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Endo > Endo 2 > Flashcards

Endo 2 Flashcards

1
Q

Ghrelin stimulates _____ and _______

A

hunger (orexigenic effect) and GH release (via GH secretagog receptor).

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2
Q

Endocannabinoids act at cannabinoid receptors in

A

hypothalamus and nucleus accumbens

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3
Q

ADH Primary function is serum osmolality regulation via regulation of aquaporin channel insertion in ________ of renal collecting duct.

A

principal cells

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4
Q

Ghreli, Leptin, Insulin levels in

Sleeve gastrectomy:
HIV lipodistrophy due to Antiretroviral therapy:
Dieting:

A

Sleeve gastrectomy: ↓Ghreli, ↓Leptin, ↓Insulin

HIV lipodistrophy due to Antiretroviral therapy:
↑Ghreli, ↓Leptin, ↑Insulin

Dieting: ↑Ghreli, ↓Leptin, ↓Insulin

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5
Q

All congenital adrenal enzyme deficiencies are autosomal recessive disorders and most are characterized by ______ and _________

A

skin hyperpigmentation and bilateral adrenal gland enlargement (due to ACTH stimulation).

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6
Q

ACTH stimultes ______ enzyme and this enzyme is inhibited by _______

A

Cholesterol desmolase

Ketoconazole

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7
Q

Angiotensin II acts on _______ enzyme

A

Aldosterone synthase (coverts corticosterone → aldosterone)

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8
Q

Txt of CAH:

A

Exogenous steroids that suppress ACTH → ↓Desmolase activity

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9
Q

Aromatase deficiency presentation:
newborn girl:
at puberty:

A

Newborn: ambiguous genitalia + virilization

at puberty: impaired ovarian estrogen synthesis → primary amenorrhea, osteoporosis, and tall stature (↓estrogen delays epiphysis fusion)

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10
Q

Exogenous corticosteroids can cause reactivation of ______ and ______

A

TB and candidiasis (blocks IL-2 production).

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11
Q

Ionized/free Ca2+ is 1° regulator of PTH; changes in ____ alter PTH secretion, whereas changes in ______ do not

A

pH

albumin concentration

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12
Q

Glucocorticoid can worsen hypocalcemia by ___________

A

decreasing expression of vit D receptors.

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13
Q

________ test is required for patients with long-term glucocorticoid therapy.

A

Bone density

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14
Q

7th B in Thyroid hormone:

A

Stimulates surfactant synthesis in Babies

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15
Q

Reverse T3 (rT3)

A

is a metabolically inactive byproduct of the peripheral conversion of T4 and its production is increased by growth hormone and glucocorticoids

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16
Q

T4→T3 Peripheral conversion is inhibited by

A

glucocorticoids, β-blockers, and propylthiouracil, Uremia

17
Q

↑ TBG in

A

pregnancy, OCP use (estrogen ↑TBG) →↑total T3/T4

18
Q

Colloid consists of _______. Production of colloid is regulated by _____, it is not dependent on ____

A

Thyroglobulins

TSH…….. not dependent on TPO

19
Q

Negative feedback primarily by free T3/T4:

A

Anterior pituitary ↓sensitivity to TRH

Hypothalamus ↓TRH secretion

20
Q

Receptors for _______ are located in nucleus.

A

Thyroid hormone

Vitamin A and D

21
Q

Exogenous glucocorticoid causing cushing syndrome. how to tell its not due to endogenous cortisol?

A

↓ Urinary excretion of cortisol

22
Q

Distinguishing feature of ACTH dependent cushing syndrome:

A
  1. Hyperpigmentation
  2. ↑ ACTH
  3. Hyperandrogenism (hirsutism, oligo/amenorrhea, OILY SKIN → due to stimulation of Zona Reticularis by ACTH)
23
Q

Zollinger-Ellison syndrome is Gastrin-secreting tumor (gastrinoma) of________

Acid hypersecretion causes recurrent ulcers in______

A

pancreas or duodenum.

duodenum and jejunum.

24
Q

Zollinger-Ellison syndrome Presents with

Test?

A

abdominal pain (peptic ulcer disease, distal ulcers), diarrhea (malabsorption).

Positive secretin stimulation test

25
Q

Achlorhydria in which conditions:

A
  1. VIPoma
  2. Somatostatinoma
  3. Pernicious anemia
26
Q

VIPoma
Endoscopic sample:

persists after_____

No response to diet changes excludes:

A

↑ pH in stomach

fasting

lactose intolerance

27
Q

Pain ↓/↑ after meal tells us about ______

Zollinger-Ellison syndrome pain _____ after meal

A

location of peptic ulcer

improves (raises pH)

28
Q

Zollinger-Ellison syndrome ulcers are refractory to ____

A

PPI

29
Q

Diarrhea in Zollinger-Ellison syndrome is due to:

Type of diarrhea:

A

Excessive gastric acid cannot be neutralized in small intestine → ↓pH inactivates pancreatic enzymes + inhibits Na/water absorption in small intestine

Result: poor digestion, steatorrhea, secretory diarrhea

30
Q

Secretin test differentiate gastrinoma from ____

A

Atrophic gastritis (hypergastrinemia)

31
Q

Glucagonoma Presents with 6 D’s:

A 
Dermatitis (necrolytic migratory erythema), 
Diabetes (hyperglycemia), 
DVT, 
Declining weight, 
Depression, 
Diarrhea
32
Q

On histology cells in pheochromocytoma are similar to ______

A

medullary thyroid cancer

polygonal or spindle shaped

33
Q

Polygonal cells in which carcinomas

A

RCC
Medullary thyroid
Pheochromocytoma

Endo (3 decks)

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