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Endo Review Flashcards

1
Q

Where is the location of secretion of growth hormone?

A

anterior pituitary

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2
Q

Where is the location of secretion of thyroid hormone?

A

thyroid gland

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3
Q

Where is the location of secretion of glucocorticoids?

A

adrenal cortex (zona fasciculata)

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4
Q

Where is the location of secretion of progesterone?

A

ovaries and placenta in pregnancy

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5
Q

Where is the location of secretion of prolactin?

A

anterior pituitary

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6
Q

Where is the location of secretion of oxytocin?

A

hypothalamus (paraventricular nucleus)

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7
Q

Where is the location of secretin of atrial natriuretic hormone?

A

atria of the heart

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8
Q

Where is the location of secretion of glucagon?

A

alpha cells of the pancreas

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9
Q

Where is the location of secretion of testosterone?

A

made in the zone reticularis of the adrenal cortex; secreted in testes (men) and ovaries (women)

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10
Q

Where is the location of secretion of FSH?

A

Anterior pituitary

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11
Q

Where is the location of secretion of ADH?

A

Hypothalamus (supraoptic nucleus)

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12
Q

Where is the location of secretion of calcitonin?

A

parafollicular C cells of thyroid

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13
Q

Where is the location of secretion of TSH?

A

Anterior pituitary

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14
Q

Where is the location of secretion of epinephrine and norepinephrine?

A

Adrenal medulla (chromaffin cells)

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15
Q

Where is the location of secretion of insulin?

A

beta cells of the pancreas

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16
Q

Where is the location of secretion of estradiol?

A

ovaries

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17
Q

Where is the location of secretion of estriol?

A

placenta

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18
Q

Where is the location of secretion of estrone?

A

fat cells

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19
Q

Where is the location of secretion of estrogen in males?

A

testes and adipocytes

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20
Q

Where is the location of secretion of PTH?

A

parathyroid glands

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21
Q

Where is the location of secretion of somatostatin?

A

delta cells of pancreas

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22
Q

Where is the location of secretion of LH?

A

anterior pituitary

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23
Q

Where is the location of secretion of mineralocorticoids?

A

zona glomerulosa of adrenal cortex

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24
Q

Where is the location of secretion of ACTH?

A

Anterior pituitary

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25
Q

What clinical finding would you expect to find in a man with high sec hormone binding globulin?

A

decreased free testosterone -> gynecomastia or ED

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26
Q

What clinical finding would you expect to find in a woman with low sex hormone binding globulin?

A

increased free testosterone -> hirsutism, acne, deep voice, and irregular periods

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27
Q

Sheehan syndrome

A

postpartum hemorrhage leading to underperfusion of the pituitary gland
pituitary necrosis and hypopituitarism
presentation
- galactorrhea due to a deficiency in prolactin
- amenorrhea after delivery
- secondary hypothyroidism leading to fatigue, cold intolerance and weight gane
- hyponatremia (rare)

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28
Q

Which hormones share a common alpha subunit?

A

LH, FSH, TSH, hCG

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29
Q

What is the most common presentation of hyperprolactinemia in a female patient?

A
  • premenopausal - hypogonadism, infertility, oligo/amenorrhea
  • postmenopausal -> asymptomatic
  • galactorrhea
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30
Q

What are some of the possible clinical features of acromegaly?

A 
large tongue
increased spacing of teeth
large hands and feet
deep voice
coarsening of facial features
impaired glucose tolerance/diabetes
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31
Q

What are the symptoms of 21-alpha-hydroxylase deficiency?

A
  • increased progesterone, increased androgens, decreased cortisol, decreased mineralocorticoids
  • hypotension -> salt wasting
  • masculinization
  • electrolyte abnormalities
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32
Q

What are they symptoms of 11-beta-hydroxylase deficiency?

A
  • increased DOC, increased androgens, decreased cortisol
  • HTN d/t increased DOC (has mineralocorticoid action)
  • masculinization
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33
Q

What food substance is an essential starting point in the synthesis of adrenal steroids?

