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1
Q

Gonadotropin use

A

used for fertility in MALES to promote spermatogenesis and leydig development (in undescended testest etc), can tx prostate cancer

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2
Q

Menotropin

A

gonadotropin from postmenopausal womens urine that stimulates fsh and LH surge to cause ovulation (IM injxn can cause multiple births)

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3
Q

Lupron Depot

A

GnRH agonist
TREATS UTERINE LEIOMYOMA (FIBROIDS) AND ENDOMETRIOUSIS (leuporlide?)
NON-PULSATILE (cont) GNRH DOSE TO actually LOWER estro (unlike pulstile which would incr estro)

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4
Q

Dysmenorreha

A

CRAMPS/ painful menses

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5
Q

Phytoestrogens

A

antiestrogen from plants, may loewr BC, tofu etc

note DES is ethinyl estradiol

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6
Q

Premarin

A

natural pharmaceutical estrogen from horse uterus used in menopause

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7
Q

environmental estro contaminents

A

BPA and DDT

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8
Q

Neuroendocrine tumor stains?

A

synaptophysin and chromogranin, cytokeratin, NSE, Cd56

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9
Q

Neuroendocrine tumor examples?

A 
SIADH (maybe)
Medullary thyroid carcinoma
Pancreatic neuroendcorine tumor eg insulinoma or gastrinoma etc
Pheochromocytoma
Ganglionneuroma (MEN2B TAG)
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10
Q

What structure does a pit adenoma lack on histo?

A

NO RETICULIN NETWORK!

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11
Q

Wht can cause hyperPIT

A

pit adenoma (most common), rarely pit carc

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12
Q

What can cause hypOpit

A

Sheehan, empty sella syndrome, Rathke cleft cyst

Inflam like sarcoidosis and TB

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13
Q

Post pit sydnromes?

A

DI, Hypothalamic suprsellar tumors (eg craniopharyngiomas), SIADH

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14
Q

What can cause hyperthyroid?

A

graves, subacute lymphocytic (painless), thyrotoxicosis
Thyroid neoplasms like FOLLIC thyroid adenoma, carc, PAPILLARY thyroid carc, ANAPLASTIC (undiff) thyroid carc, MEDULLARY thyroid carc

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15
Q

What can cause hypothyroidism?

A

Cretinism, myxedema/ hashimotos, Riedel fibrosing thyroiditis, granulmatous dequervian

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16
Q

What disorders have transient hyper then hypothyroid?

A

granulomatous De Quervian
hashimoto
goiters may be either

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17
Q

What can cause hyperPTH?

A

PRIMARY- PTH adenoma (rarely pth hyperplasia or carc)
SECONDARY- chronic hypocalc from RF, vit D def
(speudo is hypocalc but elev PTH but end organ is res to pth)

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18
Q

What can cause hyPO-PTH?

A

digeorges, absence

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19
Q

Pancr neuroendocrine tumors

A

Insulinoma, Gastrinoma, glucagonoma, somatostaninoma, VIPoma, carcinoid

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20
Q

HYPER adrenal CORTEX

A

HYPERCORT– either from PIT or ADREnal adenoma
HYPERALDO- conn’s (primary, aldo secreting adenoma), and rarely glucocorticoid-remediable aldosteronism, or SECONDARY hyperaldo- CHF activates RAAS
HYPER ANDRO- CAH
Also: NEOPLASMS: adrenal adenoma, carc, and myelolipoma

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21
Q

HYPO adrenal CORTEX

A

Primary (addisons) due to APS1, APS2, waterhouse-frederichssen
Secondary due to def

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22
Q

Hyper adrenal MEDULLA

A

Pheochromocytoma

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23
Q

Empty Sella syndrome

A

can cause hypopit

herniation of arachnoid and CSF into sella, compresses pit, may be congen or dmg

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24
Q

Rathke celft cyst

A

Rathke’s patch (usu turns into ant pit) doesnt develop, causing hypo-pit
BENIGN MUCIN-FILLED CYST, ciliated cuboidal epith with GOBLET cells

