1 Endo T Flashcards

1
Q

What are leptin’s effects on menstruation?

A

Decreased leptin from decreased fat tissue can inhibit GnRH pulsatile release causing decreased LH and FSH causing decreased estrogen causing amenorrhea. Called functional hypothalamic amenorrhea

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2
Q

What causes delayed puberty with anosia?

A

Kallman syndrome due to defective KAL-1. GnRH can’t migrate from origin in olfactory placode. Commonly see midline defects.

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3
Q

Where is the Sup. Thyroid Art. from and what nerve runs with it?

A

The STA is from the ext. carotid and runs with the external branch of the superior laryngeal nerve (innervates the cricothyroid mm) which is at risk during thyroid surgery.

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4
Q

What do Hurthle cells look like and what do they indicate?

A

They are large oxyphillic cells with granular cytoplasm and are a sign of Hashimoto’s which has mononuclear infiltrate consisting of lymphocytes/plasma cells/germinal center formation

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5
Q

What are the serum Ca/PO4 and PTH levels in Vit D deficiency?

A

serum Ca/PO4 are both low and PTH is high

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6
Q

What do LH and FSH stimulate respectively in males?

A

LH stimulates Leydig cell production of testosterone and FSH stimulates inhibit B from Sertoli cells.

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7
Q

What does the triple test look for?

A

AFP/estrdiol/hCG
AFP is synthesized early in gestation
Estradiol can be low in placental deficiency
hCG is elevated in hydidaform mole and choriocarcinoma

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8
Q

What are the side effects of steroids?

A

testicular atrophy, acne, erythrocytosis

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9
Q

Most common cause of death in diabetics?

A

MI

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10
Q

Classic galactosemia is a lack of what enzyme?

A

galactose-1-phosphate uridyl transferase

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11
Q

Craniopharyngeoma results from what and how do they appear?

A

They appear as solid, cystic, and calcified. They also arise from the Rathke pouch remnants from pharyngeal roof

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12
Q

What enzyme allows export of glycerol from adipocytes?

A

glycerol kinase (key in DKA states with elevated glucose)

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13
Q

What enzyme is deficient in orotic acuduria?

A

UMP synthase

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14
Q

Biotin is commonly in what type of enzymes?

A

Carboxylase enzymes

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15
Q

What is Laron dwarfism and what do you see?

A

Faulty GH receptor with elevated GH and low IGF-1

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16
Q

What is a metyrapone stimulation test?

A

tests HPA by blocking 11-B hydroxylase which stops cortisol synthesis leading to ACTH increase

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17
Q

What ANS receptors are on beta cells in the pancreas?

A

M3 stimulates; a2 inhibits; B2 stimulates

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18
Q

What does pomps disease present with and why?

A

defect in alpha-glucosidase which breakdown glycogen in acidic lysosomes. defect leads to a accumulation which can interfere with contraction in mm and myocytes. cardiomegaly and macroglossia occur

19
Q

What can cause serine residue phosphorylation and what is the significance?

A

TNF-a and insulin insensitivity

20
Q

What is a big difference in carcinoid and pheochromocytoma presentation?

A

Carcinoid - facial flushing HYPOtension

Pheo - HTN tachycardia

21
Q

Damage to post. pit. causes what?

A

transient central DI; permanent is from hypothalamic nun damage

22
Q

Which long acting insulin has a peak?

A

Detemir

23
Q

What enzyme is linked to MODM of the young?

A

glucokinase

24
Q

What are T3 levels like in early Hashimoto’s?

A

normal; don’t decrease until late stage disease

25
Q

Estrogen’s effects on a child’s growth?

A

precocious puberty but can cause premature epiphysis plate closure

26
Q

What enzyme is missing in essential fructosuria and what enzyme can fill in?

A

fructokinase; hexokinase

27
Q

What are the signs of zinc deficiency?

A

erythematous skin lesions occurring around body orifices, vascular and pustular w/o central clearing. hypogonadism, azoospermia, night blindness, hair loss

28
Q

What are the signs of glucagonoma?

A

necrolytic migratory erythema commonly on the perineum, extremities, and face. DM. elevated glucagon

29
Q

What is the most common enzyme deficiency in ketogenesis pathway and how will hit manifest?

A

acyl-CoA dehydrogenase and it will show as a hypoketoic hypoglycemia

30
Q

How do prolactinomas cause amenorrhea?

A

Prolactinoma suppresses GnRH which suppresses LH/FSH -> Estrogen

31
Q

What GI symptoms accompany hyperparathyroidism?

A

Peptic ulcer disease

32
Q

What do neurophysins do?

A

carry ADH and oxytocin from hypothal to post. pit.

33
Q

TzDs mechanism of action

A

PPARa upregulates GLUT4 and adiponectin

34
Q

Aldo’s effects on bicarb and Cl-?

A

Aldosterone promotes H+ secretion so w/o you’ll get non-gap metabolic acidosis with decrease in bicarb and compensatory Cl- retention

35
Q

What is MEN2 and what are the derivatives?

A

From neural crest and include medullary thyroid, pheochromocytoma, parathyroid

36
Q

Where are the two types of 5a-reductase located?

A

Type 1 - post pubescent skin

Type 2 - genitals

37
Q

How are LH and FSH suppressed respectively?

A

LH - androgens; FSH - Inhibin B

38
Q

Explain DeQuervain’s thyroiditis

A

Painful enlargement of thyroid; follow viral illness; transient hyperthyroidism due to release of thyroid hormone; initial neutrophil infiltrate followed by lymphocytic infiltrate

39
Q

Medullary thyroid cancer arises from what cells?

A

calcitonin-secreting C-cells leading to amyloid deposition

40
Q

What is the mechanism of amenorrhea of skinny girls?

A

Hypothalamic suppression

41
Q

What step in TCA cycle is inhibited in chronic alcoholics and why?

A

a-ketoglutarate b/c it takes thiamine

42
Q

What makes Epinepherine?

A

PMNT converts NE to E and is unregulated by cortisol

43
Q

What are some symptoms of hypothyroidism?

A

fatigue, weight gain, myxedema, elevated CK

44
Q

Symptoms of SIADH?

A

Euvolemic Hyponatremia; RAA is shut off and ANP is turned on