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Endocrine Flashcards

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1
Q

most common ectopic thyroid tissue site

A

tongue

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2
Q

foamen cecum

A

normal remnant of thyroglossal duct

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3
Q

alpha subunit of AP hormones

A

hormone subunit common to TSH, LH, FSH, hCG

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4
Q

beta subunit of AP hormones

A

determines hormone specificity

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5
Q

GLUT 1

A

RBC, brain, cornea Insulin independent glucose transporter

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6
Q

GLUT 2

A

bidirectional insulin independent glucose transporter on beta islet cells, liver, kidney, small intestine

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7
Q

GLUT 3

A

insulin independent glucose transporter in brain

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8
Q

GLUT 5

A

insulin independent fructose transporter in spermatocytes, GI tract

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9
Q

what cell type always uses glucose for energy even in starvation

A

RBCs-lack mitochondria so cannot use ketone bodies

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10
Q

why should beta blockers be avoided in diabetics?

A

if theyre nonselective they can stop hepatic gluconeogenesis leading to hypoglycemia

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11
Q

what does TRH do?

A

secreted by hypothalamus and increases TSH and Prolactin secretion from the AP

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12
Q

GH induces its effects via

A

JAK STAT receptor tyrosine kinase, increases IGF transcription and production in the liver

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13
Q

when is growth hormone secretion highest

A

during sleep and exercise

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14
Q

what causes a decrease in GH release

A

glucose and somatostatin

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15
Q

laron dwarfism

A

defective GH receptor leading to diminished linear growth, increase GH and decreased IGF1

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16
Q

ghrelin

A

stimulates hunger and GH release, increased in Prader Willi and with sleep loss

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17
Q

leptin

A

produced by adipose tissue and send satiety signal, decreased with decreased sleep, decreased during starvation

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18
Q

endocannabinoids

A

stimulate cortical reward centers and increase desire for high fat food

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19
Q

antidiuretic hormone

A 
monitors BP (V1 receptors) and serum osmolarity (V2 receptors)-osmolarity via aquaporin channel insertion in principal cells of the renal collecting duct 
-regulated primarily by osmoreceptor in the hypothalamus and secondarily by hypovolemia
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20
Q

Cortisol effects

A

BIG FIB
increase in blood pressure, insulin resistance, gluconeogenesis
decrease in fibroblast activity, inflammatory and immune response, bone formation

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21
Q

how does increase pH effect Ca

A

increases negative charge of albumin, increasing its affinity to bind to calcium leading to decreased free ionized calicium and symptoms of hypocalcemia including bone cramps, pain, paresthesia and carpopedal spasms

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22
Q

how does PTH increase Ca via bone breakdown

A

increases production of macrophage stimulating factor and RANK ligand (by osteoblast) which binds RANK receptor on osteoclasts and increases their activity

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23
Q

intermittent PTH causes

A

bone formation

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24
Q

what stimulates PTH secretion

A

decrease ca, increased phos, increased Mg (diarrhea, aminoglycosides, alcohol abuse, diuretics) ***although really low levels of Mg decrease PTH

