Chat Transcript: Physiology: ENDOCRINOLOGY Oct-5

[Roxanita]

ENDOCRINOLOGY


20:09:45 [acestep1] lets start
20:09:51 [Roxanita] let's start with principles? in hormones
20:09:57 [ninadnashua] YA
20:10:12 [Roxanita] what kind of molecule penetrate the membrane? non polar or polar?
20:10:58 [Roxanita] lipid molecules are non polar
20:11:39 [hutals] lipid soluble
20:11:52 [acestep1] nonpolar?
20:11:55 [hutals] or non polar penetrate
20:12:10 [acestep1] nonpolar
20:12:20 [ninadnashua] YA only lipid soluble like steroids and thyroid
20:12:25 [Roxanita] when we talk about this, a quick mnemonic for me is to think like this: Polar like polite, they wait outside the door
20:12:45 [Roxanita] but non polar as "non polite" they just enter anywhere without asking
20:12:56 [hutals] good one rox
20:13:08 [ninadnashua] good
20:13:08 [Roxanita] so the polar hormones wait outside for its Receptor
20:13:39 [Roxanita] but the non polar as Steroids and Thyroid hormones go inside the cell to its nuclear receptor
20:14:04 [ninadnashua] ya
20:14:16 [Roxanita] therefore, the Lipid solubles hormones have their receptor where?
20:14:44 [ninadnashua] in the nucleus
20:14:45 [hutals] inside the cell in the nucleus
20:15:07 [Roxanita] Name LIPID HORMONES?
20:16:21 [Roxanita] Lipid Hormones like: Thyroid hormones, what else?
20:16:28 [ninadnashua] adrenal and thyroid hormones
20:17:00 [hutals] steroids
20:17:04 [Roxanita] Steroid hormones: androgens, estrogens, progestins, Mineralocorticoids, Glucocort
20:17:20 acestep1 enters this room
20:17:26 [Roxanita] so when they ask in the exam we know what are they talking about , a peptide or lipid hormone
20:17:28 kmonica26 enters this room
20:17:28 [hutals] so which ones are slow and which ones fast?
20:17:59 [Roxanita] the slow ones are the brand new hormones
20:18:31 [Roxanita] lipid soluble, that's why they go to the nucleus to send the message and create new hormone
20:18:37 [hutals] so peptides and proteins are lipid soluble and on the surface while steroids, throid hormones are intracellular and lipid soluble....right?
20:18:38 [Roxanita] Monica, nice to see u
20:18:57 [hutals] yep, lipid soluble is slow and water soluble is fast
20:19:01 [hutals] hey mon
20:19:15 [Roxanita] Peptides are polar or water soluble, they have receptors outside the cell
20:19:25 [Roxanita] on the membrane
20:19:33 [acestep1] lipid slouble ones r slow
20:19:43 [Roxanita] Monica did you bring some questions?
20:20:08 [acestep1] lipid soluble ones r slow
20:20:31 [Roxanita] the water soluble hormones through second messengers act to release hormone that is already made
20:20:47 [Roxanita] yes lipid are slow, remember the chubby guy runs slow
20:21:13 Lorena enters this room
20:21:30 [hutals] hey lorena
20:21:41 [hutals] thats another good one rox
20:22:25 [Roxanita] so the lipid hormone act slow and the water soluble hnes act quickly
20:22:48 [Lorena] jwls cannot come today , asked me to tell you guys but will be here next time
20:23:00 [Lorena] hi ace, roxy , hutals
20:23:05 [Roxanita] which kind of hormone is stored in vesicles?
20:23:11 [Roxanita] Uhm
20:23:12 [acestep1] k
20:23:25 [Roxanita] I will do the transcript today
20:23:41 [Lorena] water soluble
20:23:42 [hutals] water soluble
20:23:44 [acestep1] H2O soluble ones
20:23:45 [Roxanita] which one guys, which kind of hormone is stored in vesicles?
20:23:53 [Roxanita] good, why?
20:24:16 [hutals] i lost my connection yesterday and couldn’t find the transcript....anyone know if it was put up?
20:24:23 [Lorena] cause otherwise would move around everywhere
20:24:32 [acestep1] so they can b sec on stimulus
20:24:49 [acestep1] ic
20:24:52 [hutals] the lipid soluble are made as needed , but water soluble are stored
20:25:05 [Lorena] i left early thats why i didnt post it
20:25:11 [hutals] female patient has increased total T4 and normal TSH.....what is probable etiology?
20:25:19 [Roxanita] there is an exception, the THYROID HORMONES are "stored" CO-VALENTLY, it binds to a protein, taht's the largest reservoir for thyroid hormone
20:25:39 [acestep1] k. thnx
20:26:00 [hutals] thanks rox
20:26:03 [Roxanita] hutals> increase of protein binding?
