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Level 1/Step 1 > Endocrine Keys > Flashcards

Endocrine Keys Flashcards

1
Q

Ventral Medial hypothalamus

A

regulates the sensation of satiety

if a lesion is present the patient will likely be massive (Very MASSIVE)

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2
Q

Ventral Lateral hypothalamus

A

regulates the sensation of hunger

if a lesion is present the patient will likely be lean (Very LEAN)

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3
Q

Dorsomedial nucleus of hypothalamus

A

Regulates
1. Feeding
2. Drinking
3. Body weight
4. Circadian rhythm

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4
Q

Preoptic nucleus synthesizes

A

GnRH

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5
Q

Preoptic nucleus role =

A

Regulation of both temperature and sleep

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6
Q

Arcuate nucleus mediates responses from

A

metabolic hormones
1. Leptin
2. Ghrelin
3. Insulin

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7
Q

Arcuate nucleus will affect functions relating to

A
  1. Metabolism
  2. Feeding
  3. Reproduction
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8
Q

What are the main physiologic conditions that activate the RAAS pathway are

A
  1. Decreased blood pressure
  2. Increased sympathetic tone
  3. Decreased NaCl delivery to macula densa cells
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9
Q

ANP and BNP effects on RAAS =

A
  1. downregulate the RAAS
  2. increasing cGMP –> increased glomerular vasodilation
  3. increasing the GFR due to increased VD
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10
Q

34F presents with
1. nausea
2. emesis
3. lethargy
4. confusion
5. altered mental status
6. seizures

A

SIADH = hyponatremia sx

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11
Q

A patient taking Amphotericin B
with new-onset
1. polydipsia
2. polyuria
3. elevated ADH

Should be tx w/

A

Pt has Peripheral/nephrogenic diabetes insipidus

Tx = Thiazide, amiloride, and indomethacin

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12
Q

Pseudohyponatremia =

A

Pt w/ a serum osmolality of 285 mOsm/kg and low Na+ serum levels (below 130)

This is because of increased oncotic = hyperproteinuria or hyperlipidemia

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13
Q

hypertonic hyponatremia =

A

SUGAR in the blood

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14
Q

Larynx supplied by X = SCAR

A

Superior laryngeal nerve
Cricothyroid

All other muscles
Recurrent laryngeal nerve

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15
Q

1week M
1. hypoplastic mandible
2. low-set ears
3. bifid uvula
4. cleft palate
5. decreased soft-tissue attenuation in the right anterior mediastinum

Congenital defeat?

A

DiGeorge syndrome 22.11.2 microdeletion
neural crest fails to migrate into the derivative pharyngeal/bronchial pouches

1st and 2nd pouches = Thyroid
3rd = inferior parathyroid + thymus
4th = superior parathyroid

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16
Q

1week M
Poor feeding
lethargy
unusual muscle movements
decreased soft-tissue attenuation in right anterior mediastinum

A

DiGeorge Syndrome
hypocalcemia = increased neuromuscular excitability

W/o the 3rd & 4th pouches the pt is not able to produce PTH which helps to increase blood Ca++ levels

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17
Q

The left inferior thyroid artery branches off from which of the following arteries?

A

Left Subclavian

Note
Right side = Brachiocephalic –> Common Carotid + Subclavian

18
Q

32F
tx w/ BB for hyperthyroidism
how is this helpful

A

BB = blocks 5-deiodinase = decreases T4–>T3 conversion

19
Q

34F
takes GC how does this affect the thyroid

A

If pt has graves = decreased Ab production

decreases T4 –> T3 peripherally

20
Q

Which drugs decreases the peripheral conversion of T4-T3

A

Amiodarone + PTU + BB + GC

21
Q

Wolff-Chaikoff effect = excess amounts of iodine

tx would be

A

Lugol’s iodine

this is given in situations where there is acute radiation exposure

22
Q

30F
HTN
Low renin

electrolytes changes?

A

Low renin = high aldosterone (Primary hyperaldosterone = Conn disease)

decreased serum K+
decrease pH = increased serum Bicarb
normal - high serum Na+

23
Q

4M
growth spurt
body odor
pigmented hair at the base of the penis

dx & tx

A

decreased 21-hydroxylase –> increased 17-hydroxylase = increased androgens

Tx: blocking ACTH

24
Q

61F
hypoechoic thyroid nodule
increased central blood flow
Clusters of cells w/ large overlapping nuclei
despersed chromatin
intranuclear inclusion bodies & grooves

A

increase BF = cancerous
Papillary Carcinoma

Orphan Annie eye nuclei
Pseudoinclusion
Laminated Ca++ deposits = Psammoma bodies

25
81F mass that has grown 3x in size rapidly experiencing hoarseness pleomorphic cells irregular giant and spindle cells
Anaplastic thyroid carcinoma TP53 mutation
26
Follicular adenoma vs carcinoma
carcinoma = vascular or capsular invasion RAS mutation uniform follicles
27
Hypocalcemia sheets of polygonal cells amyloid stroma
Medullary Carcinoma MEN2A/B RET mutation
28
Block G____ will increase Insulin levels
Blocking Gi = increase insulin levels
29
28F non-tender goiter gave birth 3 wks ago experiencing excessive sweating + palpitations HTN low free T4 and high TSH
Postpartum thyroiditis in its transient phase TH can be high Autoimmune destruction = lymphocyte-mediated thyroid follicular damage --> early release of TH Anti-thyroid peroxidase antibodies
30
40M increased gastrin levels prominent gastric folds + multiple ulcers in duodenum + proximal jejunum History or Family would include?
Dx: Zollinger-Ellison syndrome associated with MEN1 MEN1 = 3 P's (Pituitary tumors + Pancreatic endocrine tumors + Parathyroid adenoma) Parathyroid adenoma = increased PTH = increase Ca+ = constipation + muscle twitching + stones
31
Tamoxifen
SERM that can tx gynecomastia
32
Danazol
synthetic androgen that acts a partial agonist at androgen receptors
33
Rx that can cause Gynecomastia
GnRH agonist Ketoconazole = 17a-hydroxylase/17,20 lyase inhibitor 5a reductase inhibitors = decrease DHT --> increased testosterone --> increased estrogen Spironolactone = 17a-hydroxylase/17,20 lyase inhibitor Bicalutamide = testosterone receptor antagonist
34
14M Painless nodules on lips & tongue Long & thin Joint laxity Oral inspection = small, soft, flesh-colored papules TSH normal Dx
Marfanoid habitus = caused by Medullary thyroid cancer which is associated with MEN2B
35
The left superior thyroid artery branches off from which of the following arteries?
Left external carotid Note: right = Braciocephalic --> subclavian + (common carotid --> External carotid)
36
Recent viral infection Painful thyroid low T3/T4 levels High TSH
De Quervian thyroiditis = Granulomatous inflammation, multinucleated giant cells, and foamy histiocytes are classically present on histology
37
Low T3/T4 immobile thyroid gland hoarseness
Riedel Thyroiditis IgG4 systemic disease --> fibrous tissue replacing thyroid tissue + inflammatory infiltrates
38
Decrease T3 Normal T4 High TSH Increase IL-6
Euthyroid Sick Snydrome
39
Toxic multinodular goiter is associated with
focal patches of hyperfunctioning cells that work independently of TSH (commonly due to mutated, constitutively activated TSH receptors), leading to elevated T3 and T4 levels.
40
Hürthle cells arise from the thyroid follicular epithelium and are seen on histologic slides along with
lymphoid aggregates with germinal centers in patients with Hashimoto's thyroiditis

Level 1/Step 1 (15 decks)

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