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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
Q

Hyperthyroidism due to maternal Graves disease is caused by

A

Placental transfer of TSH receptor-stimulating antibodies
TSH receptor-blocking antibodies

If stimulating» blocking—> transient hyperthyroidism

If blocking»> stimulating–> transient hypothyroidism

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26
Q

Transient thyroid disregulation due to maternal Graves disease can present at _____ and last for _____ due to antibody half life.

A

10 days

8-20 weeks

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27
Q

Infants born to mother’s with Graves disease with our without thyroidectomy should be tested for

A

TSH receptor antibodies (TRAbs)

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28
Q

Adrenal cortex is derived from ______ and medulla is from ______

A

Mesoderm

Neuroectodermal cells of neural crest

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29
Q

Adrenal glands form from

A

5-8 weeks
Cortex cells 5-6 weeks
Medulla 7-8 weeks

30
Q

Adrenal medulla produces

A

Catecholamines

Epinephrine
Norepinephrine
Dopamine

31
Q

Adrenal cortex produces

A

Mineralocorticoid
Glucocorticoids
Sex hormones (DHEA)

32
Q

Most common cause of congenital adrenal hyperplasia

A

21 hydroxylase deficiency

33
Q

Aldosterone deficiency, cortisol deficiency, and increased testosterone with salt wasting is associated with

A

21 hydroxylase deficiency

34
Q

21 hydroxylase deficiency presents

A

Normal male+/- salt wasting, precocious puberty, advanced bone age

Ambiguous female, salt wasting, virilization, hirsutism

Elevated 17-OHP, abnormal ACTH stim response

35
Q

Second most common cause of Congenital adrenal hyperplasia is

A

11 beta hydroxylase deficiency

36
Q

Impaired conversion of 11 deoxycortisol causes

A

Cortisol deficiency
Increased testosterone
Aldosterone deficiency without salt wasting

11- beta hydroxylase deficiency

37
Q

Normal male/ambiguous female with high BP is ______ while ambiguous male/normal female without secondary sex characteristics with high BP is _______

A

11 beta hydroxylase deficiency

17 alpha hydroxylase deficiency

38
Q

Normal BP with salt wasting with ambiguous genitalia in both sexes is

A

3 beta hydroxy steroid dehydrogenase deficiency

39
Q

Cortisol is produced by

A

CRH from hypothalamus–>

ACTH from anterior pituitary –>

Zona faaciculata/reticularis of adrenal glands–> cortisol

40
Q

Cortisol causes

A 
Gluconeogenesis
Increased RBC production
Decreased inflammation
Immune system suppression
Calcium/phosphorus release from bone
Decreased ADH
Lipolysis
Vascular catecholamine response
41
Q

46,XX ambiguity

A

21-hydroxylase
11-beta hydroxylase
3-beta hydroxysteroid dehydrogenase deficiency

Maternal androgen/progesterone

Aromatase deficiency

42
Q

46, XY ambiguity

A

17- alpha hydroxylase
3-beta hydroxysteroid dehydrogenase deficiency

5 alpha reductase deficiency (AR)- late virilization

Androgen resistance/insensitivity

43
Q

Hypospadias + bilateral undescended testes= eval for

A

CAH

44
Q

Cryptorchidism can be associated with

A 
Hypothalamic-pituitary testicular axis abnormalities
Abdominal defects
Meningomyelocele
Trisomy 13, 18
Noonan
Smith Lemli Opitz
Familial
45
Q

Cryptorchidism is usually

A

Unilateral (2/3)
Right» left
Inguinal

46
Q

Euglycemia is maintained at birth with

A

Increasing glucagon
Decreased insulin
Catecholamine–>glycogenolysis, gluconeogenesis, lipolysis, ketogenesis

47
Q

Pituitary gland develops from

A

Ectoderm

48
Q

Anterior pituitary develops from

A

Rathke’s pouch

49
Q

Posterior pituitary develops from

A

Forebrain

50
Q

Anterior pituitary function:

A

Hormone secretion (TSH, LH, FSH, prolactin, GH, ACTH, pro-opiomelanocortin)

51
Q

Posterior pituitary function:

A

Store and secrete anterior pituitary gland hormones

52
Q

Hypothalamus hormones:

A

Vasopressin (ADH)

Oxytocin

53
Q

HPA axis functions at

A

18 weeks

54
Q

Panhypopituitarism should be treated with

A

Growth hormone

55
Q

Increased osmolality at osmoreceptors
OR
Hypovolemia at cardiovascular volume receptors –>

A

increased ADH secretion–>

Water reabsorption

56
Q

ADH causes water reabsorption by

A

Increasing distal nephron permeability
Vasoconstriction
Decreased renin
Increased ACTH

57
Q

ADH fails to cause water reabsorption in

A

Nephrogenic DI

58
Q

RAAS pathway

A

Renin–>
Angiotensin I –>
Angiotensin 2 –>
Aldosterone/ADH

59
Q

Transplacental transfer of Ca, phos and mag is by

A

Active transport

60
Q

Maternal ______ increases fetal Ca availability by _____

A

PTHrP

Increased calcitriol production –> maternal intestinal calcium absorption

61
Q

Calcium and phosphorous are reabsorbed in the neonatal

A

Kidney, proximal tubule (>90%)

62
Q

____ and ____ hormones increase calcium and phosphorous release from the bone

A

Cortisol

Thyroid hormone

63
Q

To increase Ca, PTH levels ____ and phosphorous levels are _____

A

Increase

Decreased

64
Q

Hypocalcemia can cause ______ in EKG

A

Prolonged QT

65
Q

Hypoparathyroidism and infantile hypophosphatemia cause

A

Hypercalcemia

66
Q

Hypomagnesemia can cause ____ on EKG

A

Prolonged QT

67
Q

Decreased bone matrix suggests

A

Osteopenia

68
Q

Decreased bone mineralization suggests

A

Osteomalacia

69
Q

Widened growth plates with fraying occurs in

A

Osteomalacia

70
Q

Bone disease of prematurity has low _____ and high _____

A

Phosphate

1, 25 OH D
PTH
+/- calcium, alk phos

71
Q

Pseudohypoparathyroidism is marked by

A

Decreased Calcium

Increased phosphorus

High PTH**

72
Q

In primary hypoparathyroidism, labs are

A

Decreased calcium

Increased phosphorous

Low PTH**

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