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Flashcards in Endocrine Deck (31)
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1
Q

Apocrine glands

  • location
  • location on body
  • unique
  • produce
  • activated
A
  • dermis and sub cu fat
  • axilla, arula, genial region
  • secrete sweat into fair follicle instead of directly onto skin surface
  • odorless sweat -> but bacterial action produces malordorous scent
  • in puberty
2
Q

Eccrine glands (amarocrine)

  • produce
  • location
A
  • sweat directly on skin surface

- all over body except for lip and penis

3
Q

Fat soluble hormones va water

  • fat: which ones, pathway
  • water
A
  • steroids ( aldosteron, cortisol, test, DHT, estrogen) and thyroid; cross cytoplasmic membrane, go into nucleus, bind to nuc receptor (except cortisol whose receptor is in cytoplasm); no
  • everything else
4
Q

pit

  • ant made from; remnants
  • post made from
  • sits in
  • covered by
  • connected to hypthal
  • secretes
  • craniopharyngioma: caused by, what is it, histo; contains, epi, sxs
A
  • oral ectoderm from rhatkes pouch
  • neuroectodermal tissue
  • sella turscia, part of sphenoid bone
  • diaphragm masella
  • through pit stalk
  • ACTH, MSH, GH, TSH, LH/FSH, ACTH, prolactin, ADH, and oxytocin
  • remnants of pouch; calcified cystic tumor located in suprasellar area; cysts are lined by strat squamous epi; yellow fluid the consistency of machine oil; childen between 5-10 yrs; headache, bi temp hemianopsia, hypopituitarism, growth retardation
5
Q

Parts of Ant Pit

  • pars distalis
  • pars tuberalis
  • pars intermedia
A
  • biggest part; where hormone production occurs
  • wraps pit in vascularized sheath
  • responsible for producing MSH
6
Q

Nuclei

  • supra optic nec
  • pre-optic
  • paraventricular
  • medial pre-optic
  • lateral
  • ventromedial
  • arcuate
A
  • ADH and oxy
  • thermo regulation
  • TRH, CRH, oxy, ADH, somatostatin
  • produces GnRH and thermo regulation
  • orexin -> responsible for keeping awake
  • satiety
  • GHRH and inhibits prolactin
7
Q

Staining

- basophilic

A
  • all except GH and prolactin
8
Q

Pit hormone roles

  • ACTH: comes from, releases
  • MSH: function
  • GH: func, works,
  • FSH: in women, in men
  • LH:
  • ADH
  • prolactin
  • oxytocin
  • TSH
A
  • POMC -> ACTH (releases cortisol), MSH (signal melanocytes to make melanin) appetite suppressant, reg aldosterone and inflamm response), endorphins
  • GH stimulates bone and muscle dev, works via IGF1; excess will cause gigantism or acromegaly; dwarfism caused by defect in growth hormone receptor -> elevated GH and decreased IGF1
  • dev of follicle and production of estrogen ; spermatogenesis
  • androgen production
  • water reabsorption and vasoconstriction
  • produces lmilk
  • release of milk and uterine contractions
  • stimulate growth of thyroid gland and production of T3/T4
9
Q

Cell types in pit

  • lacto
  • gonado
  • cortico
  • somato
  • thyro
A
  • prolactin
  • LH/FSH
  • ACTH
  • GH
  • TSH
10
Q

Post lobe parts

  • pars nervosa
  • infundibular stalk
  • median eminence
A
  • biggest part, holds hormones
  • connects to hypothal
  • contains hypothal-hypophyseal portal vessels
11
Q

Dopaminergic pathways in brain

  • mesolimbic/mesocortical
  • nigro-striatal
  • tubero-infundibular
A
  • controls behavior; diseased -> schizo
  • coordinated voluntary movement -> parkinsons
  • controls prolactin secretion -> when diseased get hyperprolcatinemia
12
Q

Pit tumors

  • prolactinoma: sxs; labs, imaging, tx
  • chromophobic adenoma: common, types, sxs, tx
A
  • galactorrhea, ED, hypogonadism, gynecomastia, amennorrhea/ infertility, bitemp hemi, n/v, vertigo; serum prolactin level and TRH level (elevated -> can cause elevated prolactin, hyper prolactinemia in pts hypothyroid); MRI; bromocriptine (dopamine agonist)
  • most common ;macro- men, micro- women; mass effect, remove with surgery
13
Q