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25
What does SIADH commonly arise from?
lung small cell carcinoma! | in addn to hyponatremia has cerebral edema and neuro dysfxn etc
26
Hypothalamic suprasellar tumors
gliomas and craniopharyngiomas | can cause hyper/hypo fxn of ant or post pit
27
Hypermotility/diarrhea, malabs, hypocholesterol, hyperglycemia and osteo/weakness may mean which hormomne is elev?
HYPERTHYROID
28
Levels of T3 and TSH in thyrotoxicosis?
ELEV FREE CIRC T3/T4 | so LOW TSH
29
Subacute lymphocytic painless thyroiditis
mild hyper, goiter, middle aged females, lympho infilitration, germ ctrs
30
Graves mech
IgG antibodies against TSH RECePTOR | these overstim TSH R which increases T3/T4 but decr TSH (tyep II HS)
31
Dermopathy (with shin rash aka pretibial myxedema) may mean which hormone is elev?
HYPERTHYROID as in GRAVES
32
Graves triad
Hyperthyroid Exphtalmos Dermopathy of tibia
33
Cretinism
HYPOthyroid in kids, has a dyshormonogenic goiter which is acongenital defect in Thyroid Perox (so lack of fxnl TH)
34
Myxedema is accum of
GAGs causing hypOthyroid, deepining of voice and enlarged tongue etc
35
Riedel Fibrosing Thyroiditis
HYPOthyroid due to inflam with fibrosis of HARD AS WOOD thyroid (NONtender!), airway etc
36
Granulomatous De Quervain thryoiditis
transient hyper to hypo, females mid aged | following VIRAL infxn and SELF limited, TENDER THYROID (unlike riedel fibrosing)
37
``` Hashimoto genetics ab's t4/tsh levels histo ```
HLA-DR5 assoc ab's to antimicrosomal, anti-TPO, and anti-thyroglobulin, destroys thyroid gland low T4 raises TSH histo: lympho inf, germ ctrs, hurthle cells
38
GOITERS (diffuses nontoxic/colloid simple, and multinodular)
- diffuse colloidal nontoxic simple: low iodine enalrages entire gland withOUT nodularity, incr TSH, colloid invol - multinnod: iodine def, also nontoxic euthyroid, but can progress to toxic, multilob, asymm, coilloid in follicles, flattened epith, follic hyperplasia
39
Thyroid neoplasms
follic adenoma and carc papillary thyroid carc anaplastic undifferentiated thyroid carc medullar thyroid carc
40
FOLLIC thyorid adenoma and carc
FOLLIC adenoma and carc (aden is solitary mass from TSH R mutl, encaps, colloid) (carc is common in iodine def areas, females, capsular/vasc invazn)
41
PAPILLARY thyroid carc
PAPILLARY thyroid carc- a bit yougner than above, good px, orphan annie eye and psammoma, due to exposrue to ionizing radiation usu follic type sclerosising
42
ANAPLASTIC undiff thyroid carc
AGGRO, 100% mort, older, invades local structure and causes issues w swallowing and breathing, variable morph
43
MEDULLARY thyroid carc
neuroendocrine! parafollic C cells secrete calcitonin! decr Ca (thru renal excretion incr), can deposit in tumor as AMYLOID markers are calcito and CEA! from MEN sydnrome!
44
cell types in PT gland
chief cells secrete pth oxyphils are acidophilic, large fat
45
Primary hyperPTH sx
painful BONES, renal STONES, abdominal GROANS and psychiatric MOANS (eg PT adenoma)
46
Secondary hyperPTH causes and sx
chronic hyPOcalc! maybe from renal failure, low Ca intake, steat, vit D Def metastatic calcs in tissues
47
Sx of hypocalcemia
eg from hypoPTH (from digeorges, dmg etc) | tetany, mental status, CV ocular and dental issues
48
PTH Ca and PO levels in psuedohypoPTH?
low Ca so seems like due to low PTH but PTH high, organs just resistant so builds up since no calc to bind PO, PO4 high
49
