Flashcards in Endocrine Deck (51)
Tumor of the pancreatic a cells
4 Ds: dermatitis (necrolytic migratory erythema); diabetes (hyperglycemia), DVT, and depression
- Episodic hypoglycemia and mental status changes that improve with glucose
- Have low glucose, high insulin, and high C peptide (indicating endogenous insulin production)
- Treat with surgical resection
Gatrinoma / Zollinger Ellision syndrome
- Gastrin producing tumor of pancreas of duodenum that results in treatment resistant peptic ulcers that can extend into jejunum
-Sx: abdominal pain, diarrhea (malabsorption)
- Test: exogenous secretin (S cells secreted in duodenum to decrease gastric acid sectretion) does not decrease gastrin levels
- Associated with MEN 1
- Inhibits gastrin (results in acholhydria) and CCK which promotes contraction of the gall bladder (can lead to stone and steanorrhea)
Vasoactive peptide inhibits gastric acid secretion
Watery diarrhea, hypokalemia, and acholorhydria (WDHA syndrome - Watery Diarrhea, Hypokalemia, Acholorhydria)
Which structure connects the thyroid gland with the tongue?
reminent in adult is the foramen cecum, a divot at the merge pt of the 3 parts of the tongue
How can you differentiate a thyroglossal duct cyst from a branchial cleft cyst?
TGD cyst is midline and motile (will move with swallowing), comes from patent thryoglossal duct
Branchial cleft cyst is lateral and derives from persistent cervical sinus
What are parafollicular cells in the thyroid dervied from and what cancer do they cause?
cause medullary thyroid cancer (v aggressive)
What are the name of the carrier proteins that transport posterior pituitary hormones from the hypothalamus?
Non insulin dependent
Brain, cornea, RBCs
liver, kidney, small intestine, beta islet cells
High Vmax, high Km
Insulin dependent (insulin upregulates their presence on cell surface)
Muscle and adipose
Low Km (high affinity), low Vmax
Spermatocytes, GI tract
What is another name for IGF-1?
What are the common causes of hypomagnesemia?
Aminoglycosides (gentamycin, etc)
What are the effect(s) of magnesium on PTH?
1) Mild hypomagnesemia causes increase in PTH secretion
2) Gross hypomag causes decrease in PTH secretion
Which hormones use Gas receptors?
FSH, LH, ACTH, TSH [FLAT]
What hormones signal through cGMP?
ANP, BNP, NO (EDRF)
What hormones signal through Gq?
GnRH, Oxytocin, ADH (V1), TRH, Histamine (H1), Angiotensin II, Gastrin
What hormones signal via an intracellular receptor?
Cortisol, aldosterone, T3/T4, progesterone, estrogen, vitamin D
What hormones signal through an intrinsic tyrosine kinase receptor?
Insulin, IGF-1, FGF, PDGF, EGF
What hormones signal through a receptor associated tyrosine kinase?
Prolactin, Immunomodulators (IL2, IL6, etc), GH, G-CSF, EPO, TPO
Effects of Sex Hormone Binding Globulin Levels on Men and women
- Increase SHBG in men decreases free testosterone, gynocomastia
- Decreases in SHBG in women increase free testosterone, cause hirrsuitism
- Increase SHBG (women) due to pregnancy or OPCs do nothing, free estrogen levels unchanged
What are the classic signs associated with a neuroblastoma?
Differences between neuroblastoma and willms tumor?
NB irregular, crosses midline
Wilms: renal tissue, smooth, never crosses midline, slightly older kids >4
What are pheos associated with?
MEN2A, MEN2B, neurofibromatosis type 1, von Hippel Lindau
What is the rule of pheos?
Rule of 10%
What is the pathonomonic presentation of congenital hypothyroidism?
"Cretinism" : 6 Ps, seen in kids
Poor brain development