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KAPLAN PHYSIOLOGY > Endocrinology > Flashcards

Endocrinology Flashcards

1
Q

All peptides are water soluble EXCEPT:

A

IGF-1

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2
Q

All lipid soluble hormones are synthesized as needed EXCEPT:

A

Thyroid hormone

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3
Q

All lipid soluble are attached to proteins, EXCEPT:

A

DHEA

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4
Q

Abnormal levels of TRH

A

Stimulates prolactin

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5
Q

Prolactin inhibits

A

FSH

LH

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6
Q

Rate limiting of hormone activity

A

Plasma concentration .. not the receptors

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7
Q

Permissive action

A

One hormone must be present before another can act

Cortisol — glucagon

Thyroid —– GH

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8
Q

MEN 1

A

Hyper parathyroism
Endocrine pancreas
Pituitary adenoma *****

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9
Q

MEN 2A

A

Hyper parathyroidism
Medullary carcinoma of thyroid
Pheochromocytoma

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10
Q

MEN 2 B

A

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

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11
Q

Rapid pulses of GnRH

A

LH release

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12
Q

Slow pulses of GnRH

A

FSH release

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13
Q

GnRH agonist

A

Blocks LH and FSH

USEFULLY: breast cancer and prostate cancer

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14
Q

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

A

GnRH

It’s synthesized in pre optic nuclei

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15
Q

What happen if the sulk of the pituitary is damaged?

A

Anterior pituitary hormones decrease.

Except prolactin

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16
Q

Where are ANTERIOR hypothalamic hormones stored?

A

Median eminence

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17
Q

What happens with damage of posterior pituitary?

A

Nothing

Hormones are produced and stored in HYPOTHALAMUS

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18
Q

Which NORMALLY inhibit prolactin

A

Dopamine

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19
Q

What usually stimulates ADH

A

OSMOLARITY : High

BLOOD PRESSURE: Low levels

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20
Q

Which ABNORMALLY stimulates prolactin

A

TRH

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21
Q

Which hormones are more likely to drop first in hypopituitarism

A

GH

FSH & LH

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22
Q

Failure to lactate indicates

A

A strong sign of pituitary damage

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23
Q

Infusión of insulin stimulates

A

GH

ACTH

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24
Q

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

A

They have high ADH levels

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25
Q

Why Cushing and hypothyroidism gain weight?

A

Stimulation of ADH

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26
Q

What stimulates and inhibits ADH?

A

High osmolarity +
Low blood pressure +
Angiotensin II +
CRH +

Alcohol -
Weightlessness -
Hipokalemia -
Hipercalcemia -
Lithium -
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27
Q

Physiological action of ADH:

A

COLLECTING DUCTS:

  • Reabsorbs Na V2 receptors
  • aquaporins

Arteries:
- Vasoconstriction V1 receptors

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28
Q

What ELSE can stimulate release of ADH

A

Angiotensin II

CRH

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29
Q

Why is there a volume deficiency in HIPERCALCEMIA

A

Cause high Ca levels inhibits ADH

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30
Q

Lack of ADH

A

Diabetes insipidus

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31
Q

Treatment of central diabetes insipidus

A

Desmopressine or vasopressin

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32
Q

Why is called diabetes insipidus?

A

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

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33
Q

Primary Diabetes insipidus

A

Central

No ACTH

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34
Q

Secondary Diabetes insipidus

A

Nephrogenic

Has ADH , but can’t respond

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35
Q

Excess of ADH

A

SIADH

Syndrome of Inappropriate ADH secretion

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36
Q

Causes of SIADH

A

ECTOPIC tumor
Drugs
Pain

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37
Q

Physiological effects of SIADH

A

PLASMA:
Osmolarity decrease
(A lot of water
Hyponatremia)

URINE:
Osmolarity high (Urine Na increase cause there's no water)
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38
Q

Why SIADH are euvolemic ?

A

1) ANP

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39
Q

Treatment of SIADH

A

Fluid restriction
Hypertonic
Conivaptan (V2 antagonist)

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40
Q

Euvolemic hyponatremia

A

SIADH
GLUCOCORTICOID DEFICIENCY
HYPOTIROIDISM

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41
Q

Hypervolemic hyponatremia

A

Edema
CHF
Cirrhosis

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42
Q

Hypovolemuc hyponatremia

A

Solute depletion

43
Q

ACTH action

A

Stimulates zona fasciculata (cortisol)

Stimulates zona reticularis (androgens)

44
Q

What stimulates secretion of aldosterone?

A

Angiotensin II
K

NOT ACTH
NOT ACTH

45
Q

Feedback of ACTH

A

Cortisol

46
Q

Index of androgen production in adrenals

A

DHEA sulfated

47
Q

Which steroid is not a 17 ketosteroid?

A

Testosterone

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

48
Q

Measuring 17 ketosteroids is a marker of ?

A

ALL androgens (adrenal and testicular)

  • remember testosterone is finally conjugated to a 17 ketosteroid in order to be excreted by kidney.
49
Q

Stress hormones

A

Growth hormone
Glucagon
Cortisol
Epinephrine

50
Q

What substance raise with stress hormones

A

Glucose

51
Q

What makes you get up of bed?

