Endocrine Flashcards
1
Q
Stimulates bone and muscle growth
A
GH
2
Q
stimulates milk production
A
Prolactin
3
Q
Stimulates milk secretion
A
Oxytocin
4
Q
Stimulates metabolic activity
A
thyroid hormone
5
Q
Increases blood glucose and decreases protein synthesis
A
Cortisol (glucocorticoids)
6
Q
Preps endometrium for implantation/maintenance of pregnancy
A
Progesterone
7
Q
Stimulates adrenals to make and secrete cortisol
A
ACTH
8
Q
Stimulates follicle maturation in females and spermatogenesis in males
A
FSH
9
Q
Increases plasma calcium, bone resorption
A
PTH
10
Q
Decreases plasma calcium, increase bone formation
A
Calcitonin
11
Q
Stimulates ovulation in females and testosterone synthesis in males
A
LH
12
Q
Stimulates thyroid to produce TH and uptake iodine
A
TSH
13
Q
Secretes growth hormone
A
anterior pituitary
14
Q
secretes glucocorticoids
A
adrenals
15
Q
secretes progesterone
A
ovaries
16
Q
secretes prolactin
A
anterior pituitary
17
Q
secretes oxytocin
A
hypothalamus paraventricular nucleus (stored in posterior pituitary)
18
Q
secretes atrial natriuretic peptide
A
atria of heart
19
Q
secretes glucagon
A
pancreas alpha cells
20
Q
secretes testosterone
A
testes, ovaries
21
Q
secretes FSH
A
anterior pituitary
22
Q
secretes ADH (vasopressin)
A
hypothalamus (stored in posterior pituitary)
23
Q
secretes calcitonin
A
C-cells of parathyroids
24
Q
secretes TSH
A
anterior pituitary
25
secretes epi and NE
adrenal cortex
26
secretes insulin
beta cells of pancreas
27
secretes estradiol
ovaries
28
secretes estriol
placenta
29
secretes estrone
fat
30
secretes estrogen in males
testes
31
secretes somatostatin
delta cells of pancreas
32
secretes LH
anterior pituitary
33
secretes mineralocorticoids (aldosterone)
adrenals
34
secretes ACTH
anterior pituitary
35
inability to breastfeed, amenorrhea, cold intolerance
Sheehan syndrome - ischemic infarct of pituitary after delivery
36
hormones that share a common alpha subunit
TSH, LH, FSH, hCG
37
infertility, galactorrhea, bitemporal hemianopsia
prolactinoma
38
Mnemonic for remembering the symptoms of the congenital adrenal hyperplasia syndrome
1 first number = hypertension
| 1 second number = masculinization
39
Phenotypic female unable to mature, hypertension, salt and water retention
17alpha-hydroxylase deficiency
40
Virilization of genetic female, hypotension, salt wasting, high K+, elevated ACTH
in genetic males, it will present with precocious puberty
21alpha-hydroxylase deficiency (most common CAH syndrome)
41
Excessive sodium excretion in urine, early death, unable to produce glucocorticoids, mineralocorticoids, androgens, and estrogens
3beta-hydroxysteroid dehydrogenase deficiency
42
What drug blocks desmolase ability to form pregnenolone from cholesterol?
ketoconazole
43
Virilization of genetic female, hypertension, salt and water retention
11beta-hydroxylase deficiency
44
Causes of Cushing syndrome
exogenous corticosteroids (most common)
ACTH secreting small cell lung cancer
Cushing disease (pituitary tumor making ACTH)
Adrenal tumor making cortisol
45
Side effects of cortisol use of Cushing syndrome
BAM, CUSHINGOID
Buffalo hump, Amenorrhea/acne, Moon facies, Crazy, Ulcers, Skin changes (striae, bruising, thin skin), HTN, Infections, Necrosis of femoral head, Glaucoma/cataracts, Osteoporosis, Immunosuppression, Diabetes
46
What is the only tumor that will be suppressed by the high-dose dexamethasone test?
