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A_First Aid Random Memorizing > ENDO > Flashcards

ENDO Flashcards

1
Q

which hormones share common beta subunit

A

FSH LH TSH hCG

FLAT HUG

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2
Q

which ant pit glands are basophilic

A 
B-FLAT
FSH 
LH 
ACTH
TSH

Prolactin and GH *(eosinophilic) pig

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3
Q

which pancreatic cells produce which hormone and location

A 
Beta cells (INSIDE) - insulin
alpha - glucagon (peripheral)
gamma - somatostatin (interspirsed
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4
Q

preproinsulin syntheiszed where

A

RER…cleavage into “proinsulin” and stored in secretory granules

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5
Q

growth hormone stimulates linear growth and muscle mass through…

A

IGF 1

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6
Q

how does growth hormone affect insulin

A

increases insulin resistance

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7
Q

what hypothalamic hormone does prolactin inhibit

A

GnRH (prvents ovulation and spermatogenesis)

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8
Q

GH is strucutrally homologous to…

A

prolactin

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9
Q

prolactin secretion from ant pit inhibited by…

A

dopamine from tuberoinfundibular pathway hypothal

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10
Q

how does TRH affect prolactin

A

TRH increass prolactin (so can see this in hypthyroid states)

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11
Q

how can antipsychotics cause galacorhea

A

blocking dopamine which disinhibits prolactin

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12
Q

fertility and puberty emdiated by pulsatile release of what

A

GnRH

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13
Q

treatment acomegaly

A

somatostatin (decrases GH and TSH)

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14
Q

why can you see galactorrhea in hypothyorid

A

increased TRH = increased prolactin

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15
Q

excess mineral corticoids, dcreated cortisol and sexhormones

A

17ahydroxylaes deficiency

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16
Q

ambiguous genitalia HTN

A

17ahydroxlyase deficiency

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17
Q

lab value in 17ahydroxylase def

A

lower androgens

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18
Q

effects of cortisol

A

A BIG FIB

Appetitei increased
BP increased
Insulin resistance (diabetogenic)
Gluconeogenesis/lipolysis/proteolisis increased (decreased glucose utlization)
Fibroblast activity decasdd (poor wound healing, striae, decreased colagen)
Immune (decreased inflamm and immune response)
Bone (decerased osteoblasts

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19
Q

relation between exogenous corticosteroids and TB

A

can cause reactivation TB and candidiasis (blocks IL2)

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20
Q

if steroids decrease immune response and inflammation, why do you see nutrophilia

A

decreaeses WBC adhesion so more is floating around in blood

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21
Q

steroids and mast cells

A

blocks histamine relase

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22
Q

where does pituitary sit

A

sella turcia

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23
Q

functional vs non functional pit adenoma

A

functional - poduces hormones

non functional doesnt

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24
Q

MCC pituatry adenoma

A

prolactinoma

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25
Q

presentation prolactinoma females

A

galactorrhea, amenorrhea (anovulation due to no FSH, LH)

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26
Q

presentaiton prolactinoma male

A

decrased libido

headache

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27
Q

elvated GH adn IGF1

LACK of gluose suppression

A

growth hormone adenoma

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28
Q

rx growth hormone excess

A

ocretoide (somatostatin analog) blocks GhRH

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29
Q

what tumor in children can result in hypopit

A

craniopharyngioma (can present with bilateral hemianopsia too) big clue

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30
Q

poor lactation, LOSS OF PUBIC HAIR recently after postpartum bleeding

A

sheehan syndrome (increased susepctiblity of pituitary to uundergo infarction and hypoperfusion during postpartum bleeding, esp since it’s gotten bigger beause of pregnancy)

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31
Q

atrophy or compression of pituitary

A

empty sella

herniation of arachnoid or CSF into sella turcica

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32
Q

polyuria, polydipsia, hypernatremia and high serum osmoality, low urine osmolality

A

central diabetes inspidus

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33
Q

specific gravity of urine in diabetes insipidus

A

low (keep losing free water)