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25
endocrine hormones that use cAMP
FLAT ChAMP | FSH LH ACTH TSH CRH hCG ACTH MSH PTH + calcitonin, GHRH, glucagon
26
IP3 endocrine hormones
GOAT HAG | GnRH Oxytocin ADH TRH Histamine (H1) Angiotensin II Gastrin
27
endocrine hormones with intracellular receptors
VETTT CAP | Vitamin D Estrogen Testosterone T3/T4 Cortisol Aldosterone Progesterone
28
Endo hormones with intrinsic tyrosine kinase
Insulin, IGF 1, FGF, PDGF, EGF | MAP kinase pathway
29
receptor associated tyrosine kinase
PIGGlET Prolactin Immunomodulators (cytokines, interleukins, IFN) GH, G CSF, Erythropoietin, Thrombopoietin JAK STAT pathway
30
systemic effects of T3
bone growth CNS maturation increase beta1 in heart=increase CO, HR, SV, Contractility increase basal metabolic rate via Na/K atpase activity=increase O2 consumption, RR, body temp increase glycogenolysis, gluconeogenesis, lipolysis
31
hepatic failure effect on TBG
decrease
32
TBG in pregnancy/OCP/hormone replacement therapy
increase
33
5 deiodinase
converts T4-T3 in peripheral tissues
34
wolff chaikoff effect
excess iodine temporaroly inhibits peroxidase activity--> decrease idonine organification and therefore decrease T3/T4
35
conn syndrome
aldosterone hyperactivity 2/2 adrenal hyperplasia | hypokalemia, hypertension, muscle weakness, paresthesia and hypokalemic paresis
36
metyrapone stimulation test
last step of cortisol synthesis is blocked, in normal person will result in decrease in cortisol and increase in ACTH, in adrenal insufficiency ACTH will not raise
37
primary chronic adrenal insufficiency
Addison disease | -adrenal atrophy or destruciton by a disease-autoimmune, TB, metastasis
38
shock, hyponatremia, hyperkalemia, hypoglycemia, with nuchal rigidity, petechial rash
Waterhouse friderichsen syndrome secondary to Neisseria menigitidis -hemmorhage assocaited with speticemia, DIC, or endotoxic shock
39
tertiary adrenal insufficiency
caused by abrupt exogenous steroid withdrawal, aldosterone synthesis unaffected
40
abd distension with firm irregular mass that crosses midline in child
neuroblastoma-neural crest cell derivative | as opposed to wilms tumor (smooth and unilateral)
41
opsoclonus myoclonus syndrome
dancing eyes dancing feet-neuroblastoma | assocaited with n myc overexpression
42
bombesin and neuron specific enolase +
neuroblastoma
43
what common pain relief medication should be avoided in hyperthyroidism
NSAID/ibuprofen-can displace t3/t4 form TBP and increase thyrotoxic state -acetominophen is preferred instead
44
hashimoto thyroiditis increased risk of what canecer
non hodgkin lymphoma
45
hurthle cells with lymphoid aggregates and germinal centers on thyroid histo
Hashimoto thyroiditis (on exam enlarged nontender thyroid)
46
increase ESR, jaw pain, very tender thyroid
deQuervain thyroiditis (subacute thyroiditis) self limited usually following flu like illness and histo: granulomatous infiltration - iodine uptake would show diffuse decrease in iodine uptake treatment: NSAIDs
47
fixed hard painless goiter with sx of hypothyroid
Riedel thyroiditis - thyroid replaced by fibrous tissues-fibrosis can extend to local structures and mimic anaplastic carcinoma - a manifestation of IgG disease-autoimmune pancreatitis, retroperitoneal fibrosis, noninfectious aortitis
48
jod basedow phenomenon
thyrotoxicosis if a patient with iodine deficiency goiter is made iodine replete
49
empty appearing nuceli with central clearing, psamomma bodies, nuclear grooves
papillary carcinoma-lyphatic invasion is common | history of radiation as a child, RET BRAF mutations
50
uniform follicle with capsular invasion
follicular carcinoma
51
sheets of cells in an amyloid stroma/uniform polyglonal or spindle shaped cells
medullary carcinoma hematogenous spread produces calcitonin MEN 2A, 2B RET gene
52
markes pleomorphism, irregular giant cells, biphasic spindle cells
anaplastic/undifferentiated carcinoma
53
