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Flashcards in endocrine - Memory Deck (33):
1

venous drainage of adrenals

Similar to testicles; L into L renal vein, R directly into IVC

2

similarities in the alpha subunit of pituitary hormones

FSH, LH, hCG, and TSH

3

delta cells release

somatostatin; can have somatostatinoma with hyper/hypoglycemia, gallstones, steatorrhea, etc.

4

positive regluators of insulin

GH and hyperglycemia; beta agonists

5

Negative regulators of insulin

somatostatin, hypoglycemia and cortisol; alpha-2 agonists inhibit insulin

6

Prolactin

promotes milk production; inhibits GnRH; Negative feedback by stimulating dopamine

7

GH regulators

somatostatin and glucose inhibit; exercise and sleep increase it

8

GH function

increases Linear bone growth through somatomedin and muscle mass. Increases Insulin resistance

9

Rate limiting enzyme in Adrenal steroid synthesis

Desmolase; inhibited by antifungal drug ketoconazole; activated by ACTH

10

Cortisol mechanism for anti-inflammation

inhibits PL-A2 and COX-2, decreases neutrophil adhesion (will see neutrophilia), blocks histamine release, reduces eosinophils, Blocks IL-2 production

11

Cortisol function

upregulates alpha-1 receptors for blood pressure, increases insulin resistance, increases gluconeogenesis

12

Metyrapone

inhibits 11-beta hydroxylase; increases ACTH surge because a decrease in cortisol. The 17-hydroxy corticosteroid will be produced and can be found in urine

13

Hashimoto Thyroiditis pathogenesis

antimicrosomal antithyroglobulin antibodies, HLA-DR5, increased risk of non-hodgkin's lymphoma

14

Hashimoto histology

Hurthle cells, lymphocytic infiltrate with germinal centers

15

Hashimoto presentation

hypothyroid (can be hyper early), PAINLESS, high antiperoxidase tighters

16

Cretinism presentation

Pot bellied, pale, puffy-faced child with protruding umbilicus and protuberant

17

Subacute Thyroiditis (de Quervain's)

follows flu-like illness, HLA-B35. Histo: granulomatous mixed cellular (vs. hashimoto), no antiperoxidase (vs. hashimoto)

18

Subacute thyrotoxicosis (granulomatous thyroiditis)

painful goiter, thyrotoxicosis followed by hypothyroidism.

19

Riedel's thyroiditis

thyroid is replaced by fibrous tissue "hard as rock". Painless, Anti thyroid peroxidase. Macrophages and eosinophils (vs. hashimoto)

20

toxic multinodular goiter

follicles are distended with colloid and lined by flattened epithelium with areas of fibrosis and hemorrhages. The focal patches of hyperfunctioning follicular cells are working independently of TSH due to mutation in TSH receptor.

21

Papillary carcinoma

Radiation, psammoma, orphan annie, RET BRAF

22

Follicular Carcinoma

Hematogenous spread, invades capsule, hurthle cells, RAS

23

Medullary carcinoma

Parafollicular cells. Amyloid calcitonin, MEN 2A 2B, RET

24

Struma Ovarii

Thyroid releasing teratoma

25

Hyper PTH clinical

Bones, Moans, Grones, and stones; Osteitis fibrosa cystica - cystic bone spaces filled with borwn fibrous tissue.. Bones of pelvic girdle, pectoral girdle, and limbs, subperiosteal thinning, salt an pepper appearance of skin. Increased calcium stimulates gastrin secretion -> peptic ulcers

26

secondary hyper PTH

presents with hypocalcemia and is due to renal failure mostly, with increased levels of phosphorous and decreased calcium. The bone lesions in secondary are Renal osteodystrophy

27

Causes of secondary hyperthyroid

Testicular cancer or neoplasm releasing hCG which shares alpha subunit with TSH and can increase thyroid

28

how does alkalosis cause functional hypocalcemia

More negative charge to albumin so more binding of free calcium which can lead to tetany but total body calcium levels remain same.

29

Treatment for Nephrogenic DI

hydrochlorothiazide (paradoxical antidiuretic effect), Indomethacin (prostaglandins inhibit ADH so inhibit prostaglandin synthesis), amiloride

30

Treatment for SIADH

Demeclocycline and H2O restriction

31

SIADH sodium and volume status

euvolemic hyponatremia; initial increase in volume inhibits renin and reduces aldosterone to deplete excess volume and therefore euvolemia and hyponatremia

32

SIADH causes

Ectopic (small cell lung cancer), Lung diseases, CNS disorder, Drugs (cyclophosphamide)

33

Causes of hypopituitarism

Sheehan syndrome (hemorrhagic infarct postpartum bleeding; presents w failure to lactate), craniopharyngioma (Rathke's pouch), empty sella syndrome, pituitary apoplexy (acute bleeding into preexisting adenoma, acute depletion of ACTH and cortisol can lead to cardiovascular collapse)