20:26:37 [Lorena] agree with rox
20:26:39 [Roxanita] the lipid hormones can't be stored because they would croos readily the vesicle membrane
20:26:48 [Roxanita] hutals> what's the reason?
20:26:58 [Lorena] steroids cause that probably she is taking oral contraceptives or she is pregnant
20:27:02 [acestep1] good pt
20:27:20 [Roxanita] What is a "Prohormone"?
20:27:20 [hutals] yes, increased in protein binding, or TBG. Estrogen can cause this....especially in pregnant women
20:27:58 [Lorena] inactive form of a hormon that needs to be cleaved by an enzyme which is usually stored with the prohormone
20:28:08 [hutals] the free T4 would be normal, which is the active form, but the bound and total T4 would be elevated
20:28:11 [Roxanita] for example in pregnant women, they have increase on T4 b/c what Lorena explain in the forum
20:28:42 [Roxanita] Lorena> good
20:29:20 [Lorena] strogens can increase -because of the same raison- steroids, the bound part
20:29:27 [Roxanita] Also Cortisol is binding to a protein: a Globulin
20:29:30 [hutals] so will this patient have signs of hyperthyroid?
20:29:41 [Lorena] cause they are also lipid soluble so need a protein binding like thyroid hormones
20:29:46 [Roxanita] uhu
20:29:51 [Roxanita] no signs,
20:29:51 [acestep1] no- hutals
20:30:05 [Lorena] no, it is only the free hormone who is active hutals
20:30:09 [Roxanita] b/c it's T3 which is the active hormone
20:30:39 [hutals] thats right, the labs might show abnormality, but the free T4 is what really matters, so probably no signs
20:31:05 [Roxanita] Adrenal Androgens? are water soluble?
20:31:07 [acestep1] agree- hutals
20:31:22 [acestep1] no-rox
20:31:33 [Lorena] no lipid solubles
20:31:43 [Roxanita] as we know adrenal androgens are steroids but b/c they conjugate with a Sulphate they become water soluble
20:31:44 [Lorena] they are lipid solubles
20:31:51 [hutals] lipid soluble
20:32:19 [Roxanita] that's how they can be transported through plasma, interesting isn't it?
20:32:33 [Roxanita] b/c they don't have a protein carrier
20:32:43 [Lorena] yes
20:32:52 crusher enters this room
20:32:58 [Roxanita] it's the sulphate their way of transport through blood
20:33:00 [hutals] pt comes in after head injury damaging pit stalk. what hormone is likely to be increased?
20:33:10 [acestep1] ic
20:33:15 [crusher] hi everyone
20:33:31 [hutals] hey crusher
20:33:32 [Roxanita] all water soluble hne are dissolved in plasma?
20:33:32 [crusher] prolactin
20:33:34 [acestep1] hi
20:33:34 [Lorena] prolactin
20:33:41 [Roxanita] hi crusher
20:33:48 [acestep1] prolactin?
20:33:52 [crusher] hi roxi
20:34:02 [Roxanita] yes PRL
20:34:37 [crusher] cos inhibition of inhibitory hormone resukt in inc release
20:34:37 [acestep1] ok illbrb
20:34:42 [Roxanita] because there will be an absence of the inhibitor factor of PRL so PRL will increase
20:34:44 [hutals] if damage to pit stalk, PRL will rise because it is normally inhibited while others are stim by hypothal
20:34:49 [Roxanita] uhu
20:34:58 [acestep1] agree - da inh it
20:35:20 ash enters this room
20:35:25 [acestep1] must say my prayers. brb in 5 mins
20:35:40 [Roxanita] water soluble hormones are ready for use but their action last few seconds but lipid soluble hnes last long, exceptions for both cases?
20:35:42 [hutals] no prob ace
20:35:42 [Lorena] hi ash
20:35:43 [ash] hi all
20:35:50 [hutals] hey ash
20:36:00 [Roxanita] Hi Ash
20:36:04 [ash] what r we discussing 2day?
20:36:11 [ash] hi all
20:36:26 [hutals] endocrine and GI physiology
20:36:37 [hutals] right?
20:36:39 [ash] thanx
20:36:42 [Roxanita] ENDOCRINE AND GASTRO
20:37:04 [hutals] are the hormones in the hypothalamic ant pit water or lipid soluble?
20:37:16 [Roxanita] between the water soluble hormones, which hormone have longest T1/2?
20:37:17 [ash] roxanita can you please change thew color ,i cant read.thanks
20:37:18 [Lorena] water soluble
20:37:48 [Lorena] Anterior= Acuose
20:38:00 [Roxanita] this?
