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endo high yield Flashcards

1
Q

post pituitary hormones

A

oxytocin

ADH/vasopressin

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2
Q

pituitary gland sits inside what and where is it located

A

sella tursica (in center of skull, center of sphenoid bone)

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3
Q

adenohypophesis

A

ant pituitary

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4
Q

neurohypophesis

A

post pituitary

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5
Q

ant pituitary hormones

A 
GH
TSH
ACTH
FSH
LH
PRL
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6
Q

hypothalamus hormones

A 
GnRH
GHRH
CRH
GHIH/somatostatin
Dopamine
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7
Q

where does unfiltered arterial blood flow in; why?

A

hypothalamus; no BBB

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8
Q

types of hormone kinetic mechanisms

A

steroid/thyroid mechanism

second messenger systems

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9
Q

hypopituitarism causes

A

ant pituitary path

lesions in hyopthalamus or adenohypophysis
nonsecretory chromophobe adenomas
sheehan’s syndrome, empty sella syndrome

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10
Q

diabetes insipidus etiology/sx

A

no ADH from post pit
cannot concentrate urine
thirst wakes from sleep

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11
Q

hyperpituitarism

A

ant pit; adenoma secreting one hormone

prolactinoma
somatotroic adenomas (excess GH)
corticotroph tumors (ACTH; cushing)
gonadotropic adenomas
thyrotrophic adenomas
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12
Q

thyroid composition

A

tyrosine + iodine

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13
Q

what is exported in thyroid hormone synthesis

A

T3

T4

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14
Q

what is imported in thyroid hormone synthesis

A

iodine

tyrosine

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15
Q

T3 type of receptor

A

cell membrane

nuclear

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16
Q

active thyroid hormone

A

T3

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17
Q

enzyme that converts T4 > T3

A

5’ deoiodinase

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18
Q

hypothyroid/myxedema causes

A

hashimotos

iodine def

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19
Q

hashimotos thyroiditis etiology

A

autoimmune
most euthyroid then hypothyroid
transient hyperthyroid possible

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20
Q

hyperthyroid/thyrotoxicosis causes

A

graves disease

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21
Q

graves disease etiology, sx

A

women > men
exopthalmos
goiter

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22
Q

dequervains subacute granulomatous thyroiditis etiology

A

self limited, painful inflammation of thyroid
autoimmune/viral
women>men, 10-40
begins with hyperthyroid, then hypothyroid, then euthyroid

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23
Q

reidels thyroiditis

A

rock hard, woody thyroid
mimics carcinoma
older women

fibrotic proliferation, may cause hypothyroidism or dyspnea

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24
Q

goiters simple vs multinodular

A

simple: iodine def or too many goitrogens (Ca and luroine in water, brassicae, polluted water)
multinodar: very large, often mistaken for cancer

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25
Q

thyroid adenomas

A

90-99% of nodules are benign adenomas
may cause pressure sx
post menopausal women

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26
Q

malignant thyroid tumors

A

most papillary carcinoma
estrogen receptors, well differentiated
low mortality, solitary noduels more likely to be cancer
men < 40 more likely cancer

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27
Q

calcitonin produced where

A

parafollicular cells of thyroid

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28
Q

calcitonin actions

A

lowers blood Ca, preserves bone Ca

acts on bone
-inhibits resorption by osteoclasts

acts on kidney
(conc in cortex)
inc Ca, Na, K excretion
Dec Mg excretion

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29
Q

PTH vs calcitonin actions on Ca, Na, K, Mg in blood, bone, kidney

A

PTH: ca inc blood, dec bone, dec ca excretion in kidney (via vit D)

Cal: ca dec blood, inc bone, inc excretion of Ca/Na/K and dec exretion of Mg in kidney

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30
Q

outer layer adrenal cortex

name, hormones/actions

A

zona glomerulosa (mineral corticoids; aldosterone)

