Endocrinology

Question 1

All peptides are water soluble EXCEPT:

Answer 1

IGF-1

Question 2

All lipid soluble hormones are synthesized as needed EXCEPT:

Answer 2

Thyroid hormone

Question 3

All lipid soluble are attached to proteins, EXCEPT:

Answer 3

DHEA

Question 4

Abnormal levels of TRH

Answer 4

Stimulates prolactin

Question 5

Prolactin inhibits

Answer 5

FSH

LH

Question 6

Rate limiting of hormone activity

Answer 6

Plasma concentration .. not the receptors

Question 7

Permissive action

Answer 7

One hormone must be present before another can act

Cortisol — glucagon

Thyroid —– GH

Question 8

MEN 1

Answer 8

Hyper parathyroism
Endocrine pancreas
Pituitary adenoma *****

Question 9

MEN 2A

Answer 9

Hyper parathyroidism
Medullary carcinoma of thyroid
Pheochromocytoma

Question 10

MEN 2 B

Answer 10

NO Hyper parathyroidism *****
Medullary carcinoma of thyroid
Pheochromocytoma

Question 11

Rapid pulses of GnRH

Answer 11

LH release

Question 12

Slow pulses of GnRH

Answer 12

FSH release

Question 13

GnRH agonist

Answer 13

Blocks LH and FSH

USEFULLY: breast cancer and prostate cancer

Question 14

All anterior pituitary hormones are synthesized in Supra optic and paraventricular nucleus, EXCEPT:

Answer 14

GnRH

It’s synthesized in pre optic nuclei

Question 15

What happen if the sulk of the pituitary is damaged?

Answer 15

Anterior pituitary hormones decrease.

Except prolactin

Question 16

Where are ANTERIOR hypothalamic hormones stored?

Answer 16

Median eminence

Question 17

What happens with damage of posterior pituitary?

Answer 17

Nothing

Hormones are produced and stored in HYPOTHALAMUS

Question 18

Which NORMALLY inhibit prolactin

Answer 18

Dopamine

Question 19

What usually stimulates ADH

Answer 19

OSMOLARITY : High

BLOOD PRESSURE: Low levels

Question 20

Which ABNORMALLY stimulates prolactin

Answer 20

TRH

Question 21

Which hormones are more likely to drop first in hypopituitarism

Answer 21

GH

FSH & LH

Question 22

Failure to lactate indicates

Answer 22

A strong sign of pituitary damage

Question 23

Infusión of insulin stimulates

Answer 23

GH

ACTH

Question 24

Why pregnant and women in her menstrual cycle have water retention?

Answer 24

They have high ADH levels

Question 25

Why Cushing and hypothyroidism gain weight?

Answer 25

Stimulation of ADH

Question 26

What stimulates and inhibits ADH?

Answer 26

High osmolarity + Low blood pressure + Angiotensin II + CRH + ``` Alcohol - Weightlessness - Hipokalemia - Hipercalcemia - Lithium - ```

Question 27

Physiological action of ADH:

Answer 27

COLLECTING DUCTS: - Reabsorbs Na V2 receptors - aquaporins Arteries: - Vasoconstriction V1 receptors

Question 28

What ELSE can stimulate release of ADH

Answer 28

Angiotensin II | CRH

Question 29

Why is there a volume deficiency in HIPERCALCEMIA

Answer 29

Cause high Ca levels inhibits ADH

Question 30

Lack of ADH

Answer 30

Diabetes insipidus

Question 31

Treatment of central diabetes insipidus

Answer 31

Desmopressine or vasopressin

Question 32

Why is called diabetes insipidus?

Answer 32

Because of polyuria . Too much water caused by a deficiency in reabsorption by deficiency of ADH

Question 33

Primary Diabetes insipidus

Answer 33

Central | No ACTH

Question 34

Secondary Diabetes insipidus

Answer 34

Nephrogenic | Has ADH , but can't respond

Question 35

Excess of ADH

Answer 35

SIADH | Syndrome of Inappropriate ADH secretion

Question 36

Causes of SIADH

Answer 36

ECTOPIC tumor Drugs Pain

Question 37

Physiological effects of SIADH

Answer 37

PLASMA: Osmolarity decrease (A lot of water Hyponatremia) ``` URINE: Osmolarity high (Urine Na increase cause there's no water) ```

Question 38

Why SIADH are euvolemic ?

Answer 38

1) ANP

Question 39

Treatment of SIADH

Answer 39

Fluid restriction Hypertonic Conivaptan (V2 antagonist)

Question 40

Euvolemic hyponatremia

Answer 40

SIADH GLUCOCORTICOID DEFICIENCY HYPOTIROIDISM

Question 41

Hypervolemic hyponatremia

Answer 41

Edema CHF Cirrhosis

Question 42

Hypovolemuc hyponatremia

Answer 42

Solute depletion

Question 43

ACTH action

Answer 43

Stimulates zona fasciculata (cortisol) Stimulates zona reticularis (androgens)

Question 44

What stimulates secretion of aldosterone?

Answer 44

Angiotensin II K NOT ACTH NOT ACTH

Question 45

Feedback of ACTH

Answer 45

Cortisol

Question 46

Index of androgen production in adrenals

Answer 46

DHEA sulfated

Question 47

Which steroid is not a 17 ketosteroid?

Answer 47

Testosterone | ** it becomes a 17 ketosteroid for being excreted by the kidney

Question 48

Measuring 17 ketosteroids is a marker of ?

Answer 48

ALL androgens (adrenal and testicular) * remember testosterone is finally conjugated to a 17 ketosteroid in order to be excreted by kidney.