20:38:01 [hutals] hCG?
20:38:15 [ash] good thanks
20:38:18 [Lorena] hCg has the longest
20:38:22 [hutals] they're all water soluble...very good lor
20:39:01 [Roxanita] that's a good reflexion hutals
20:39:47 [Roxanita] between the water soluble hormones, which hormone have longest T1/2?
20:40:10 [Lorena] rox, it is hCG
20:40:12 usmle12004 enters this room
20:40:33 [Roxanita] Lorena> yes
20:40:41 [ash] hi usmle12004
20:40:45 [Roxanita] and between the lipid solubles?
20:40:49 [hutals] hey usmle
20:40:55 [crusher] which hormone is responsible for spermatogenesis.....?
20:40:59 [Roxanita] hi usmle
20:41:01 [Lorena] T4
20:41:01 [hutals] T4 i think
20:41:13 [ash] t4
20:41:21 [Lorena] FSH crush
20:41:30 [Roxanita] yes T4, b/c it has more affinity to its carrier
20:41:35 [Roxanita] yes FSH
20:41:35 [usmle12004] hi guys
20:41:39 [crusher] u got it...its FSH
20:41:43 [usmle12004] u carry on
20:41:46 [Lorena] altought it need testosterone too derived from the laydi cells
20:41:50 [usmle12004] want to join from tommorrow
20:41:59 [usmle12004] am just checking now
20:42:20 [Roxanita] nice to have you here usmle
20:42:39 [Lorena] strogens in a male..where do they derive from?
20:42:57 [Roxanita] what is the rol of the liver related with the hormonal function?
20:43:20 [crusher] converted from testosteron in sertolic cells?
20:43:30 [Roxanita] adrenal gland: Zona RETICULARIS
20:43:39 [ash] agree with crusher
20:43:44 [Lorena] very good crush
20:43:46 [Roxanita] Lorena> is that correct?
20:43:55 [Lorena] and ash
20:44:03 [hutals] testosterone converts to estadiol via aromatase
20:44:07 [crusher] androgens converted into estrogen
20:44:34 [ash] role of liver -proteins formed in liver bind with hormones prolonging their action
20:44:40 [Lorena] yes hutals , in fat tissues
20:44:41 [Roxanita] ok
20:45:01 [ash] rather t1/2
20:45:05 [crusher] yes by aromatase activiuty in adipose tissues
20:45:16 [Lorena] thats why males with obesity can have gynecomastia
20:45:29 [crusher] agree with lorena
20:46:08 [ash] aromatase is also present in sertoli cells
20:46:11 [crusher] a man is taking steroid ,,what will be his steroid and LH FSH level?
20:46:17 [Roxanita] uhu
20:46:38 [Lorena] agree with ash about the role of the liver ,a lso increase solubility of steroids to be eliminated in urine
20:47:13 [Roxanita] hormones from the posterior pituitary?
20:47:16 [ash] sex steroid increased and fsh and lh decreased
20:47:17 [Lorena] LH and FSH would be decreased
20:47:27 [hutals] decreased
20:47:50 [ash] roxanita adh and oxytosin
20:47:51 [Lorena] oxytocin and ADH roxy
20:48:27 [hutals] agree
20:48:31 [crusher] yes inc STEROID and DEC FSH LH from neg feedback
20:48:37 [Roxanita] ok and what is Sheehan SYndrome?
20:48:54 [ash] pituitary infarction
20:49:07 [ash] usually in pregnancy
20:49:10 [crusher] sheehan from the necrosis of ant pitutray...
20:49:19 [Lorena] during pregnancy pituitary is bigger so more susceptible to infarction -sheehan sx is infartion post partum
20:49:29 [ash] therefore decreased pituitary hormones
20:49:35 [Lorena] usually cauze hemorraghe
20:49:49 [Roxanita] why the pituitary is so vulnerable to infarction during delivery?
20:49:57 [hutals] sudden cessation of lactation, hemorrhagic infarction of pit usually related to hypoivolumic episode during delivery
20:50:01 [ash] it is coagulative necrosis
20:50:10 [crusher] if a person is given GnRJH in PULSATILE fashion leevel of STEROID,FSH,LH be???
20:50:21 [ash] increased
20:50:28 [Roxanita] wow ash
20:50:37 [acestep1] fsh lh
20:50:44 [hutals] estrogen inhibits PRL release, delivery of placenta removes inhibition and lactation begins
20:50:53 [Roxanita] coagulative necrosis good
20:50:56 [ash] if continuous then down regulation of receptors and decrease
20:51:08 [Lorena] pulsatile level is like normal , all increased
20:51:12 [ash]
20:51:17 [acestep1] u sure ash .cuz i remb in brain its always liquefactive. can u qoute ur source
20:51:33 [Roxanita] What situations can cause Hyperprolactinemia?
