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usmle rx qbank > Endo 1 > Flashcards

Endo 1 Flashcards

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USMLE® Step 1 flashcards
1
Q

how will TBG T3 T4 look like in a woman who is taking post menopausal hormone replacement

A

Estrogen increases TBG
increases TOTAL T3 T4
normal free T3 T4
euthyroid hyperthyroxinemia

total is high cause most of t3 t4 is bound to ybg

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2
Q

undergo nuclear translocation to act on zinc finger proteins and ultimately alter targeted-gene expression.

A

vitamin D3
steroids
estro
progestro

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3
Q

increase peripheral sensitivity to insulin by binding to and stimulating the activity of nuclear transcription factors called peroxisome proliferator–activated receptors.

A

thiazolinadones
glitazones

SE edema weight gain hepatotoxic and CI in heart failure as increase risk of MI

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4
Q

what drug do u give prior to pheochromocytoma ressection

A

irreversible alpha antag

SE can be miosis or pupillary constriciton

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5
Q

antidiabetic meds that decrease glucagon release

A

eexanetide pramlintide
GLP1 analogues
pancreatitis and hyhpoglycemoa

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6
Q

FSH works on?

A

granulosa cells to make estrogen

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7
Q

what would be the immediated effects of OCP that cause low FSH

A

low esttogen in follicular phase

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8
Q

essential amino acid to make thyroid hormones

A

tyrosine

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9
Q

arginine is a precursor of

A

NO
creatinien
urea

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10
Q

tryptophan precursor for

A

niacin (b6) and serotonin (bh4 and b6)

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11
Q

Glucagon and epinephrine act via the Gs pathway, leading to an increase in protein kinase A levels which in turn increases

A

fructose 2,6 bisphosphate

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12
Q

dysfunctional signal recognition particle (SRP).

Where is this signal sequence most likely located?

A

The signal peptide that sends a protein into the (endoplasmic reticulum) ER during translation is composed of a series of hydrophobic amino acids found at the N-terminus of the protein, and is recognized by the signal-recognition particle (SRP).

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13
Q

tumors of the adrenal medulla in adults and are derived from chromaffin cells, which arise from

A

neural crest

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14
Q

Pheochromocytomas may be associated with germline mutations such as those responsible for

A

MEN2A, MEN2B, von Hippel–Lindau disease, and neurofibromatosis type 1.

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15
Q

responsible for ADH production.

A

The supraoptic nucleus of the hypothalamus

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16
Q

he lateral nucleus of the hypothalamus is thought to be

A

hunger center” of the brain. Damage to this area leads to anorexia and starvation,

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17
Q

in hypoglycemia wat happens to glucose uptake into b celll

A

still takes place

glut 2 is insulin inependnt

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18
Q

what is neurophysin 1 used for

A

transport of oxytocin from paraventricular nucleus

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19
Q

ADH is transported by

A

neurophysin II

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20
Q

post pituitary hormones are made in

A

supraoptic nucleus … paraventricular nucleus

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21
Q

what is the treatment in primary hyperaldosteronism

A

spirinolactone

inhibits aldosterone

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22
Q

hypokalemai is mostly assoc with which type of acid base imbalacnce

A

metabolic alkalosis due to increased H+ secretion

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23
Q

how does spironolactone cause gynecomastia

A

en because it decreases testosterone production, increases peripheral conversion of testosterone to estradiol, and displaces estradiol from sex hormone-binding globulin

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24
Q

Hyperuricemia has been associated with use of

A

thiazide diuretics

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25
Q

ototoxicity (diuretic)

A

loop

26
Q

Examples of hormones that act through the GPCR and cAMP-mediated signal transduction

A

FSH/LH, TSH, ACTH, ADH, PTH, and glucagon, calcitonin

27
Q

Atrophy of pancreatic tissue with dystrophic calcification

A

chronic pancreatitis

28
Q

Periportal inflammation and necrosis with ballooning degeneration of hepatocytes

A

hepatitis A

29
Q

The classic triad of ascending cholangitis

A

right upper quadrant pain
fever
jaundice

30
Q

recurrent yeast infections, hyperglycemia, low insulin and C-peptide levels, as well as a family history of gestational diabetes

A

maturity onset diabetes of ypung
due to glucokinase gene modification
glucokinase turns glucose into glucose 6 phosphate and promotes glycolysis —– more ATP made —- closees the K+ channels and insulin is secreted

31
Q

17 alpha hydroxylase def

A

the only CAH to have a sex hormone def

so no testosterone …. female charactersitsics

32
Q

first trimester pregnant girl
hyperthyroidism
txt?