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34
Q

water depriv test in central DI

A

deprivation cauess they to keep peein g(still low urine osmolarity)

give ADH analog and urine osmolaitiy goes up)…able to concetrate urine and keep more water in

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35
Q

imparied renal responset o ADH

A

nephrogenic DI

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36
Q

bipolar person keeps peeing

A

lithium can cause nephrogenic DI

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37
Q

water depriv result nephrogenic DI

A

give ADH analog, no effect on urine osm (urine osm still low)

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38
Q

DI has what effect on serum osm

A

inncreases it (keeps losing free water)

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39
Q

SIADH does what to serum osm

A

decreases osm (keeps in too much watere)

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40
Q

Na and serum osmolality in SIADH

A

hyponatremia

low serum osm

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41
Q

what cancer can cause SIADH

A

small cell lung cancer

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42
Q

MOA demeclocycline

A

blocks ADH

so this medication causes nephrogenic DI

but treats
SIADH

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43
Q

hyperosmotic volume contraction

A

DI

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44
Q

why is the body still euvolemic in SIADH

A

bod responds to water retention by increassing ANP and BNP and decreasing aldosterone which will increase Na excretion into urine (hyperosmolar urine)…but further worsens SIADH hyponatremia

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45
Q

what chemo drug can cause SIADH

A

cyclophsphamide

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46
Q

transporter that mediates glucose uptake in skeletal muscle cells

A

GLUT4

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47
Q

TSH function

A

stimulates small amt of T3 and lots of T4

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48
Q

relationship of reverse T3 and T4

A

peripheral T4 floating around gets converted to rt3

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49
Q

how is t4 converted to t3 in peripheral tisssue

A

5’deiodinase

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50
Q

what inhibits peripheral t4 to t3 conversion

A

glucocorticoids

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51
Q

wolff chaikoff effect

A

excess iodine will temporarily inhibit thyroid peroxidase which will decrase iodine organification and deccrease t3/t4 production

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52
Q

what mediates oxidation of I to I2

A

thyroid perioxidase

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53
Q

how to form MIT and DIT

A

I2 + thyroglobuiln (tyrosine residues)

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54
Q

what couples DIT and MIT together

A

thyroid perioxidase

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55
Q

what iodinates thyroglobulin to form MIT and DIT

A

thyroid perioxidase

56
Q

which binds nuclear reeptor at greater affinity t3 or t4

A

t3

57
Q

target PTU and methimazole

A

PTU porpylthiouracil - thyroid peroxidase and 5 deiodinase

methimazole - inhibits thyroid peroxidase only

58
Q

which antithyroid med blocks peripiheral conversion t4-t3

A

PTU Prevents Peripheral conversion

59
Q

teratogen in early pregnancy thyroid med

A

methimazole (meth is a teratogen)

60
Q

adverse affect PTU

A

hepatotoxicity (so use it in later pregnancy instead of meth)

61
Q

anterior neck mass, mobile

A

thyroglossal duct

62
Q

oremnant of thyrglossal duct

A

foramen cecum (remember thyroid starts and tongue andmoves donward)

63
Q

baswe of tongue mass

A

lingual throid

64
Q

how does thyroid icrease basal metabolic rate

A

via increasing Na K ATPase!!!!!! and increasing B1 adrenergic receptors

65
Q

how does thyroid affect cholesterol and glucose

A

hypocholesterolemia
hyperglycemia

thyroid incerases gluconeogenesis and glygogenolysis (icnreased sugar in blood)

66
Q

Igg autantibody TSH receptor (stimualtes

A

Graves disease (increased produciton adn release of TH)

67
Q

hyper thyroid, diffuse goiter, exophtalmos and pretibila myxedma

A

grave disease

68
Q

dough like appearance on shin

A

pretibial myxedema which will increase fibroblast secretion of GLYCOASMINOGLYCANS which will increase osmotic muscle swelling and muscle inflmattion

