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Endocrine Flashcards

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1
Q

Zona glomerulosa of adrenal gland

A

most superficial layer of cortex
secretes aldosterone
controlled by renin-angiotensin

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2
Q

Zona fasciculata of adrenal gland

A

middle layer of cortex
secretes cortisol/sex hormones
controlled by ACTH/CRH

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3
Q

Zona reticularis of adrenal gland

A

deepest layer of cortex
secretes sex hormones (androgens)
controlled by ACTH/CRH

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4
Q

Medulla of adrenal gland

A 
secretes catecholamines (chromaffin cells)
has preganglionic sympathetic fibers
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5
Q

Post pituitary secretion

A

ADH
oxytocin
from neuroectoderm

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6
Q

Ant pituitary secretion

A 
FSH
LH
ACTH
TSH
prolactin
GH
melanotropin
from oral ectoderm (Rathke's pouch)
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7
Q

Endocrine cells of pancreas

A

alpha-glucagon
beta-insulin
delta-somatostatin

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8
Q

Insulin secretion pathway

A

increased Glc, increases ATP
K+ channels close, depolarizes cell
Ca2+ channels open
Ca2+ stimulates insulin release

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9
Q

Transporters of glucose in membrane

A

Glut1-RBC/brain
Glut2-beta islet cells/liver/kidney/intestines (bidirectional)
Glut4-adipose/muscle tissue (insulin dependent)

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10
Q

Stimulators of insulin release

A

hyperglycemia
GH
beta2-antagonists

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11
Q

Inhibitors of insulin release

A

hypoglycemia
somatostatin
alpha2-agonists

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12
Q

Regulators of prolactin

A

TRH increases

dopamine decreases

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13
Q

Regulators of TSH

A

TRH increases

Somatostatin decreases

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14
Q

Somatostatin role

A

inhibitors GH and TSH

antigrowth

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15
Q

GnRH role

A

increase FSH/LH

inhibited by prolactin

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16
Q

Prolactin characteristics

A 
inhibits ovulation/spermatogenesis
promotes milk production
inhibits GnRH release
inhibited by dopamine/stimulated by TRH
from ant pituitary
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17
Q

GH/somatotropin characteristics

A

linear growth & muscle mass though IGF1/somatomedian secretion
released in pulses by GHRH
increased secretion during sleep/exercise
inhibited by Glc/somatostatin

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18
Q

HTN
hypokalemia
ambiguous genitalia in male

A 
17alpha-hydroxylase deficiency
decreased DHT (testosterone)
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19
Q

Hypotension (volume)
hyperkalemia
female
pseudohermaphroditism

A

21-hydroxylase deficiency

masculinization

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20
Q

HTN

masculinization

A

11beta-hydroxylase deficiency

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21
Q

Cortisol characteristics

A 
from zona fasiculata
decreases bone formation
increases epi/NE sensitivity (alpha1 receptors) on arterioles
increase insulin resistance
increased gluconeogenesis
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22
Q

Regulation of cortisol

A

increased by CRH/ACTH

excess cortisol decreases CRH/ACTH

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23
Q

PTH characteristics

A

increased bone resorption
increased renal Ca2+ resorption/decreased phosphate renal resorption
increases calcitriol production of kidneys

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24
Q

Vit D characteristics

A

1,25 (OH)2 in kidney
increases Ca2+/phosphate absorption in GI
also increases bone resorption

