Brainscape's Knowledge GenomeTM


Top Flashcards (Certified)
All Flashcards

UWORLD QuestionQuestions > Endo/Repro > Flashcards

Endo/Repro Flashcards

1
Q

MEN 1

A

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

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

MEN 2A

A

medullary carcinoma thyroid- MEN 2
Pheochromocytoma- MEN 2

Parathyroid Tumor- also seen in?

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

MEN 2B

A

medullary carcinoma of thyroid- MEN 2
pheochromocytoma- MEN 2

MUCOSAL NEUROMA- 2B ONLY

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

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

A

MEN 2 A & B

adrenal medulla and secrete catecholamines

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

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

which ones are NOT alleviated by b-blocker therapy?

A

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

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

PPAR-Y regulates which 4 genes?

A 
INCREASES
Adiponectin
Fatty Acid Transport protein
Insulin receptor substrate
GLUT-4 Transporter
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

PERMISSIVE=
ADDITIVE=
SYNERGYSTIC=

A

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

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

Subperiosteal thinning is characteristic of?

how does this manifest clinically?

A

Hyperparathyroidism

subperiosteal erosions of medial phalanges
SALT & PEPPER appearance of calvarium

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

What prevents lactation during pregnancy?

A

high levels of circulationg estrogen and progesterone

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

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

A

Mullerian agenesis = FULLY DEVELOPED SECONDARY SEXUAL CHARACTERISTICS

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

INCREASED AFP

v

DECREASED AFP

A

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

DOWN Syndrom

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

Decreased Estriol levels in pregnancy are a sign of what?

A

placental insufficiency

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

hCG is increased in what? (3)

A

trophoblastic issues-

multiple gestation
hydatiform mole
choriocarcinoma

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

What inhibits GnRH?

Inhibiting GnRH decreases which hormones? (2)

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

A

TESTOSTERONE

FSH=> SERTOLI => Inhibin B feedback inhibition

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

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

GIGANTISM v Acromegaly

A

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

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

IGF-1 from where affects linear growth?

A

Liver (not hypothalamus= central nervous activity

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

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

A

Laron DWARFISM.

Defective GH Receptors

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

Glucocorticoids are catabolic causing what? (5)

What do they increase?

A 
muscle weakness
skin thinning
impaired wound healing
osteoporosis 
immunosuppression

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

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

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

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

A

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.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

Adenexal mass in elderly female?

serum marker for this?

A

Ovarian Cancer

CA-125

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

Within the cell where would ACTH biosynthesis occur?

Which cells of the body would have this portion well developed

A

steroids are synthesized in the SER

Adrenals, gonads, liver (steroid producers)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

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?

A

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)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

Aspiration Pneumonia risk factors?

A

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

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

Hyperprolactinemia in women can cause?

A

Estrogen Deficiency => (hypogonadism SE)