Common primary brain tumor

  • glioma: epi; sxs;
  • astrocytoma: what is it, age, sxs
  • optic nerve glioma: epi, sequelae
  • craniopharngioma: epi, what is it
  • pit adenoma: sxs
  • schwannoma: epi, sxs
  • ependymoma: epi, sxs
  • brainstem glioma: epi, sxs
  • medulloblastoma: epi, grow, sxs
  • pineal glannd tumor: epi, sxs
  • meningioma: epi, comes from, sxs
A
  • adults (35); seizure and headache;
  • type of glioma; 35-50; alt mental status, headache, n/v
  • children; deteriorating vision but only 5% lead to blindness
  • children, calcified cystic tumor
  • mass effect, increased production of hormone
  • 18-24 yrs; hearing loss
  • 5 yrs; headache, vomiting, hydrocephalus
  • 20-40 yrs; weakness and CN dysfunction
  • under 10 yrs; fast; behavior changes and increased ICP
  • 35-40; headache and hydrocephalus
  • 40-60; rises from arachnoid cap; seizure and spastic weakness
14
Q

Thyroid

  • blood supply
  • blood drainage
  • branch that runs w/ sup vessels; sequelae if damaged
  • embyology: from, descends, stimulating hormone produced, thyroid hormone produced
  • histo: follicles; follicular cells; parafollicular
  • function of T3/4: main, bone, catecholamine, heat, metabolism
A
  • ext carotid a -> sup thyroid a; subclavian -> cervical thyroid trunk -> inferior thyroid artery
  • superior and middle thyroid into IJV, and inferior thyroid a into brachiocephalic
  • external branch of sup laryngeal n (from vagus) -> will have a problem with pitch of voice -> cannot make high tones
  • 3rd and 4th floor of pharynx, descend from base of tongue and through thyroglossal duct; 16-20 weeks, 18-20 weeks
  • follicles are sphere shaped and contain iodine; follicular produce T3/4 and when inactive they are cuboidal but when active they are tall columnar; parafollicular produce calcitonin
  • regulate BMR and increases protein synthesis; reg bone growth and growth hormone, increases sensitivity to catecholamine, generates heat, reg protein /carb/ fat metabolism
15
Q

Production of thyroid hormone

  • pathway
  • diff in
A
  • iodine goes into follicular cell; iodide binds to tyrosine, then becomes triiodotyosine and tetraiodoyrosine
  • T3 is more active and T4 is more abundant
16
Q

Graves dx

  • what is it
  • diff from multi nodular and adenoma
  • patho
  • epi
  • sxs
A
  • entire thyroid gland is over producing thyroid hormone
  • only the nodules/tumor are over producing hormone
  • auto antibodies target TSH receptor and activate it
  • middle age female
  • ## goiter, exopthalmos (enlargement of extra oc muscles and increased fibroblast proliferation and ground substance production), weight loss, tachy, heat intolerance
17
Q

Toxic multi nodular goiter

  • what is it
  • hot vs cold –> importance
A
  • isolated nodules that produce thyroid hormone

- hyperfucntioning nodule vs hypofunctioning nodule –> cold nodule has 10% chance of being malignant and

18
Q

Toxic thyroid adenoma

  • what is it
  • caused by
A
  • solitary neoplasm, can be hot or cold

- genetic mutation causing an adenoma

19
Q

Subacute thyroiditis

- what is it

A
  • viral illness causes inflammation which causes leak of thyroid hormone -
    > hyper thyroid -> then run out -> hypothyroid -> then go back to normal
20
Q

Hyperthyroidism

  • TSH
  • T3/4
  • what happens next
  • manage: sxs, problem, cure
A
  • low
  • high
  • radio-iodine uptake scan -> look for hot nodules
  • BB: control sympathetic sxs, PTU or methemitazole -> block peripheral conversoin T4 to T3 (can cause agranulocytosis, give radioactive iodine to abalte thyroid gland
21
Q

Hypothyroid

  • sxs
  • primary
  • secondary
  • tertiary
A
  • weight gain, hair loss, cool extreme, weight loss, cold intolerance, fatigue
  • problem is at level of thyroid gland
  • problem at pit gland
  • problem at hypothal
22
Q

Hashimotos

  • what is it
  • sequelae
  • gross
  • histo
A
  • auto-antibodies that attack TPO or thyroglobulin
  • gradual destruction of follicles
  • firm, large, lobulated gland
  • ## mono-nuclear parenchymal infiltration with well developed germinal centers
23
Q

DeQuervians throiditis: what is it, diff from subacute

  • cretinism: what is it, sxs, management
  • lymphocytic thyroiditis: what is it
A
  • subacute thyroidits that occurs after viral infection; will be painful, neck pain
  • maternal hypothyroid leading to congenital hypothyroid; stunted growth, poor feeding, intellect disability thickened facial features; give thryoid hormone immediately once born
  • post partum, self limited
24
Q