20:52:12 [hutals] pit tumor??
20:52:19 [acestep1] yes- gree with lor
20:52:20 [Roxanita] uhu
20:52:28 [ash] that is the only part of brain with coagulative necrosis as it is derived embryologically from rathkes pouch in mouth .favourite distracter in usmle
20:52:52 [crusher] ye...every thing increase ...
20:52:54 [acestep1] k . thnx
20:52:55 [hutals] birth control pills, hydralazine, H2 blockers
20:52:58 [ash] drugs inhibiting dopamine
20:53:05 [Roxanita] very good ash thanks
20:53:24 [ash] you r welcome
20:53:25 [Lorena] drugs, also reflex
20:53:50 [Roxanita] what is the clinic of Hyperprolactinemia?
20:54:07 [Lorena] hypersensitive nipples can even stimulate the reflex and result in prolactinemia
20:54:33 [crusher] what is the role of iodine in thyroid hormone synthesis?
20:54:33 [Roxanita] really?
20:54:48 [hutals] secondary amenorrhea (PRL inhibits GnRH) , galactorrhea, impotence in males
20:54:55 [acestep1] amnerrhea in f also dec libido n watery discahrge from nipples-
20:55:21 [acestep1] in males i think gynecomastia n sterility
20:55:40 [ash] decreased libido,hypogonadism
20:56:00 [hutals] what is the treatment of hyperPRL?
20:56:11 [Lorena] agree with hutals
20:56:18 [ash] bromocriptine or estrogen
20:56:19 [Lorena] bromocriptine
20:56:20 [acestep1] combs with thyroglobulin n forms mono n di thyroid- crusher
20:56:39 [crusher] bromocriptine is dopamine agonist
20:56:45 [acestep1] agree with lor
20:56:53 [ash] also used in?
20:56:54 [Roxanita] if is a prolactinoma, surgical removal, yes or bromocriptina
20:56:57 [hutals] yes, bromocriptine is a dopamine analogue (inhibits PRL)
20:57:24 [hutals] surgery if sella enlarged as with prolactinoma....very good
20:57:31 [ash] bromocriptine is also used for parkinsonism
20:57:53 [crusher] what is the MOA of propiylthyrouracil?
20:58:12 [Roxanita] crusher> Iodine links with Tyrosine to for monoiodotyrosine?
20:58:39 [acestep1] agree with rox
20:58:44 [crusher] what is the MOA of methamizole
20:58:54 [Roxanita] could you explain the process please crusher
20:58:57 [Lorena] omg
20:59:45 [Lorena] yes, cauze i dont remember
21:00:25 [hutals] inhibits deiodination from T4 to T3
21:00:59 [hutals] is deodination even a word??
21:01:29 [crusher] ok..iodine is first taken up by the tyroid follicle .this iodine is iodinated to thyroglobulin molecule to form MIT or DIt ..which then further release in blood
21:01:39 [Roxanita] ok, Iodide ions: I- are 40x higher in [] than in blood, they enter the follicular cells by losing an e- to Iodine I2
21:02:47 [ash] good job
21:03:01 [Roxanita] Iodine attaches to tyrosine and?
21:03:23 CarlosEnrique enters this room
21:03:34 [Lorena] how would be the levels of T4 in a patient with exogenous intake of anabolics?
21:03:35 [crusher] thyroglobulin ,,,,its attachment with iodine
21:04:01 [Roxanita] yes,
21:04:20 [crusher] i think in anabolic Tsh same and T4 dec?
21:04:37 [Lorena] yes crush very good
21:05:14 [Roxanita] either 1 or 2 iodine attaches to Tyrosine in thyroglobulin to form mono or di iodotyrosine
21:05:21 [ash] total serum t4 will increase,rtu will increase but iodine 131 will be decreased
21:05:49 [Roxanita] Hi Carlos
21:05:57 [ash] will be back in 1/2 an hour
21:06:03 [hutals] increased T4 and decreased TSH and I 131
21:06:09 [CarlosEnrique] Hi roxanita
21:06:24 [hutals] hey carlos
21:06:43 [Lorena] hi carlos
21:06:57 [CarlosEnrique] Excuse me. I´m new here
21:07:05 [Lorena] TSH will remain normal
21:07:27 [CarlosEnrique] I don´t understand very well this chat
21:07:51 [Roxanita] we are talking about thyroid hormone
21:07:54 [hutals] welcome carlos. feel free to jump in whenever or sit back and observe. tonight we're discussing endocrine and gastro physiology
21:08:03 [Roxanita] actions of T3?
