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Neo Boards > Endo > Flashcards

Endo Flashcards

1
Q

When does the fetal thyroid gland develop?

A

3 weeks gestation

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2
Q

From what tissues does the thyroid gland develop?

A

Endoderm

- pharyngeal floor

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3
Q

When do thyroid follicles develop and begin thyroglobulin production?

A

8 weeks gestation

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4
Q

Iodide can accumulate in the fetal thyroid at ___ weeks.

A

10 weeks

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5
Q

When does the fetal pituitary gland produce TSH?

When does the fetal thyroid gland produce thyroid hormones?

A

12 weeks

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6
Q

When do T4 levels surge?

A

18-20 weeks (at hypothalamus and pituitary maturation) and again at birth
Peak levels at 24-36 hours of age

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7
Q

When do T3 levels increase?

A

30 weeks (T4 to T3 via Type I deiodinase)

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8
Q

Where are T3 levels highest in the fetus?

A

Brain and Pituitary

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9
Q

When do T3 levels peak?

A

Dramatic increase at birth–> 24-36h due to increase T4-> T3 conversion

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10
Q

The fetus metabolises t4

A

Reverse T

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11
Q

TSH levels are low until _____ then increase with age

A

18 to 20 weeks

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12
Q

Cold exposure at birth causes TSH levels to

A

Dramatically increase at 30 minutes of age

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13
Q

In terms infants T4 levels increase due to _______ while in preterm infants T4 ________ at birth

A

Dramatic TSH surge

Blunted TSH surge and loss of maternal T4

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14
Q

Placental estrogens cause increase in

A

Maternal thyroxine bonding globulin, T4, T3

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15
Q

HCG causes increase in _____ due to HCG mimic of _____

A

T4, T3

TSH

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16
Q

Placental conversion of ______ to ______ allow transfer to fetus

A

T4, rT3

T3, T2

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17
Q

TSH is produced by

A

Anterior pituitary

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18
Q

TRH is produced by

A

Hypothalamus

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19
Q

90% of the thyroid hormone secreted from the thyroid is

A

T4

9% T3
1% rT3

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20
Q

Congenital hypothyroidism is primarily caused by

A

Thyroid dysgenesis (75%)

Thyroid dyshormonogenesis (10%)
Transient hypothyroidism (10%)
Hypothalamic -pituitary defect (5%)
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21
Q

Transient hypothyroxinemia of prematurity affects ____% of infants _______

A

50%

<30 weeks

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22
Q

Congenital hypothyroidism with 8th nerve abnormality causing deafness could be due to _____, inherited _______