Na retention, H/K excretion

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31
Q

middle layer adrenal cortex

name, hormones/actions

A

zona fasiculata (glucocorticoids; cortisol)

stress response, glucose inc, immunity

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32
Q

layers of adrenal gland

A 
inner neurological medulla (SNS; epi/nore)
outer cortex (corticoids)
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33
Q

inner layer adrenal cortex

name, hormones/actions

A

zona reticularis (glucocorticoids; sex steroids)

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34
Q

primary hyperparathyroidism causes

A

adenoma of parathyroid
elevated Ca
stones bones moans

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35
Q

secondary hyperparathyroidism causes

A

hyperplasia due to hypocalcemia or hyperphosphatemia, renal failure, vit D def
serum ca low (reactive)

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36
Q

hypoparathyroidism

A

low serum ca
high serum phosphate
chovsteks sign, trousseaus sign
CATS go numb

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37
Q

pheochromocytoma

A

tumor in adrenal medulla
secretes catecholamines
HTN, arrythmias
gyperglycemia, hypermetabolism

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38
Q

neuroblastoma

A 
childhood tumor of adrenal medulla
most sporadically (some hereditary)
often born w it
large abdominal mass
often affects other neuro tissues
course variable, some fatal
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39
Q

addisons

A

hypoadrenalism (ADD some cortisol)

most often autoimmune
sometimes TB or idiopathic atrophy, medulla unaffected

weakness, faitgue, wt loss, diarrhea, vomiting
hyperpigmentation (high ACTH/K, low Na, Cl)

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40
Q

cushings

A

hyperadrenalism (CUSHION of cortisol)
iatrogenic, pituitary adenoma

moon face, buffalo hump, purple straie

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41
Q

conn syndrome

A

solitary aldosterone secreting adenoma in adrenal cortex

causes hyperaldosteronism (low renin and K, high Na and aldosterone)

high blood vol, tachycardia, arrythmia

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42
Q

“parent steroid”

A

pregnenolone

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43
Q

where does pregnenolone come from

A

cholesterol

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44
Q

estrogens are reduced from

A

testosterones and androstenediones

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45
Q

aldosterone is stimulated by

A

ACTH
hyperkalemia
angiontensin 2

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46
Q

alpha cells of pancreas secrete

A

glucagon

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47
Q

beta cells of pancreas secrete

A

insulin

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48
Q

delta cells of pancreas secrete

A

somatostatin

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49
Q

what are ducts lined with (tissue/cell type)

A

cuboidal epithelium

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50
Q

ductless glands are called

A

endocrine glands

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51
Q

insulin function

A

announces sugar t/o body
insulin is always around glucose

triggers biochem pathways that spare fat

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52
Q

insulin lack effects on catabolism and anabolism + their major risks

A

inc catabolism (inc glycogenolysis, gluconeogenesis, lipolysis) > DKA

dec anabolism (hyperglycemia) > water + salt depletion

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53
Q

diabetic ketoacidosis (DKA)

A

life threatening acidosis caused by lack of insulin (usually in type I)

insulin lack > cellular catabolism > inc ketone (3-hydroxybutyrate)

cells burn fats because they dont have sugar (sugar high in blood, low in cells); ketones toxic to liver

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54
Q

DKA causes

A 
undiagnosed diabetes
lack/interruption of insulin therapy
stress of comorbidity (MI, CHF)
infxn (release of glucocorticoids)
emotional disturbance (also raises stress hormones)
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55
Q

DKA clinical presentation

A 
GI (abd pain, vomiting)
thist, polyuria, oliguria
hypotensive, tachycardic
hyperventilation, "ketone breath"
drowsiness
56
Q

type I vs type II DM

A

type I -
STOP B cells from producing insulin; insulin lack, good receptors
autoimmunity to islet cells, KA, retinopathy, nephropathy
insulin DEPENDENT

type II -
too much insulin/not enough receptor activity
genetic, obesity, insulin excess > def, no KA
insulin RESISTENT

both have high blood sugar

57
Q

zollinger ellison syndrome etiology/sx

A

tumor in pancreas, secretes gastrin
peptic ulcers, gastric hypersecretion, malabsorption, diarrhea
60% malignant