Question 49

Stress hormones

Answer 49

Growth hormone Glucagon Cortisol Epinephrine

Question 50

What substance raise with stress hormones

Answer 50

Glucose

Question 51

What makes you get up of bed?

Answer 51

Cortisol

Question 52

Functions of ANP Atrial Natriuretic Peptide

Answer 52

EXCRETES Na Blocks aldosterone Blocks ADH

Question 53

Want increase release of ANP

Answer 53

Stretch of atrium | CHF (cardiac failure)

Question 54

Which other organs does aldosterone affect ?

Answer 54

Salivary ducts Sweat glands Distal colon

Question 55

Actions of aldosterone

Answer 55

Collector tubule: - increase Na/k pump: o Reabsorption of Na o Excretion of K - secretion of H - production of ADH - increase thirst - Na reabsorption proximal tubule

Question 56

Why Hyperaldoateronism doesn't cause hypernatremia

Answer 56

It absorbs Na and water

Question 57

What increase release of aldosterone

Answer 57

``` Low blood pressure Renin Angiotensin II HYPONATREMIA HYPERKALEMIA ```

Question 58

What decrease aldosterone

Answer 58

Weightlessness | High blood pressure

Question 59

Hyperaldoateronism types

Answer 59

With hypertension o Primary o Secondary With hypotension o Secondary

Question 60

Conn's syndrome

Answer 60

More Na reabsorption More water reabsorption (Hypertension) Hypokalemia H secretion HCo3 production (Metabolic alkalosis) Hypocalcemia

Question 61

Why there's no hypernatremia in primary hyperaldoateronism ?

Answer 61

Equal reabsorption of Na and H2O | Sodium scape

Question 62

Most important cause of secondary hyperaldoateronism

Answer 62

Renal arterial stenosis There's a over secretion of renin

Question 63

Hypertensive + hypokalemia

Answer 63

Conn's syndrome

Question 64

What does primary vs secondary hyperaldoateronism difference?

Answer 64

Secondary has edema, primary not because Na escape

Question 65

Actions of cortisol

Answer 65

Direct: Breaks proteins Gluconeogenesis Release fatty acids Permissive: Glucagon to glycolysis Cathecolamines to tone of arteries

Question 66

Primary hypercortisolism

Answer 66

Cushing syndrome | Adenoma adrenal

Question 67

Characteristics of Cushing syndrome

Answer 67

Includes: Hypercortisolim Hyperaldoateronism Hyper androgenism

Question 68

Cause of secondary hypercortisolism

Answer 68

Ectopic or pituitary adenoma

Question 69

How do I determine the origin of hypercortisolism?

Answer 69

ACTH

Question 70

Clinical characteristics of Addison

Answer 70

Hypocortisolism Hypoaldosteronism Hupoandrogenism

Question 71

Hyperpigmentation

Answer 71

Primary hypocortisolism Addison | Ectopic ACTH

Question 72

What's the only difference between 21 hydroxylase deficiency and 11 hydroxylase deficiency?

Answer 72

21 hydroxylase deficiency has LOW BLOOD PRESSURE

Question 73

What's the only difference between 11 hydroxylase deficiency and 17 hydroxylase deficiency?

Answer 73

17 hydroxylase deficiency has Lower ANDROGENS PRODUCTION

Question 74

Most common cause of primary hypocortisolism

Answer 74

Autoimmune

Question 75

Most common cause of secondary hypocortisolism

Answer 75

Sudden withdrawal of glucocorticoids

Question 76

Which catecholamine acts on B2 receptor?

Answer 76

Epinephrine

Question 77

Vascular regulation of pressure

Answer 77

NE *orthostatic hypotension

Question 78

Tissues which express 5 Alfa reductase

Answer 78

External genitalia Prostate Sebaceous glands Penile tissue

Question 79

Most potent androgen

Answer 79

DHT Dihydrotestosterone

Question 80

Aromatase

Answer 80

Estradiol

Question 81

5 Alfa reductase

Answer 81

DHT

Question 82

Which tissues express aromatase

Answer 82

Leydig cells | ADIPOSE TISSUE

Question 83

Wolffian ducts

Answer 83

Testosterone

Question 84

Urogenital sinus and genital organs

Answer 84

DHT

Question 85

Absence of female intern structures

Answer 85

MIF

Question 86

Effect of androgens in muscle

Answer 86

Increase protein synthesis and decrease breakdown

Question 87

FSH LH increased

Answer 87

Bilateral cryptorchidism

Question 88

Eyaculation

Answer 88

Parasympathetic POINT AND SHOOT

Question 89

Positive feedback loops

Answer 89

Estrogen - LH - FSH Oxytocin

Question 90

Which hormone has termogenic properties :

Answer 90

Progesterone

Question 91

High hormone increases hungry

Answer 91

Progesterone

Question 92

Estradiol is produced

Answer 92

Ovary

Question 93

Estrone

Answer 93

Ovary and adrenal

Question 94

Estrogen in menopause

Answer 94

Estrone

Question 95

Estriol

Answer 95

Placenta

Question 96

Estrogens potency

Answer 96

Estradiol > estrone > estriol

Question 97

Why fat men have boobs ?

Answer 97

Aromatase in adipose tissue

Question 98

POS

Answer 98

``` High estrone Low estradiol High DHEA High testosterone High LH ```

Question 99

Differentiation of ovarian vs adrenal hirsutism

Answer 99

Measure DHEAS | Dexamethasone suppression

Question 100

How oviduct contract

Answer 100

Prostaglandins from sperm

Question 101

Maintenance of pregnancy first trimester

Answer 101

Corpus luteum 10 first ydays: progesterone After 10 days : Hcg

Question 102

Good marker of fetal well being

Answer 102

Estriol

Question 103

Placental well being

Answer 103

hPL | Lactogeno placentario