A

Pendred syndrome

Autosomal recessive

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23
Q

Thyroid screening for congenital hypothyroidism should happen at ______ age

A

36-72h

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24
Q

1-5% of infants born to mother’s with Graves disease will have

A

Congenital hyperthyroidism

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25
Hyperthyroidism due to maternal Graves disease is caused by
Placental transfer of TSH receptor-stimulating antibodies TSH receptor-blocking antibodies If stimulating>> blocking---> transient hyperthyroidism If blocking>>> stimulating--> transient hypothyroidism
26
Transient thyroid disregulation due to maternal Graves disease can present at _____ and last for _____ due to antibody half life.
10 days 8-20 weeks
27
Infants born to mother's with Graves disease with our without thyroidectomy should be tested for
TSH receptor antibodies (TRAbs)
28
Adrenal cortex is derived from ______ and medulla is from ______
Mesoderm Neuroectodermal cells of neural crest
29
Adrenal glands form from
5-8 weeks Cortex cells 5-6 weeks Medulla 7-8 weeks
30
Adrenal medulla produces
Catecholamines Epinephrine Norepinephrine Dopamine
31
Adrenal cortex produces
Mineralocorticoid Glucocorticoids Sex hormones (DHEA)
32
Most common cause of congenital adrenal hyperplasia
21 hydroxylase deficiency
33
Aldosterone deficiency, cortisol deficiency, and increased testosterone with salt wasting is associated with
21 hydroxylase deficiency
34
21 hydroxylase deficiency presents
Normal male+/- salt wasting, precocious puberty, advanced bone age Ambiguous female, salt wasting, virilization, hirsutism Elevated 17-OHP, abnormal ACTH stim response
35
Second most common cause of Congenital adrenal hyperplasia is
11 beta hydroxylase deficiency
36
Impaired conversion of 11 deoxycortisol causes
Cortisol deficiency Increased testosterone Aldosterone deficiency without salt wasting 11- beta hydroxylase deficiency
37
Normal male/ambiguous female with high BP is ______ while ambiguous male/normal female without secondary sex characteristics with high BP is _______
11 beta hydroxylase deficiency 17 alpha hydroxylase deficiency
38
Normal BP with salt wasting with ambiguous genitalia in both sexes is
3 beta hydroxy steroid dehydrogenase deficiency
39
Cortisol is produced by
CRH from hypothalamus--> ACTH from anterior pituitary --> Zona faaciculata/reticularis of adrenal glands--> cortisol
40
Cortisol causes
``` Gluconeogenesis Increased RBC production Decreased inflammation Immune system suppression Calcium/phosphorus release from bone Decreased ADH Lipolysis Vascular catecholamine response ```
41
46,XX ambiguity
21-hydroxylase 11-beta hydroxylase 3-beta hydroxysteroid dehydrogenase deficiency Maternal androgen/progesterone Aromatase deficiency
42
46, XY ambiguity
17- alpha hydroxylase 3-beta hydroxysteroid dehydrogenase deficiency 5 alpha reductase deficiency (AR)- late virilization Androgen resistance/insensitivity
43
Hypospadias + bilateral undescended testes= eval for
CAH
44
Cryptorchidism can be associated with
``` Hypothalamic-pituitary testicular axis abnormalities Abdominal defects Meningomyelocele Trisomy 13, 18 Noonan Smith Lemli Opitz Familial ```
45
Cryptorchidism is usually
Unilateral (2/3) Right>> left Inguinal
46
Euglycemia is maintained at birth with
Increasing glucagon Decreased insulin Catecholamine-->glycogenolysis, gluconeogenesis, lipolysis, ketogenesis
47
Pituitary gland develops from
Ectoderm
48
Anterior pituitary develops from
Rathke's pouch
49
Posterior pituitary develops from
Forebrain
50
Anterior pituitary function:
Hormone secretion (TSH, LH, FSH, prolactin, GH, ACTH, pro-opiomelanocortin)
51
Posterior pituitary function:
Store and secrete anterior pituitary gland hormones
52
Hypothalamus hormones:
Vasopressin (ADH) | Oxytocin
53
HPA axis functions at
18 weeks
54
Panhypopituitarism should be treated with
Growth hormone
55
Increased osmolality at osmoreceptors OR Hypovolemia at cardiovascular volume receptors -->
increased ADH secretion--> | Water reabsorption
56
ADH causes water reabsorption by
Increasing distal nephron permeability Vasoconstriction Decreased renin Increased ACTH
57
ADH fails to cause water reabsorption in
Nephrogenic DI
58
RAAS pathway
Renin--> Angiotensin I --> Angiotensin 2 --> Aldosterone/ADH
59
Transplacental transfer of Ca, phos and mag is by
Active transport
60
Maternal ______ increases fetal Ca availability by _____
PTHrP | Increased calcitriol production --> maternal intestinal calcium absorption
61
Calcium and phosphorous are reabsorbed in the neonatal
Kidney, proximal tubule (>90%)
62
____ and ____ hormones increase calcium and phosphorous release from the bone
Cortisol | Thyroid hormone
63
To increase Ca, PTH levels ____ and phosphorous levels are _____
Increase | Decreased
64
Hypocalcemia can cause ______ in EKG
Prolonged QT
65
Hypoparathyroidism and infantile hypophosphatemia cause
Hypercalcemia
66
Hypomagnesemia can cause ____ on EKG
Prolonged QT
67
Decreased bone matrix suggests
Osteopenia
68
Decreased bone mineralization suggests
Osteomalacia
69
Widened growth plates with fraying occurs in
Osteomalacia
70
Bone disease of prematurity has low _____ and high _____
Phosphate 1, 25 OH D PTH +/- calcium, alk phos
71
Pseudohypoparathyroidism is marked by
Decreased Calcium Increased phosphorus High PTH**
72
In primary hypoparathyroidism, labs are
Decreased calcium Increased phosphorous Low PTH**

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