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Flashcards in Endo/Repro Deck (92)
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1

MEN 1

Tumors in 3Ps
Parathyroid - where is this also seen?
PANCREAS
PITUITARY

2

MEN 2A

medullary carcinoma thyroid- MEN 2
Pheochromocytoma- MEN 2

Parathyroid Tumor- also seen in?

3

MEN 2B

medullary carcinoma of thyroid- MEN 2
pheochromocytoma- MEN 2

MUCOSAL NEUROMA- 2B ONLY

4

Pheochromocytomas? Seen in which disease? act where and do what?

MEN 2 A & B
adrenal medulla and secrete catecholamines

5

Symptoms of Graves Disease? (2 unique + many others)

which ones are NOT alleviated by b-blocker therapy?

1) Pretibial myxedema - orangepeel/scaly skin

2) Opthalmia is NOT ALLEVIATED =(exopthalmos,
periorbital edema, eye movement limitations)

Palpations,nervousness,easy fatigability, fine tremor, diarrhea, hyperhidrosis, heat intolerance, weight loss, hyperreflexia

6

PPAR-Y regulates which 4 genes?

INCREASES
Adiponectin
Fatty Acid Transport protein
Insulin receptor substrate
GLUT-4 Transporter

7

PERMISSIVE=
ADDITIVE=
SYNERGYSTIC=

P=administration of cortisol allows epinephrine to achieve its full vasoconstrictive potential

A= combined effects equal the sum

S= combined effects EXCEEDS the sum of the individual drug effects

8

Subperiosteal thinning is characteristic of?

how does this manifest clinically?

Hyperparathyroidism

subperiosteal erosions of medial phalanges
SALT & PEPPER appearance of calvarium

9

What prevents lactation during pregnancy?

high levels of circulationg estrogen and progesterone

10

What would be seen in primary amenorrhea in Mullerian agenesis v Turners Syndrome?

Mullerian agenesis = FULLY DEVELOPED SECONDARY SEXUAL CHARACTERISTICS

11

INCREASED AFP

v

DECREASED AFP

DATING ERROR; NTDefects, Anterior wall defects (Ophalocele, gastroschsis) multiple gestation


DOWN Syndrom

12

Decreased Estriol levels in pregnancy are a sign of what?

placental insufficiency

13

hCG is increased in what? (3)

trophoblastic issues-

multiple gestation
hydatiform mole
choriocarcinoma

14

What inhibits GnRH?

Inhibiting GnRH decreases which hormones? (2)

These 2 hormones affect which cells and have what feedback inhibition?

TESTOSTERONE

FSH=> SERTOLI => Inhibin B feedback inhibition

LH=> LEYDIG CELLS=> Testosterone => feeback inhibition of LH & GnRH

15

GIGANTISM v Acromegaly

excess GH before closure of epiphysis V. after closure of epiphysis

16

IGF-1 from where affects linear growth?

Liver (not hypothalamus= central nervous activity

17

Diagnose a Pt. with high Serum GH but low IGF-1 levels? MOA?

Laron DWARFISM.

Defective GH Receptors

18

Glucocorticoids are catabolic causing what? (5)

What do they increase?

muscle weakness
skin thinning
impaired wound healing
osteoporosis
immunosuppression

Liver protein synthesis = INCR. Gluconeogenesis & glycogenolysis => hyperglycemia (+peripheral antagonism of insulin)

19

Long Term Glucocorticoid Therapy (>3weeks) can cause what?

Under stressful conditions what can happen during this therapy regimen and how do you prevent this?

HPA (hypothalamic-pituitary-adrenal) axis supression = DECR. CRH ACTH & Cortisol

Adrenal crisis may occur under stress (infxns/surgery) if an appropriate increase in Glucocorticoids is not given.

20

Adenexal mass in elderly female?

serum marker for this?

Ovarian Cancer

CA-125

21

Within the cell where would ACTH biosynthesis occur?

Which cells of the body would have this portion well developed

steroids are synthesized in the SER


Adrenals, gonads, liver (steroid producers)

22

What type of anion gap change would you expect in Septic shock and why?

what other condition my cause a similar anion gap change and why?

Lactic Acid Metabolic Acidosis Increases Anion Gap in Septic shock
due to impaired tissue oxygenation => Decr. Ox.Phos. => shunt pyruvate to lactate after glycolysis

Hepatic Hypoperfusion/Failure => lactic acid buildup (liver = site of lactate clearance)

23

Aspiration Pneumonia risk factors?

Altered consciousness (cough reflex& glottis fxn impairment) = dementia.
Dysphagia (neurological complications)
GERD
Mechanical Comprimise (NG/Endotracheal Tubes)
Protracted vomiting

Think of an OLD man with GERD/Strokes/Dementia/and Tubes that give him Pneumonia

24

Hyperprolactinemia in women can cause?

Estrogen Deficiency => (hypogonadism SE)

Galactorrhea
Amenorrhea
Decr. Bone densitiy
Vaginal Dryness

25

What are the Endocrine Side effects of SPIRINOLACTONE?

Anti-androgenic

26

Drugs used to treat hirsutism?

Antiandrogens flutamide (inhibits binding to testosterone receptors)

Finasteride (5-alpha-reductase inhibitor)

Spirinolactone (anti-androgenic)

27

Rare life threatening complication of antithyroid medications? What test is used to determine if present?

Agranulocytosis (absolute neutrophil count of less than 500/mL)

WBC count with a differential

28

Maternal rubella infection (symptoms in mom?) and sympotms in child

fever
maculopapular rash
post. auricular and suboccipital lymphadenopathy
rash from Trunk to periphery (feet)
polyarthritis/arthralgia


CHILD:
Sensorineural deafness
cataracts
PDA (cardiac)

29

What types of receptors utilize MAP-Kinase signaling pathway? describe this pathway?

Growth Factors (EGF PDGF FGF)

Receptor auto phosphorylates and triggers phosphorylation of Ras protein

30

What type of receptor utilize JAK/STAT signaling pathway?

Cytokines
Growth Hormone (NOT GF=mapkinase)
Prolactin
IL-2