58
Q

insulinoma etiology/sx

A

beta cell tumor, produces hypoglycemia
confusion, stupor, LOC
relieved by eating

59
Q

thymic hyperplasia etiology

A

lymphoid follices in thymus

often in myasthenia gravis, chornic inflammatory + immune states, SLE, graves, RA

60
Q

digeorge syndrome etiology

A

aplasia/hypoplasia of thymus with parathyroid development failure

total absence/severe lack of cell mediated immunity and often hypoparathyroidism

may have developmental defects in heart and great vessels

61
Q

DIT + DIT

A

T4 (thyroxine)

62
Q

DIT + MIT

A

T3 (triiodothyronine)

63
Q

oxytocin composition + origin

A

peptide from PVN of hypothalamus (stored in post pit)

64
Q

oxytocin stimulation

A

uterine cervix stretching, breast suckling

65
Q

oxytocin inhibition

A

lack of neural stimuli

66
Q

oxytocin actions

A

uterus: stim contractions, initiates labor
breast: initiates milk ejection

67
Q

ADH/vasopressin composition + origin

A

peptide from SO nucleus of hypothalamus

68
Q

ADH/vasopressin stimulation

A

inc blood solute conc, dec BV, pain/drugs/low BP

69
Q

ADH/vasopressin inhibition

A

adequate hydration, alcohol

70
Q

ADH/vasopressin actions

A

kidneys: stim tubule cells to reabsorb H2O from forming urine back into blood

71
Q

hyper-secretion ADH/vasopressin

A

SiADH

72
Q

hyposection ADH

A

DI

73
Q

GH composition + origin

A

protein from somatotropic cells of ant pituitary

74
Q

GH stim

A

GHRH release; which is due to low glood GH, deep sleep, hypglycemia, inc blood AA, dec FAs, exercise

75
Q

GH inhibition

A

GH feedback inhibition, IGFs, hyperglycemia, hyperlipidemia, obesity, emotional deprivation (inc GHIH, dec GHRH)

76
Q

GH action

A

liver, muscle, bone, cartilage

anabolic; stim somatic growth, mobilizes fat, spares glucose

77
Q

hyper-secretion GH

A

gigantism, acromegaly

78
Q

hypo-secretion GH

A

pit. dwarfism

79
Q

TSH composition + origin

A

glycoprotein from thyrotropic cells of ant pit

80
Q

TSH stim

A

TRH, cold temp (infants)

81
Q

TSH inhibition

A

feedback inhibition thyroid hormones, GHIH, PIH

82
Q

TSH action

A

thyroid; stim release of thyroid hormones

83
Q

TSH hyper-secretion

A

hyperthyroid

84
Q

TSH hyposecretion

A

hypothyroid

85
Q

ACTH composition + origin

A

peptide from corticotropic cells of ant pit

86
Q

ACTH stim

A

CRH (fever, hypoglycemia, stressors)

87
Q

ACTH inhib

A

glucocorticoid feedback inhibit

88
Q

ACTH action

A

adrenal cortex; promotes release of glucocorticoids and androgens

89
Q

hyper-secretion ACTH

A

cushings dz

90
Q

FSH composition + origin

A

glycoprotein from gonadotropic cells of ant pit

91
Q

FSH stim

A

GnRH

92
Q

FSH inhib

A

feedback inhibition estrogen/testosterone

93
Q

FSH actions

A

ovaries and testes: stim ovarian follicle matruation, production of estrogens, sperm cell production

94
Q

FSH hyposecretion

A

failure of sexual maturation

95
Q

LH composition + origin

A

glycoprotein from gonadotropic cells of ant pit

96
Q

LH stim

A

GnRH

97
Q

LH inhib

A

feedback inhibiton estroens, progesterones, testosterones

98
Q

LH action

A

ovaires and testes: triggers ovulation, stim ovarian production of estrogens + progestone, promotes testosterone production

