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Flashcards in Endocrine Deck (172):
1

Medullary Ca thyroid

Parafollicular C cells ( calcitonin)

2

Desmopressin

ADH analogue

3

Orphan Annie

Papillary ca

4

Octreotide is a

Somatostatin

5

Increased 5-HIAA in urine

Carcinoid syndrome

6

24 hr insulin

Glargine
Detemir

7

Post prandial insulin

Aspart Lispro Glulisine

8

Demeclocycline

ADH antagonist (tetracycline)

9

pituitary hormones with similar beta subunits

HCG and TSH (LSH and FH closer)

10

what is tesamorelin

GHRH analog used for HIV associated lipodystrophy

11

alKaLowsis has

low calcium

12

cushings disease

ACTH secreting pituitary adenoma (can be suppressed by high dose dexa)

13

aldosterone action

Na and H2O absorption
K and H secretion

14

what happens to aldosterone in 2 and 3 adrenal insuffinincty

preserved

15

neuroblastoma 3 lab markers

HVA and VMA
bomebsin and neuron-speific enolase
N-myc oncogene (N for)

16

dancing eye and dancing feet diagnosis

neuroblastoma

17

increased metanephrines in urine

phaechromocytoma

18

pre-tibial myxedema seen in

graves disease

19

two assicated blood lab finding ins hypothyroidism

CK and cholesterol high

20

lymphocytic thyroiditis aka

hashimoto

21

de quervain aka

sub a/c thyroiditis
VAIN for PAIN

22

reidel thryoid feels like a

stone

23

HLA associton for hashimoto

HLA-DR5

24

follicle working independently of TSH: what goiter

toxic multinodular goiter

25

cause of death in thyroid storm

tachyarrythmia

26

Jod basedow is the opposite of

wolff chaikoff

27

treatment for thryoid storm

propyl thiouracil, propranol, prednisolone (PPP)

28

for thyroid cancer think of

pap smear

29

shortened 4th and 5th digit what disease

psuedohypoparathyroidism (albright hereditary osteodystrophy)
unresponsive kidney to PTH

30

familial hypocalciuric hypercalcemia MM

defective Ca sensor on parathyroid cells

31

increased cAMP in urine

primary hyperparathyroidism

32

what is renal ostodystrophy

bone disease due to 2 or 3 hyperpara due to renal disease

33

autonomous hyperparathyoridism

tertiary

34

pegvisomant is

GH receptor antagonist for acromegaly

35

lithium be careful about

DI and hypthyroidism

36

HCO3 is - in DKA

decreased

37

necrolytic migratory erythema

glucogonoma (DVT and depression in addition to DM)

38

enzyme def in carcinoid syndrome

niacin (tryptophan channeled to 5HT)

39

zollinger E sndrome location

pancreas and duodenum

40

positive secretin stimulaiton test used for

ZE syndrome

41

MEN codes

PPP
PAT
NAT

42

what class is metformin and SE

biguanide and lactic acidosis

43

what class is chlorpropamide and SE

sulphonyl urea (hypoglycemia)

44

PPAR gamma activated by which anti-DM drug

glitazones/thiazoledinediones

45

eg of alpha glucosidase inhibitors

acarbose miglitol

46

...vaptans are

ADH antagonists for SIADH at V2 recetpor

47

MC and GC activity

fludrocortisone

48

cinacalcet

sensitize ca+ sensing receptor of parathyroid cells (will decrease PTH)

49

hypo-osmotic volume contraction eg

ADRENAL INSUFFICIENTY

50

subperiosteal thinning

primary hyperparathyridism

51

mother and baby virilization

placental aromatase def

52

blood transfusion then hypocalcemia

due to citrate chelation

53

branchical cleft cyst from

persistent cervical sinus

54

will there be HT in neuroblastoma

NO (phaeochromoccytoma-episodic)

55

anterior and post pituitary dev

oral ectoderm (rathke: anterior) and neuroectoderm

56

herediary hypothalamice DI protein

neurohypophysin

57

GH incrase insulin

because resistance

58

beta2 and insulin

enhances(a2 inhibits)

59

GnRH regulated by

prolactin (dop sup prol and prol sup GnRH)
p316

60

hypogly in non-medical setting

im glucagon (iv dextrose medical)

61

Gherlin secreted from and function

Stomach (hunger and GH release)

62

21 a hydroxylase in glomerulosa

11 deoxy corticosterone (active)

63

future of testosterone

estradiol (Aromatase), dihydrotestosterone (5 a reductase)

