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Board Review - C - Endocrine > Endo III > Flashcards

Endo III Flashcards

1
Q

thyroid hormone synthesis

A

in follicles
-produce T4

T3 - in peripheral tissues - more active

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2
Q

action of thyroid hormones

A

bone growth
CNS maturation
more B1 on heart
increased basal metabolic rate - more Na/K-ATPase

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3
Q

thyroxine binding globulin

A

binds most T3/T4 in blood
-only free hormone active

decreased TBG - liver failure, steroid
increased TBG - pregnancy or OCP use

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4
Q

5’deiodinase

A

convert T4 > T3 peripherally

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5
Q

thyroid peroxidase

A

oxidation and organification of iodine

also coupling of MIT and DIT

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6
Q

PTU

A

inhibit thyroid peroxidase and 5’deiodinase

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7
Q

methimazole

A

inhibit only thyroid peroxidase

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8
Q

wolff chaikoff effect

A

excess iodine - inhibit thyroid peroxidse

decreased T3 and T4 production

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9
Q

cushings

A

excess cortisol

MCC - exogenous corticosteroids

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10
Q

screening test cushings

A

24 hour free cortisol in urine

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11
Q

high cortisol and low ACTH

A

adrenal tumor - MRI confirm

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12
Q

high cortisol and high ACTH

A

test further
dexamethasone suppression test
CRH stimulation test

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13
Q

cushing disease

A

ACTH secreting pituitary adenoma

will be suppressed with high dose dexamethasone

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14
Q

ectopic secretion of ACTH

A

paraneoplastic

-will not respond to high dose dexamethasone

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15
Q

cushing disease results

A

1 suppression with high dose dexamethasone

2 increased ACTH and cortisol with CRH

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16
Q

ectopic secretion of ACTH

A

1 no suppression high dose dexamethasone

2 no increase ACTH/cortisol with CRH

17
Q

adrenal insufficiency

A

low secretion of glucocorticoids and aldosterone

weak, fatigue, orthostatic hypotension, muscle ache, weight loss, sugar and salt craving

18
Q

acute primary adrenal insufficiency

A

waterhouse friedrichsen

-adrenal hemorrhage with septicemia or shock

19
Q

chronic primary adrenal insufficiency

A

addison disease

arophy or destruction by disease

20
Q

metyrapone test

A

metyrapone - block convestion 11-deoxycortisol > cortisol

normal response - low cortisol and high ACTH

with adrenal insufficiency - see no rise in ACTH

21
Q

primary adrenal insufficiency

A

hypotension
hyperK
metabolic acidosis
skin and mucosa hyperpigment - MSH - byproduct of increased ACTH production from POMC

22
Q

secondary adrenal insufficiency

A

decreased pituitary ACTH production

no hyperpigmentation
no hyperK - aldosterone synthesis preserved

23
Q

tertiary adrenal insufficiency

A

chronic steroid use

-aldosterone ok

24
Q

neuroblastoma

A

adrenal medulla tumor in children
-from neural crest

has homer wright rosette

abdomnal mass - cross midline

HVA and VMA elevated

bombesin and neuron specific enolase positive

25
Q

neuroblastoma genetic

A

associated with overexpression N-myc

26
Q

pheochromocytoma

A

MC tumor adrenal medulla in adults

from chromaffin cells - neural crest

see catecholamines and metanephrines in urine

27
Q

rule of 10s

A

with pheochromocytoma

-10 % malignant, B/L, extra-adrenal, calcify, kids

28
Q

episodic HTN

A

pheochromocytoma

29
Q

associations with pheochromocytoma

A

NF1
VHL
MEN 2A
MEN 2B

30
Q

tx pheochromocytoma

A

irreversibla a-antagonist
-phenoxybenzamine

followed by B-blocker

a-blockade first - avoid HTN crisis

31
Q

hypothyroid

A

less reflexes

hypercholesterol - decreased LDL receptors

32
Q

hyperthyroid

A

more reflexes

hypocholesterol - increased LDL receptors

33
Q

hashimotos

A

autoimmune - anti-thyroid peroxidase Abs
-also - antimicrosomal and anti-thyroglobulin Abs

with HLA-DR5

enlarged nontender thyroid

34
Q

risk with hashimotos

A

non-hodgkin lymphoma

35
Q

early hyperthyroid in hashimotos

A

due to follicular rupture - thyrotoxicosis

36
Q

hurthle cells

A

hashimotos - lymphoid aggregate - germinal centers

37
Q

cretinism

A

congenital hypothyroid

pot belly, pale, puffy face, protruding umbilicus, protuberant tongue, poor brain development

38
Q

de quervain thyroiditis

A

subacute

follow flu-like illness

granuloma inflammation

jaw pain - very tender thyroid

39
Q

riedel thyroiditis

A

thyroid - replace with fibrous tissue

manifestation of IgG4 systemic disease

fixed hard painless goiter

Board Review - C - Endocrine (5 decks)

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