21:08:21 [CarlosEnrique] ok, thanks
21:08:26 [Roxanita] where in the cell is the receptor for T3 ?
21:09:07 [Lorena] inside the cell
21:09:31 [acestep1] i think cytoplasm?
21:09:34 [Lorena] because it is lipid soluble
21:09:44 [Roxanita] ok, the receptor for T3 is in the nucleus but it can also bind to the mitochondria and affect its function
21:10:02 [CarlosEnrique] like steroids hormones
21:10:08 [Lorena] cool
21:10:16 [acestep1] ic
21:10:19 [Lorena] thats why regulates metabolism and in thermogenic
21:10:36 [acestep1] yes gd pt lor
21:10:45 [Roxanita] in this case, the mitochondria will: increase cellular respiration, therefroe Increase ATP production, so the rate of heat production will be alseo high, increase in temperature
21:11:13 ggg enters this room
21:11:23 [Roxanita] that's why in hyperthyroidism, the person feels hot all the time
21:11:38 [acestep1] gd pt rox
21:11:43 [hutals] hey ggg
21:12:24 [Lorena] also increases sensitiovuty to cathecolamines so increased HR
21:12:47 [acestep1] agree
21:13:05 [hutals] which vitamin requires thyroid hormones?
21:13:26 [Lorena] vit A
21:13:39 [acestep1] y
21:13:43 [Roxanita] How is the control of secretion of Thyroid hormones?
21:14:12 [acestep1] free t4 levels
21:14:19 [Lorena] hypothyroid patients look pales
21:14:27 [acestep1] -ve feedback
21:14:30 [Lorena] agree with ace
21:14:33 [hutals] thyroid hormones required for conversion of carotene to Vit A and hypothyroid pts can suffer from night blindness and yellowing of skin....right lor
21:15:00 [Roxanita] hutals> oh good, thanks
21:15:03 [acestep1] hey hutals whst teh source of ur last q
21:15:08 [Lorena] T4 but then it is converted in T3 ibn the pituitary
21:15:23 [acestep1] ic. didnt know tht
21:15:43 [CarlosEnrique] hutals> thanks
21:15:46 [acestep1] yes agree- lor
21:15:51 [hutals] k@plan endocrine physiology section (thyroid hormones)
21:16:13 [acestep1] ic . thnx
21:16:53 [hutals] no prob....i actually didnt know that, but thought it would make a good question
21:17:11 [Lorena] excellent q's huts
21:17:21 [acestep1] yes . it was a v gd q
21:17:33 [acestep1]
21:17:37 [Roxanita] talking about Thyroid Gland, what other hormone id produced by this gland?
21:18:03 [hutals] now ur making me blush
21:18:10 [acestep1] calcitonin
21:18:30 [acestep1] lol
21:18:34 [Roxanita] where in the thyroid?
21:18:35 [Lorena] yes agree with ace
21:18:42 [Lorena] C cells
21:19:09 [acestep1] yes. agree with lor
21:19:24 [Roxanita] if you have a microphotograph how do you recognize this 2 different cells
21:20:06 [Lorena] i dont know...how?
21:20:18 [acestep1] same here
21:20:55 [Lorena] because they are not in follicles? they are parafollicular...
21:21:09 [Roxanita] the cells responsible for thyroid hne are FOLLICLES and surrounding them are the Parafolllicular cells
21:21:25 [hutals] calcitonin is a tumor marker for medulary carcinoma
21:22:09 [Lorena] thanks
21:22:19 [Roxanita] I see it like the leydig cells; the follicles are like seminal tubules
21:22:47 [Roxanita] And what this PARAFOLLICULAR or C cells produce?
21:23:12 [hutals] synthesize calcitonin
21:23:15 [acestep1] ok yes. got it!- rox . thnx
21:23:39 [Roxanita] yes as we know the C is CALCITONIN
21:23:54 [Lorena] ok
21:24:15 [Roxanita] just be ready to recognize the colloid inside the Follicles
21:24:19 [acestep1] hey rox 2 add i think pink thing in teh follicle n the cells will b low cuboidal- col - if teh cell v active then large nuclues as well
21:24:25 [Roxanita] CALCITONIN, which main action is?
21:24:43 [Lorena] deposition of calcium
21:24:52 [acestep1] move ca in2 teh bones
21:24:58 [hutals] lowers Ca in plasma
21:25:17 [hutals] by decreasing cone resorption
21:25:34 [hutals] i mean bone, not cone
21:25:39 [Roxanita] I have this CALCI TONIN... TONes the CALCIUM
21:25:41 [acestep1] agree with hutals
21:26:12 [Lorena] bone resorption?
