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endo > ENDO > Flashcards

ENDO Flashcards

1
Q

Endocrine glands mostly do what

A

Provide homeostasis

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2
Q

How do hormones circulate

A

Free and Bound

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3
Q

What form of hormones are the bio active from found in plasma

A

Free

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4
Q

What are 3 responsibilities of hormones

A

Cell metabolism
Growth
Reproduction

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5
Q

What is important about polypeptides

A

Large lipid insoluble molecules that elicit a cascade of events

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6
Q

Steroid’s have what characteristics?

A

Small lipid soluble molecules that elicit a response

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7
Q

Increased hormone does what the synthesis and production, as an example of what

A

Decreases

Negative Feedback

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8
Q

What is an example of positive feedback

A

Increased levels stimulate an inhibitor to decrease levels

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9
Q

What is primary hyper function

A

Stimulation within the hormone secreting gland

Ex: T3/T4

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10
Q

What is secondary hyper function

A

Stimulation of pituitary gland or hypothalamus

Ex: TSH

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11
Q

What is ectopic hyper function

A

Hormone secreted from tissue other than a usual source.

Ex: Small cell Lung cancer ADH or Cortisol

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12
Q

What is resistance hypofunction

A

Unable to target tissue that recognizes the hormone = decreased response

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13
Q

What is an adenoma?

2 examples

A

Benign enlargement of a gland

  • could be malignant
  • could be salt secreting
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14
Q

Whwhat is the definition of hypoplasia

A

Under or incomplete development (congenital)

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15
Q

What is an example of initial tests for hypothyroidism

A

TSH
Primary = Low
Secondary = High

W/ low T3/T4 in both cases

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16
Q

What is the axon terminal of the hypothalamic neuron

A

Posterior pituitary

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17
Q

ADH is AKA

A

Vasopressin

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18
Q

4 main mechanisms of ADH

A

V1 = contracts smooth muscle

V2 = retian water in the body

Collecting duct increases water content, decreases urine volume

Acts on the renal tubule to concentrate the urine

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19
Q

What are the regulating receptors of the posterior pituitary (2)

A

Osmoreceptors

Baroreceptors

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20
Q

When ADH is released osmolality increases causing what two things?

A

1) decreased production of urine

2) thirst center activation

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21
Q

Increased serum sodium does what two things?

A

Causes

Hypovolemia and Hypotension

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22
Q

Drugs that can increase serum NA (4)

A

MDMA
NSAIDs
Amiodarone
Neuroleptics

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23
Q

Inhibition of ADH does what? (2)

A

Causes :
low plasma osmolality
High normal Bp and Volume

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24
Q

What is ETOHs effect on NA

A

Diuretic that inhibits Na release

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25
Q

Which is the most sensitive osmo or baro receptors

A

OSMO

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26
Q

Wha this the job of the osmoreceptors

A

Detect an increase in osmotic pressure

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27
Q

What is the job of the baroreceptor?

A

Detect decreased Bp

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28
Q

When ADH is released what is its affect on blood vessels and the kidneys

A

Blood vessels constrict

Kidneys increase reabsorption of water

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29
Q

What are two ADH disorders

A

SIADH

Diabetic Insipidous

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30
Q

What is the patho of SIADH

A

Excess amounts of ADH without osmotic stimulus

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31
Q

What are initial findings of SIADH

A

Normal plasma volume with normal osmolality

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32
Q

What are lab manifestations of SIADH (4)

A

Low plasma osmolality

Low serum sodium

High Urine specific gravity (inc concentration)-THICK PEE

High urine Na+

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33
Q

Is there edema with SIADH

A

Despite water retention there is not much edema

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34
Q

What is the serum NA in SAIDH

A

Low serum NA+

35
Q

What does low NA+ due to cells?

A

Shifts fluid from extra cellular to inside the cells

36
Q

What are 4 etiologies for SIADH

A

CNS or Lung D/O

Malignant Ectopic ADH

Drugs

OTher

37
Q

What 4 CNS disorders are associated with SIADH

A 
Stroke 
Subarachnoid hemmorage 
Meningitis / encephalitis 
Trauma 
Brain tumor
38
Q

3 causes for a pulmonary etiology of SIADH

A

TB
PNA
Neoplasms

39
Q

What is associated with tumors that are secreted by ectopic ADH

A

Small Cell Cancer

40
Q

What can help you find small cell cancer lesions

A

CT/MRI of the chest

41
Q

What 3 sxs would cause you to do a CT/MRI of the chest to search for small cell lung cancer

A

Hypopnea

Oliguria

Anura

42
Q

What types of meds can cause SIADH (7)

A 
Antidepressants 
Anti neoplastic agents 
Anticonvulsants 
MDMA 
NSIADs 
Opiates 
Opiates / Amiodarone
43
Q

What are the classic sxs of a pheo

A

HTN HA diaphoresis palpitations

44
Q

Medulary thyroid cancer marfanoid habitus pheo is consistent with with a MEN

A

MEN 3 (2B)