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25
Role of calcitonin
decrease bone resorption of Ca2+
26
Functions of T3 (thyroid hormone)
brain maturation bone growth beat-adrenergic effect increase basal metabolic rate (via Na+/K+ ATPase activity)
27
Regulation of thyroid hormones (T3/T4)
TRH stimulates TSH, which stimulates follicular cells to make T4/T3 T3 (-) feedback on ant pituitary
28
``` HTN wt gain moon facies buffalo hump osteoporosis ```
Cushing's syndrome increased cortisol (steroids/tumor) also see thin skin and immune suppression truncal obesity seen
29
HTN hypokalemia alkalosis low plasma renin
``` Primary hyperaldosteronism (Conn's sydnrome) from adrenal hyperplasia/adenoma ```
30
HTN hypokalmeia high plasma renin no growth on adrenal glands
Secondary hyperaldosteronism | renal artery stenosis/renal failure/cirrhosis
31
Skin hyperpigmentation adrenal atrophy hypotension hyperkalemia
Addison's disease/adrenal insufficiency lack of aldosterone and cortisol involves entire cortex of adrenals
32
N. meningitidis infection DIC acute hypotension/hyperkalemia
Waterhouse-Friderichsen syndrome | hemorrhage of adrenal glands
33
``` Episodic HTN headache 40 y/o male persperiation pallor ```
Pheochromocytoma chromaffin cell tumor secreting dopamine/NE/epi has urinary VMA (NE/epi metabolite) tx with irreversible alpha antagonist (phenoxybenazmine) before surgery
34
4 y/o male increased homovanillic acid in urine metastasis seen throughout body
Neuroblastoma | overexpression of N-myc gene
35
Nontender, enlarged thyroid Huerthle cells cold intolerance wt gain
Hashimoto's thyroiditis (hypothyroidism) assc with HLA-DR5 and lymphoma thyroid peroxidase antithyroglobulin Abs
36
``` Pale protruding umbilicus pot bellied puffy faced child protuberant tongue ```
Cretinism due to lack of fetal iodine (hypothyroidism) mother with goiter
37
Tender thyroid wt gain post flu sx subside after 1 wk
``` Subacute thyroiditis (de Quervain's) self limited hypothyroidism ```
38
Painless goiter hard/fixed thyroid wt gain cold intolerance
Reidel's thyroiditis fibrosis of thyroid tissue IgG4 related systemic disease
39
focal patches of hyperfunctioning follicular cells | increased T3/T4
Toxic multinodular goiter | mutation of TSH receptor
40
Bilateral proptosis waxy discoloration of skin on ant legs wt loss palpitations
Grave's disease thyroid stimulating Ig pretibial myxedema (skin problem) ophthalmopathy
41
Thyroid growth empty appearing nuclei pasammoma bodies
Papillary carcinoma of thyroid good prognosis Orphan Annie's eyes=empty nuclei
42
Decreased serum Ca2+ increased phosphate in urine thyroid mass sheets of cells in amyloid stroma
Medullary carcinoma of thyroid assc with MEN 2A and 2B produces calcitonin
43
Bone space filled with brown fibrous tissue hypercalcemia constipation
Osteitis fibrosa cystica | from excess PTH
44
Hypocalcemia hyperphosphatemia CKD bone lesions
Renal osteodystrophy | hyperparathyroidism due to renal disease
45
Contraction of facial m. with tapping facial n. occlusion of brachial a. causes carpal spasm hypocalcemia
``` Hypoparathyroidism Autoimmune or DiGeorge syndrome causes tetany facial contraction=Chvostek's sign carpal spasm=Trousseau's sign ```
46
AD hypocalcemia short 4th/5th digits short stature
Albright's hereditary osteodystrophy | PTH unresponsiveness of kidney
47
Galactorrhea infertility amenorrhea Bilateral hemianopia
Pituitary adenoma | decreased GnRH
48
Increased IGF-1 Glc intolerance large hands/feet coarse facial features
Acromegaly | usually due to pituitary adenoma
49
Thirst dilute urine concentration of urine following desmopressin
Central diabetes insipidus no ADH production Nephrogenic DI does not respond to desmopressin
50
Hyponatremia concentrated urine osmolarity improves with demeclocycline
SIADH assc with small cell lung cancer/head trauma/pulmonary disease/cyclophosphamide correct Na+ levels slowly
51
