pp clues endocrine Flashcards
(243 cards)
1
Q
- Somatotrope
- Gonadotrope
A
- GH
- LH, FSH
2
Q
Thyrotrope?
Corticotrope?
A
TSH
ACTH
3
Q
Lactotrope?
suppressed by?
A
PRL
Dopamine
4
Q
What receptors do protein hormones use?
A
Cell membrane receptors
G-coupled
5
Q
What receptors do steroid hormones use?
A
Nuclear membrane receptors
6
Q
mc 2nd msger
A
cAMP
7
Q
What are the steroid hormones?
A
“PET CAD”
Note: thyroid hormone acts like a steroid
Progesterone
E2
Testosterone
Cortisol
Aldo
Vit D
8
Q
What does Exocrine mean?
A
Secretion into non-blood
9
Q
What is Autocrine?
A
Works on itself
10
Q
What is Paracrine?
A
Works on its neighbor
11
Q
What is Merocrine?
A
Cell is maintained => exocytosis
12
Q
What is Apocrine?
A
Apex of the cell is secreted
13
Q
What is Holocrine?
A
The whole cell is secreted
14
Q
What organs do not require insulin?
A
“BRICKLE”
Brain
RBC
Intestine
Cardiac, Cornea
Kidney
Liver
Exercising muscle
15
Q
What does GnRH do?
A
Stimulates LH, FSH
16
Q
What does GRH do?
A
Stimulates GH
17
Q
What does CRH do?
A
Stimulates ACTH
18
Q
What does TRH do?
A
Stimulates TSH
19
Q
What does PRH do?
A
Stimulates PRL
20
Q
What does DA do?
A
Inhibits PRL
21
Q
What does SS do?
A
Inhibits GH
22
Q
What does ADH do?
A
Conserves water, vasoconstricts
23
Q
What does oxytocin do?
A
Milk letdown, baby letdown
24
Q
What does GH do?
A
IGF-1 release from liver
25
What does TSH do?
T3,T4 release from thyroid
26
What does LH do?
Testosterone release from the testis,
Estrogen and Progesterone release from the ovary
27
What does FSH do?
Sperm or egg growth
28
Milk production
PRL
29
Cortisol release from adrenal gland
ACTH
30
Skin pigmentation
MSH: melanocyte-stimulating hormone
31
What are the stress hormones?
Epi: Immediate
Glucagon: 20min
Insulin: 30min
ADH: 30min
Cortisol: 2-4hr
GH: 24hr
32
Concentrates urine
ADH
33
Too little ADH => urinate a lot
Diabetes Insipidus
34
Brain not making ADH
Central DI
35
What is Nephrogenic DI?
Blocks ADH receptor,
can be caused by Li and Demecocycline
36
DI: Water Deprivation failed?
Renal problem
37
What does giving DDAVP tell you?
DDAVP => Central DI concentrates >25%
38
What is SIADH?
Too much ADH => expand plasma vol => pee Na
39
What is the difference b/w DI and SIADH?
DI has dilute urine,
SIADH has concentrated urine
40
What is Psychogenic Polydipsia?
Pathologic water drinking => low plasma osmolarity
41
What does Aldosterone do?
Reabsorbs Na, secretes H+/ K+
42
What is a Neuroblastoma?
Adrenal medulla tumor in kids,
dancing eyes/feet, secretes epi and norepinephrine
43
What is a Pheochromocytoma?
Adrenal medulla tumor in adults, 5 P's
44
What does the Zona Glomerulosa make?
Aldosterone "salt"
45
What is the primary regulatory control for the Zona Glumerulosa?
Renin-Angiotensin
46
What does the Zona Fasiculata make?
Cortisol "sugar"
47
What is the primary regulatory Control for the Zona Fasiculata?
ACTH, CRH
48
What does the Zona Reticularis make?
Androgens "sex"
49
What is the primary regulatory control for the Zona Reticularis?
ACTH, CRH
50
What do chromaffin cells produce?
Catecholamines
51
What is the primary regulatory control for chromaffin cells?
Preganglionic sympathetic fibers
ACH
52
What is Conn's syndrome?
High Aldo (tumor), Captopril test makes it worse
53
What does ANP do?
Inhibits Aldo, dilates renal artery (afferent arteriole)
54
What does Calcitonin do?
Inhibits osteoclasts => low serum Ca2+
55
What is MEN I?
"Wermer's": Pancreas, Pituitary, Parathyroid adenoma (high gastrin) "PPP"
| multiple endocrine
56
What is MEN II?