45
Q

Patient presents with fatigue and jumpy for 4 months, heart races on exertion, sxs worsen over a month, hands shake a lot, irritable, heat intolerance, menstrual flow light, Diplopia @ outward gaze, DTRs with rapid relaxation

first test/2nd/3rd

A

TSH
Free T4
CBC

HCG
EKG

46
Q

Primary Hyperthyroid has what labs

A

High T3
High T4

Low TSH

47
Q

RAIU with increased iodine uptake signals

A

Primary Hyperthyroidism- Graves Disease

48
Q

What are the hallmarks of graves

A 
Exopthalmos 
Lid Lag 
Clubbing 
Reflex relaxation 
AFIB 
Diplopia
49
Q

What’s a good treatment for Graves

A

I-131 thyroid tissue radiation

50
Q

Fatigued, skin dry, menses irregular, skin is dry. Heart sounds are normal but distant. What disease

A

Hypothyroidism

51
Q

Hypothyroid = what labs

A

Free T4 T3 normal low ish

TSH way high

52
Q

What is the best aspect for evaluating thyroid hormone

A

free T4

53
Q

EKG with sinus bradycardia and low voltage for hypothyroidism is significant for what?

A

Explains the Distant heart sounds

54
Q

What is the expected heart rate in hypothyroidism

A

Low Bp

55
Q

Treatment for thyroid disease oral meds get what length of treatment

A

The rest of their life

56
Q

When is the ideal time to check TSH when checking for a change in dosage

A

5-6 weeks

57
Q

Thyroid oral meds have what medication guidelines

A

Can not take other meds 4 hours after, and take it first thing in the Morning, dont allow them to stop abruptly

58
Q

What happens if you stop oral thyroid meds abruptly

A

Myxedema crisis

59
Q

.elevated Bp, with apprehension, severe HA, perspiration, rapid heart beat, facial pillow
Abprubt onset lasting 10-25 mins each

A
60
Q

What are the endocrine and non endocrine causes of HTN

A 
Endo 
Pheo 
Hyperaldost. 
Hyperthyroid
Hypercortisol 
Cushing 
Non
Obesity 
Sleep Apnea 
Renal Artery Stenosis 
Drugs (Illicit / illegal) -NSAIDS
61
Q

What is the bet test to check for a pheo

Then, confirmed by what test?

A

Plasma fractionated metanephrine

Then 24 hr urine

62
Q

Best study for PHEO first

A

NON CON CT ABD CHEST

63
Q

What is the name of the pheo like tumor that is not on the adrenal gland

A

Paraganglioma

64
Q

2 meds for pre pheo surgery

A

Alpha blockade
Then
Beta blocker

Phenoxybenzamine

65
Q

What is an associated finding of gigantism

A

Facial acne

66
Q

Overgrown sex characteristics increased height and acne can be due to what and hirsutism?

A

Excess androgens

67
Q

2 places androgens can come from in excess in a female

A

Ovaries and adrenal glands

68
Q

What is in excess with androgen overproduction of the adrenal glands ; what is depleted

A

17 OH progesterone

21 OH progesterone

69
Q

What are the two types of CAH ; differences?

A 
Classic (Salt wasting) and 
Non classic (Androgynous presentation)
70
Q

CAH treatment

A

Glucocorticoid to suppress the excess aldosterone

-can consider a mineral corticoid as well

71
Q

Cushing syndrome sxs

A

Irregular menses
Oncoming
Depression
Wt Gain

Puffy face

72
Q

Hirsutism represents an increase in what

A

Androgens

73
Q

What defines dependent hypercortisolism

A

High Dexameth, 24 hr urine, and ACTH (normalx4 times the ULMN) tests

Cushing Disease / ACTH pituitary adenoma

74
Q

Ten times the normal ACTH finding could be what?

A

Ectopic, insanely elevated
Lung Cancer
Oat cell
Carcinoid

75
Q

High cortisol on dexamethsaone with low ACTH = what disease

ACTH independent Hypercortisolism

A

(ACTH independent Hypercortisolism)

76
Q

(ACTH independent Hypercortisolism) can be due to what two things

A

Iatrogenic - exogenous corticosteroid

Adrenal hyperplasia

77
Q

Treatment for Cushing disease

A

Surgical removal (transphenoidal)

78
Q

What two things can occur as a result of Cushing disease surgery

A

Hyperpituitarism

DI

79
Q

Orthostatic hypertension indicated what things (3)

A

Low volume (ex: due to diarrhea)

Thyroid over drive

Electrolyte abnormalities

80
Q

What should you consider if a patient presents with amenorrhea

A

Pregnancy

81
Q

Low flow through the kidney does what

A

Effects all bodily function

82
Q

Hyponatremia and hyperkalemia can be a cause of what

A

Hypo thyroid
SIADH
Anemia

think about Addison disease

83
Q

If you suspect someone has Addison’s what else should you test for?

A

Autoimmune thyroiditis

TB

endo (3 decks)

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