hypocalcemia, sortened 4th/5th digits, short stature
Albright hereditary osteodystrophy | -unresponsiveness of kidney to PTH
54
familial hypocalciuric hypercalcemia
defective ca receptor on parathyroid cells -PTH cannot be suppressed by increase in ca2+ miild hypercalcemia with nml to high PTH, hypocalciuria
55
cystic bone spaces filled with brown fibrous tissue consisting of hemosiderin from hemorrhages
osteitis fibrosa cystica
56
atrophy or compression of pituitary
empty sella syndrome often idiopathic, common in obese women
57
Kimmelstiel-Wilson nodules
chronic complication of Diabetes, Nodular glomerulosclerosis
58
increased beta hydroxybutyrate
a ketone body intermediate and a sign of insulin deficiecncy
59
dermatitis, DVT, depression, diabetes
glucagonoma, tumor of pancreatic alpha cells causing excess of glucagon
60
low blood glucose, symptoms of hypoglycemia, resolution of symptoms after normalization of glucose levels
insulinoma | -decreaed blood glucose and increase C peptide
61
recurrent diarrhea, cutaneous flushin, asthmatic wheezing, right sided valvular disease
Carcinoid syndrome-increase 5 hydroxyindoleactic acid in urine, niacin deficiency (pellagra) tx: surgical resection and somatostatin, octreotide
62
secretin stimulation test
used to diagnose zollinger ellison syndrome-gastrinoma, give pts secretin and see if gastrin levels remain elevated
63
MEN 1
parathyroid pituitary (prolactin or GH) pancreatic (gastrinoma, insulinoma, VIPomas, glucagonomas) MEN 1 gene
64
MEN2a
parathyroid, pheochromocytoma, medullaruy thyroid cancer | RET gene
65
MEN 2b
pheochromocytoma, medullary thyroid carcinoma, oral/intestinal ganglioneuromatosis RET gene
66
rapid actin insulin
aspart, glulisine, lispro-monomeric form so work faster than regular insulin (hexamer) se: hypersensitivity, hypoglycemia rare
67
intermediating acting insulin
NPH
68
long acting insulin
detemir and glargine (no peak) | once a day dosing
69
metformin
biguanide, mech not known decreased gluconeogenesis, increases glycolysis, increase peripheral glucose uptake (increase inculin sensitivity) SE: GI upset, lactic acidosis (not used in renal or liver insufficieny) causes weight loss
70
``` chlorpropamide tolbutamine glimepiride glipizide glyburide ```
sulfonylureas - close K channel in beta cells, causing membrane depolarization and increase insulin release with ca influx - stimuelat the release of insulin used in T2DM (need some islet fuction) se: risk of hypoglycemia in renal failure, first generation: disulfiram like effects, second generation hypoglycemia
71
pioglizatone, rosiglitazone
bind PPARgamma an dincrease insulin sensitivity via adipnoectin, T2DM se: weight gain, hepatotoxicity, HF increased risk of fractures
72
exenatide
GLP1 analog | increse insulin and decrease glucagon release used in T2DM se: nausea, vomitting, pancreatitis
73
linagliptin, saxagliptin, sitagliptin
DPP4 inhibitors increase insulin, decrease glucagon release used in T2DM se: mild urinary or respiratory infections
74
pramlintide
amylin analog -decreases gastric emptying used in T2DM se: glucosuria, UTIs, vaginal yeast infections
75
acarbose, miglitol
alpha glucosidase inhibitors -acarbose, miglitol inhibit brush border alpha glucosidass causing delayed carbohydrate hydrolysis and glucose absorption decrease postprandial hyperglycemia se: GI disturbances, not used in IBD, colonic ulceration, intestinal obstruction
76
cinacalcet
sensitizes Ca sensing receptors in parathyroid gland to circulating Ca2+ and decreased PTH, used in hypercalcemia due to primary or secondary hyperparathyroidism toxicity: hypocalcemia
77
demeclocycline
ADH antagonist SIADH toxicity: nephrogenic DI, photosensitivity, abnormalities of the bone and teeth
78
somatostatin used for
acromegaly, carcinoid syndrome, gastrinoma, glucagonoma, esophageal varices
79
conivaptan, tolvaptan
ADH antagonists used for SIADH, block the action of ADH at the V2 receptor

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