AD hypocalcemia short 4th/5th digits short stature
Albright's hereditary osteodystrophy | PTH unresponsiveness of kidney
52
Contraction of facial m. with tapping facial n. occlusion of brachial a. causes carpal spasm hypocalcemia
``` Hypoparathyroidism Autoimmune or DiGeorge syndrome causes tetany facial contraction=Chvostek's sign carpal spasm=Trousseau's sign ```
53
Hypocalcemia hyperphosphatemia CKD bone lesions
Renal osteodystrophy | hyperparathyroidism due to renal disease
54
Bone space filled with brown fibrous tissue hypercalcemia constipation
Osteitis fibrosa cystica | from excess PTH
55
Decreased serum Ca2+ increased phosphate in urine thyroid mass sheets of cells in amyloid stroma
Medullary carcinoma of thyroid assc with MEN 2A and 2B produces calcitonin
56
Thyroid growth empty appearing nuclei pasammoma bodies
Papillary carcinoma of thyroid good prognosis Orphan Annie's eyes=empty nuclei
57
Bilateral proptosis waxy discoloration of skin on ant legs wt loss palpitations
Grave's disease thyroid stimulating Ig pretibial myxedema (skin problem) ophthalmopathy
58
focal patches of hyperfunctioning follicular cells | increased T3/T4
Toxic multinodular goiter | mutation of TSH receptor
59
Painless goiter hard/fixed thyroid wt gain cold intolerance
Reidel's thyroiditis fibrosis of thyroid tissue IgG4 related systemic disease
60
Tender thyroid wt gain post flu sx subside after 1 wk
``` Subacute thyroiditis (de Quervain's) self limited hypothyroidism ```
61
``` Pale protruding umbilicus pot bellied puffy faced child protuberant tongue ```
Cretinism due to lack of fetal iodine (hypothyroidism) mother with goiter
62
Nontender, enlarged thyroid Huerthle cells cold intolerance wt gain
Hashimoto's thyroiditis (hypothyroidism) assc with HLA-DR5 and lymphoma thyroid peroxidase antithyroglobulin Abs
63
4 y/o male increased homovanillic acid in urine metastasis seen throughout body
Neuroblastoma | overexpression of N-myc gene
64
``` Episodic HTN headache 40 y/o male persperiation pallor ```
Pheochromocytoma chromaffin cell tumor secreting dopamine/NE/epi has urinary VMA (NE/epi metabolite) tx with irreversible alpha antagonist (phenoxybenazmine) before surgery
65
N. meningitidis infection DIC acute hypotension/hyperkalemia
Waterhouse-Friderichsen syndrome | hemorrhage of adrenal glands
66
Skin hyperpigmentation adrenal atrophy hypotension hyperkalemia
Addison's disease/adrenal insufficiency lack of aldosterone and cortisol involves entire cortex of adrenals
67
HTN hypokalmeia high plasma renin no growth on adrenal glands
Secondary hyperaldosteronism | renal artery stenosis/renal failure/cirrhosis
68
HTN hypokalemia alkalosis low plasma renin
``` Primary hyperaldosteronism (Conn's sydnrome) from adrenal hyperplasia/adenoma ```
69
polydipsia polyuria obese 45 y/o peripheral neuropathy
Diabetes mellitus type 2
70
17 y/o ketoacidosis low serum insulin
Diabetes type I
71
Type I diabetic | bleeding from the nose
Mucomycosis/rhizopus infection
72
Recurrent diarrhea cutaneous flushing R sided heart murmur growth at the appendix
``` Carcinoid syndrome (neuroendocrine cells) assc with GI metastasis secretes 5HT increased urine 5HIAA niacin deficiency ```
73
Rugal thickening of stomach recurrent ulcers growth of pancreas
Zollinger-Ellison syndrome | gastrin secreting tumor, increasing H+ secretion
74
Origin of post pituitary
neuroectoderm (dienchephalon)
75
Origin of ant pituitary
ectoderm from orpharynx | Rathke's pouch
76
Cells types assc with ant and post pituitary
ant-parvocellular | post-magnocellular (PVN and supraoptic nucleus)
77
Tx for hyperprolactinomia
bromocriptine (DA2 agonist)
78
Sheehan syndrome
postpartum necrosis of ant pituitary due to shock/hemorrhage decreased blood to enlarged pituitary
79
Reason for pallor in hypopituitarism
loss of melanocyte stimulating hormone (MSH)
80
Major mortality with acromegaly
cardiovascular disease | DM

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