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Clin Med/Spec > Endo Exam > Flashcards

Endo Exam Flashcards

1
Q

How do hormones cross the cell membrane?

A

Typically cannot cross via diffusion

GPCR, receptor tyrosine kinase, ligand gated ion channels

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2
Q

When can a hormone cross the cell membrane by diffusion?

A

Lipid soluble

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3
Q

What does the magnitude of response to a hormone depend on?

A

How many receptors are occupied at the target cell

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4
Q

What is the free hormone concentration affected by?

A
  1. Secretion of hormone
  2. Elimination of hormone
  3. Extent of hormone binding to plasma proteins
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5
Q

What cancer can produce ACTH?

A

SCLC

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6
Q

Clinical manifestations of Cushing’s d/t cortisol excess

A

Obesity, HTN, poor wound healing, hyperglycemia, hypokalemia, alkalosis

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7
Q

Clinical manifestations of Cushing’s d/t androgen excess

A

Hirsutism, menstrual problems, erectile dysfunction

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8
Q

Results of mineralocorticoid deficiency

A

Dehydration, decr Na, incr K, metabolic acidosis

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9
Q

Glucocorticoid deficiency

A

Weakness, weight loss, vomiting, hypoglycemia

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10
Q

Where is the pituitary located?

A

Sella turcica at the base of the skull

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11
Q

What structures is the pituitary located near?

A

Cavernous sinuses, nasal sinuses, carotid arteries, cranial nerves II, III, IV, VI (can all be compressed by tumors)

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12
Q

What causes the pituitary to double in size?

A

Pregnancy

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13
Q

What hormones are produced in the adenohypophysis?

A

GH, TSH, PRL, FSH, LH, ACTH

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14
Q

What is stored and released in the neurohypophysis?

A

ADH (vasopressin) and oxytocin

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15
Q

What are the stimulants for PRL?

A

TRH, DA antagonists

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16
Q

What inhibits PRL?

A

DA

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17
Q

What can cause hyposecretion of pituitary hormones?

A

Agenesis, atrophy, destruction

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18
Q

What causes hypersecretion of pituitary hormones?

A

Tumor, hyperplasia

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19
Q

What inhibits GH production?

A

Glucose

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20
Q

Which hormone is first effected by hypopituitarism?

A

GH

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21
Q

What inhibits PRL secretion?

A

DA

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22
Q

Where is DA produced?

A

Hypothalamus

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23
Q

What is the MC cause of Addison’s?

A

Autoimmune adrenalitis

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24
Q

What are the different categories of etiology for Addison’s?

A

A

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25
Q

What are the MAIN lab signs of primary adrenal insufficiency?

A
  1. Hyponatremia

2. Hyperkalemia

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26
Q

What is aldosterone escape?

A

A

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27
Q

What are the 3 confirmatory tests for primary aldosteronism?

A
  1. Aldosterone:renin
  2. Confirmatory testing
  3. CT scan —> (if want to go to surgery) Adrenal venous sampling to test aldosterone
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28
Q

What is cushingoid habitus?

A
  1. Central obesity
  2. Moon face
  3. Supraclavicular fat
  4. Dorsal fat pad
  5. Abdominal purple striae
  6. Easy bruising
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29
Q

Dichotomy of Cushing syndrome

A

ACTH dependent vs ACTH independent

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30
Q

Three tests for Cushing

A
  1. Low dose dexamethasone suppression test
  2. 24hr urine free cortisol (twice)
  3. Late night salivary cortisol swabs (twice)
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31
Q

Classic triad of pheo

A
  1. Episodic HA
  2. Sweating
  3. Tachycardia
32
Q

What is hirsutism?

A

Unwanted male pattern hair growth in women

33
Q

What is hyperthecosis

A

Full beard

34
Q

Another name for 21-hydroxylase deficiency

A

Congenital adrenal hyperplasia

35
Q

What is the rate limiting step when TSH is really high in a normal person?

A

Iodine

36
Q

Why does one iodine make such a difference between T3 and T4?