Galactorrhea
Amenorrhea
Decr. Bone densitiy
Vaginal Dryness

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
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
31
MCC Congenital Adrenal Hyperplasia? What causes CAH with hypokalemia (<-why is this?)
21- Hydroxylase Deficiency 11 B-hydroxylase Deficiency (hypokalemia is due to production of the weak mineralocorticoid (aka aldosterone like activity) of 11-deoxycorticosterone assoc. w/ ambiguous genitalia, hypertension, hypokalemia in early life
32
MCC of female infertility? Treatment(2)/how it works?
anovulation Rx: menotropin (acts like FSH=> forms dominant ovarian follicle) then induce ovulation with hCG (large dose) to stimulate LH surge.
33
Human Placental Lactogen does what? to whom?
In mother due to Increased insulin resistance Stimulates proteolysis stimulates lipolysis inhibits gluconeogenesis
34
glucagonoma clinical findings? 3
DM necrolytic erythema anemia hyperglycemia, stomatitis, cheilosis, abdominal pain.
35
Actopic ACTH production = clinical findings?
rapid onset: ``` Hyperpigmentation Proximal muscle weakness, hypokalemia, hyperglycemia, markedly elevated levels of serum ACTH ```
36
PNMT catalyzes which step of catecholamine production? what is it? What Controls its activity transcriptionally?
NE--> Epi; Phenylethanolamin-N-methyltransferase (PMNT) Cortisol INCR. Transcription of PMNT 4:1 (80% v 20%) EPI: NE ratio due to upreg of NE--> EPI by Cortisol/PMNT
37
Catecholamine synthesis Pathway?
Phenylalanine -Phenylalanine Hydroxylase-> Tyrosine (from K synthesis in liver or diet) -Tyrosine Hydroxylase-> DOPA -DOPA Decarboxylase-> Dopamine -Dopamine B-Hydroxylase-> NE -PNMT-> Epi EPI=> degraded by MAO & COMT (monoamine oxidase & catechol-O-methyltransferase)
38
Tap to hide keyboard in DKA what happens to potassium (intra & extracellularly) and why?
potassium loss occurs via osmotic diuresis induced by glycosuria. intracellular potassium decreases extracellular potassium increases or doesn't change
39
what happens to urine osmolality in nephrogenic diabetes insipidus when vasopressin is administered?
urine osmolality will not change due to kidney not responding properly to the hormone.
40
when vasopressin is administered in central diabetes insipidus what happens to the urine osmolality?
urine osmolality will increase, because production of vasopressin is decr./nonexistant ( but the kidneys will respond when it is injected). >50% increase indicates complete Central DI
41
when is anovulation commonly seen and how?
The first 5 to 7 years after menarche and the last 10 years before menopause it manifests with menstrual cycle variability
42
MCC of DM type I?
autoimmune insulinitis,
43
SIADH can be secondary to which cancer | and what are its findings?
SCC of the lung; paraneoplastic low plasma sodium low plasma osmolality concentrated urine incresed urinary sodium
44
5 possibilites with PCOS?
``` Hyperandrogenism chronic anovulation oligomenorrhea multiple ovarian cysts => ALSO Obesitiy / insulin resistance / dysllipidemia ```
45
Clomiphene MOA?
Estrogen receptor modulator => prevents negative feedback leadig to increase FSH & LH (gonadotropins) => ovulation- used in infertility (in PCOS)
46
Which bacteria might cause hemorrhagic destruction of bilateral adrenal glands?
Meningococcal sepsis. ALSO +DIC= Waterhous-Friderichsen syndrome
47
Which cells secrete Mullerian Inhibiing Factor? What does MIF do specifically?
Sertoli cells Involution of paramesonephric ducts (blocks their maturation)
48
what causes herediary fructose intolerance? symptoms?
Aldose B deficiency failure to thrive jaundice hepatomegaly
49
Embryologic origin of anterior v posterior pituitary
anterior= rathke's pouch ( outpouching of pharyngeal roof) posterior= extension of Hypothalamus
50
Craniopharyngioma is seen most commonly in which patients? What is it derived from? 3 components commonly seen?
Rathkes pouch remnants in anterior pituitary MC childhood brain tumor Solid, Cystic, Calcified
51
IP3 messenger system.
Epi activates 2nd Messenger=> activates PhosphoLipase-C to break Membrane phospholipiids into: 1) IP3 => activates SR to rls Ca2+ 2) DAG => activates PK-C ProteinKinase-C is activated by DAG and Ca2+ rlsd from Sarcoplasmic reticulum.
52
Which days are the Secretory phase of the Menstrual Cycle? Describe how Progesterone effects this phase and what occurs to the endometrium.
days 15-28 Progesterone rls by corpus luteum => uterine glad coils and secretes glcogen-rich mucus Endometrial stroma => edmatous and traversed by tortuous spiral arteries from deep layer-> uterine lumen.
53
When is metformin contraindicated?
Conditions that predispose to Lactic Acidosis: b/c it can cause LA buildup ``` Renal failure liver dysfunction CHF Alchoholism sepsis ```
54
Side effects of Amiodarone (5)
thyroid dysfunction )(40% iodine by weight) corneal micro-deposits blue-gray skin discoloration drug related hepatitis pulmonary fibrosis-rare &life threatening
55
Biotin is a necessary cofactor for which enzymatic processes and how does it act? what can lead to its deficiency
Carboxylase enzymes CO2 carrier on the surface of the enzyme Excessive ingestion of egg whites (avidin)
56
Main side effects of Thiazolidinediones? what if Insulin is used concurrently?
Improve insulin resistance (less resistant via PPAR-y) fluid retention => weight gain + edema from fluid as well as CHF precipitation? fluid retention is worsened
57
which form of Cushing syndrome has a decrease in ACTH and cortisol levels after high does dexamethasone suppression testing? which does not?
Pituitary adenoma Ectopic ACTH Secretion (SCC carcinoma)
58
MC cell type in the normal pituitary?
Somatotrophs (growth hormone)
59
Glucocorticoid effects on the CBC?