21:26:21 [hutals] another good one rox...keep em comin
21:26:40 [Roxanita] for that it needs to get the calcium somewhere:
21:26:53 [acestep1]
21:27:22 [hutals] it lowers the plasma calcium by decreasing the activity of osteoclasts, which then decreases bone resorption
21:27:37 [hutals] that should be reabsorption i guess
21:27:46 [Roxanita] hutals> good
21:28:02 [Lorena] oh ok, decreases bone resorption then
21:28:13 [acestep1] k
21:28:30 [Lorena] i didnt see that part sorry
21:28:55 [Roxanita] and the opposite to Calcitonin?
21:29:13 [Lorena] does calcitonin have any clinical use?
21:29:16 [hutals] PTH??
21:29:20 [Lorena] PTH is the opposite
21:29:28 [Roxanita] yes
21:29:56 [acestep1] yes- in osteoporosis
21:30:03 [Lorena] good
21:30:23 [acestep1] thnx
21:30:26 [Roxanita] what is the main function of PTH?
21:30:56 [acestep1] inc s. ca
21:31:14 [Lorena] increase free calcium
21:31:16 [Roxanita] there is an N* question on the forum about it, I put some graphics on the answers if you guys want to check it
21:31:24 [acestep1] inc vit d ( active ) , inc ca absp from dcts
21:31:45 [acestep1] n mobilizes ca from bones
21:31:45 [hutals] raise free Ca
21:31:59 [acestep1] . thnx
21:32:06 [Lorena] and dump phosphate
21:32:24 [hutals] yes, btw rox.....those are some excellent questions and pics that you've been posting
21:32:28 [hutals]
21:32:28 [acestep1] . agree
21:32:35 [Lorena] PTH : Phosphate Trashing Hormone
21:32:51 [Lorena] yes rox, i love those q's
21:33:02 [acestep1] lol. good one lor
21:33:21 [acestep1] ill lk as well after we r done
21:33:39 [Lorena] it is in f irst a id
21:34:50 [Lorena] so in all primary disorders calcium and phosphate go in opposite directions...what is the exception?
21:35:10 [Roxanita] q: A 46 y.o. woman presents to your office with mood swings, hot flashes, night sweats and absence of menses for the last 4 months. A pregnancy test is neg. Which test do you ask next?
21:35:46 [acestep1] dunno - lor
21:36:08 [acestep1] hrt
21:36:33 [acestep1] imean these r post menopiuasal s/s- rox
21:36:34 [hutals] FSH
21:36:38 [Roxanita] ok, let's see this case...
21:36:52 [Lorena] FSH , LH
21:36:57 [acestep1] k
21:37:07 [Roxanita] woman with classic menopausal symptoms, decline of Estrogens...
21:37:22 [Lorena] in renal failure
21:37:23 [acestep1] agree
21:37:28 [Roxanita] FSH and LH will both be increased
21:37:46 [acestep1] k
21:37:52 [Roxanita] we ask for both, is that right?
21:37:56 [acestep1] thnx
21:38:26 [hutals] the FSH i think is more sesitive because inc LH could be part of ovulation
21:38:55 [acestep1] agree with hutals
21:38:56 [Lorena] but you dont have ovulation in menopause
21:39:07 [hutals] the FSH increases much more than LH, but both increased (no surge seen with LH)
21:39:34 [Roxanita] 2 y.o. boy is seen for failure to thrive, he has abnormal frontal bossing, wrist deformities and bowing of the legs. His social history is significant for both the father and mother working night shifts at the local sewer plant and sleeping throught the day with the child. The child is DX
21:39:58 [hutals] right, but you are trying to rule out other causes, so increase LH can be from ovulation and other causes, but increased FSH is more specific
21:40:14 [Lorena] rickkets
21:40:22 [Roxanita] DX with RICKETS, which is a deficiency of VitD. The active form of Vit D, 1-259OH)2 has the property of?
21:40:47 [hutals] agree, rickets
21:40:53 [Lorena] increase absorbtion in small inetstine of calcium and phosphate
21:41:01 [Roxanita] it was in a question in the forum, similar though...
21:41:06 [Roxanita] Lorena> right
21:41:45 [ash] also increased reabsorption by renal tubules
21:41:51 [Roxanita] Vit D incr resorption of bone and it boosts intestinal phosphate and calcium absorption.
21:42:01 [hutals] menopause mneumonic is HAVOC....Hot Flashes, Atrophy of Vagina, Osteoporosis, Coronary artery disease
21:42:09 [Lorena] yes , with PTH present
21:42:34 [Roxanita] Vit D also incr renal reabsorption of phosphate and calcium.