"Sipple's": Pheo, Medullary thyroid cancer, PTH
| multiple paraneoplastic syndrome
57
MEN IIb
"MEN IIb": Pheo, Medullary thyroid cancer, Oral/GI neuromas
| marfanoid
58
What does CCK do?
Gallbladder contraction, bile release
58
Gluconeogenesis by proteolysis => thin skin
Autoimmu
Cortisol
59
What is Addison's disease?
Autoimmune destruction of adrenal cortex => hyperpigmentation, ↑ACTH
60
What is Waterhouse Friderichsen?
Adrenal hemorrhage
61
What is Cushing's syndrome?
High cortisol (pituitary tumor or adrenal tumor or small cell lung CA)
62
What is Cushing's disease?
High ACTH (pituitary tumor)
63
What is Nelson's syndrome?
Hyperpigmentation after adrenalectomy
64
If the low-dose dexamethasone test suppresses, what does that tell you?
Normal, obese, or depressed
65
If the low-dose dexamethasone test does not suppress, what does that tell you?
Cushing's => do high dose test
66
If the high-dose dexamethasone test suppresses, what does that tell you?
Pituitary tumor => ACTH (call brain surgeon)
67
If the high-dose dexamethasone test does not suppress, what does that tell you?
Adrenal adenoma => Cortisol (call general surgeon)
* Small cell lung cancer => ACTH (call thoracic surgeon)
68
What are the survival hormones?
Cortisol: permissive under stress
TSH: permissive under normal
69
What does Epinephrine do?
Gluconeogenesis, glycogenolysis
70
What does Erythropoietin do?
released from?
release dt?
Makes RBCs
Hypoxia
71
What does Gastrin do?
Stimulates parietal cells => IF, H+
72
What does Growth hormone do?
Growth, sends somatomedin to growth plates, gluconeogenesis by proteolysis
73
What is a Pygmie?
No somatomedin receptors
74
What is Achondroplasia = Laron Dwarf?
Abnormal FGF receptors in extremities
75
What is a Midget?
↓Somatomedin receptor sensitivity
76
What is Acromegaly?
Adult bones stretch "my hat doesn't fit", coarse facial features, large furrowed tongue, deep husky voice, jaw protrusion,
↑IGF-1 b/c of GH tumor
77
What is Gigantism?
Childhood acromegaly
78
What does GIP do?
Enhances insulin action => post-
prandial hypoglycemia
79
What does Glucagon do?
Gluconeogenesis, glycogenolysis, lipolysis, ketogenesis
80
What does Insulin do?
Pushes glucose into cells
81
What is Type I DM?
anti-islet cell Ab, GAD Ab, Coxsackie B, low insulin, DKA, polyuria, polydipsia, polyphagia
82
What is Type II DM?
Insulin receptor insensitivity,
high insulin,
HONK coma,
acanthosis
83
How does DKA present?
Kussmal respirations, fruity
breath (acetone), altered mental
84
What is the Dawn phenomenon?
Morning hyperglycemia 2° to GH
85
What is the Somogyi Effect?
Morning hyperglycemia 2° to
evening hypoglycemia
86
What is Factitious Hypoglycemia?
Insulin injection (↑insulin, ↓C-peptide)
87
What is an Insulinoma?
Tumor (↑insulin, ↑C-peptide)
88
What is Erythrasma?
Rash in skin folds, coral-red Wood's lamp
89
What is Syndrome X = Metabolic Syndrome?
"Pre-DM"=> HTN, dyslipidemia, hyperinsulinemia, acanthosis nigricans
90
What are foot ulcer risk factors?
DM/ Glycemic control
* Male smoker
* Bony abnormalities
* Previous ulcers
91
What conditions cause weight gain?
Obesity
* Hypothyroidism
* Depression
* Cushing's
* Anasarca
92
What does Motilin do?
stimulates segmentation (1° peristalsis, MMC)
93
What does Oxytocin do?
Milk ejection, baby ejection
94
Kallmann syndrome?