69
Q

graves hypersensitivity

A

type II

70
Q

HADR3 HLA B8

A

graves disseae

71
Q

how does T4 decrase TSH

A

downregulated TRH on anterior pit so it will not produce as much TSH

72
Q

rx graves

A 
5 Ps
propanolol
propylthiouracil
prednsolen (steroids)
potassium iodide
73
Q

“hot” enlarged thyroid gland

A

multinodular goiter (work independently of TSH and increase relase of t3 t4

74
Q

iodine deficient patient who is given iodine causes thyrotoxicosis

A

thyrotoxicosis

75
Q

mental retardation, short stature, coarse facila features
proatruding umblicus
protuberant tomgue

A

cretinism

76
Q

myxedema

A

doughy skin due to increased glycosaminoglycans

77
Q

low thyroid can cause what to choleserol

A

hypercholetolemia

78
Q

HLA DR5

A

hashimotos

79
Q

how does hashiotos present

A

initla hyperthyroidism (as thyroid follicles are destroyed) then ebcomes euthyroid then hypothyroid

low T4 and higher TSH

80
Q

histologic hallmark hashimotos

A

Hurthle cells

lymphoid aggregates with germinal centr

81
Q

lmyphoid aggregates with germinal centers

A

hashimotos

incresaed risk for marginal non hodgkin lymphoma B cell

82
Q

thyroiditis after viral infection with TENDER thyroid

A

subacute gran thyroditis

83
Q

hard as wood non tender thyroid

A

reidel fibrosing thyrodisi

thyroid replaced by fibroid tissue

84
Q

how does thyroid cancer look on iodine radio uptake studies

A

DECREASED UPTAKE (SO DO A Fine needle BIOPSY …IF IT’S COLD)

graves or nodular goiter will have increaesed uptake (hot)

85
Q

fibrous capsul solitary growth thyroid (most are cold) no capsular or vascular invasion

A

thyroid adeoma

benign

86
Q

MCC thyoird cacinoma

A

thyroid carcinoma

87
Q

histologic hallmark papillary thyroid

A

orphan annie eyes

empty nuclei with WHITE CENTRAL CELARING

88
Q

empty uclei with white central celaring

A

papillaryy

89
Q

histologic hall marks of papillary thyroid

A

Papi and Moma adoptee Orphan Annie

papillary
psamomma bodies
orphan annie eys

90
Q

RAS mutation

A

follicular carcinoma

91
Q

invasion of thtroid capsule and vasculature uniform follicles

A

follicular CARCINOMA

92
Q

what thyroid carcinoma likes to spread to blood

A

folicular

93
Q

which carcinomas like to spread to blood

A

follicular
RCC
HCC

94
Q

malignant proliferation of C cells

A

medullary carcinoma

95
Q

hypocalcemia and thyroid mass

A

medullary carcinoma

96
Q

malignant cells in amyloid stroma

A

medulary carcinoma thyroid

97
Q

assocation familial medulary carcinoma

A

MEN 2A 2B

RET oncogene mutations

98
Q

mutation Men 2A and 2B

A

ret mutation oncogene

99
Q

undifferentiated malignant tumor of thyroid

A

anaplastic carcinoma (similar to reidel’s but seen in ELDERLY)

REIDELS SEEN IN YOUNG

100
Q

congo red staining thyroid mass

A

medullary

amyloid has malignant cells in it

101
Q

increasd calcitonin thyroid mass

A

medullary

102
Q

MOA clomiphne

A

estrogen recepo modulation (decreases negative feedback inhibition of hpothalamus) there bincreaseing LH and FSH

103
Q

genital lesion painful ulcer with ragged border and grey exudate with inguinal lymphadenopatyh

A

chancroid H ducreyi *curved gram neg rod)

104
Q

camp signaling hormones

A 
FLAT ChAMP
FSH
LH
ACTH
TSH
CRH
hcG
ADH
MSH
PTH
105
Q

how will Mg affect PTH

A

like Ca
low Mg = High PTH
high mg -> low PTH

106
Q

how does PTH affect cAMPin urine

A

high PTH will increase cAMP in urine because it actiavtes kidney cells via Gs mechanism