Increase neutrophil count- why? below decreased lymphocyte, Monocyte, basophil, eosinophil counts Demargination of neutrophils previously attached to the vessel wall
60
What do anion inhibitors like perchlorate and pertechnetate do?
Block iodide absorption by the thyroid gland via competitive inhibition
61
Thionamides (name 2) MOA?
Decrease the formation of thyroid hormones by inhibiting thyroid peroxidase methimazole/carbimazole & propylthiouricil
62
How do Iodide salts treat thyroid disorders?
inhibit synthesis as well as release of thyroid hormones
63
Causes for hyperthyroidism? 4
Graves (MC) toxic adenoma toxic multinodular goiter thyroiditis
64
5 Metabolic processes Glucagon stimulates? (one is under special circumstances)
``` glycogenolysis gng lipolysis UREA PRODUCTION KETOACID Synthesis (when glucose is unavailable to cells) ```
65
What results from a deficiency of insulin and an excess of glucagon coupled with adrenergic activation and increased levels of cortisol and growth hormone?
DKA
66
Metabolic syndrome risk factors
hypertension abdominal obesity atherogenic dyslipidemia insulin resistance
67
Which medications decrease peripheral conversion of T4 to T3?
``` propythiouracil glucocorticoids amiodarone iopanic acid non-selective b-blockers ```
68
why is dieteary fructose RAPIDLY metabolized?
it bypasses PFK-1 the rate limiting enzyme of glycolysis.
69
Activation of Ret? (what type of gene regulator is RET?)
proto-oncogene=> Medullary Thyroid cancer
70
OverExpression of RAS causes which cancers?
follicular thyroid cancer and some follicular adenomas
71
Anaplastic thyroid cancer is caused by what action on what gene regulator?
Inactivating mutations of p53
72
What tye of gene regulator is bcl-2? What change to it causes which specific cancers?
BCL-2 mutations => upregulated in follicular lymphomas (anti-apoptotic)
73
Characteristic histiologic findings of thyroiditis (subacute/granulomatous)?
mixed cellular infiltration with occasional multinucleated giant cells
74
Granulomatous thyroiditis diagnostic findings- 4? another name for this
``` Thyrotoxicosis features tenderness over the thyroid gland increased ESR markedly-reduced radioactive iodine uptake POST-FLU ``` subactue
75
Abberant serine and threonine residue phosphorylation by serine kinase can lead to what? and can occur due to which 4 things?
insulin resistance. TNF-alpha catecholamines glucocorticoids glucagon
76
What patients might experience amenorrhea due to loss of pulsatile secretion of GnRH from the hypothalamus?
Anorexia Nervosa
77
MEN1 pancreatic tumors are also known as?
gastrinoma MENIN gene on the chromosome 11
78
Where is Vasopressin synthesized | where is it released?
Hypothalamus | Post. Pituitary
79
Hyperthyroid signs NOT improved by B-blocker = (4)?
increased tissue oxygen consumption circulating thyroxine levels weight loss exopthalmos-graves
80
What hormone therapy is used for treatment of infertility?
Pulsatile administration of GnRH agonist stimulate FSH and LH release
81
Non-pulsatile/constant infusion of GnRH or longer-lasting analogs suppress FSH and LH release and treat which diseases?
Precocious puberty Endometriosis Dysfunctional uterine bleeding
82
Which drug is used to treat against a.k.a. prophylaxis against Mycobacterium AViuM? What type of patients is the seen in?
Azithromycin HIV-positive patients with CD4 count less than 50 cells per milliliter
83
Very long chain fatty acids and phytanic acid are metabolized by which organelle? What type of disease is seen with this with what symptoms?
Peroxisome's Neurological defects from improper CNS myelination
84
What causes wet age-related macular degeneration?
Increased vascular endothelial growth factor Treat with anti-vegf herapy
85
(3) symptoms associated with vitamin A overuse?
Intracranial hypertension = >papilledema Skin changes Hepatosplenomegaly
86
Vitamin D overdose symptom?
Necrotizing enterocolitis and infants | hemorrhagic stroke in adults
87
Teratogenic effects of excessive vitamin a ingestion are?
Microcephaly Cardiac anomalies Fetal death
88
Vitamin B2 (riboflavin) deficiency is characterized by which six traits?
``` Cheilosis Stomatitis Glossitis Dermatitis Corneal vascularization ariboflavinosis ```
89
C-peptide, how is it used and what leads to its secretion it? What would decrease it's secretion?
Marker of the total rate of endogenous beta cell insulin secretion under steady-state conditions Sulfonylureas (glyburide) increase the rate of insulin secretion and C-peptide levels in DM 2 Acarbose inhibits alpha glucoside ace reducing postprandial hyperglycemia decreasing insulin secretion
90
Findings of neuroblastoma?
Opsoclonus – myoclonis paraneoplastic syndrome Increase copies of N-myc gene Most common extracranial neoplasm and children Two years old Small blue round cells Retroperitoneal mass hypertension anorexia Dumbbell tumor Pancytopenia, hepatomegaly, proptosis,. Orbital ecchymosis, Increase catecholamines in urine Better with younger (<1) age Worsens with more copies of N-myc
91
``` Cryptococcus neoformans morphology? Virulence factor Epidemiology Infection Diagnosis Treatment ```
M- Oval encapsulated cells with narrow-based buds V- polysaccharides capsule E – soil/pigeon droppings opportunistic respiratory I – long, meningeal encephalitis, disseminated D – India ink stain/ latex agglutination of CSF, Sabouraud's agar, GMS stain tissue Rx- IV Amphotericin B +oral Flucytosine for meningitis Fluconazole for not meningitis
92
what is absolutely necessary for acute pyelonephritis
vesicouretral reflux | retrograde flow

UWORLD QuestionQuestions (12 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2025 Bold Learning Solutions. Terms and Conditions