A

cholesterol

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34
Q

What effect does cortisol have on bone formation and immune system functioning?

A

decreases both

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35
Q

What are the potential side effects of glucocorticoid use?

A

BAM, CUSHINGOID

  • buffalo hump
  • amenorrhea
  • moon facies
  • crazy
  • ulcers
  • skin changes
  • HTN
  • infection
  • necrosis of femoral head
  • glaucoma
  • osteoporosis
  • immune suppression
  • diabetes
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36
Q

What are the most common causes of Cushing syndrome?

A
  1. exogenous steroid use
  2. ACTH-producing small cell lung cancer
  3. Cushing Dz
  4. adrenal adenoma
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37
Q

What are the clinical manifestations of Addisons disease? What is the cause?

A
  • Addison disease is caused by autoimmune destruction of the adrenal glands -> decreased aldosterone, cortisol
  • hyponatremia, hyperkalemia, hypotension, fatigue, skin hyperpigmentation, anorexia, weight loss
38
Q

Most common cause of primary hyperaldosteronism?

A

B/L adrenal hyperplasia

39
Q

Medical treatment for hyperaldosteronism?

A

aldosterone antagonist (spironolactone)

40
Q

Adrenal disease associated with skin hyperpigmentation

A

Addison disease

41
Q

HTN, hypokalemia, metabolic alkalosis

A

Conn syndrome

42
Q

What tumor locations are associated with the three different types of multiple endocrine neoplasia?

A

MEN 1 - parathyroid adenoma, pancreas, pituitary
MEN 2A - pheochromocytoma, parathyroid hyperplasia, medullary thyroid
MEN 2B - pheochromocytoma, medullary thyroid, mucosal neuromas (and marfinoid body habitus)

43
Q

What might a lab detect int he urine of a patient with pheochromocytoma?

A

increased metanephrines and normetanephrine in the plasma; increased VMA in the urine

44
Q

Most common tumor of the adrenal gland

A

benign non-functioning adenoma

45
Q

Most common tumor of the adrenal medulla in adults

A

pheochromocytoma

46
Q

Most common tumor of the adrenal medulla in children

A

neuroblastoma

47
Q

medical treatment for pheochromocytomas

A

resection; alpha blocker (nonselective)

48
Q

What is the most common location for ectopic thyroid tissue?

49
Q

How would pregnancy affect serum third hormone levels?

A
  • increased total binding globulin (body thinks free T4 and T3 are low)
  • increased total T4
  • TSH may be decreased
50
Q

What are the causes of congenital hypothyroidism? How can it be prevented?

A
  • complete genesis, hypoplasia, or ectopic location
  • thyroid-related enzyme deficiency
  • dysfunctional hormone production, transportion
  • TSH resistance
  • transfer of anti-thyroid meds or Abs from mother
  • iodine-deficient diet in mom during pregnancy

Prevention: add iodine to diet of pregnant moms; identify congenital hypothyroidism early

51
Q

A 35 year old woman has a diffuse painless goiter and hypothyroidism. What is the most likely diagnosis, and what are the most likely relative values of TSH and thyroid hormone?

A

Hashimoto

Increased TSH, decreased thyroid hormones

52
Q

How does hypothyroidism affect cholesterol levels?

A

hypothyroidism will cause elevations of LDL and total cholesterol

53
Q

A 35-year old woman has a diffuse goiter and hyperthyroidism. What are the most likely relative laboratory values of TSH and thyroid hormones?

A

(Graves Dz)

  • decreased TSH
  • increased TSI
  • increased T3, T4
54
Q

What is the most likely diagnosis with an extremely tender thyroid gland?

A

subacute thyroiditis (de Quervain)

55
Q

What is the most likely diagnosis with pretibial myxedema?

56
Q

What is the most likely diagnosis with pride in recent weight loss in a medical professional?

A

thyroid hormone abuse

57
Q

What is the most likely diagnosis with palpation of a single thyroid nodule?

A

thyroid adenoma (toxic)

58
Q

What is the most likely diagnosis with palpation of multiple thyroid nodules?

