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Flashcards in Endocrinology Deck (115)
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1
Q

Hormones in the Anterior Pituitary axis are

A

All water-soluble

2
Q

What are synthesized in neuronal cell bodies in the arcuate and paraventricular nuclei

A
  1. TRH
  2. CRH
  3. GRH
  4. PIF
3
Q

Where is GnRH synthesized

A

Preoptic nucleus

4
Q

What is secreted from Anterior Pituitary

A
  1. TSH
  2. ACTH
  3. LH
  4. FSH
  5. GH
  6. Prolactin
5
Q

MEN 1:

A

HyperPTH

Enocrine pancreas

Pituitary edenoma

6
Q

MEN 2A:

A

Medullary carcinoma of the thyroid

Pheochromocytoma

HyperPTH

7
Q

MEN 2B:

A

Medullary carcinoma of the thyroid

Pheochromocytoma

8
Q

Kallman sydrome

A

Isolated deficiency of Gonadotropins due to defective GnRH synthesis leading to decrease LH, FSH and sex steroids

9
Q

Posterior pituitary is made up of

A

Distal neuron terminals

10
Q

Posterior pituitary secretes

A

ADH

Oxytocin

both peptide hormones

11
Q

ADH synthesized in

A

Supraoptic and paraventricular nuclei of the hypothalamus

12
Q

What suppresses ADH secretion

A

Ethyl alcohol

Weighless environment

13
Q

What is the affect of ANP on kidneys

A

Dilation of afferent arteriole

Constriciton of Efferent arteriole

14
Q

What drugs can cause SIADH

A

SSRI

Carbamazepine

15
Q

Change of permeability in DI

A

Decreases

16
Q

Change of water permeability in dehydration

A

Increase

17
Q

Change of water permeability in SIADH

A

Increase

18
Q

Change of water permeability in Primiary polydipsia

A

Decrease

19
Q

Urine flow in DI

A

Increase

20
Q

Urine flow in Dehydration

A

Decrease

21
Q

Urine flow in SIADH

A

Decrease

22
Q

Urine flwo in Primary polydipsia

A

Increas

23
Q

Urine osmo in DI

A

Decrease

24
Q

Urine osmo in dehydration

A

Increase

25
Q

Urine osmo in SIADH

A

Increase

26
Q

Urine osmo in Primary polydipsia

A

Decrease

27
Q

ECF volume in DI

A

Decrease

28
Q

ECF volume in dehydration

A

Decrease

29
Q

ECF volume in SIADH

A

Increase

30
Q

ECF volume in Primary polydipsia

A

Increase

31
Q

ECF osmo (Na concentration) in DI

A

Increase

32
Q

ECF osmo (Na concentration) in Dehydration

A

Increase

33
Q

ECF osmo (Na concentration) in SIADH

A

Decrease

34
Q

ECF osmo (Na concentration) in Promary polydipsia

A

Decrease

35
Q

ICF volume in DI

A

Decrease

36
Q

ICF volume in dehydration

A

Decrease

37
Q

ICF volume in SIADH

A

Increase

38
Q

ICF volume in Primary polydipsia

A

Increase

39
Q

ICF osmo in DI

A

Increase

40
Q

ICF osmo in dehydration

A

Increase

41
Q

ICF omso in SIADH

A

decrease

42
Q

ICF osmo in Primary polydipsia

A

Decrease

43
Q

ACTH controls the release of

A

Cortisol

Adrenal androgens

44
Q

What part of adrenal cortex is aldosterone secreted from

A

Zona glomerulosa

45
Q

What part of adrenal cortex is cortisol secreted from

A

Zona fasciculata

46
Q

What part of adrenal cortex are androgens secreted from

A

Zona reticularis

47
Q

Absence of mineralocorticoids and aldosterone (absence of zona glomerulosa) leads to

