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Flashcards in Endocrine Deck (79):
1

most common ectopic thyroid tissue site

tongue

2

foamen cecum

normal remnant of thyroglossal duct

3

alpha subunit of AP hormones

hormone subunit common to TSH, LH, FSH, hCG

4

beta subunit of AP hormones

determines hormone specificity

5

GLUT 1

RBC, brain, cornea Insulin independent glucose transporter

6

GLUT 2

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

7

GLUT 3

insulin independent glucose transporter in brain

8

GLUT 5

insulin independent fructose transporter in spermatocytes, GI tract

9

what cell type always uses glucose for energy even in starvation

RBCs-lack mitochondria so cannot use ketone bodies

10

why should beta blockers be avoided in diabetics?

if theyre nonselective they can stop hepatic gluconeogenesis leading to hypoglycemia

11

what does TRH do?

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

12

GH induces its effects via

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

13

when is growth hormone secretion highest

during sleep and exercise

14

what causes a decrease in GH release

glucose and somatostatin

15

laron dwarfism

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

16

ghrelin

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

17

leptin

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

18

endocannabinoids

stimulate cortical reward centers and increase desire for high fat food

19

antidiuretic hormone

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

20

Cortisol effects

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

21

how does increase pH effect Ca

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

22

how does PTH increase Ca via bone breakdown

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

23

intermittent PTH causes

bone formation

24

what stimulates PTH secretion

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

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