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ENDO Flashcards

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1
Q

Endocrine glands mostly do what

A

Provide homeostasis

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2
Q

How do hormones circulate

A

Free and Bound

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3
Q

What form of hormones are the bio active from found in plasma

A

Free

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4
Q

What are 3 responsibilities of hormones

A

Cell metabolism
Growth
Reproduction

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5
Q

What is important about polypeptides

A

Large lipid insoluble molecules that elicit a cascade of events

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6
Q

Steroid’s have what characteristics?

A

Small lipid soluble molecules that elicit a response

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7
Q

Increased hormone does what the synthesis and production, as an example of what

A

Decreases

Negative Feedback

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8
Q

What is an example of positive feedback

A

Increased levels stimulate an inhibitor to decrease levels

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9
Q

What is primary hyper function

A

Stimulation within the hormone secreting gland

Ex: T3/T4

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10
Q

What is secondary hyper function

A

Stimulation of pituitary gland or hypothalamus

Ex: TSH

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11
Q

What is ectopic hyper function

A

Hormone secreted from tissue other than a usual source.

Ex: Small cell Lung cancer ADH or Cortisol

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12
Q

What is resistance hypofunction

A

Unable to target tissue that recognizes the hormone = decreased response

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13
Q

What is an adenoma?

2 examples

A

Benign enlargement of a gland

  • could be malignant
  • could be salt secreting
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14
Q

Whwhat is the definition of hypoplasia

A

Under or incomplete development (congenital)

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15
Q

What is an example of initial tests for hypothyroidism

A

TSH
Primary = Low
Secondary = High

W/ low T3/T4 in both cases

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16
Q

What is the axon terminal of the hypothalamic neuron

A

Posterior pituitary

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17
Q

ADH is AKA

A

Vasopressin

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18
Q

4 main mechanisms of ADH

A

V1 = contracts smooth muscle

V2 = retian water in the body

Collecting duct increases water content, decreases urine volume

Acts on the renal tubule to concentrate the urine

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19
Q

What are the regulating receptors of the posterior pituitary (2)

A

Osmoreceptors

Baroreceptors

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20
Q

When ADH is released osmolality increases causing what two things?

A

1) decreased production of urine

2) thirst center activation

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21
Q

Increased serum sodium does what two things?

A

Causes

Hypovolemia and Hypotension

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22
Q

Drugs that can increase serum NA (4)

A

MDMA
NSAIDs
Amiodarone
Neuroleptics

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23
Q

Inhibition of ADH does what? (2)