99
Q

LH hyposecretion

A

failure of sexual maturation

100
Q

PRL composition + origin

A

protein from prolactin cells of ant pit

101
Q

PRL stim

A

dec PIH (dopamine), estrogens, BC, breast feeding

102
Q

PRL inhib

A

PIH (dopamine)

103
Q

PRL action

A

breast secretory tissue: promotes lactation

104
Q

hyper-secretion PRL

A

galactorrhea, cessation menses, impotence in males

105
Q

hypo-secretion PRL

A

poor milk production in nursing

106
Q

Function insulin

A

Binds insulin receptors to induce glucose uptake into insulin dependent tissues

107
Q

Hyposecretion insulin

A

DM 1+2
LADA

108
Q

Hypersecretion insulin

A

Insulinoma

109
Q

Regulation insulin

A

Glucose enters B cells > inc ATP > K channels close/depolarization > VGCa open, Ca rushes to stimulate insulin exocytosis

110
Q

Synthesis insulin

A

Preproinsulin>proinsulin> exocytosis of insulin and C peptide

111
Q

Glucagon functions

A

Glycogenolysis, gluconeogenesis, lipolysis, ketone production

112
Q

Glucagon hypersecretion

A

Glucagonoma

113
Q

Glucagon regulation

A

Secreted due to hypoglycemia
Inhibited by insulin / hyperglycemia / SS

114
Q

Somatostatin function

A

Dec GH and TSH

115
Q

Ghrelin is secreted where + has what function

A

Stomach, stim hunger

116
Q

Gastrin is secreted where and has what function

A

enhancing gastric mucosal growth, gastric motility, and secretion of hydrochloric acid (HCl) into the stomach. It is present in G cells of the gastric antrum and duodenum

117
Q

CKK is secreted where and has what function

A

Small intestine -

118
Q

Leptin is secreted where and has what function

A

Satiety hormone

119
Q

function cortisol

A

Inc appetite, BP, insulin resistance, gluconeogenesis, lipolysis, proteolysis

Dec fibroblast activity, inflammation, immune response, bone formation, blocks IL2 production

120
Q

DHEA origin

A

Adrenal cortex - Zona reticularis

121
Q

Epinephrine origin

A

Adrenal medulla, chromaffin cells

122
Q

Norepinephrine origin

A

Adrenal medulla
Chromaffin cells

123
Q

Amide hormones are derived from what/examples

A

Tyrosine
Epi, norepi, thyroid hormones

124
Q

Peptide hormones ex

A

Insulin
PTH
Hypothalamic, pituitary hormones

125
Q

Steroid hormones derived from/ex

A

Cholesterol

Pregnenolone, cortisol, DHEA/testosterone, estrogens, progesterone, Vit D

126
Q

Amide receptors

A

On surface of membrane, A 1-2, B 1-3

127
Q

Peptide hormone receptors

A

Protein receptors, on surface of cell membrane, C protein receptors, cAMP second messenger

128
Q

Steroid hormone receptors

A

Intracellular

129
Q

Cholesterol endocrine function

A

Cholesterol desmolase > pregnenolone > 17OHpregnenolone > DHEA

130
Q

17a hydroxylase endocrine function

A

Converts pregnenolone > DHEA and progesterone > androstenedione

131
Q

Aromatase endocrine function

A

Converts androstenedione > estrone and testosterone > estradiol

132
Q

5 reductase endocrine function

A

Converts testosterone > DHT

133
Q

21 hydroxylase + 11b hydroxylase endocrine function

A

Converts progesterone > 11 deoxycorticosteone > corticosterone (to eventually be made into aldosterone)

134
Q

Function of Vit D

A

Inc absorption Ca and Ph, enhances mineralization of bone

Inc PTH > dec Ca and Ph > inc 125OHD

135
Q

Liver and kidney forms of Vit D

A

25OHD liver 125OHD kidney

nplex (11 decks)

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