Thyroid CA

  • papillary: common, epi, from, histo, prognosis, tx, mets
  • follicular: epi, originates, mets, prognosis
  • medullary: caused by; originates from, sxs, associated w
  • anaplastic: common, epi, infiltrates, prognosis
A
  • most common; young; from follicular cells; branching papilla w/ fibrovasc stalk lined by cuboidal epi w/ ground glass nuclei, will also see centrally calcified structures (psamomma bodies); slow growing; one lobe -> thyroid lobesctomy; METS to the LN
  • older pts, female; from follicular cells; mets to bone; good
  • germline mutation in RET (TYK); parafollicular cells; painful mass; extracellular deposits of amyloid; MEN 2 a and b
  • rare, older, local vasc supply making it unresectable, lethal
25
Q

Zona glomerulosa

  • produces
  • stimulated by
  • inhibited by
  • function
  • conns syndrome: what is it, how, labs
  • adrenal insuff: caused by, deficiencies
A
  • aldosterone
  • hypo vol, natremia and hyper K -> AGII
  • hypervol
  • increase Na/K channels, induces release of ADH, stimulates thirst center of brain
  • hyper aldosteonr; aldosterone secreting tumor; hypo K, hyper Na, vol, acidic (bc reabsorbing K and kicking out H
  • congentical adrenal hyperplasia; 21 hyroxylase def (cant make cortisol either -> have virilization) or 11 hydoxylase def (can make 11-deoxy corticosterone which acts like aldosterone so will have HTN)
26
Q

Zona fasiculata

  • produces
  • stimulated by
  • inhibited by
  • function
  • cushing: dx vs syndrome; sxs;
  • dex test: steps
  • addisons: what is it, sxs, test, tx
  • addisonian crisis: what is it, sxs, tx
A
  • gluco corticoid -> cortisol
  • ACTH
  • will break down protein and gluconeogenic;
  • problem is ectopic vs adrenal tumor producing cortisol; buffalo hump, truncal obesity, moon face, poor wound healing, osteoporosis;
  • purpose of low dose test is to diff normal from those who produce too much cortisol, purpose of high dose is if it suppresses then pit tumor and if it doesnt then it is adrenal tumor or small cell of lung -> check ACTH and if high then it is small cell and if low then adrenal
  • low cortisol causes hyper ACTH; fatigue, ortho htn, darkening of skin; ACTH stim test -> will not illicit response; life long glucocorticoid replacment
  • adrenals shut down because of super stress; n/v, syncope, pain, hemodynamic collapse; IV glucocorticoids
27
Q

Zona reticularis

  • produces
  • stimulated by
  • MOA
A
  • sex hromones
  • ACTH
  • responsible for secondary sex characteristics
28
Q

medulla

  • produces
  • stimulated by
  • inhibited by
  • acts in
  • MOA
  • neuroblastoma: epi, type, weird fact, sxs, tx
  • pheochromocytoma: epi, sxs, dx, tx; rule of 10
A
  • epi and nor epi
  • stress, hypoglycemia
  • hyperglycemia
  • liver and adrenal gland, glycogenolysis and gluconegenesis
  • child CA; neuroendocrine; can regress spontaneously to benign; abd pain or mass effect (compression on SC), VMA or HVA in urine; resection
  • adults; episodic htn (drugs unable to control), palpitations, anxiety, headache, weight loss; 24 hr urine catecholamine and metanephrines; resection with alpha block and then beta block; 10 malignant, 10 bilateral, 10 kids, 10 met
29
Q

Hormones of Kidney

- EPO: produced by, stimulated, inhibited by

A
  • renal parenchymal cells; hypoxia; normal O2 levels
30
Q

Pancreas

  • insulin: made in, connected to, stimulation, w/o gluc, inhibited by, utilized in, second messenger
  • glucagon: produced by, stimulated by, inhibited by, acts on, omoa -> sxs, dx, tx
  • somatostatin: produced by, stimulated, function, omoa -> sxs
  • pancreatic polypeptide: stimulated by, inhib, works on, function
A
  • beta, c-peptide, glucose, insulinoma and sulfonylurea; hypoglycemia, all cells except brain/ RBC/ intestine/ cardiac/ kidney/ liver/ exercising muscle; TYK
  • alpha; hypoglycemia and stress; hyperglycemia; adrenal cortex, liver, adipose tissue; gluconeogenesis, glycogenolysis, lipolysis, ketogenesis; erythematous papules or plaques seen on face, extremities, or peroneum; biopsy; octreotide
  • delta cells; insulin and glucagon; inhibits insulin and glucagon, shut down GI secretion and motility; severe constipation
  • hypoglyemia; glucose; liver/ pancreas; glyogenolysis;
31
Q

Calcitonin

  • made by
  • function
  • works through
A
  • parafollicular cells
  • inhibits osteoclast activity, stimulate Ca deposition, decrease Ca reabsorption in kidney and GI
  • cAMP