ACTH producing pituitary tumor (Cushing disease)
47
Triad of hypertension, metabolic alkalosis, hypokalemia
hyperaldosteronism
48
Most common cause of primary hyperaldosteronism
Adrenal adenoma (Conn syndrome)
49
Medical treatment for hyperaldoesteronism
Spirinolactone, Eplerenone
50
Adrenal insufficiency with skin pigmentation
Addison's disease (AI destruction of adrenals)
51
Hypotension, hyponatremia, hyperkalemia, hypoglycemia, fatigue, weight loss, anorexia
Primary adrenal insufficiency
52
Tx of primary adrenal insufficiency
glucocorticoids, fludracortisone (mineralocorticoid)
53
Causes of secondary hyperaldosteronism (high renin and aldosterone)
renal artery stenosis, JG cell tumor, CHF, cirrhosis, nephrotic syndrome (detect hypoperfusion/low BP)
54
Pituitary tumors, Pancreatic endocrine tumors (Z-E syndrome, VIPoma, insulinoma), Parathyroid adenomas
MEN 1 (PPP)
55
Mutation in MEN 1
MEN 1 - tumor suppressor
56
Mutation in MEN2A and 2B
RET - receptor tyrosine receptor
57
Parathyroid hyperplasia, medullary thyroid cancer, pheocromocytoma
MEN 2A (PPM)
58
Pheocromocytoma, medullary thyroid cancer, mucosal neruomas
MEN 2B (PMM)
59
Most common tumor of adrenal medulla in kids
Neuroblastoma
60
Features of neuroblastoma
Homer-Wright rossettes
Neurofibrillary stain
N-myc oncogene overexpression
Bombesin tumor marker
61
Symptoms of pheocromocytoma
Paroxysms of palpitations (tachycardia), perspiration, pain (HA), pallor, pressure (HTN)
62
Treatment of pheocromocytoma
Alpha blocker - phenoxybenzamine, pentolamine
can follow with beta blocker
surgical resection
beta blocker alone will cause hypertensive crisis due to vasoconstriction of alpha agonism
63
Diagnosis of pheocromocytoma
VMA in urine, metanephrine and normetanephrine in plasma
64
Remnant of the thyroglossal duct
foramen cecum
65
Enlarged, non-tender thyroid with lymphoid aggregates on bx, Hurthle cells, associated with autoantibodies and hypothyroidism
Hashimoto's thyroiditis
66
Fixed, rock hard painless goiter, hypothyroidism, fibrous tissue with eosinophils and macs on bx, may extend into local structures
Riedel thyroiditis
67
Hypothyroidism with very tender thyroid + granulomatous inflammation following URI
Subacute granulomatous thyroiditis
68
Effects of congenital hypothyroidism (cretinism)
intellectual disability, impaired growth, protuberant abdomen, protuberant tongue
69
Hyperthyroidism, pretibial myxedema, proptosis and exopthalmos, goiter, increased uptake of radioactive iodine, thyroid stimulating Abs
Grave's disease
70
Thyrotoxicosis in a pt who is repleted with iodine after being deficient
Jod-Basedow phenomenon
71
Complications of thyroidectomy
hoarseness - damage to recurrent laryngeal nerve
| hypocalcemia - removal of parathyroid glands
72
Empty-appearing nuclei with central clearing, nuclei can look like ground glass, psammoma bodies, nuclear grooves, most common thyroid cancer
Papillary carcinoma
73
Papillary carcinoma gene mutations
RET and BRAF - both receptor tyrosine kinases
74
Follicular carcinoma gene mutation
RAS
75
Unique spread via hematogenous spread, uniform cuboidal cells, invasion thru thyroid capsule
Follicular carcinoma
76
Originates from parafollicular C cells, associated with high calcitonin, polygonal stroma, amyloid stoma, MEN 2A and 2B
Medullary carcinoma
| -screen all pts for pheocromocytoma due to MEN association
77
Older pt with rock hard thyroid, poor prognosis
Anaplastic carcinoma
78
What is lymphoma in the thyroid associated with?
Hashimoto's thyroiditis
79
Location of GLUT-1 transporters
RBCs, brain, cornea, placenta (insulin independent)
80
Location of GLUT-4 transporters
skeletal muscle, adipose tissue (insulin dependent)
81
Location of GLUT-2 transporters
Beta cells of pancreas, kidneys, liver, small intestine (insulin independent)
82
What type of receptor is insulin?
tyrosine kinase
83
Mechanism of insulin release from beta cells
glucose metabolized --> increase ATP --> close K+ channels --> hyperpolarize cell --> open VG Ca2+ channels --> Ca2+ influx --> insulin released from vesicles
84
What complications of diabetes are associated with nonenzymatic glycosylation?
small vessel dz - retinopathy, nephropathy
| large vessel dz - atherosclerosis, CAD, peripheral vascular dz, gangrene (limb loss)
85
What complications of diabetes are associated with osmotic damage?
neuropathy, cataracts
86
How are tissues damaged in diabetes due to osmotic damage?
Schwann cells, retina, kidneys, lens lack sorbitol dehydrogenase, so they can't convert sorbitol to fructose
-do have aldose reductase to form sorbitol from glucose
87
What are two life threatening complications of DKA?
arrhythmias - due to hyperkalemia
| Mucormycosis caused by rhizopus infection - lethal brain fungus infection