21:42:53 [Lorena] diff between cushing syndrome and cushing disease?
21:42:59 [Roxanita] hutals> hey thanks
21:42:59 [acestep1] agree
21:43:37 [acestep1] d/s- pitutary cause synd - many causes
21:44:01 [Roxanita] acestep1> agree
21:44:23 [Lorena] yes
21:45:09 [Roxanita] VitD sx is stimulated by a decrease in serum Ca, an increase in PTH or a decrease in serum phosphate
21:45:27 [ash] acth level in syndrome is raised and in disease is low
21:45:37 [Lorena] where in the kidney is this ca and phosphate reabsorption takes place?
21:45:39 [Roxanita] A lack of Vit D causes what in children? and what in adults?
21:45:43 [acestep1] i think all 3
21:46:00 [Lorena] rickets in children, osteomalacia in adults
21:46:07 [ash] receptors for parathyroid hormone are located on which bone cells?
21:46:09 [hutals] rickets and osteomalacia
21:46:15 [acestep1] agree- ash
21:46:30 [acestep1] agree- hutals
21:46:38 [ash] calcium in proximal tubule and phosphate in distal
21:46:50 [hutals] on osteoblasts
21:47:01 [ash] right hutals
21:47:01 [acestep1] i think for po4 - pcts?
21:47:17 [Lorena] good ash , that is the only hormonal action in the proximal tubule
21:47:23 [hutals] What 2 conditions other than pregnancy increase hCG?
21:47:28 [acestep1] ic
21:47:52 [ash] sorry it is calcium in distal and phosphates in proximal
21:48:02 [Lorena] mola
21:48:03 [acestep1] molar preg n chorioca
21:48:19 [acestep1] yes thts wht i remb- ash
21:48:43 [Lorena] agre with ace
21:48:50 [hutals] agree, PTH increases ca reabsorption in distal tubule and decreases phosphate reabsorption in proximal tubule
21:49:01 [CarlosEnrique] see you tomorrow
21:49:08 [hutals] yep, Hydatidiform moles in women or choriocarcinoma
21:49:17 [hutals] bye carlos
21:49:19 [Lorena] yes, sorry for the mix
21:49:26 [ash] remember p and p phosphate in proximal
21:49:27 [Lorena] bye carlos see you
21:49:33 [Roxanita] oh carlos, tomorrow we have Immuno
21:49:43 [acestep1] ok . always remb way po4 always lost or absp from pcts
21:49:48 [Roxanita] IMMUNO for wednesday, thrusday and friday
21:49:53 [ash] bye carlos
21:49:58 [acestep1] good 1 ash
21:50:09 [Lorena] thanks ash
21:50:11 [acestep1] k
21:50:29 [ash] roxanita i liked your idea for everyday discussions a lot.it helps with the studies
21:50:32 [Roxanita] that's a good one aces: PO4 leaves or come through Pct
21:50:50 [hutals] i apologize in advance that i can't make it on thurs this week and all of next week . but i will be here on other days
21:50:59 [Roxanita] PO4--Proximal good
21:51:03 [Lorena] why people with cushing have that appearance?
21:51:19 [Lorena] i wont come this week but i will see you next one
21:51:27 [ash] redistribution of fat occurs
21:51:38 [acestep1] awww- well miss u lor
21:51:54 [Lorena] thanks ace
21:51:57 [acestep1] agree with ash
21:52:08 [acestep1]
21:52:15 [Roxanita] Lorena> we will miss u
21:52:28 [ash] yeah
21:52:30 [hutals] this is why its important to keep the group large so that we it won't have too much impact when we can't make it. please be sure to leave a post on other sites every once in awhile so that new ppl can always join
21:52:40 [Lorena] yes , redistribution of fat because hyperinsulinemia
21:52:56 [Roxanita] I promise I will come
21:53:06 [acestep1] k
21:53:20 [acestep1] lol
21:53:36 [ash] adrenal hormone essential for survival?
21:53:40 [acestep1] ill try my best 2 come on tiem as well
21:53:41 [Lorena] and because of increasec cortisol , movilization of proteins so they have thin limbs
21:54:00 [acestep1] k.
21:54:00 [Lorena] aldosterone is essential
21:54:02 [Roxanita] Cortisol prevents the synthesis of prostaglandins by blocking which enzyme?
21:54:11 [hutals] i usually post reminders on other sites, but wont be able to next week, if someone can fill in for me that would be great
21:54:14 [acestep1] agree- lor
21:54:16 [ash] i am not missing immunology either
21:54:35 [acestep1] phospoholipase a2 n cox
21:54:36 [ash] cyclooxygenase
21:54:48 [Lorena] phospholipase?
21:55:17 [Lorena] why cushing people have blue striae?