A

Causes :
low plasma osmolality
High normal Bp and Volume

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24
Q

What is ETOHs effect on NA

A

Diuretic that inhibits Na release

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25
Which is the most sensitive osmo or baro receptors
OSMO
26
Wha this the job of the osmoreceptors
Detect an increase in osmotic pressure
27
What is the job of the baroreceptor?
Detect decreased Bp
28
When ADH is released what is its affect on blood vessels and the kidneys
Blood vessels constrict | Kidneys increase reabsorption of water
29
What are two ADH disorders
SIADH | Diabetic Insipidous
30
What is the patho of SIADH
Excess amounts of ADH without osmotic stimulus
31
What are initial findings of SIADH
Normal plasma volume with normal osmolality
32
What are lab manifestations of SIADH (4)
Low plasma osmolality Low serum sodium High Urine specific gravity (inc concentration)-THICK PEE High urine Na+
33
Is there edema with SIADH
Despite water retention there is not much edema
34
What is the serum NA in SAIDH
Low serum NA+
35
What does low NA+ due to cells?
Shifts fluid from extra cellular to inside the cells
36
What are 4 etiologies for SIADH
CNS or Lung D/O Malignant Ectopic ADH Drugs OTher
37
What 4 CNS disorders are associated with SIADH
``` Stroke Subarachnoid hemmorage Meningitis / encephalitis Trauma Brain tumor ```
38
3 causes for a pulmonary etiology of SIADH
TB PNA Neoplasms
39
What is associated with tumors that are secreted by ectopic ADH
Small Cell Cancer
40
What can help you find small cell cancer lesions
CT/MRI of the chest
41
What 3 sxs would cause you to do a CT/MRI of the chest to search for small cell lung cancer
Hypopnea Oliguria Anura
42
What types of meds can cause SIADH (7)
``` Antidepressants Anti neoplastic agents Anticonvulsants MDMA NSIADs Opiates Opiates / Amiodarone ```
43
What are the classic sxs of a pheo
HTN HA diaphoresis palpitations
44
Medulary thyroid cancer marfanoid habitus pheo is consistent with with a MEN
MEN 3 (2B)
45
Patient presents with fatigue and jumpy for 4 months, heart races on exertion, sxs worsen over a month, hands shake a lot, irritable, heat intolerance, menstrual flow light, Diplopia @ outward gaze, DTRs with rapid relaxation first test/2nd/3rd
TSH Free T4 CBC HCG EKG
46
Primary Hyperthyroid has what labs
High T3 High T4 Low TSH
47
RAIU with increased iodine uptake signals
Primary Hyperthyroidism- Graves Disease
48
What are the hallmarks of graves
``` Exopthalmos Lid Lag Clubbing Reflex relaxation AFIB Diplopia ```
49
What’s a good treatment for Graves
I-131 thyroid tissue radiation
50
Fatigued, skin dry, menses irregular, skin is dry. Heart sounds are normal but distant. What disease
Hypothyroidism
51
Hypothyroid = what labs
Free T4 T3 normal low ish TSH way high
52
What is the best aspect for evaluating thyroid hormone
free T4
53
EKG with sinus bradycardia and low voltage for hypothyroidism is significant for what?
Explains the Distant heart sounds
54
What is the expected heart rate in hypothyroidism
Low Bp
55
Treatment for thyroid disease oral meds get what length of treatment
The rest of their life
56
When is the ideal time to check TSH when checking for a change in dosage
5-6 weeks
57
Thyroid oral meds have what medication guidelines
Can not take other meds 4 hours after, and take it first thing in the Morning, dont allow them to stop abruptly
58
What happens if you stop oral thyroid meds abruptly
Myxedema crisis
59
.elevated Bp, with apprehension, severe HA, perspiration, rapid heart beat, facial pillow Abprubt onset lasting 10-25 mins each
60
What are the endocrine and non endocrine causes of HTN
``` Endo Pheo Hyperaldost. Hyperthyroid Hypercortisol Cushing ``` ``` Non Obesity Sleep Apnea Renal Artery Stenosis Drugs (Illicit / illegal) -NSAIDS ```
61
What is the bet test to check for a pheo Then, confirmed by what test?
Plasma fractionated metanephrine Then 24 hr urine
62
Best study for PHEO first
NON CON CT ABD CHEST
63
What is the name of the pheo like tumor that is not on the adrenal gland
Paraganglioma
64
2 meds for pre pheo surgery
Alpha blockade Then Beta blocker Phenoxybenzamine
65
What is an associated finding of gigantism
Facial acne
66
Overgrown sex characteristics increased height and acne can be due to what and hirsutism?
Excess androgens
67
2 places androgens can come from in excess in a female
Ovaries and adrenal glands
68
What is in excess with androgen overproduction of the adrenal glands ; what is depleted
17 OH progesterone 21 OH progesterone
69
What are the two types of CAH ; differences?
``` Classic (Salt wasting) and Non classic (Androgynous presentation) ```
70
CAH treatment
Glucocorticoid to suppress the excess aldosterone -can consider a mineral corticoid as well
71
Cushing syndrome sxs
Irregular menses Oncoming Depression Wt Gain Puffy face
72
Hirsutism represents an increase in what
Androgens
73
What defines dependent hypercortisolism
High Dexameth, 24 hr urine, and ACTH (normalx4 times the ULMN) tests Cushing Disease / ACTH pituitary adenoma
74
Ten times the normal ACTH finding could be what?
Ectopic, insanely elevated Lung Cancer Oat cell Carcinoid
75
High cortisol on dexamethsaone with low ACTH = what disease | ACTH independent Hypercortisolism
(ACTH independent Hypercortisolism)
76
(ACTH independent Hypercortisolism) can be due to what two things
Iatrogenic - exogenous corticosteroid Adrenal hyperplasia
77
Treatment for Cushing disease
Surgical removal (transphenoidal)
78
What two things can occur as a result of Cushing disease surgery
Hyperpituitarism DI
79
Orthostatic hypertension indicated what things (3)
Low volume (ex: due to diarrhea) Thyroid over drive Electrolyte abnormalities
80
What should you consider if a patient presents with amenorrhea
Pregnancy
81
Low flow through the kidney does what
Effects all bodily function
82
Hyponatremia and hyperkalemia can be a cause of what
Hypo thyroid SIADH Anemia think about Addison disease
83
If you suspect someone has Addison’s what else should you test for?
Autoimmune thyroiditis | TB

ENDO (3 decks)

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