Hypogonadotropic hypogonadism: defective migration of GnRH- releasing neurons
95
association of Kallmann syndrome
No puberty or incomplete puberty
can't smell
can't hear
can't pee
96
origin and action of erythropoietin
renal parenchymal cells
erythropoiesis in bone marrow
97
stimulator and inhibitor of Erythropoietin
Hypoxia stimulates
high 02 inhibits
98
causes of polycythemia with normal erythropoietin
lose of plasma
stress polycythemia
Gaisbock's syndrome
99
causes of polycythemia with high erythropoietin: hypoxia
acute hypoxia: tachypnea and dyspnea
Chronic hypoxia: clubbing, polycythemia
RLD, COPD, Renal cell carcinoma
100
causes of polycythemia with low erythropoietin
bone marrow cancer
polycythemia rubra vera
essential thrombocythemia
101
Adrenal cortex: Aldo stimulator and effector tissue
stimulator: high K, Low volume , low Na+
late DCT, early collecting duct and ascending colon
102
Aldo inhibitor and action
Hypervolumia
Increase production of Na-K pumps and K/H exchange
103
Aldo syndrome: too much
Conn's syndrome
HTN, High Na, low K, alkalosis
104
Aldo syndrome: too little
Adrenal insufficiency
21 HO
17 HO
11 HO
This may be seen in adults abrupt withdrawal of steroid
105
Cortisol origin and stimulus
Zona fasciculata
stress, hypoglycemia
106
cortisol inhibitor and effector tissue
hyperglycemia
permissive and up-regulate all receptors during stress
107
cortisol physiologic action
proteolysis
gluconeogenesis
108
cortisol anti-inflammatory action(I- KISS
Inhibits
phospholipase A
* Kills T-lymphocytes
and eosinophils
* Inhibit macrophage
migration
* Stabilizes mast cells
* Stabilizes
endothelium
109
too little cortisol
adrenal insufficiency
21 HO
11 HO
110
too much cortisol
Cushing's syndrome
111
the 3 Cushing's Disease
Pituitary adenoma
Small cell carcinoma
Adrenal adenoma
112
dexamethasone suppression occurs
Obesity
depression
normal variant
113
dexamethasone suppression does NOT occurs with Hi ACTH
small cell carcinoma
114
dexamethasone suppression does NOT occurs with low ACTH
Adrenal adenoma
115
high does dexa will suppress
Pituitary adenoma
116
High does Dexa will not suppress
small cell carcinoma
117
in women Progesterone (B4 menses) =
testosterone in men
118
origin of Testosterone and stimulus
zona reticularis
male external genitalia
119
Action of testoterone
Aggression, increase appetite, violence, hi RBC, hi Libido
120
sources of DHEA-S
adrenal in males
Ovaries
121
DHT made by _______________(enzyme) in ______________(locattion)
5 a-reductase
testes
at birth and puberty
122
hi DHT
Androgenic balding
PCOS
123
5 a reductase blocker
Fenesteride/Dutasteride
124
FLutamide moa
blocks DHT receptors
125
Epinephrine origin and stimulus
adrenal medulla
Stress/hypoglycemia
126
EPi inhibitor and target
hyperglycemia
liver and adrenal cortex, Heart
127
EPI action
glycolysis
gluconeogenesis
glycogenolysis
128
Excess NE and Epi
Pheo and Neuroblastoma
129
symptoms of Excess NE and Epi
Intermittent HTN, palpitations, diaphoresis and headaches
130
seen in Neuroblastoma with hi EPi and NE
Opsoclonus
hypsarrhythmia
(EEG: https://www.researchgate.net/figure/EEG-findings-in-hypsarrhythmia-burst-suppression-variant-there-are-bursts-of-bilateral_fig2_256086128
131
treatment for hi EPI/ NE
phentolamine
phenoxybenzamine (zero order)
132
surgery for hi EPI/NE
give alpha blocker until surgery
Beta-blocker right b4 surgery to block catecholamine effect
133
MC abdominal mass in children
Neuroblastoma
134
Stress hormone released immediately
Receptors
EPI : B1/2 : GS, a1:Gq, a2: Gi
135
Stress hormone released 20min
Glucagon: Gs
136
Stress hormone released 2-4hr
cortisol permissive up regulation of all receptors
137
Stress hormone released 24hr
GH: Jak-stat
produces sugar
138
Released within 30 mins of Stress
Insulin:RTK-MAPK: pushes glucose in cells
ADH :V2:GS: normalizes Osmolarity cause by sugar
139
Pancrease hormones
glucagon: from ALPHA cells
* Insulin: from BETA cells
