Endo p. 322-326 Flashcards Preview

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Flashcards in Endo p. 322-326 Deck (47):
1

Name the T3 functions—4 B’s:

Brain maturation
Bone growth
β-adrenergic effects
Basal metabolic rate 

2

When are the levels of TBG decr?

in hepatic failure, steroids usage

3

How does T3/T4 change the basal metabolic rate?

via  Na+/K+-ATPase activity Ž--> incr O2 consumption, RR, body temperature


4

Which adrenaline receptors in the heart does T4/T3 affect?

incr β1 receptors in heart =  incr CO, HR, SV,
contractility

5

What effect does T3/T4 have on glycogen and lipids?

incr glycogenolysis, gluconeogenesis, lipolysis

6

 When are the TBG leves incr?

in pregnancy or OCP use (estrogen incr TBG).

7

T or F? Propylthiouracil inhibits only peroxidase.

F. inhibits both peroxidase and 5'-deiodinase

8

Explain the Wolff-Chaikoff effect:

excess iodine temporarily inhibits thyroid peroxidase-->
Ž decr iodine organification--> decr T3/T4 production.

9

T3 binds --- receptor with ---- affinity than T4.

nuclear
greater

10

Methimazole inhibits ---.

peroxidase

11

coupling of monoiodotyrosine and di-iodotyrosine happens via which enzyme?

peroxidase

12

T4 is converted to T3 in peripheral tissue by which enzyme?

5'deiodinase

13

Which Anions inhibit iodine oxidation?

perchlorate, pertechnetate, thiocyanate, iodide

14

High-dose dexamethasone suppression test causes what in Cushings dx?

free cortisol suppression

15

How many mg is administred during High-dose dexamethasone test?

8mg - high dose

16

Name 3 cause for incr in cortisol?

- Exogenous corticosteroids
- Primary adrenal adenoma, hyperplasia, or carcinoma
- ACTH-secreting pituitary adenoma, paraneoplastic ACTH

17

Difference between Cushing syndrome and Cushing disease?

ACTH-secreting pituitary adenoma - C. disease
incr Cortisol from variety of conditions - C. syndrome

18

2 path causing Cushing syndrome?

small cell lung cancer, bronchial carcinoids

19

Is adrenal tumor an ACTH-independent or dependent Cushing syndrome?

ACTH-independent Cushing syndrome

20

Is ectopic ACTH secretion an ACTH-independent or dependent Cushing syndrome?

ACTH-dependent

21

CRH stimulation test helps diagnose which pathology?

Cushing disease (incr ACTH) vs
ectopic ACTH secretion (no incr of ACTH)

22

What an alternative test used to dx adrenal insufficiency?

Metyrapone stimulation test

23

metyrapone blocks which process?


11-deoxycortisol --> Ž cortisol

24

Pt presents w/ sudden onset of massive
hemorrhage and shock. What is the adrenal path?

Primary Acute adrenal insufficiency or Waterhouse-Friderichsen syndrome

25

Competitive athlete on school break shows signs of adrenal insufficiency, which type is his pathology?

Tertiary: chronic exogenous precipitated by abrupt withdrawal.

26

skin and mucosal hyperpigmentation is seen in which type of adrenal insuff.? and why?

Primary

27

TB can cause what kind of Adrenal insuff.?

Chronic—aka Addison disease. Due to
adrenal atrophy or destruction by disease

28

--- is a byproduct of  ACTH production from ----.

MSH
pro-opiomelanocortin

29

In which type of Adrenal insuff. is Aldosterone synthesis unaffected?

Tertiary

30

Primary adrenal insuff. is associated with which autoimmune syndromes?

polyglandular syndromes

31

Which adrenal insuff. spares the skin and mucosa? and why?

Tertiary and Secondary, because there is a decr in ACTH production --> less MSH by product

32

What is the MC tumor of the adrenal medulla in children?

Neuroblastoma

33

Classic histology presentation of Neuroblastoma:

Homer-Wright rosett and small, round, blue/purple nuclei

34

Name 2 paths derived from neural crest?

Neuroblastoma, Pheochromocytoma

35

Homovanillic acid (HVA) a breakdown product of?

dopamine

36

---- is a breakdown product of norepinephrine.

vanillylmandelic acid (VMA)

37

“dancing eyes-dancing feet” are seen in?

Neuroblastoma, Subacute screlosing P.

38

Name episodic hyperadrenergic symptomsof pheochromocytoma (5 P’s):

Pressure (incr BP)
Pain (headache)
Perspiration
Palpitations (tachycardia)
Pallor

39

T or F? Wilms tumor can cross the midline vs. Neuroblastoma which is smooth and unilateral.

F. its the opposite

40

Why is α-blockade administred in Pheochromocytoma
before giving β-blockers prior to tumor resection?

to avoid a hypertensive crisis.

41

What % causes calcification in pheochromocytoma?

10% calcify

42

Neuroblastoma has an overexpression of which onco-gene?

N-myc oncogene

43

What is a typical histology of Pheochomocytoma?

enlarged pleomorphic nuclei, typical of malignancy.

44

2 tumor markers for Neroblastoma?

Bombesin and neuron-specific enolase ⊕.

45

Name one phath that use Bombesin and neuron-specific enolase as tumor markers?

lung cancer (bronchial carcinoid)

46

3 Paths associated with Pheochomocytoma?

neurofibromatosis type 1,
von Hippel-Lindau disease,
MEN 2A and 2B.

47

Urine and plasma findings is Pheochromocytoma?

 catecholamines and metanephrines in urine and plasma.