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IDC School > Endocrine > Flashcards

Endocrine Flashcards

1
Q

what are the major glands of the endocrine system?

A

Hypothalamus
Pituitary
Thyroid
Parathyroid
Pancreas
Adrenals
Ovaries/Testes
Pineal Gland

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2
Q

What is a specific cell with specific receptors that will respond to specific hormones

A

target cells

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3
Q

Why does TSH bind to receptos on cells of the thyroid gland but not to the cells of ovaries

A

because ovarian cells do not have TSH receptors

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4
Q

What are the lipid soluble hormones

A

steroid hormones
thyroid hormones
nitric oxide

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5
Q

what are water soluble hormones

A

amino acids:
Short chain- Antidiuretic hormone
Long Chain - Insulin

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6
Q

how do hormones influence their target cells

A

by chemically binding to specific protein receptors

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7
Q

what is the master gland of the body because it regulates the activity of endocrine glands

A

pituitary gland

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8
Q

what is the stalk like structure that attaches the pituitary gland to the hypothalamus

A

infundibulum

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9
Q

what is the blood vessels of the infundibulum called

A

hypophyseal portal veins which connect capillaries in the hypothalamus to capillaries in the anterior pituitary and carries hormones secreted by the hypothalamus

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10
Q

what is a hormone that stimulates an endocrine gland to grow and secrete its hormones

A

tropic hormones

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11
Q

what hormone promotes synthesis and secretion of Insulinlike Growth Factors (IGF’s)

A

Human Growth Hormone (hGH)

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12
Q

What stimulates protein synthesis, helps maintain muscle and bone mass and promote healing of injury and tissue repair

A

Insulinlike growth factor

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13
Q

What stimulates the synthesis and secretion of thyroid hormones by the thyroid gland

A

Thyroid stimulating hormone

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14
Q

What initiates the development of ovarian follicles and stimulates follicular cells to excrete estrogen

A

Follicle- stimulating hormone (FSH)

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15
Q

What triggers ovulation in females and stimulates the testes to secrete testosterone

A

Luteinizing hormone (LH)

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16
Q

Where is ACTH secreted from

A

The anterior pituitary

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17
Q

What hormone causes construction of arterials thus causing an increase in blood pressure

A

Antidiruretic hormone (ADH)

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18
Q

Follicular cells produce which two thyroid hormones

A

Thyroxine (T4)
Triiodothyronine (T3)

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19
Q

Where is T3/T4 produced

A

Follicular cells of the thyroid

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20
Q

What stimulates protein synthesis, increases the use of glucose and fatty acid for ATP production, increase triglyceride breakdown and reduce cholesterol

A

Thyroid hormones

Which also play an important role in maintenance of normal body temperature

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21
Q

What hormone is produced by the parafollicular cells of the thyroid gland

A

Calcitonin (CT)

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22
Q

What is within the parathyroid glands that release parathyroid hormone

A

Secretory cells called CHIEF CELLS

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23
Q

What promotes the formation of calcitrol (active form of vitamin D) which acts in the gut to instead the rate of calcium, magnesium and phosphate absorption from food into the blood

A

Parathyroid hormone

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24
Q

Alpha cells in the pancreatic islets secrete what and is stimulated from where

A

Secretes glucagon
Stimulated by the sympathetic division of the autonomic nervous system

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25
Q

Beta cells in the pancreatic islets secrete what and is stimulated from where

A

secretes insulin
stimulated by the parasympathetic division of the ANS

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26
Q

what conditions initiate the renin-angiotensis-aldosterone pathway

A

dehydration
sodium deficiency
hemorrhage

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27
Q

in the adrenal cortex- zona fasciculata the most abundant glucocorticoid is cortisol, how does cortisol have anti-inflammatory effects

A

inhibit white blood cells that participate in inflammatory response

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28
Q

what are the female sex hormones

A

estrogen
progesterone

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29
Q

what is a protein hormone that inhibits the secretion of FSH

A

inhibin

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30
Q

what produces testosterone, the primary androgen/ male sex hormone

A

the testes

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31
Q

what is a small endocrine gland attached to the roof of the third ventricle of the brain at the midline

A

the pineal gland

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32
Q

what is the hormone secreted by the pineal gland

A

melatonin

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33
Q

With age, what happens to human growth hormone

A

decreses- causing muscle atrophy

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34
Q

with age, what happens to the thyroid hormones

A

decreases - causing decreased metabolic rate, increased body fat and hypothyroidism

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35
Q

with age, what happens to the parathyroid hormone

A

rises - rise in PTH and fall in calcitonin decreases bone mass

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36
Q

with age, what happens with insulin production

A

releases more slowly - blood glucose levels will increase faster

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37
Q

pronlonged exposure to high levels of cortisol causes what

A

wasting of muscles
supression of immune system
ulceration of GI tract
Failure of the pancreatic beta cells

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38
Q

what is whipples triad

A

< 70 mg/dl glucose
altered mental status
signs and symptoms resolve with glucose elevation