64

most common CAH

21 a hydroxylase (salt wasting infancy, precocious puberty childhood, virilization in XX.
21 a and 11 b (not in 17 a)

65

LAbs in CAH

17 a- ess andostenedione
21a= 17 hydroxy progesterone more renin
11 b= less reninin

66

CAH why size

ACTH

67

steroids and TB

IL 2

68

increased Ph and calcium

more binding to albumin in alkalosis

69

2 actions of vitamin D

increased absorption of both, increased resorption of both, no action in kidney

70

4 actions of PTH

bone both
DCT calcium, PCT Po4 loss
PCT 1 a hydroxylase

71

OCP and pregnancy- free estrogens

unchanged, increased SHBG

72

somatostatin suppress both and why

T3 and GH synergize for bone growth

73

active of thyroid hormone

T3 (T4 to T3 by 5' de iodinase)

74

TBG and estrogen

estrogen increase TBG, OCP and pregnancy
decrease in hepatic failure and seroids

75

Iodine go to the cell by

Na I symporter
Inhibited by perchlorate, pertechnate, thiocyanate and P iodide

76

methimazole vs propyl thiouracil

propyl thiouracil- both peroxidase and 5' deiodinase
Methimazole- only peroxidase

77

cushing disease, CRH test

ACTH and cortisol will increase
(ectopic no increase)

78

metyrapone stimulation test

inhibit 11 deoxy cortisol-cortisol
ACTH increase normal
in adrenal insufficiency, ACTH remain decreased

79

addison disease

chronic adrenal insufficiency (primary)

80

hyponatremic volume contraction

primary adrenal insufficency

81

secondary adrenal insufficiency

pituitary ACTH decrease
spares skin and aldosterone

82

Tertiary adrenal insufficiency

due to treatment, spares aldosterone

83

conn syndrome

primary hyperaldosteronism

84

aldosterone escape(be aware)

no edema and hypernatremia in conn syndrome

85

homer wright rosette

neuroblastoma

86

wilms vs neuroblastoma

neuroblastoma- irregular and cross midline

87

secondary hyperaldosteronism due to

increased renin

88

pheochromocytoma associated conditon

NF type 1, MEN 2A and 2B, van hippel landau disease

89

episodic hypertension/spells

pheochromocytoma

90

panic attack vs pheochromocytoma

BP very high and headache

91

treatment for pheochromocytoma

phenoxybenzamine

92

myxoedema seen in

hypothyroidism

93

4 causes of hypothyroidism

hashimoto, cretin, subacute, reidels
sub acute = de quervein

94

immunology of hashimoto

antiperoxidase (microsomal), anti thyroglobulin

95

hashimoto histology

lymphocytic thyroiditis (germinal center)
Hurthle cells

96

hashimoto risk

NHL

97

cretin two features at birth

prolonged jaundice, protruding umbilicus

98

Flu leading to hypothyroidism

sub acute (De quervein) (self limited)

99

only hypothyroidism pain

de quervein (self limited)

100

why reidel is stone like

replaced by fibrous tissue
mimic anaplastic cancer, extend to local tissues
IgG4 mediated

101

histology of de quervein

granulomatous inflammation

102

Graves disease exophthalmos why?

increased glycosamino glycans from retrooribital fibroblasts (same for pre tibial myxedema- dermal fibroblasts)

103

3 conditons of hyperthroidism

Graves
Toxic MNG
Job basedow

104

Treatment for Graves disease

Radioactive iodine

105

exophthalmos treatment

prednisolone

106

thyroidectomy- superior laryngeal artery goes with

superior laryngeal nerve
(recurrent laryngeal nerve with inferior thyroid)

107

nothing to say about

follicular carcinoma of thyroid

108

histology of papillary carcinoma

orphan annie, psammoma, nuclear grooves

109

risk of papillary carcinoma

childhood irradiation, RET and BRAF mutation

110

congo red and thyroid cancer

medullary ca
(nest of polygonal cells with amyloid)

111

thyroid cancer with finely dispersed chromatin with ground glass appearance

orphan annie

112

pseudohypoparathyroidism aka

albright hereditary osteodystrophy
unresponsiveness to hormone

113

PTH independent hypercalcemia

excess ingestion and cancer

114

familial hypocalciuric hypercalcemia

parathyroid does not know increased calcium levels
calcium absorption normal though serum caclcium high. PTH is normal to high