A

toxic multi nodular goiter

59
Q

What is the most likely diagnosis in hyperthyroidism with a recent study using IV contrast (iodine)?

A

Jod-Basedown phenomenon

60
Q

What is the most likely diagnosis with eye changes: proptosis, edema, injection?

61
Q

What is the most likely diagnosis with hyperthyroidism and with a history of thyroidectomy or radio ablation of thyroid?

A

too much exogenous thyroid hormone

62
Q

What type of thyroid cancer is associated with activation of receptor tyrosine kinases?

A

papillary and medullary

63
Q

What type of thyroid cancer is associated with Hashimoto thyroiditis as a risk factor?

A

B cell lymphoma

64
Q

What type of thyroid cancer arises from parafollicualr C cells?

65
Q

What type of thyroid cancer is associated with RAS mutation or PAX8-PPARgamma-1 rearrangement?

A

follicular

66
Q

What type of thyroid cancer is associated with rearrangements in RET oncogene?

A

papillary and medullary

67
Q

What type of thyroid cancer is associated with a mutation in the BRAF gene?

68
Q

What nerve can be easily damaged in thyroid surgery and lead to hoarseness?

A

recurrent laryngeal nerve

69
Q

What is the most common thyroid cancer?

70
Q

Enlarged thyroid cells with ground-glass nuclei

A

follicular thyroid cancer

71
Q

most likely electrolyte abnormality with perineal tingling perioral paresthesias, and recent thyroidectomy?

A

hypocalcemia

72
Q

How is hemoglobin glycosylated in diabetes mellitus to form HgbA1C?

A

non enzymatic glycosylation

73
Q

Which type of diabetes is associated with HLA-DR3 and HLA-DR4?

74
Q

In which tissues will you find GLUT-2 receptors?

A

beta cells, liver, kidney, small intestine

75
Q

Which tissues depend on insulin for glucose?

A

GLUT4 transporters - skeletal muscle and adipose tissue

76
Q

What are three important component of DKA management? HHS management?

A

DKA - fluids, insulin drip, fix electrolytes (especially potassium); goal is to close the anion gap
HHS - fluids and insulin; goal is to fix serum osmolarity

77
Q

What the common precipitating factors for DKA?

A 
missed insulin
new Dx
stress -> infection
dehydration
MI/trauma
alcohol/drug abuse
78
Q

What are the five categories of criteria for the diagnosis of metabolic syndrome?

A
  1. waist circumference >40 (M); >35 (F)
  2. triglycerides >150
  3. HDL <40 (M); <50 (F)
  4. BP >130/85
  5. fasting glucose >/=100mg/dL
79
Q

What liver disease is associated with obesity?

80
Q

At what BMI is a patient considered obese?

81
Q

What are the three functions of vitamin D?

A
  1. increase dietary absorption of Ca2+
  2. increase dietary absorption of phosphate
  3. increase bone turnover
82
Q

How does PTH affect Ca2+? Pi?

A

increase Ca2+, decrease Pi
increase bone resorption
increase renal reabsorption of Ca2+

83
Q

What cell type produces PTH? What cell type produces calcitonin?

A

PTH -> chief cells of parathyroid

Calcitonin -> parafollicular C cells of the thyroid

84
Q

What are two signs of hypocalcemia?

A

Chvostek and Trousseau

85
Q

What are the two most important causes of primary hyperparathyroidism?

A
  1. PTH adenoma

2. PTH hyperplasia

86
Q

What are some possible causes of hypocalcemia?

A
  1. decreased vitD intake/deficiency
  2. hypoparathyroidism (surgery, autoimmune, DiGeorge)
  3. acute pancreatitis
87
Q

Most common cause of hypercalcemia?

A

primary hyperparathyroidism

88
Q

Most common cause of primary hyperparathyroidism?

A

parathyroid adenoma

89
Q

Most common cause of secondary hyperparathyroidism?

A

chronic renal failure

90
Q

Most common cause of hypoparathyroidism

A

parathyroid removal

DIT Cards (16 decks)

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