* Somatostatin: from DELTA cells
* Pancreatic Polypeptide: from ‘F’ cells
140
Catabolic 2nd MSG
c-AMP
Jat stat: GH
cortisol
141
Glucagon target
adrenal cortex
liver
adipose tissue
142
glucagon stimulus and inhibitor
Sti: Hypoglycemia/stress
Inh: hyperglycemia
143
MOA of glucagon
gluconeogenesis
glycogenolysis
lypolysis
ketogenesis
144
Alpha cell tumor with necrolytic migratory erythema
hi glu
hi lipid
hi ketones
145
Insulin stimulus and inhibitor
hyperglycemia
hypoglycemia
146
what tissues do not require insulin
low Km hi affinity
Brain
RBC
Intestine
cardiac/cornea
kidney
liver
exercising muscle
147
insulinoma signs
hypogluc hi C-Peptide
CT scan--> surgery
148
Infants: Nessidioblastosis
same as insulinoma
subtotal pancreatectomy
149
Delta cells
somatostatin
sti: insulin and glucagon
inch: low insulin and glucagon
150
what is the analog of somatostatin
octreotide
slows gastric emptying/GI blood flow in
esophageal varicose bleeding
151
Stomach hormones
Gastrin
Ghrelin Vs Leptin
152
Duodenum hormone
Secretin
CCK
Motilin
GIP
VIP
Somatostatin
153
Secretin is stimulated by
low PH(acid) from stomach
154
action of secretin
(+) pancreas and GB =Bicarb
(- )Gastrin
slow gastric emptyingC
155
CCK stimulated by
Food( FAT)
for fat and protein digestion
156
CCK stimulate
Pancreas (digestive enzyme) and gallbladder(bile)
157
CCK second msg
IP3/DAG
158
# Duodenum
GPI stimulus and inhibition
glucose
high pH
159
Target of GIP and MOA
Pancreatic islet cells
enhances insulin secretion
160
GIP syndromes
Dumping syndrome: Billroth II
causes insulin resistance (type 2 diabetes)
161
somatostatin
| stimulus & inhibition
Duodenal hormones
High pH
purely inhibitory
162
# Auerbach's plexus
VIP
| stimulus and Inhibition
duodenal hormones
High pH
inhibitory paracrine
163
VIPOMA
watery diarrhea
CAT scan
surgery
164
what are the causes of watery diarrhea
Vibrio
ETech
Giardia
Vipoma
165
# stomach antrum
Gastrin
high pH
Low pH
166
Gastrin target & MOA
Parietal cell
HCL and intrinsic factor production
| Ca++ 2nd msg
167
What is gastrinoma
pancreatic tumor
zollinger-Ellison syndrome
hi, unsuppressable gastrin
167
Gastrinoma may be associated with what syndrome
MEN-1
| pancreatic tumor
168
# Right Atrium and Ventricle
ANP
| stimulus & inhibitor
high volume
Low volum
169
ANP target and MOA
Afferent renal artery dilateion
inhibits aldosterone
| 2nd msg: NO
170
ANP syndrome results in
polyuria, nocturia and hyponatremia
171
Calcium metabolism
| Hormones
PTH
Vitamin D
Calcitonin
172
# enbrionic origin
PTH
3rd/4th pharyngeal pouch
parathyroid gland
173
# stimulus/inhibitor
PTH
low Ca++, Hi Phosphorus
Hi Ca++, low phosphorus
174
PTH target
osteoclasts of bone
kidney PCT
Kidney Late DCT
175
MOA of PTH
stimulate osteoclast
phosphorus secretion increase
activate 1-alpha hydroxylas--> make vit D
| C-AMP
176
# low PTH syndrome
PTH receptor defect is
x-linked dominant pseudo hypoparathy with short 3rd and 5th digit
177
mcc or 1st hypo PTH
Thyroidectomy
178
Normal Ca++ with Hypo PTH
Pseudopseudo PTH
179
# Hi PTH
1st Hi PTH
parathyroid adeno
isolated hi ca++
180
inflammatory bone condition causing scaring
osteosclerosis
181
increase osteoclastic activity, Ca++ and alkaline Phosphatase
Osteitis Deformans
182
loss of bone mass, matrix and miniralization
osteopenia
183
thick bone, no marrow, low osteoclastic activity
osteopetrosis
184
soft bones
loss of mineralization
osteomalacia
185
hi osteoclastic activity, loss of matrix/osteoid, less osteoblastic acitivity...post menopause
osteoporosis
186
2nd hi PTH
Renal failure
Renal osteodystrophy
187
Vit D deficiency
osteomalacia
Rickets
188
# Vit D production
Skin
Liver
Renal
Cholecalciferol
25-oH
1,25 D, OH
189
Vit D target tissue
Kidney
GI
Bone
190
MOA of vit D
Production of Ca-ATPase
Production CBP
stimulates
Osteoblast activity
191
Calcitonin production
Parafollicular cells of thyroid
| stimulated by hi Ca++
192
Calcitonin function
