Endo

Question 1

foramen cecum is remnant of

Answer 1

thyroglossal duct

Question 2

layers of adrenal cortex (outer to inner) and what they make

Answer 2

GFR:
glomerulosa - aldosterone
fasciculata - cortisol
reticularis - sex hormones

Question 3

MC tumor of adrenal medulla in kids vs adults

Answer 3

kids - neuroblastoma

adults - pheo

Question 4

alpha subunit is common to what hormones

Answer 4

TSH, LH, FSH, hCG

Question 5

tissues w/ insulin dependent glucose uptake

Answer 5

BRICK L

brain, RBCs, intestine, cornea, kidney, liver

Question 6

GLUT1, GLUT2, GLUT4 - how do they work and where found

Answer 6

1 - insulin independent. RBCs, brain
2 - bidirectional. beta islet cells, liver, kidney, small intestine
4 - insulin dependent. adipose, skeletal muscle

Question 7

adrenergic stimulation/inhibitors of insulin release

Answer 7

beta 2 agonists stimulate insulin release

alpha 2 agonists dec insulin release

Question 8

link btwn hypothyroidism and hyperPRL

Answer 8

TRH stimulates PRL release - not significant at physiologic levels, but when TRH is elevated in hypothyroid, can cause hyperPRL

Question 9

somatostatin neg regulates what 2 hormones?

Answer 9

GH, TSH

Question 10

2 types of drugs that stimulate PRL secretion

Answer 10

DA antagonists (like antipsychotics)
estrogens

Question 11

antimicrobial drug that can cause adrenal insuff

Answer 11

ketoconazole

Question 12

17alpha hydroxylase def, 21 hydroxylase def, 11beta hydroxylase def - all of these are what type of disorder? what are hormone levels in each one? which is most common?

Answer 12

congenital adrenal hyperplasias
17alpha - inc aldo, dec cortisol, dec androgens
21 - dec aldo, dec cortisol, inc androgens
11beta - dec aldo (but inc 11-deoxycorticosterone - another mineralocorticoid), dec cortisol, inc androgens

21 is most common

Question 13

fns of cortisol

Answer 13

maintain BP (esp alpha 1 receptors)
dec bone formation
anti inflammatory
inc insulin resistance
inc gluconeogenesis, lipolysis, proteolysis
inhibit fibroblasts

Question 14

Mg effect on PTH secretion

Answer 14

dec Mg > inc PTH

severely dec Mg > dec PTH

Question 15

what cells make calcitonin?

Answer 15

parafollicular cells in thyroid (C cells)

Question 16

4 main fns of T3

Answer 16

4 Bs - 
brain maturation
bone growth
beta adrenergic effects
basal metabolic rate (inc)

Question 17

Wolff Chaikoff effect

Answer 17

excess iodine temporarily inhibits TPO > dec T3/4 synth

Question 18

MCC cushing’s syndrome

Answer 18

exogenous steroids

Question 19

aldosterone secrecting adrenal adenoma called

Answer 19

Conn’s syndrome

Question 20

2 findings that are present in primary but not secondary adrenal insufficiency

Answer 20

primary has skin hyperpigmentation and hyperkalemia, secondary doesnt

Question 21

Waterhouse Friderichsen syndrome

Answer 21

acute primary adrenal insufficiency caused by N. meningitidis septicemia, DIC and endotoxic shock

Question 22

type of cell that makes up pheo

Answer 22

chromaffin cell

Question 23

tx of pheo

Answer 23

first, irreversible alpha antagonists to prevent HTN crisis
next beta blockers to slow HR
then can surgically remove

Question 24

marker indicating presence of neuroblastoma

Answer 24

urine HVA (homovanillic acid - breakdown product of DA)

Question 25

findings in cretinism

Answer 25

``` 5 Ps - pot belly pale puffy face protruding umbilicus protuberant tongue ```

Question 26

granulomatous inflammation in thyroid

Answer 26

subacute thryoiditis (de Quervain's)

Question 27

fibrosis of thyroid

Answer 27

Reidel's thyroiditis - painless, hypothyroid

Question 28

pathophys of toxic multinodular goiter

Answer 28

patches of hyperfunctioning follicular cells working independently of TSH > inc release of T3/4

Question 29

Jod Basedow phenomenon

Answer 29

thyrotoxicosis if pt w/ iodine def goiter is made iodine replete

Question 30

cause of death from thyroid storm

Answer 30

arrhythmia

Question 31

really bad kind of thyroid CA

Answer 31

anaplastic

Question 32

MC type of thyroid CA

Answer 32

papillary

Question 33

which type of thyroid CA makes calcitonin?

Answer 33

medullary - from parafollicular cells

Question 34

bone dz assoc w/ hyperPTH

Answer 34

osteitis fibrosa cystica - cystic bone spaces filled w/ brown fibrous tissue

Question 35

Albright's hereditary osteodystrophy

Answer 35

pseudohypoPTH AD kidney unresponsive to PTH hypoCa, shortened 4/5th digits, short stature

Question 36

MC type of pituitary adenoma

Answer 36

prolactinoma

Question 37

Sheehan's syndrome

Answer 37

postpartum infarct of pituitary causing panhypopituitarism

Question 38

Kimmelsteil wilson nodules

Answer 38

deposits in nodular glomerulosclerosis assoc w/ diabetic nephropathy

Question 39

Kussmaul respirations assoc w/

Answer 39

DKA

Question 40

carcinoid syndrome

Answer 40

carcinoid tumor "after" the liver (not confined to GI) secretes 5HT - paroxysms of diarrhea, cutaneous flushing, asthmatic wheezing, right sided valvular dz

Question 41

inheritance pattern of MEN syndromes

Answer 41

AD

Question 42

gene assoc w/ MEN2a/b

Answer 42

ret

Question 43

MEN 1 manifestations

Answer 43

parathyroid tumors pituitary tumors pancreatic endocrine tumors

Question 44

MEN 2a manifestations

Answer 44

medullary thyroid CA pheo parathyroid tumors

Question 45

MEN 2b manifestations

Answer 45

medullary thyroid CA pheo oral/intestinal ganglioneuromatosis, marfanoid habitus

Question 46

AEs of metformin

Answer 46

GI upset | lactic acidosis **

Question 47

AEs of first gen sulfonylureas

Answer 47

disulfiram like effects

Question 48

pramlintide - mech, use

Answer 48

``` amylin analog (dec glucagon secretion) type 1 and 2 DM ```

Question 49

-gliptin drugs - what is the mechanism / use

Answer 49

DPP4 inhib - stop incretin degradation to increase insulin and dec glucagon used in T2DM

Question 50

2 drugs used to reduce production of thyroid hormone

Answer 50

propylthiouracil and methimazole

Question 51

demeclocycline - mech, use

Answer 51

ADH antagonist | used in SIADH