Endo

Question 1

Persistence of tyroglossal duct leads to

Answer 1

Pyramidal lobe of thyroid

Question 2

Adrenal cortex derived from?

Adrenal medulla derived from?

Answer 2

Mesoderm

Neural crest

Question 3

Most common ectopic thyroid tissue site?

Answer 3

tongue

Question 4

Medullary chromaffin cells are considered as?

Answer 4

Modified postganglionic sympathetic neurons

Question 5

Acidophils secrete what and basophils secrete what of anterior pituitary?

Answer 5

Acidophils-Prolactin, GH

Basophils-FSH, LH, ACTH, TSH

Question 6

What secretes MSH?

Answer 6

Melanotropin (MSH) secreted from intermediate lobe of pituitary

Question 7

Difference in insulin and C-peptide in insulinoma, sulfonyurea, and exogenous insulin

Answer 7

Insulinoma + sulfonylurea both increase insulin and C-peptide while exogenous insulin lacks C-peptide

Question 8

does insulin cross placenta?

Answer 8

no

Question 9

What is the known mechanism under which TNFalpha, glucagon, and glucocorticoids, high FFA cause insulin resistance?

Answer 9

Serine phonsphorylation through activation of serine kineases which result in phosphorylation of serine/threonine residues in Beta subunit of insulin receptors hindering downstream signaling resulting in resistance to normal actions of insulin.

Question 10

GLUT 1
GLUT 2
GLUT 3
GLUT 4
GLUT 5

Answer 10

RBC, Brain Cornea (Insulin independent)
B-cells pancreas, liver, kidney, small intestine
Brain
Adipose tissue, striated muscle (insulin dependendent)
(fructose): spermatocytes, GI tract

Question 11

GH and B2 agonists have what effect on insulin?

Answer 11

increase insulin through insulin resistance

Question 12

Early and Late treatment for severe hypoglycemia

Answer 12

Early (mild/moderate hypoglycemia)-fast acting carbohydrates (glucose tablet, sweetened fruit)
Late (unconscious)-IM glucagon.

*IM Glucose is not an option

Question 13

Prolactin is under the control of and controls what?

Answer 13

Under control of dopamine where relased is decreased and It is increased by TRH

Question 14

Somatostatin function

Answer 14

Decrease GH, TSH

Question 15

TRH function

Answer 15

Increase TSH, prolactin

Question 16

Analog of GHRH used to treat HIV associated lipodystrophy

Answer 16

Tesamorelin

Question 17

Excess prolactin is associated with what response

Answer 17

Prolactin inhibits GnRH–>inhibiting LH/FSH–>amenorrhea/hypogonadism and excessive decreases libido

Question 18

Stimulators of prolactin secretion (2)?

Answer 18

Estrogen (OCPs, pregnancy) +TRH

Question 19

Another name for IGF-1

Answer 19

Somatomedin C

Question 20

Direct tissue effects of GH and effects on liver

Answer 20

Tissue effects: Increase insulin resistance (increase glucose), increase lipolysis (increased FFA), increased protein synthesis
Effect on liver: increase IGF-1–>acts on growth and development of bone, cartilage, and soft tissue

Question 21

Growth hormone secretion increases and decreases with what?

Answer 21

Increases with exercise/sleep, decreases with glucose/somatostatin (via negative feedback by somatomedin)

Question 22

Leptin
Secreted by?
Function?
Regulation in various conditions?

Answer 22

Adipose tissue
Satiety hormone
Decreased with decreased sleep, starvation, mutation in leptin gene

Question 23

Ghrelin
Secreted by?
Function?
Regulation in various conditions?

Answer 23

Stomach
Stimulates hunger
Increased with decreased sleep, Prader willi

Question 24

Cortisol function (BIG FIB)

Answer 24

Increase BP, Insulin resistance (diabetogenic), Increase gluconeogenesis, lipolysis, and proteolysis, decrease fibroblast activity, decrease inflammatory and immune responses, decrease bone formation

Question 25

What affect does increase in pH have on albumin and calcium?