Inhibit osteoclastic activity
| c-AMP
193
# what cancer and syndrome
Increase calcitonin, low osteoclastic activity, thick bone
| osteopetrosis
Medullary carcinoma of thyroid
RET gene
MEN 2 a
| pheocho, parathyroid adenoma
194
2nd line drug for osteoporosis
| works like calcitonin
Bisphoshonate (dronate)
Very corrosive to GI
causes osteonecrosis
195
Dopamine agonist
L-Dopa/carbidopa
bromocriptin
selegiline
amatadine
196
Carbidopa moa
stops L-DOpa break down in liver and GI
197
Selegilin MOA
MOA-a inhibitor
198
Bromacriptin SE
fibrosis: cardiac plueral
retroperitoneal
199
Amantedine
NMDA antagonist
increase Dopamin release
decrease dopamin reuptake
inhibit viral uncoating
200
# D2 blocker
Phenothiazine family
Anti emetic
strong anticholinergic effect
| sedative
201
Phenothiazine
*Prochlorperazine
adult antiemetic
202
# Phenothiazine
promethazine
children Antiemetic
203
# Phenothiazine
Fluphenazine
Long acting (great for homeless and no insurance pt)
204
Dopamin blockers indication
Schizophrenia
Bipolar disorder
Acute psychosis
Delirium
Acute agitated states
205
# Butyrophenones (D2 blocker)
Haloperidol
Droperidol
Severe combative psychosis
206
# atypicals
D-4 receptor blocker are use for
negative symptoms
extrapyramidal SE
207
# D4 blocker
Clozapine SE
agranulocytosis
208
MC pituitary tumors
nonfunctional adenomas
209
prolactinoma
MC functional pituitary tumor
210
what are all pituitary tumors associated with
hi prolactin
| galactorrhea and amenorrhea
211
which pituitary hormone is both catabolic and anabolic
GH
| anabo: released after1st REM
Catabolic: release after 24 hrs of stress
212
symmetrical Dwarf is a
somatomedin (GH) receptor sensitivity defecite
213
achondroplasia
asymmetrical dwarf
214
mcc short stature
genetic
GH defi
chronic disease
215
excess GH
hyperglycemia
rapid bone growth
216
coarse facial feature
hyperglycemia
hat, shoes don't fit
acromegaly
| organomegaly
217
what is the only protein hormone with Nuclear receptor
Thyroid Hormone
218
protein hormone that croses placenta
| permissive
thyroid hormone
| controls growth and development
219
# TRH
hi TSH also stimulate
Prolactin
| galactorrhea and amenorrhea
220
# Pituitary
TSH (+) has the same alpha chain as
HCG, LH,FSH
221
foramen cecum
base of tongue where thyroid gland migrated
222
# permissive hi thyroid
explain HTN, hi O2 demand and hi Hrt rate
upregulate B1
| Low T3 downregulate B1:slow
223
Hypothyroidism
| in Baby and mom
Cretinism
224
mom only hypothyroidism
| how long will baby present normal
baby normal
225
# hypothyroid
mc in American adult
Hashimoto's disease
226
hypothyroidism dt viral illness
De Quervain's dz
| painful, diffuse, firm, jaw pain
227
lymphocytic thyroiditis is seen with
postpartum
immune reconstitutional
228
Riedel's Struma
hard thyroid mass
painless
229
# hyperthyroidism
Grave's Dz
toxic multinodular goiter
| thyroid storm, congestive Hrt failure
230
Hyperthyroidism : Grave's Dz
treatment
Propranolol
propylthiouracil
Methimazole
I-131
| Propylthiouracil: use in first trimester of pregnancy
231
# ADH
supraoptic and paraventricular nuclei
| stimulus and inhibition
Hi osmolarity
low osmolarity
232
ADH MOA
increase vascular resistance
increase absorption of water using urea
233
ADH target
endothelial cells (V-1)
collecting duct or nephrons (V-2)
| DDAVP for hemophilia a and VW Dz
234
Diabetes insipidus
| cause
lack ADH or receptor defect
| brain/kidney
235
treat central DI with
DDAVP
236
Neprogenic DI
| causes
Lithium(bipolar pt)
demclocycline
'vaptan
237
treat Nephrgenic DI with
Hyrochlorothiazide
| sensitizes receptor
238
SiADH
| cause
Pian
hi ICP
hypoxic lung dz
drugs
cancer
239
SiADH urine is inappropriate
| normal plama volume, low NA
hi NA
hi Osmo
240
nipple stimulaton and term pregnancy (uterine distention)
| hormone
Oxytocin
| IP3/DAG
241
oxytocin moa
milk ejection
uterin contractions
| overlapse with ADH --H2O intoxication
vaginal orgasm
induce labor