what do D cells and PP cells in endocrine pancr do
D cells secrete somatostatin to suppress BOTH insulin and glucagon Pancr Polypeptide cells inhibit intestinal motility
50
Diseases that can be incr in DM
reitnopathy, cerebral infarct, MI, atheroscl, gangrene, infections, nephroscl, pierph neurop, HTN
51
Insulinoma and Gastrinoma
Pancreatic endocrine tumors INsulinoma- NET benign causing episodic hypogly with metnal status changes, give glucose to tx Gastrinoma: ZE sydnrome Others
52
What cells make up adrenal medulla?
Enterochromaffin cells which secre catechol and SUSTENACULAR cells which support
53
Diff in RAA levels between primary and secondary hyperaldo?
primary (conns)- excess aldo, lowering renin | secondary (from CHF)- excess activation of RAAS so high renin AND aldo
54
Addisons types
PRIMARY CHRONIC ADRENOCORTICAL INSUFF Autoimmune Polyendocrine Syndrome type 1 (APS1) wiht chronic candida, skin/dental/nail changes, other autoimm disorders APS2- autoimm thyroiditis and T1DM assoc Waterhouse Fredrichsen- necrosis of boht adreanal glands caused by sepsis or DIC in kids with neisseria mening Can also be caused by TB and fungal, carc from lung etc
55
Sx of addisons types
primary adrenal insuff Fatiguer/weakness/GI, high ACTH causing skin pigment from MSH, low aldo thus high K/H so hypokalemia
56
Pheochromocytomas are usually
unilateral, benign, HTN assoc (10-10-10), often have CV issues or arr
57
pheochromo histo
lobualr pattern with salt n pepper chromatin, polygonal cells surr by sustenacular cells
58
MEN sydnromes
MEN 1 Wermer (PPP) MEN 2A Sipple (PAT) MEN 2B (TAG)
59
Wermers genetics sx
``` MEN 1 (11q13 gene encodes menin for tumros) PPP Parathyroid elev Pancr gastrinoma etc Pit aden eg prolactinoma ``` sx ulcers, hypogly, hypercalc, lithasis, gynecom, acromeg
60
Sipples | genetics
MEN2A PAT parathyroid hyper adrenal pheochrom thyroid med thyroid carc RET protooncogene on 10q11 FAMILIA medullary thyroid carc variant of MEN2A (has med carc ONLY, dev at older age)
61
MEN2B genetics clincical pres
TAG Thyroid med carc (hypocalc) Adrenal pheochrom Ganglioneuroma Genetics RET protooncogene mut clinical: marfoid features, tumor
62
Cretinism sx
hypothyroid in kids, coarse facial features, dyshormone goiter with defect in TPO, MR, protruding tongue, umbilical hernia
63
Candida can cause
APS1! (a type of addisons adrenal insuff)
64
Neisseria mening in kids may cause?
Waterhouse fredrichson, with sepsis and adrenal insuff (like addisons)
65
Marfanoid features may mean
MEN2B TAG! (thyroid carc, pheochromo cyt adrenal, and ganglio) from RET proto
66
Which disease incorporate Pheochrom?
MEN2 A and B! (PAT and TAG)
67
Which endocrine tumor comes from previous exposure to ionizing radiation?
Papillary thyroid carcinoma, with orphan annie eye cells
68
Which goiter is nontoxic?
Multinodular! | from iodine def but can progress to thyrotox, colloid
69
Which issue causes painful thyroid?
GRANULOMATOUS DEQUERVIAN! follows viral infxn | riedels fibrosing is hard as wood NONtender
70
Which endocrine issue has abd striae?
cushings
71
Calcium Correction Equation!
We need to correct for calcium by using this equation when there is high (>4) albumin in the blood: corrected ca = TOTAL SERUM CA +/- [(4-alb)x0.8] so if alb is higher tan 4, subtract from total serum ca if alb lower than 4, add to total serum ca

T2 Endo/Repro (11 decks)

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