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39
Q

where does ACTH come from

A

corticotropin-releasing hormone

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40
Q

what are two types of spontaneous hypoglycemia

A

fasting and postprandial

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41
Q

what glucose level shows impairment of brain function

A

50 mg/dl

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42
Q

what are symptoms of sympathomimetic hypoglycemia

A

anxiety
nervousness
irritability
nausea
vomiting
palpations
tremors

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43
Q

what are clinical finding of neuroglycopenic hypoglycemia

A

altered consciousness
lethargy
confusion
combative
agitation
unresponsive

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44
Q

what is the treatment for hypoglycemia

A

eat or drink glucose
glucagon if unable to eat/drink
50% dextrose 50-100mg IV

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45
Q

what are three stages of stress response

A

fight or flight
slower stress response
exhaustion

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46
Q

what is the fasting glucose in someone who is prediabetic

A

100-125 mg/dl

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47
Q

what could cause abnormal glucose values that may seem as though someone might be prediabetic

A

patient forgot to fast
well controlled type I or II
cushing syndrome (excess cortisol)
medications such as corticosteroids, antibiotics, beta blockers, psychiatric meds, HCTZ

Hyper thyroidism

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48
Q

what is the first line treatment for prediabetes

A

weight loss/ exercise

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49
Q

if weight loss and exercise do not work for prediabetes what is the second line of treatment

A

metformin

50
Q

what is the overnight fasting glucose value that must occur on more than one occasion for type one diabetes

A

126 mg/ml

51
Q

how is type I diabetes characterized

A

autoimmune antibodies
children to 30 years old
deficiency of insulin production

52
Q

what are the essentials of diagnosis for type I

A

3 P’s
polyuria
polydipsia
polyphagia

53
Q

what are the clinical finding in type I

A

unexplained weight loss
fatigue
poor wound healing
blurred vision
higher prevalence of STI, UTI, YEAST infection

54
Q

what is the treatment for type I

A

insulin is the only medication effective in lowering glucose levels in type I

55
Q

what are some complications of type I diabetes

A

insulin overdose
neuropathy
nephropathy
heart disease
opthalmology

56
Q

what are the essentials of diagnosis for type II diabetes

A

insulin resistant due to inadequate activity
over 40
obese

57
Q

what are the glucose parameters for someone with type II. Random and overnight fasting

A

Overnight fasting- 126 or higher on more than one occasion
Random - 200+

58
Q

what is the stage one treatment for type II

A

diet and exercise

59
Q

what is the stage two treatment for type II

A

Metformin/Glucophage is first line medication

60
Q

what is stage III treatment for type II

A

insulin requirement due to inability to control with oral medications

61
Q

what is macrosomia

A

high birth weight

62
Q

what is the glucose level of someone with DKA

A

> 250

63
Q

what are the findings in someone in DKA

A

dehydration- possible stupor
rapid deep breathing with “FRUITY” breath
hypotension with tachycardia
mild hypothermia

64
Q

what is the treatment for DKA

A

volume repletion is the initial management priority (3-4L of LR first 8 hours)
insulin
MEDEVAC

65
Q

what are the complications of DKA

A

AMI
Bowel infarction
renal failure
rarely cerebral edema

66
Q

what is the most common cause of endemic goiter

A

iodine deficiency

67
Q

what are the clinical findings of a goiter

A

usually asymptomatic
or
tracheal compression
respiratory distress
dysphagia

68
Q

what are the essentials of diagnosis for hypothyroidism

A

weak
cold intolerance
constipation
depression
menorrhagia
delayed DTR

69
Q

what are some causes of hypothyroidism with a goiter

A

autoimmune
- hashimotos
- thyroiditis
subacute (de quervains thyroiditis)
IODINE DEFICIENCY
genetic
hep C
Drugs: lithium, amiodarone, methimazole

70
Q

what early signs of hypothyroidism occur with the hair

A

thinning of hair
thin, brittle nails

71
Q

primary hypothyroidism is due to what

A

thyroid gland disease

72
Q

secondary hypothyroidism is due to what

A

lack of pituitary TSH

73
Q

what are causes of hypothyroidism without goiter

A

thyroid surgery
deficient pituitary TSH
severe illness
drugs: lithium, amiodarone…..iodine
radiation therapy

74
Q

what is the treatment for hypothyroidism

A

Levothyroxine (T4)

75
Q

what are the symptoms of hyperthyroidism

A

sweating
weight loss
heat intolerance
menstrual irregularity
tachycardia
tremor
stare (exophthalmos)

76
Q

what is the seen in graves disease

A

goiter often with a bruit
ophthalmopathy
thyroid stimulating immunoglobulins

77
Q

whais the most common cause of hyperthyroidism

A

graves disease

78
Q

what lab results will you see in hyperthyroidism

A

TSH will be low
T4 sometimes normal, T3 elevated

79
Q

what is the treatment for graves disease

A

radioactive iodine is the treatment of choice in active duty personnel

Propranolol (Beta blocker) for symptomatic relief of tachycardia, tremors, and anxiety

