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Flashcards in Endocrine Deck (24):
1

GFR

GFR corresponds with Salt (Na), Sugar (glucocorticoids), and sex (androgens)

2

Adrenal cortex and medulla

Zona Glomerulosa - Renin-Angiotensin ; Aldosterone
Zona Fasciculata - ACTH, CRH ; Cortisol, Sex hormones
Zona Reticularis - ACTH, CRH ; Sex hormones (androgens)
Chromaffin cells - Preganglionic sympathetic fibers ; Catecholamines (epinephrine, norepinephrine)

3

Pheochromocytoma

Most common tumor of the adrenal medulla in adults

4

Neuroblastoma

Most common tumor of the adrenal medulla in children. Rarely causes hypertension

5

Posterior pituitary (neurohypophysis)

Secretes vasopressin (ADH) and oxytocin, made in the hypothalamus and shipped to posterior pituitary via neurophysins (carrier proteins). Derived from neuroectoderm

6

Anterior pituitary (adenohypophysis)

Secretes FSH, LH, ACTH, TSH, prolactin, GH, melanotropin (MSH). Derived from oral ectoderm (Rathke pouch). a subunit - hormone subunit common to TSH, LH, FSH, and hCG. b subunit - determines hormone specificty.
Acidophils - GH, prolactin
B-FLAT: Basophils - FSH, LH, ACTH, TSH

7

Glucose regulation

FA 308

8

Adrenal steroids and congenital adrenal hyperplasias

FA 312

9

Signaling pathways of endocrine hormones

cAMP - FSH, LH, ACTH, TSH, CRH, hCG, ADH (V2-receptor), MSH, PTH, calcitonin GHRH, glucagon.
cGMP - ANP, NO (EDRF) (think vasodilators)
IP3 - GnRH, Oxytocin, ADH (V1-receptor), Angiotensin II, Gastrin
Steroid receptor - Vitamin D, Estrogen, Testosterone, T3/T4, Cortisol, Aldosterone, Progesterone
Intrinsic tyrosine kinase - Insulin, IGF-1, FGF, PDGF, EGF
Receptor-associated tyrosine kinase - Prolactin, Immunomodulators (e.g., cytokines IL-2, IL-6, IL-8, IFN), GH

10

Wolf-Chaikoff effect

excess iodine temporarily inhibits thyroid peroxidase -> dec iodine organification -> dec T3/T4 production

11

Cushing syndrome

FA 317

12

Waterhouse-Friderichsen syndrom

Acute primary adrenal insufficiency due to adrenal hemorrhage associated with Neisseria meningitids septicemia, DIC, and endotoxi shock.

13

Neuroblastoma

Most common tumor of the adrenal medulla in children, usually <4 years old. Originates from neural crest cells. Occurs anywhere along the sympathetic chain. Most common presentation is abdominal distension and a firm, irregular mass that can cross the midline (vs. Wilms tumor , which is smooth and unilateral). Homovanillic acid (HVA), a breakdown product of dopamine, inc in urine. Bombesin +. Less likely to develop hypertension. Associated with overexpression of N-myc oncogene.

14

Pheochromocytoma

FA 319

15

Hyperthyroidism

FA 322

16

Thyroid storm

Stress-induced catecholamine surge seen as a srious complication of Graves disease and other hyperthyroid disorders. Presents with agitation, delirium, fever, diarrhea, coma, and tachyarrhythmia (cause of death). May see inc ALP due to inc bone turnover. Treat with the 3 P's: B-blockers (propanolol), Propylthiouracil, corticosteroids (Prednisone)

17

Thyroid cancer

FA 323

18

Papillary carcinoma

Most common, excellent prognosis. Empty-appearing nuclei ("Orphan Annie" eyes), psammoma bodies, nuclear grooves. Inc risk with RET and BRAF mutations, childhood irradiation.

19

Follicular carcinoma

Good prognosis, invades thyroid capsule (unlike follicular adenoma), uniform follicles.

20

Medullary carcinoma

From parafollicular "C cells"; produces calcitonin, sheets of cells in an amyloid stroma, associated with MEN 2A and 2B (RET mutations)

21

Undifferentiated/anaplastic carcinoma

Older patients; invades local structures, very poor prognosis

22

Lymphoma

Associated with Hashimoto thyroiditis

23

Hyperparathyroidism

FA 323

24

Hypoparathyroidism

FA 324