115

primary, sec, ter hyperparathyroid names

osteitis fibrosa cystica
renal osteodystrophy
autonomous

116

code for osteitis fibrosa cystica

stones, bones, groans, psychiatric overtones

117

increased C AMP in urine

osteitis fibrosa cystica

118

dopamine agonists

bromocryptine and cabergolline

119

pituitary adenoma and sex drive

low libido

120

untreated proalctinoma in female

decreased estrogen - causes osteoporosis and vaginal dryness

121

two treatment for acromegaly

somatostatin (octreotide)
pegvisomant (GH receptor antagonist)

122

acromegaly and cancer

increased risk of colorectal polyp

123

cause of death in gigantism

heart failure

124

hyperosmotic volume contraction

DI urine sp gravity 290

125

causes of nephrogenic DI

lithium and demeclocycline

126

treatment for nephrogenic DI

thiazide and amiloride, indomethacin

127

euvolmeic hyponatremia

SIADH(aldo decreases= euvolemia)

128

SIADH (Sir CPM)

correct hyponatremia slowly

129

SIADH treatment

fluid restriction and vaptans
hypertonic saline

130

3 causes of low pituitary hormones

sheehan, empty sella, apoplexy

131

apoplexy clinical features

meningeal irritation, headache, ophthalmoplegia

132

type 2 DM complication

hyperosmolar coma

133

common cause of death in DM

MI

134

DM 2 types of pathogenesis

glycation (retina and kidney)
osmotic damage (lens and schwann cells)

135

glycation in kidney

nodular glomerulosclerosis (kimmel steil wilson)

136

lipotoxicity

insulin resistance (serine phosphorylation) and decreased insulin secretion

137

type 1 and 2 DM genetics

weak for type 1 and strong for type 2
HLA DR3 and DR4 for type 1

138

histology of type 1 and type 2

leukocyte infiltrate in type 1,
IAPP (islet amylod polypeptide) in type 2

139

respiration in DKA

kussmaul (rapid and deep)

140

glucagonoma clinical features

dermatitis (necrolytic migratory erythemaaaaaa), DM, DVT, depression

141

carcinoid tumor serete

serotonin (neuroendocrine cells enterochromaffin cells)

142

4 clinical features of carcinoid syndrome

diarrhea, flushing, wheezing, TR

143

carcinoid syndrome wo situations

extraintestinal, metastasis
intestine- most common malignancy

144

secretin stimulation test for

gastrinoma (ZEsyndrome)
gastrin remains elevated

145

mucosal neuroma and marfanoid habitus

MEN 2B

146

PAT and NAT

A pheochromocytoma, T medullary thyroid cancer of thyroid

147

gestational DM treatment

insulin

148

insulin class

postprandial = ALG and regular
basal = determir, glargine, NPH

149

lispro

reversal of lysine and proline

150

insulin for DKA

regular (short acting)

151

name 3 standard drugs for DM

Biguanides (metformin), sulphonylureas (---ide),
Glitazones/thiazolidine diones

152

2 DM drugs that enhance insulin sensitivity

biguanides (metformin) and glitazones

153

DM drug CI in renal disease

biguanides (cause lactic acidosis) and GI upset

154

sulphonylurea side effect

first gen= disulphiram
2nd gen= hypoglycemia (increased in renal failure)

155

advantage of glipizide

short acting, decrease incidence of hypoglycemia

156

glitazones side effect

weight gain and heart failure

157

classify new DM drugs

GLP1 agonists, inhibitors of DPP4, kidney, intestine

158

GLP1 agonist

exenatide, liraglutide

159

inhibitor of GLP 1 lysis

gliptins

160

kidney absortion

flozins (SGLT2)

161

intestine absorption

alpha glucosidase = acarbose, miglitol

162

flushins

flozins (SGLT2)

163

glitazones MOA

PPARgamma enhance adiponectin
increase insulin sensitivity

164

pregnancy antithyroid

PTU
aplasia cutis with methimazole

165

PTU toxicity

hepatotoxicity, ANCA vasculitis

166

use of octreotide

acromegaly, carcinoid syndrome, glucagonoma, gastrinoma, varices

167

ADH antagonists

vaptans and demeclocycline

168

local steroid side effect

thinning of skin

169

cincalcet is opposite to

familial hypocalciuric hypercalcemia
PTH decrease

170

thyroid enzyme inhibited by

beta blockers
deiodinase

171

subperiosteal thinning and salt and pepper skull

hyperparathyroidism

172

meglitinide is functionally similar to

sulphonylurea