80
Q

what signs and symptoms will you see in a toxic multinodular goiter

A

can cause hyperthyroidism
sweating
weight loss
anxiety
loose stools
heat intolerance
tachycardia
tremor

81
Q

what suggests a possible malignant thyroid nodule

A

hoarseness or vocal cord paralysis
nodules in men or young women
nodule that is firm, large and adherent to trachea or strap muscles

82
Q

what is the imaging of choice for a nodule

A

ultrasound

83
Q

what is the treatment of a thyroid nodule

A

refer to endo
ultrasound guided fine needle aspiration

84
Q

what are signs of acute adrenal crisis

A

headaches
lassitude
nausea/vomitting
abdominal pain and diarrhea
confusion or coma
cyanosis
dehydration
sparse axillary hair

85
Q

what are two causes of acute adrenal crisis

A

primary - destruction or dysfunction of the adrenal cortex

Secondary - resulting from ACTH hyposecretion

86
Q

what is the hallmark for adrenal crisis

A

sudden withdrawl of steroid medication

87
Q

what is the treatment for adrenal crisis

A

dexamethasone or hydrocortisone

88
Q

what is a common cause of chronic adrenal insufficiency

A

addisons disease

89
Q

what are the symptoms of chronic adrenal

A

weakness fatigue
weight loss
myalgia
anorexia
n/v
anxiety
mental irritability

90
Q

what is the treatment for chronic adrenal

A

hydrocortisone is the drug of choice

91
Q

what medications can increase blood glucose

A

prednisone
HCTZ

92
Q

what is the treatment for gestational diabetes

A

diet and exercise

93
Q

what is characterized by Anovulation, polycystic ovaries and hyperandrogenism

A

polycystic ovarian syndrome

94
Q

what will you see on LH/FSH lab on someone with pcos

A

typically 2:1 to 3:1
normal is 1:1

95
Q

what is the treatment for pcos

A

weight management and exercise
doesnt work? metformin

96
Q

how will a male with hypogonadism present

A

fatigue
decreased strength
poor libido
hot flashes
ERECTILE DYSFUNCTION
gynecomastia
infertility
small testes

97
Q

what does high fsh/lh indicate in males

A

primary testicular failure from:
atrophy from previous mumps (ask in history about mumps dx in past)
autoimmune destruction
previous chemo/rad exposure

98
Q

what does low FSH/LH indicate in males

A

secondary hypogonadism from:
Hypogonadotropic hypogonadism
hyperprolactinemia
use of opiates or steroids
other hypothalamus or pituitary disorders

99
Q

what is the treatment for hypogonadism

A

should only be initiated with MO guidance

-check additional labs
-Transdermal testosterone (preferred)
-IM testosterone (longer acting)

100
Q

what causes gynecomastia

A

excess estrogen in males

101
Q

what causes excess estrogen in males

A

aging
obesity
puberty

102
Q

what drug could cause gynecomastia

A

Isoniazid (INH)
alcohol
anabolic steroid
opioids
marijuana
antipsychotics

103
Q

true gynecomastia will be localized where

A

subareolar region only

104
Q

what is the treatment for gynecomastia

A

puberty - self resolving
Adult- behavior mod
Adult- selective estrogen receptor modulator
testosterone therapy

105
Q

what is metabolic syndrome

A

3 or more of the following:
abdominal obesity
high triglycerides
HDL <40 male 50 for female
fasting glucose 100 or higher
hypertension

106
Q

what is the treatment for metabolic syndrome

A

weight management and physical activity

107
Q

complications of metabolic syndrome

A

cardiovascular risk

108
Q

treatment for gynocomastia if no red flags are present

A

do nothing

109
Q

clinical findings for pcos

A

menstral disorder
infertility
obesity
acne
insulin resistant
dyslipidemia

110
Q

if a pcos patient is desiring pregnancy what is the treatment

A

clomiphene

111
Q

who manages pcos

A

obgyn

112
Q

if testosterone is low what other labs will you order

A

obtain LH, FSH and Prolactin

113
Q

primary hypogonadism is from

A

mumps

114
Q

secondary hypogonadism is from

A

opiates or steroid s

115
Q

what additional labs will be drawn with treatment of hypogonadism

A

hematocrit
prostate specific antigen (psa)

116
Q

what are red flags for gynecomastia

A

asymmetry
nipple retraction
nipple bleeding, discharge
unusual firmness

117
Q

what labs are ordered for gynecomastia

A

free testosterone
LH/FSH
Beta Hcg
Thyroid function panel
Liver function panel

118
Q

pcos FHS/LH lab ratio

A

2:1 to 3:1

119
Q

What is the leading cause of Addison disease

A

Tuberculosis

120
Q

Symptoms of Addison disease

A

Weakness fatigue
Weight loss
Anorexia
N/V
Anxiety
Mental irritability
Hyperpigmentation of skin

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