A

A

37
Q

Clinical presentation of hyperthyroidism

A

High metabolism = weight loss, nervousness, tachycardia, heat intolerance
Exophthalmus

38
Q

MC cause of hyperthyroid

A

Grave’s Disease

39
Q

What is Grave’s dz?

A

A

40
Q

Clinical presentation of hypothyroidism

A

Low metabolism = weight gain, lethargy, bradycardia, cold intolerance, myxedema

41
Q

What are 3 common causes of hypothyroidism?

A

Hashimoto’s, atrophy, surgery

42
Q

What is the best imaging modality for the thyroid?

A

US

43
Q

What bx method is used for sampling the thyroid?

A

FNA (cytology)

44
Q

Subacute painful, rapid enlargement of the thyroid

A

De Quervain

45
Q

What are the 2 main categories of thyroid neoplasms?

A

Follicular and C-cell

46
Q

What are the types of follicular cell neoplasms?

A

Papillary carcinoma
Follicular adenoma
Follicular carcinoma
Poorly differentiated/anaplastic carcinoma

47
Q

What are the types of C cell neoplasms?

A

Medullary carcinoma

48
Q

What are the clinical manifestations of hyperprolactinemia?

A

Infertility, menstrual irregularity, galactorrhea

49
Q

What are some things that trigger the HPA axis?

A

Cerebral cortex, environment, feedback from organs that it controls

50
Q

What is the best thyroid function screening test?

A

TSH

51
Q

How do you follow patients on thyroid hormone tx?

A

-Follow TSH (low: decr levo, high: incr levo)

52
Q

If TSH is abnormal what is the next test to look at?

A

FT4 - determines thyroid hyperfunction or hypofunction

53
Q

What does FT4 measure?

A

Free thyroxine levels

54
Q

What does FT3 measure?

A

Serum triiodothyronine

55
Q

If TSH is low and T4 is normal, what test do you look at next?

A

FT3

56
Q

What is FTI?

A

Free thyroxine index (used when patient has protein abnormalities

57
Q

What is RAIU?

A

Radioactive iodine test

58
Q

What is cretinism?

A

Congenital hypothyroidism d/t maternal hypothyroidism or infant hypopituitarism

59
Q

What are the clinical manifestations of cretinism?

A

Macroglossia, hoarse cry, coarse facial features, umbilical hernia, weight gain

60
Q

How is cretinism treated?

A

Levo

61
Q

What is a thyroid storm?

A
  • Potentially fatal complication of untreated thyrotoxicosis (MC after a precipitating event)
  • hypermetabolic state
62
Q

What type of event can precipitate a thyrotoxicosis crisis?

A

Surgery, trauma, infection, pregnancy

63
Q

How do steroids help in a thyroid storm?

A

Inhibits the peripheral conversion of T4 into T3 and impairs thyroid hormone production

64
Q

What is levothyroxine?

A

Synthetic T4

65
Q

Why is T4 given instead of T3?

A

A

66
Q

How is BP altered by hypothyroidism?

A

DPB increased

67
Q

How does hyperthyroidism affect the BP?

A

SBP increased

68
Q

What can you do for sx relief in hyperthyroidism?

A

Beta-blocker to slow everything down

69
Q

hormones produced by the hypothalamus

A

GNRH, GHIH, GnRH, PIF, TRH

70
Q

hormones produced by the anterior pituitary

A

ACTH, FSH, LH, GH, PRL, TSH

71
Q

hormones released from the posterior pituitary

A

ADH, oxytocin

72
Q

hormones produced by the thyroid

A

T3 & T4

73
Q

hormones produced by the adrenal cortex

A

aldosterone & cortisol

74
Q

hormones produced by the adrenal medulla

A

epi & NE

75
Q

action of cortisol

A

energy metabolism, permissive action for other hormones (presence enhances action of other hormones)

76
Q

action of mineralocorticoids

A

regulate plasma volume via effects on serum electrolytes

77
Q

action of thyroid hormone

A

controls basal metabolism in most tissues

Clin Med/Spec (11 decks)

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