Answer 25

increase pH-->increased affinity of albumin (increased negative charge ) to bind Ca2+-->hypocalcemia

Question 26

3 types of CA2+

Answer 26

Ionized, bound to albumin, bound to anions

Question 27

CAH treatment

Answer 27

Low dose corticosteroids. Decrease ACTH-->decrease adrenal cortex stimulation (Normally increased ACTH because decreased cortisol secretion)

Question 28

Where oes calcium and phosphate reabsorption occur in kidney?

Answer 28

Calcium-DCT | Phosphate-PCT

Question 29

Is calcitonin a significant calcium regulator hormone?

Answer 29

No thyroidectomy would not cause significant changes in calcium levels

Question 30

4 main functions of T3 hormone

Answer 30

1) Bone growth 2) BMR increase 3) Brain maturation 4) B-adrenergic effect

Question 31

Where does T3 bind?

Answer 31

Nuclear receptors specifcically in hormone binding regions in DNA promoter

Question 32

How is MIT/DIT recycled after I4/I3 released from thyroglobulin to enter the periphery?

Answer 32

Iodotyrosine deiodinase

Question 33

Rule of 10s for pheochromocytoma

Answer 33

10%: | Bilateral, malignant, calcify, extra-adrenal, kids

Question 34

5 episodic hyperadrenergic symptoms of pheochromocytoma

Answer 34

Pressure (increase BP), Pain (headache), Perspiration, Palpitations (tachycardia), Pallor

Question 35

How to avoid hypertensive crisis in pheochromocytoma tumor resection?

Answer 35

alpha antagonists (phenoxybenzamine) followed by beta bolckers prior to tumor resection. alpha antagonists must be achieved prior to beta blockers

Question 36

What represents an increase in BMR in hyperthyroidsim?

Answer 36

Increase in Na+/K+ ATPase channels synthesis +activity

Question 37

Treatment for thyroid storm

Answer 37

3 P's | Propanalol (b-blockers), Propylthiouracil, Prednisolone (corticosteorids)

Question 38

Antibodies in hashimoto

Answer 38

Antimicrosomial (anit-thyroid peroxidase), and antithyroglobulin

Question 39

Tender vs nontender thyroid in causes of hypothyroidism

Answer 39

Tender-Subacute dequarvain | Nontender-Hashimoto thyroiditis

Question 40

Most common enzyme deficient in dyshormonogenetic goiter in cretinism?

Answer 40

Thyroid peroxidase

Question 41

Hashimoto, subacute de quervain granulomatous thyroidisits, and riedel thyroiditis type of thyroid

Answer 41

Hashimoto-nontender Subacute thyroiditis-very tender!! Riedel-nontender

Question 42

lymphoid aggregate with germinal center

Answer 42

hashimoto thyroiditis

Question 43

granulomatous inflammation with very tender thyroid

Answer 43

subacute dequervain thyroiditis

Question 44

thyroid replaced by fibrous tissue (hypothyroid)

Answer 44

riedel thyroiditis

Question 45

How is biopsy performed for characterizing thyroid nodules

Answer 45

fine needle aspiration

Question 46

Medullary carcinoma of thyroid associated with what mutation?

Answer 46

RET

Question 47

IGF-1 has what functions

Answer 47

secreted by liver and acts on bone, soft tissue, cartilage

Question 48

Na+ level in Central DI, nephrogenic di, psychogenic polydipsia

Answer 48

Central and nephrogenic >142 while

Question 49

Treatment of nephrogenic diabetes insipidus

Answer 49

HCTZ, indomethacin, amiloride

Question 50

Type of hyponatriemia in SIADH

Answer 50

Euvolemic hyponatremia

Question 51

Why is there elevated risk of lactic acidosis with metformin?

Answer 51

Increase production of lactate by anaerbic glycolysis. Normally, lactate produced in intestine converted to glucose via gluconeogenesis in liver, but metformin inhibits this gluconeogenic process. Results in elevated lactate circulating levels with risk of lactate acidosis.

Question 52

4 actions of PPAR target genes

Answer 52

1) increase adiponectin (which decreases insulin resistance) 2) increase fatty acid transport protein3) increase insulin receptor substrate 4) increase GLUT-4

Question 53

This drug decreases gastric emptying and decreases glucagon that can be used in type I dm and type 2 dm

Answer 53

pramlintide

Question 54

Sensitizes Ca 2+ sensing receptor in parathyroid gland to ciculating Ca2+-->decrease PTH

Answer 54

Cinacalcet