A

Cortisol

52
Q

Functions of ANP Atrial Natriuretic Peptide

A

EXCRETES Na
Blocks aldosterone
Blocks ADH

53
Q

Want increase release of ANP

A

Stretch of atrium

CHF (cardiac failure)

54
Q

Which other organs does aldosterone affect ?

A

Salivary ducts
Sweat glands
Distal colon

55
Q

Actions of aldosterone

A

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
56
Q

Why Hyperaldoateronism doesn’t cause hypernatremia

A

It absorbs Na and water

57
Q

What increase release of aldosterone

A 
Low blood pressure
Renin
Angiotensin II
HYPONATREMIA
HYPERKALEMIA
58
Q

What decrease aldosterone

A

Weightlessness

High blood pressure

59
Q

Hyperaldoateronism types

A

With hypertension

o Primary
o Secondary

With hypotension
o Secondary

60
Q

Conn’s syndrome

A

More Na reabsorption
More water reabsorption
(Hypertension)

Hypokalemia
H secretion
HCo3 production
(Metabolic alkalosis)

Hypocalcemia

61
Q

Why there’s no hypernatremia in primary hyperaldoateronism ?

A

Equal reabsorption of Na and H2O

Sodium scape

62
Q

Most important cause of secondary hyperaldoateronism

A

Renal arterial stenosis

There’s a over secretion of renin

63
Q

Hypertensive + hypokalemia

A

Conn’s syndrome

64
Q

What does primary vs secondary hyperaldoateronism difference?

A

Secondary has edema, primary not because Na escape

65
Q

Actions of cortisol

A

Direct:
Breaks proteins
Gluconeogenesis
Release fatty acids

Permissive:
Glucagon to glycolysis
Cathecolamines to tone of arteries

66
Q

Primary hypercortisolism

A

Cushing syndrome

Adenoma adrenal

67
Q

Characteristics of Cushing syndrome

A

Includes:
Hypercortisolim
Hyperaldoateronism
Hyper androgenism

68
Q

Cause of secondary hypercortisolism

A

Ectopic or pituitary adenoma

69
Q

How do I determine the origin of hypercortisolism?

A

ACTH

70
Q

Clinical characteristics of Addison

A

Hypocortisolism
Hypoaldosteronism
Hupoandrogenism

71
Q

Hyperpigmentation

A

Primary hypocortisolism Addison

Ectopic ACTH

72
Q

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

A

21 hydroxylase deficiency has LOW BLOOD PRESSURE

73
Q

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

A

17 hydroxylase deficiency has Lower ANDROGENS PRODUCTION

74
Q

Most common cause of primary hypocortisolism

A

Autoimmune

75
Q

Most common cause of secondary hypocortisolism

A

Sudden withdrawal of glucocorticoids

76
Q

Which catecholamine acts on B2 receptor?

A

Epinephrine

77
Q

Vascular regulation of pressure

A

NE

*orthostatic hypotension

78
Q

Tissues which express 5 Alfa reductase

A

External genitalia
Prostate
Sebaceous glands
Penile tissue

79
Q

Most potent androgen

A

DHT Dihydrotestosterone

80
Q

Aromatase

A

Estradiol

81
Q

5 Alfa reductase

A

DHT

82
Q

Which tissues express aromatase

A

Leydig cells

ADIPOSE TISSUE

83
Q

Wolffian ducts

A

Testosterone

84
Q

Urogenital sinus and genital organs

A

DHT

85
Q

Absence of female intern structures

A

MIF

86
Q

Effect of androgens in muscle

A

Increase protein synthesis and decrease breakdown

87
Q

FSH LH increased

A

Bilateral cryptorchidism

88
Q

Eyaculation

A

Parasympathetic

POINT AND SHOOT

89
Q

Positive feedback loops

A

Estrogen - LH - FSH

Oxytocin

90
Q

Which hormone has termogenic properties :

A

Progesterone

91
Q

High hormone increases hungry

A

Progesterone

92
Q

Estradiol is produced

A

Ovary

93
Q

Estrone

A

Ovary and adrenal

94
Q

Estrogen in menopause

A

Estrone

95
Q

Estriol

A

Placenta

96
Q

Estrogens potency

A

Estradiol > estrone > estriol

97
Q

Why fat men have boobs ?

A

Aromatase in adipose tissue

98
Q

POS

A 
High estrone
Low estradiol
High DHEA
High testosterone
High LH
99
Q

Differentiation of ovarian vs adrenal hirsutism

A

Measure DHEAS

Dexamethasone suppression

100
Q

How oviduct contract

A

Prostaglandins from sperm

101
Q

Maintenance of pregnancy first trimester

A

Corpus luteum

10 first ydays: progesterone
After 10 days : Hcg

102
Q

Good marker of fetal well being

A

Estriol

103
Q

Placental well being

A

hPL

Lactogeno placentario

KAPLAN PHYSIOLOGY (2 decks)

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