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Flashcards in Endocrine Pathology - First Aid Deck (116)
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1

What are the 4 main etiologies of Cushing Syndrome?

Exogenous corticosteroids

1˚ adrenal adenoma, hyperplasia, or CA

ACTH-secreting pituitary adenoma

Paraneoplastic ACTH secretion

2

Conn Syndrome

1˚ aldosteronism

Adrenal adenoma, hyperplasia, CA

3

Where does paraneoplastic ACTH come from? (2)

Small cell lung CA

Bronchial carcinoids

4

What are the findings of Cushing syndrome?

Hypertension, hyperglycemia (IR)

Weight gain, moon facies, truncal obesity, buffalo hump

OsteoporosisAmenorrhea

Immune Suppression

Skin changes: thinning, striae

5

What are the 3 tests used to measure cortisol?

Free cortisol 24 urine analysis

Midnight salivary cortisol

Overnight low-dose dexamethasone suppression test

6

What two things directly regulate prolactin?

+ TRH

- Dopamine

7

How does prolactin ↓ fertility?

Inhibits GnRH synthesis and release

8

What negative feedback is involved in prolactin secretion?

Prolactin ↑ dopamine synthesis

9

What things ↑ GH secretion?

GHRH: ↑during exercise and sleep

10

What things ↓ GH secretion? (2)

Glucose and SST

11

Where is vasopressin/ADH synthsized?

Hypothalamus - supraoptic nuclei

12

What is the main function of ADH?

Serum osmolarity regulation 

↓Serum osmolarity

↑Urine osmolarity

13

In what part of the kidney does ADH have its effect?

Principal cells of renal collecting duct

14

ADH is __________ in central diabetes insipidus and ___________ in nephrogenic DI and 1˚ polydipsia.

Decreased = Central DI

Increased = Nephrogenic DI & 1˚ polydipsia

15

Desmopressin

ADH analog

Central DI, bedwetting

16

What regulates ADH release?

Osmoreceptors in hypothalamus (1˚)

Hypovolemia (2˚) 

17

What effects does Cortisol have?

BIG FIB

BP

Insulin resistance 

Gluconeogenesis, lipolysis, and proteolysis

↓ Fibroblast activity (striae)

Inflammatory and Immune responses

Bone formation

18

How does cortisol increase BP?

Upregulates α1-receptors on arterioles

↑Sensitivity to NE/Epi

19

How does cortisol ↓ inflammatory and immune responses?

Inhibits production of LT and PG

Inhibits leukocyte adhesion → neutrophilia

Blocks histamine release from mast cells

Reduces eosinophils

Blocks IL-2 production

20

How does cortisol ↓ bone formation?

↓ Osteoblast activity

21

Exogenous corticosteroids can cause reactivation of TB and candidiasis - what is the mechanism?

Blocked IL-2 production

22

What secretes PTH?

Chief cells of parathyroid

23

What are the effects of PTH?

↑ Bone resorption

↑ Kidney reabsorption of Ca in DCT

↓ Kidney reabsorption of PO4 in PT

↑ 1, 25-(OH)2 D3 (calcitriol) via 1α-hydroxylase

24

What triggers an increase in Ca absorption from the intestine?

1, 25 OH D3

1α-hydroxylase

Kidney (PTH)

Granuloma

25

What things will ↑ PTH secretion?

↓ serum Ca 

↓ serum Mg - diarrhea, aminoglycosides, diuretics, EtOH abuse

 

26

Plasma Ca exists in what 3 forms?

Ionized | 45%

Bound to albumin | 40%

Bound to anions | 15%

27

What does an ↑ in pH do to Ca levels?

↓ ionized Ca

↑ Ca bound to albumin

Hypocalcemia - cramps, pain, parasthesias, carpopedal spasm

28

D3 comes from ____________.

D2 comes from ____________.

Both are convereted to 25-OH in the ________.

Sun exposure in skin

Ingested plants

Liver

29

What effects does active vitamin D have?

↑ bone resporption

↑ dietary absoption of both Ca and PO4

30

Calcitonin is released from the _____________ of the thyroid in response to ____________.

Parafollicular cells (C cells)

↑ serum Ca 

↓ bone resportion