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Flashcards in Endocrine Deck (48):
1

insulin cascade on skeletal muscle/fat cells

- binds to receptor (tyrosine kinase activity) --> Pi3K leads to inc GLUT 4 transporters and glycogen, protein and lipid synthesis
- RAS/MAP kinase pathway leads to cell growth and DNA synthesis

2

GLUT 4 receptors on

skeletal muscle and adipose tissue

3

GLUT 1 receptors on

RBCs, brain, cornea

4

GLUT 5 receptors on

spermatocytes, GI tract

5

GLUT 2 receptors on

B islet cells, liver, kidney, small intestine

6

glucagon made in the

alpha cells of the pancreas

7

CRH function

increases ACTH, MSH, B-endorphin
-- all these hormones are created through cleavage of POMC
-- B endorphin is a pentapeptide that binds to delta and mu receptors

8

prolactin function

- decreased GnRH secretion
- prolactin itself is inhibited by dopamine

9

somatostatin function

- decreases GH and TSH secretion

10

TRH function

increases TSH and prolactin secretion

11

ADH/Diabetes insipidus

- synthesized in the hypothalamus
- permanent DI occurs when there is damage to the hypothalamus
- nephrogenic doesnt respond to ADH, central does

12

cortisol mechanism of increasing blood pressure

- upregulates alpha receptors on arterioles --> increases sensitivity to norepi and epi

13

PTH secreted by

chief cells of parathyroid

14

low Mg's effect on PTH

decreased Mg increases PTH
severely decreased Mg decreases PTH

15

calcitonin secreted by

parafollicular cells in the thyroid

16

hormones that use cAMP signalling pathway

FLAT ChAMP
- FSH, LH, ACTH, TSH, CRH, hCG, ADH (V2 receptor), MSH, PTH, calcitonin, GHRH and glucagon

17

hormones that use cGMP pathway

NO and ANP

18

hormones that use IP3 pathway

GOAT HAG
- GH, oxytocin, ADH (V1 receptor), TRH, histamine, ang II, gastrin

19

hormones that act on intrinsic tyrosine kinase receptors

insulin, IGF-1, FGF, PDGF, EGF

20

hormones that act on receptor associated tyrosine kinases

prolactin, immunomodulators (IL-2, 6, 8, IFN) and GH
PIG

21

enzyme responsible for oxidation of iodine, iodination of TG and MIT/DIT coupling

thyroid peroxidase

22

thyroglossal duct cyst

anterior midline neck mass that moves with swallowing or protrusion of the tongue

23

most common tumor of the adrenal medulla in kids vs. adults

neuroblastoma vs. pheo

24

post pit

ADH and oxytocin
- derived from neuroectoderm
- hormones produced in the thalamus, moved to the post pit by neurophysins

25

ant pit

ACTH, GH, TSH, FSH, LH, MSH, prolactin
- derived from oral ectoderm (Rathke pouch)

26

secondary hyperaldosteronism

- due to renal perception of low intravascular volume (overactive RAAS)
- renal artery stenosis, CHF, cirrhosis, nephrotic syndrome
- treat with spironolactone

27

Waterhouse-Friderichson syndrome

acute primary adrenal insufficiency associated with Neisseria meningitidis septicemia, DIC and endotoxic shock

28

Neuroblastoma

- most common adrenal medulla tumor in kids
- arises from neural crest cells
- firm, irregular mass that can cross the midline
- inc HVA, assocaited with n-myc oncogene

29

pheo

- associated with VHL, MEN 2A and 2B, NF1
- increased urinary VMA
- treat with irreversible alpha agonist (phenoxybenzamine) and beta blockers before resection

30

Hashimoto Thyroiditis

- most common cause of hypothyroidism in iodine sufficient areas
- anti-thyroid peroxidase, anti-microsomal and anti-thyroglobulin Abs
- may be hyperthyroid early in the course
- histo: Hurthle cells, lymphoid aggregate with germinal centers
- moderately enlarged, non-tender thyroid

31

Subacute/de Quervain/granulomatous thyroiditis

- self limited following flu-like illness
- may be hyperthyroid early in course
- histo: granulomatous inflammation
- inc ESR, jaw pain, VERY tender thyroid

32

Reidel thyroiditis

- thyroid replaced by fibrous tissue, may extend into local tissues, mimicking anaplastic carcinoma (but this is in young people)
- IgG2 related systemic disease
- fixed, hard, rock-like thyroid

33

Wolff-Chaikoff effect

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

34

toxic multinodular goiter

focal patches of hyperfunctioning follicular cells independent of TSH due to mutation in TSH receptor
- hot nodules are rarely malignant

35

Jod-Basedow phenomenon

- thyrotoxicosis if a pt with iodine deficiency goiter is made iodine replete

36

papillary thyroid carcinoma

- most common, excellent prognosis
- orphan annie nuclei (empty appearing), psammoma bodies, nuclear grooves
- inc risk with RET and BRAF mutations, childhood irradiation

37

follicular thyroid carcinoma

- good prognosis, invades thyroid capsule (unlike adenoma)
- spreads hematogenously

38

medullary thyroid carcinoma

- from parafollicular C cells in an amyloid stroma
- calcitonin
- associated with men 2A and 2B

39

pseudohypoparathyroidism

- Albright hereditary osteodystrophy
- AD unresponsiveness of kidney to PTH (end organ resistance to PTH due to Gs mutation)
- hypocalcemia, shortened 4th/5th digits, short stature

40

treatment for acromegaly

somatostatin analogs - octreotide
or GH receptor antagonist - pegvisomant

41

treatment for nephrogenic vs. central DI

- central: DDAVP and hydration
- nephrogenic: HCTZ, indomethacin, amiloride and hydration

42

causes and treatment of SIADH

- causes: ectopic ADH (small cell lung cancer), CNS disorders/head trauma, pulmonary disease (COPD, pneumonia), drugs (cyclophosphamide)
- treat with fluid restriction, IV hypertonic saline, conivaptan, tolvaptan, demeclocycline

43

Whipple triad

- episodic CNS symptoms associated with insulinoma
- lethargy, syncope and diplopia

44

Zollinger-Ellison Syndrome

- gastrin secreting tumor of the pancreas or duodenum
- acid hypersecretion leads to ulcers in the duodenum and jejunum
- associated with MEN 1

45

MEN 1

diamond
- pituitary tumors (prolactin or GH)
- parathyroid tumors
- pancreatic endocrine tumors (Z-E, insulinomas, VIPomas, glucagonomas)
- commonly presents with kidney stones and stomach ulcers

46

MEN 2A

square
- parathyroid hyperplasia
- pheo (chromaffin cells)
- medullary thyroid carcinoma
** RET proto-oncogene

47

MEN 2B

triangle
- oral/intestinal ganglioneuromatosis (mucosal neuromas)
- pheo
- medullary thyroid carcinoma
- marfanoid habitus
** RET proto-oncogene

48

hormones that use steroid receptors

Vit D, Estrogen, Testosterone, T3/T4, cortisol, aldosterone, progresterone
VETTT CAP