A

Loss of Na

Decrease volume of ECF

Low blood P

Circulatory shock

48
Q

Absence of glucocorticoids, cortisol (damage to zona fasciculata) leads to

A

Circulatory failure

Inability to readily mobilize energy source

49
Q

Deciciency of 21 β-OH leads to

A

Decreas BP and increase androgens

50
Q

Deficiency of 17 α - OH leads to

A

Increase BP and decrease androgens

51
Q

Deficiency of 11 β - OH leads to

A

Increase BP (due to DAG) and increase androgens

52
Q

What is the index for all androgens

A

Urinary 17-ketosteroids

53
Q

What is the major stimulus for zona glomerulosa

A

Angiotensin 2

54
Q

Stress hormones are

A

GH

Glucagon

Cortisol

Epi

55
Q

Metabolic action of Cortisol

A

Promotes teh mobilization of energy stores:

  1. Promotes degradation and delivery of Protein
  2. Promotes lipolysis and increase delivery of free FA and glycerol
  3. Raises blood glucose leves
56
Q

What else directly stimulates teh zona glomerulosa to secrete aldosterone

A

Hyperkalemia

57
Q

Cushings is basically

A

Hypercortisolism

  1. Syndrome: any origin of cortisol
  2. Disease: due to an adenoma of the anterior pituitary
58
Q

Characteristics of Cushings

A
  1. Obesity because of hyperphagia
  2. Moon face and buffalo hump
  3. Protein depletion
  4. Inhibition of inflammatory response and poor wound healing
  5. Hyperglycemia leads to insulin resistance
  6. Hyperlipidemia
  7. Bone breakdown and osteoporosis
  8. Thinning of skin with wide purple striae
  9. Increased adrenal androgens
  10. Salt and water retention (hypertension) with potassium depletion and hypokalemic alkalosis
  11. Increased thirst and polyuria
  12. Anxiety, depression
59
Q

Addison’s diease is

A

Primary Hypocortisolism

60
Q

Cortisol deficiency leads to

A
  1. Weakness
  2. Fatigue
  3. Anorexia
  4. Hypotension
  5. Hyponatremia
  6. Hypoglycemia
61
Q

Conn’s syndrome is

A

Primary hyperaldosteronism

62
Q

What coverts Norepinephrine into epinephrine

A

PMNT

63
Q

Metabolic end products of catecholamines

A

Metanephrines

VMA

64
Q

How does Glucuse promote the release of Insulin

A
  • Glucose metabolism increases ATP
  • Increased ATP closes K channels and depolarizes the β-cells
  • Depolarization opens up voltage-dependedn Ca channels and increases intracellular Ca
  • Increased intracellular Ca promotes exocytosis of insulin
65
Q

β-Cells of pancreas release

A

Insulin

66
Q

α-cells of pancreas release

A

Glucagon

67
Q

Affect of Alkalosis on free plasma Ca?

A

Decrease

68
Q

Affect of Acidosis on free plasma Ca

A

Increase

69
Q

Affect of Lithium on Ca

A

Shits sigmoid Ca/PTH curve to the right causing higher Ca levels are needed to suppress PTH: leads to Hypercalcemia

70
Q

Hypomagnesemia affect on Ca

A

Inhibits PTH secretion causing hypocalcemia

71
Q

Most common cause of secondary hyperPTH is

A

Renal failure

72
Q

Denosumab is

A

Used to treat Osteoporosis

Inhibitor of RANKL

73
Q

Teriparitide is

A

Used in treatment of osteoporosis

Synthetic PTH

74
Q

Thyroglobulins conatin

A

Large numbers of thyroid hormones

75
Q

Na/I symporter blocked by

A

Perchlorate and Thiocyanate

76
Q

Pendrin is

A

Na independednt I transporter along apical membrane

77
Q

What oxidizes I- to Io

A

Thyroperoxidase (TPO)

78
Q

Thyroid-binding globulin is

A

What Thyroid is bound to when circulating the body

79
Q

T4 is activated to T3 by

A

5’ monodeiodinase

80
Q

T4 is degragated to rT3 by

A

5 monodeiodinase

81
Q

How does thyroid hormone increase metabolic rate

A

By increasing the activity of the membrane bound Na/K ATPase in many tissues

82
Q

Hypothyroid in fetal growth causes

A
  • Abnormalities in Nervous system due to decreased dendritic branching an dmyelination
  • Leads to Cretinism
83
Q

