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USMLE Step 1-2015 > Endo > Flashcards

Endo Flashcards

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USMLE® Step 1 flashcards
1
Q

Persistence of tyroglossal duct leads to

A

Pyramidal lobe of thyroid

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2
Q

Adrenal cortex derived from?

Adrenal medulla derived from?

A

Mesoderm

Neural crest

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3
Q

Most common ectopic thyroid tissue site?

A

tongue

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4
Q

Medullary chromaffin cells are considered as?

A

Modified postganglionic sympathetic neurons

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5
Q

Acidophils secrete what and basophils secrete what of anterior pituitary?

A

Acidophils-Prolactin, GH

Basophils-FSH, LH, ACTH, TSH

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6
Q

What secretes MSH?

A

Melanotropin (MSH) secreted from intermediate lobe of pituitary

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7
Q

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

A

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

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8
Q

does insulin cross placenta?

A

no

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9
Q

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

A

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.

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10
Q 
GLUT 1
GLUT 2
GLUT 3
GLUT 4
GLUT 5
A

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

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11
Q

GH and B2 agonists have what effect on insulin?

A

increase insulin through insulin resistance

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12
Q

Early and Late treatment for severe hypoglycemia

A

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

*IM Glucose is not an option

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13
Q

Prolactin is under the control of and controls what?

A

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

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14
Q

Somatostatin function

A

Decrease GH, TSH

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15
Q

TRH function

A

Increase TSH, prolactin

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16
Q

Analog of GHRH used to treat HIV associated lipodystrophy

A

Tesamorelin

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17
Q

Excess prolactin is associated with what response

A

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

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18
Q

Stimulators of prolactin secretion (2)?

A

Estrogen (OCPs, pregnancy) +TRH

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19
Q

Another name for IGF-1

A

Somatomedin C

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20
Q

Direct tissue effects of GH and effects on liver

A

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

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21
Q

Growth hormone secretion increases and decreases with what?

A

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

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22
Q

Leptin
Secreted by?
Function?
Regulation in various conditions?

A

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

23
Q

Ghrelin
Secreted by?
Function?
Regulation in various conditions?

A

Stomach
Stimulates hunger
Increased with decreased sleep, Prader willi

24
Q

Cortisol function (BIG FIB)

A

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

25
Q

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

A

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

26
Q

3 types of CA2+

A

Ionized, bound to albumin, bound to anions

27
Q

CAH treatment

A

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

28
Q

Where oes calcium and phosphate reabsorption occur in kidney?

A

Calcium-DCT

Phosphate-PCT

29
Q

Is calcitonin a significant calcium regulator hormone?

A

No thyroidectomy would not cause significant changes in calcium levels

30
Q

4 main functions of T3 hormone

A

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

31
Q

Where does T3 bind?

A

Nuclear receptors specifcically in hormone binding regions in DNA promoter

32
Q

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

A

Iodotyrosine deiodinase

33
Q

Rule of 10s for pheochromocytoma

A

10%:

Bilateral, malignant, calcify, extra-adrenal, kids

34
Q

5 episodic hyperadrenergic symptoms of pheochromocytoma

A

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

35
Q

How to avoid hypertensive crisis in pheochromocytoma tumor resection?

A

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

36
Q

What represents an increase in BMR in hyperthyroidsim?

A

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

37
Q

Treatment for thyroid storm

A

3 P’s

Propanalol (b-blockers), Propylthiouracil, Prednisolone (corticosteorids)

38
Q

Antibodies in hashimoto

A

Antimicrosomial (anit-thyroid peroxidase), and antithyroglobulin

39
Q

Tender vs nontender thyroid in causes of hypothyroidism

A

Tender-Subacute dequarvain

Nontender-Hashimoto thyroiditis

40
Q

Most common enzyme deficient in dyshormonogenetic goiter in cretinism?

A

Thyroid peroxidase

41
Q

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

A

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

42
Q

lymphoid aggregate with germinal center

A

hashimoto thyroiditis

43
Q

granulomatous inflammation with very tender thyroid

A

subacute dequervain thyroiditis

44
Q

thyroid replaced by fibrous tissue (hypothyroid)

A

riedel thyroiditis

45
Q

How is biopsy performed for characterizing thyroid nodules

A

fine needle aspiration

46
Q

Medullary carcinoma of thyroid associated with what mutation?

A

RET

47
Q

IGF-1 has what functions

A

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

48
Q

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

A

Central and nephrogenic >142 while

49
Q

Treatment of nephrogenic diabetes insipidus

A

HCTZ, indomethacin, amiloride

50
Q

Type of hyponatriemia in SIADH

A

Euvolemic hyponatremia

51
Q

Why is there elevated risk of lactic acidosis with metformin?

A

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.

52
Q

4 actions of PPAR target genes

A

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

53
Q

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

A

pramlintide

54
Q

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

A

Cinacalcet

USMLE Step 1-2015 (18 decks)

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