21:55:18 [Roxanita] Steroids inhibit PHOSPOLIPASE A2, while NSAIDS inhibit Endoperoxide SYnthase
21:55:23 [Roxanita] Lorena> Good
21:55:39 [Lorena] thank you
21:55:49 [acestep1] thin skin
21:57:04 [Lorena] because synthesis of proteins is decreased due to cortisol, collagen is defficient so inestability = striae and they are blue because there is purpura inside the striae
21:57:17 [Lorena] i mean purple
21:57:30 [hutals] ruptured blood vessels in stretch marks, coritsol weakens collagen
21:57:56 [acestep1] agree
21:58:10 [Lorena] very good hutals...you guys have been listening to g ol ja n
21:58:16 [Roxanita] Estrogen is responsible for all the following except: a) breast development; b) maintaning pregnancy; c) maturation and maintenance of fallopian tubes, uterus , cervix and vagina; d) both neg and posit feedback effects on FSH and LH secret e)increasing the uterine treshold to contractile stim durin
21:58:24 [Roxanita] during pregnancy
21:58:46 [hutals] yep, gol jan is incredible!
21:59:07 [acestep1] maintaining preg
21:59:11 [Lorena] is it b?? i am not sure
21:59:23 [hutals] B maintaining pregnancy
21:59:23 [ash] which of the 2 hormones estrogen and progesterone is responsible for water retention.what is the mechanism?
22:00:19 [acestep1] estro
22:00:30 [Lorena] estrogen? because estrogen increases sx og proteins in liver that helps maintain oncotic pressure?
22:00:37 [Roxanita] ash> estrogen?
22:01:14 [Roxanita] Lorena> good
22:01:22 [ash] estrogen is right
22:01:34 [Roxanita] the answer is e)
22:01:43 [ash] i dont know the mechanism but lorena's answer sounds good
22:01:53 [Roxanita] rogen decreases the uterine treshold to contractile stimuli during pregnancy
22:02:11 [Lorena] thanks rox
22:02:17 [Roxanita] Estrogen
22:02:55 [hutals] yes but progesterone is responsible for maintenance of pregnancy.....right?
22:02:57 [Lorena] ok i have to go , it was a great chat today guys thank you very much and i will see you next week
22:03:15 [acestep1] hey rox i thought prog did tht
22:03:16 [hutals] nite lor
22:03:19 [Roxanita] what is the action of Estrogen replacement therapy?
22:04:21 [Roxanita] bye ash, thanks
22:04:33 [Roxanita] Bye Lorena, thanks for the pearls
22:05:06 [acestep1] pearls rox?
22:05:41 [Roxanita] she said many interesting things
22:06:05 [acestep1] yes. agree
22:06:46 [hutals] What effect does progesterone have on FSH? or LH?
22:06:55 [Roxanita] Estrogen replacement therapy after menopause has all the following effects except: a)increasing risk of breast cancer b) decrease risk of heart disease c) decrease hot flashes d)delaying osteoporosis
22:08:21 [acestep1] i think LH?
22:08:36 [acestep1] no i think both
22:08:56 [hutals] a is my guess
22:08:57 [acestep1] via GnRH
22:09:17 [hutals] Progesterone is inhibitory to both Gonadotrophins
22:09:19 [Roxanita] hutals> negative feedback is on both through GnRH
22:09:39 [acestep1] agree
22:09:54 [acestep1] hey I’m tired
22:10:13 [hutals] progesterone will inhibit both LH and FSH
22:10:15 [acestep1] ill cu guys later
22:10:28 [Roxanita] this question is from board simulator and the answer for them is a)increasing risk for breast cancer
22:10:33 [hutals] nite ace
22:10:35 [acestep1] k
22:10:47 [acestep1] gn hutals
22:11:58 [acestep1] take care
22:12:02 [Roxanita] well guys I think we should move faster on the chat because people is staying for only 2 hours
22:12:25 [Roxanita] guys bring your questions and let's move fast on next chats
22:12:32 [hutals] if its every day, maybe 2 hrs is better than 3?? what do you think?
22:12:48 [Roxanita] yeah, you've got a point, 2h will be fine
22:13:26 [Roxanita] ok from now the chats will be from 8 to 10 (eastern time)
22:13:28 [hutals] i'll stay 2 or 3, both good for me.....just a suggestion since many ppl left after 2 hrs??
22:15:25 [Roxanita] ok, I will post the chat
22:15:42 [hutals] ok rox....ur doing a great job!!! nite and thx
22:15:52 [Roxanita] ok guys for tomorrow we have IMMUNOLOGY
22:16:09 [Roxanita] c u guys tomorrow, Good night, thanks everybody.