A

PTU

methimazole is CI in first trimestwr

33
Q

ethanol intoxication …. NAD NADH ratio

A

in ethanol metabolism NAD is used to make NADH

so NADH;NAD ratio is high …. stops gluconeogenesis tooooo

34
Q

insulin and growth hormonesacts through which kind of cell surface receptor

A

tyrosine kinase

35
Q

at risk for non hodgkin lymphoma

A

hypothyroid patients

36
Q

complications of graves if not treated

A

fractures — high level of thyroxin increases osteoclast activity
life threatening thyroid storm
fetal hyperthyroidism

37
Q

glycoprotein hormone that is secreted from the interstitial cells of the kidney to increase RBC production. Upon erythropoietin binding to its receptor (EpoR), intracellular nonreceptor tyrosine kinases transduce signals via the JAK-STAT pathway.

A

erythropoetin

38
Q

DKA triggers

A

infection
steroid use
no insulin

39
Q

right adrenal vein vs left

A

The right adrenal vein drains directly into the IVC

Left drains into renal vein first

40
Q

The adrenal medulla secretes catecholamines (epinephrine, norepinephrine, and dopamine) in response to

A

direct stimulation by preganglionic sympathetic neurons. These neurons use the neurotransmitter acetylcholine

41
Q

deficiency of debranching enzyme

A

cori disease
milder form of von gierke disease
hypoglycemia and normal lactate levels

42
Q

serine/threonine kinase receptor

A

transforming growth factor-beta is an example of a molecule that has its action mediated by a receptor serine/threonine kinase.

43
Q

graves disease nodular or diffusely enlarged thyroid

also what type of antibodies

A

diffusely enlarged

anti TSH

44
Q

21 vs 11 hydroxylase def

A

syncopal episodes can be distinguishing factor

wont occur in 11 …. coz of 11 deoxycortisone

45
Q

bblocker overdose treatment

A

glucagon
Beta blocker overdose can present with symptoms of cardiogenic shock, including pale and cool extremities, bradycardia, and hypotension.

46
Q

what is the mechanism of red palms in liver cirrhosis

A

hyperesterinism

like testicular atrophy, gynecomastia, spider angiomas loss of hair

47
Q

disulfiram-like reaction secondary to ethanol consumption at a cocktail party.
diabetic patient

A

first degree sulfonylurea
chlopropamide
tolbutamide

48
Q

ic SBLA cancer syndrome: Sarcoma, Breast, Leukemia, and Adrenal gland cancers.

A

li fraumeni
p53
normally a tumor suppressor

49
Q

vongierke

A

glucose 6 phosphatase def
severe hypoglycemia
increaed triglycerides
increased lactic acid

50
Q

cori disease

A

debranching enzyme

NO LACTIC ACID buildup

51
Q

manifest at birth with symptoms of vomiting, hypotonia, and hypotension.
catecholamine synthesis problem

A

dopamine B hydroxylase def

52
Q

Increased levels of calcitonin are expected in patients with which type of cancer

A

medullary thyrooid cancer

53
Q

Tall, crowded follicular epithelial cells with scalloped colloids

A

graves disease

54
Q

Lymphocytic infiltrate with occasional germinal center formation

A

postpartum thyroiditis

55
Q

Thyroid tissue replaced with inflammatory infiltrate

A

reidel thyroiditis

fibrosis may etend to nearby tissues

56
Q

w inflammatory infiltrate with multinucleated giant cells

A

subacute thyroiditis
viral
self limiting
increased ESR CRP

57
Q

HLADR5 increases risk of

A

HASHIMOTOOOOO

58
Q

76-year-old patient is found to have a large thyroid mass with pleomorphic spindle cells on biopsy. An x-ray also reveals metastasis to the lungs. This patient’s large mass is consistent histologically and clinically with a very aggressive tumor. The posterior spread and subsequent metastatic spread, along with his presenting symptoms, point to a diagnosis o

A

ANAPLASTIC CARCINOMA

poorly differentiated, pleomorphic cells on histology.

59
Q

follicular thyroid carcinoma i

A

DISTANT hematogenous metastasis

60
Q

polygonal to spindle-shaped cells with granular cytoplasm in an amyloid-filled stroma.

A

medullary thyroid carcinoma

usmle rx qbank (29 decks)

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