growth; PTH

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monster

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rocket

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rocket

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banana

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Explain how the hormonal contraceptive progestin, alone and in combination with estrogen, prevents conception. (SIGS 7.3a)

Combo: Estrogen: inhibits FSH release ant. pit.; progestin: thickens cervical mucus-> decr. sperm penetration; progestin only: suppress GnRH, LH & FSH

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Describe the endocrine disorders seen in MEN-1, including clinical features and morphologic findings of affected organs (SIGS 7.1b).

3P's: Primary hyperparathyroidism (hypercalcemia, nephrolithiasis), Pituitary adenoma (varies), Pancreatic tumors (gastrinoma is most common; gastric ulcers)

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Classify the ACTH-dependent and ACTH-independent endogenous causes of Cushing syndrome. (SIGs 7.2b)

Dependent: high ACTH, high cortisol (Cushing Disease)- pituitary adenoma ; Indep: low ACTH, high cortisol (Cushing's syndrome)- adrenal adenoma/corticosteroids)

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