Affect of thyroid on heart

A

Positive inotropic and chronotropic

84
Q

Hashimoto’s thyroiditis

A

Autoimmune destruction of the thyroid and lymphocytic inflitration leading to primary hypothyroidism

85
Q

Hashimoto’s clinical

A
  1. Decrease in BMR
  2. Blood lipids and plasma cholesterol elevated
  3. Hyperprolactinemia in women
  4. Decrease GFR: leads to hyponatremia due to inability to excrete excess water
  5. Inability to convert carotene to vitamin A: yellowing of the skin and night blindness
  6. Decrease food intake but overweight
  7. DTR with slow relaxation phase
  8. Dry, cool skin
  9. Non-pitting edema
86
Q

Cretinism is

A

Untreated postnatal hypothyroidism

Dwarfism with mental retardation

87
Q

Graves disease is

A

Autoimmune antibody direcetly stimuate thyroid receptor leading to Primary hyperthyroidism

88
Q

Grave’s clinical

A
  1. Increase BMR and heat production
  2. Palpitations and arrhythmias
  3. Weight loss with increased food intake
  4. Protein wasting and muscle weakness
89
Q

Most rapid treatment for Graves

A

Beta Blockers

90
Q

What stops production of thyroid hormone in Graves

A

Methimazole

PTU

91
Q

What stops conversiton of T4 to T3

A

Steroids such as dexamethasone

92
Q

Laron syndrome

A

Laron dwarfism due to tissue resistance to GH

93
Q

Stimulation test for GH

A

arginine infusion

94
Q

Mecasermin

A

Recombinant IGF given for Laron dwarfism

95
Q

Major anabolic effect of IGF-1 is

A

Increases teh synthesis of cartilage in the epiphyseal plate of long bones

96
Q

Most factors that regulate GH secretion are identical to those that regulate

A

Glucagon

97
Q

LH in males stimulates

A

Leydig cells to produce Testosterone and DHT

98
Q

FSH in males stimulates

A

Sertoli cells

99
Q

LH impacts leydig cell to produce testosterone by activating

A

StAR via Gs-cAMP pathway

100
Q

Aromatase in males

A

stimulate the aromatization of teh A-ring of testosterone converting it into estradiol

101
Q

Ejaculation is achieved by

A

rhythmic contraction of the bulbospongiosus and the ischiocavernous muscles

102
Q

Pseudohermaphrodite is

A

an individual with the genetic onstitution and gonads of one sx and the genitalia of the other

103
Q

Female pseudohermaphroditism is due to

A

female fetus exposed to androgens during the 8th to 13th wk of development

104
Q

What induces ovulation

A

LH surge

105
Q

Luteal phase is dominated by

A

the elevated plasma levels of progesterone

106
Q

FSH secretion during Follicular phase cuases

A

Proliferation of granulosa cells and increased estrogen secretion withing a cohort of follicles

107
Q

LH in females acts on

A

Theca cells to release androgens

108
Q

FSH in females acts on

A

Granulosa cells to convert Androgens from Thca cells to Estrogen

109
Q

Metabolic pathways in preovulatory follicle favor

A

Production of progesterone

110
Q

What type of estrogen is formed by adipose

A

Estrone

111
Q

What estrogen formed by placenta

A

Estriol

112
Q

Polycystic Ovarian Syndrome is characterized by

A
  1. Infertility
  2. Hirsutism
  3. Obesity
  4. Insulin resistance
  5. Amenorrhea
  6. Oligomenorrhea
113
Q

What do you look for in Polycystic Ovarian Syndrome

A

High androgens, High LH and DHEA and low FSH

114
Q

Treat amenorrhea of PCOS with

A

Metformin

115
Q

Treat androgenization of PCOS with

A

Spironolactone