107
Q

how will PTH affect bone

A

cystic bone spaces with brown fibrous tissue hyper parathyroidsim)

consisting of osteo clasts and hemosierin

108
Q

tourssea sign

A

hypocalcemia
fill bP cuff and get muslces spasms
tap on

109
Q

higher than normal Ca levels required to suppress PTH (excessive renal Ca uptake

A

familial hypocalciuric hypercalcima

due to defective G coupled Ca ensing receptor

110
Q

inflammation islets

A

t1dm

111
Q

ketones

A

by hydroxybutryate and acetoacetate

112
Q

mechanism t2dm

A

decrased numbers of insulin receptors!! = insulin resistance

113
Q

aymloid deposits in islet cells

A

T2DM (islets are overworked)

114
Q

marker t2dm

A

islet amyloid polypeptide deposits

115
Q

elderly comes in with high glucose levels, hypotension and coma ABSENT KETONES

A

HYPEROSMOLAR non ketototic coma

116
Q

how does diabetes cause cardiac complications

A

nonenzymatic gltosylation of larg medium sized vessels leads to athersceloriss in large vessles, leasds to hyaline arterioloscleorisis (kidny)

117
Q

how is peripheral neuropathy caused in diabetes

A

osmotic damge to schwann cells (hyperglycemia increases glucose to SORBITAL metabolism faldose B which can deposit and cause damage)

118
Q

marker insulinoma

A

C peptide

119
Q

marker exogenous insulin

A

high insulin LOW C PEPTIDE

120
Q

achlorhydria, cholelithiasis ans steatorrhea

A 
somatostatinoma
no gastric acid
no contration of gallbladder
galls tones
no fat digestion
121
Q

water diarrhea hypokalemia

A

VIPoma

122
Q

abodinal striae cushings mcechaniem

A

cortisol inhibits collagen syntehsis

123
Q

how does cushing cause HTN

A

increase up regulatio nof a1 receptors

124
Q

cortisol inhibits ….

A

il2
histamine
phoslipase a2

125
Q

bilateral adrenal atrophy

A

eogenous corticosteroids (steroids inhibits ACTH which will decrease stimulation of adernals)

126
Q

high cortisol, low acth

A

exogenous glucocorticoids or adrenal tumor

127
Q

high cortisol, high actch, high dose suppresses dex suppresses acth, CRH increass ACTH and cortisol

A

pituitary adeoma (cushing disease)

128
Q

high cortisol high actch, high dose doesn’t dex doesn’t suppress actch, CRH stimulation doesn’t incerase ACTH and cortisol

A

ectopic ACTCH secretion (ct chest abdomen or pelvis)

129
Q

hypernatremia, hypokalemia, metabolic alkaosis HTN

A

hyperaldostronism

HTN

130
Q

secondary hyperaldosteronism causes

A

renovascular hypertension (activates RAAAS system) , renin producing tumors and edma

131
Q

salt wasting and precocious puberty…clitormegaly in females

A

21 hydroxylase ef SHUNTING SEX

decreased cortisol increased ACTH, low aldosterone = HYPOTENSION

132
Q

precocious puberty clitromegaly NO SALT WASTING

A

11 hydroxylase deficiency

133
Q

excess mineralocortoids but no cortisol and sex steroids, ambiguous genitalia and sexual development HTN

A

17a hydroxylase

134
Q

salt wasting

A

hyponatremia, hyperkalemia

due to decreased aldosterone

135
Q

clle type medullary adrenal

A

chromaffin cells

136
Q

brown tumor of adrenla medulla

A

pheochromocytoma

137
Q

what to give before taking out pheochomo

A

pehnoxybenzamine (irreverisble a antagonist) follwoed by b blockers to prevent massive surge of catecholamines and hypertensive crisis

A_First Aid Random Memorizing (17 decks)

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