Endocrine Flashcards
What is necrosis? (3)
non-programmed cell death = noisy
inflammation
nucleus destroyed first
What is apoptosis? (3)
programmed cell death = quiet
no inflammation
nucleus guides it and is destroyed last
What is pyknosis?
nucleus turns into blobs
What is karyohexis?
nucleus fragments
What is karyolysis?
nucleus dissolves
What is a somatotrope?
GH
What is a gonadotrop? (2)
LH, FSH
What is a thyrotrope?
TSH
What is a corticotrope?
ACTH
What is a lactotrope?
PRL
What receptors do protein hormones use?
cell membrane receptors
What receptors to steroid hormones use?
nuclear membrane receptors
What are the steroid hormones?
PET CAD (note: TH acts like a steroid hormone)
P: progesterone E: estrogen T: testosterone C: cortisol A: aldosterone D: vitamin D
What does endocrine mean?
secretion into blood
What does exocrine mean?
secretion into non-blood
What is autocrine?
works on itself
What is paracrine?
works on its neighbor
What is merocrine?
exocytosis (cell is maintained)
What is apocrine?
apex of cell is secreted
What is holocrine?
whole cell is secreted
What organs do not require insulin?
BRICKLE
B: brain R: RBC I: intestine C: cardiac/cornea K: kidney L: liver E: exercising muscle
What does GnRH do?
stimulates LH and FSH
What does GRH do?
stimulates GH
What does CRH do?
stimulates ACTH
What does TRH do?
stimulates TSH
What does PRH do?
stimulates PRL
What does DA do?
inhibits PRL
What does SS do?
inhibits GH
What does ADH do? (2)
conserves water
vasoconstricts
What does oxytocin do? (2)
milk letdown
baby letdown
What does GH do?
IGF-1 release from liver
What does TSH do?
T3 and T4 release from thyroid
What does LH do? (2)
testosterone release from testes
estrogen and progesterone release from ovary
What does FSH do?
sperm or egg growth
What does ACTH do?
cortisol release from adrenal gland
What does MSH do?
skin pigmentation
What are the stress hormones? (6)
immediate: epinephrine 20 min: glucagon 30 min: insulin 30 min: ADH 2-4 hrs: cortisol 24 hrs: GH
What does ADH do?
concentrates urine
What is Diabetes Insipidus?
too little ADH… urinate a lot
What is Central DI?
brain not making ADH
What is Nephrogenic DI? (2)
blocked ADH receptor
can be caused by lithium and demecocycline
What does the water deprivation test tell you?
if fail to concentrate urine => DI
What does giving DDAVP tell you?
if concentrate > 25% => central DI
What is SIADH?
too much ADH => expanded plasma volume => pee Na
What is the difference between DI and SIADH? (2)
DI has dilute urine
SIADH has concentrated urine
What is psychogenic polydipsia? (2)
pathologic water drinking
low plasma osmolarity
What does aldosterone do? (2)
reabsorbs Na
secretes H/K
What is neuroblastoma? (3)
adrenal medulla tumor in kids
dancing eyes/feet
secretes catecholamines
What is a pheochromocytoma?
adrenal medulla tumor in adults
5 P's: pressure palpitations pain (h/a) perspiration pallor
What does the Zona Glomerulosa make?
aldosterone… “salt”
What does the Zona Fasiculata make?
cortisol… “sugar”
What does the Zona Reticularis make?
androgens… “sex”
What is Conn’s syndrome? (2)
high aldosterone (due to tumor) captopril test makes it worse
What does ANP do? (2)
inhibits aldosterone
dilates renal artery (afferent arteriole)
What does calcitonin do?
inhibits osteoclasts
What is MEN I?
“Wermer’s” PPP
Pancreas
Pituitary
Parathyroid adenoma
high gastrin
What is MEN II?
“Sipple’s”
Parathyroid
Pheochromocytoma
Medullary thyroid cancer
What is MEN III?
“Men Ilb”
Pheochromocytoma
Medullary thyroid cancer
Mucosal neuromas (oral/GI)
Marfanoid
What does CCK do? (3)
gallbladder contraction
bile release
inhibits gastric motility (closes sphincters)
What does cortisol do? (2)
gluconeogenesis by proteolysis
leads to thin skin
What is Addison’s disease? (3)
autoimmune destruction of adrenal cortex
hyperpigmentation
increased ACTH
What is Waterhouse Friderichsen? (2)
adrenal hemorrhage
MC bug implicated N. meningitidis
What is Cushing’s Syndrome?
high cortisol due to pituitary tumor, small cell lung tumor, adrenal tumor
What is Cushing’s Disease?
high cortisol due to a pituitary tumor
What is Nelson’s Syndrome?
hyperpigmentation after adrenalectomy
If the low-dose dexamethasone test suppresses, what does that tell you?
normal, obese or depressed
If the low-dose dexamethasone test does not suppress, what does that tell you?
Cushing’s… do a high dose test
If the high-dose dexamethasone test suppresses, what does that tell you?
Pituitary tumor
If the high-dose dexamethasone test does not suppress, what does that tell you?
if ACTH high - small cell lung cancer
otherwise - adrenal adenoma
What are the survival hormones? (2)
cortisol: permissive under stress
TSH: permissive under normal
What does epinephrine do? (2)
gluconeogenesis
glycogenolysis
What does erythropoietin do?
makes RBCs
What does gastrin do?
stimulates parietal cells to release IF and H+
What does growth hormone do? (3)
growth
sends somatomedin to growth plates
gluconeogenesis by proteolysis
What is a pygmie?
no somatomedin receptors
What is achondroplasia (Laron Dwarf)?
abnormal FGF receptors in extremities
What is a midget?
low somatomedin receptor sensitivity
What is acromegaly? (6)
adult bones stretch... "my hat doesn't fit" coarse facial features large furrowed tongue deep husky voice jaw protrusion increased IGF-1 due to GH tumor
What is gigantism?
childhood acromegaly
What does GIP do? (2)
enhances insulin action
leads to post-prandial hypoglycemia
What does glucagon do? (4)
gluconeogenesis
glycogenolysis
lipolysis
ketogenesis
What does insulin do?
pushes glucose into cells and K+ follows
What is Type I DM? (8)
anti-islet cell Ab GAD Ab coxsackie B virus low insulin DKA polyuria polydypsia polyphagia
What is Type II DM? (4)
insulin receptor insensitivity
high insulin
HONK coma
acanthosis nigricans
How does DKA present? (3)
Kussmaul respirations
fruity breath (acetone)
altered mental status
What is the Dawn Phenomenon?
morning hyperglycemia secondary to GH
What is the Somogyi Effect? (2)
morning hyperglycemia secondary to evening
hypoglycemia
What is factitious hypoglycemia?
insulin injection (high insulin and low C-peptide)
What is an insulinoma?
tumor (high insulin and high C-peptide)
What is erythrasma?
rash in skin folds
What is Metabolic Syndrome X? (5)
"Pre-DM" hypertension dyslipidemia hyperinsulinemia acanthosis nigricans
What are foot ulcer risk factors? (4)
DM/glycemic control
male smoker
bony abnormalities
previous ulcers
What conditions cause weight gain? (5)
obesity hypothyroidism depression Cushing's anasarca
What does motilin do?
stimulates segmentation (primary peristalsis - myometric complexes)
What does oxytocin do? (2)
milk ejection
baby ejection
What does PRL do?
milk production
What does PTH do?
chews up bone
What does Vitamin D do?
builds bone
What do parathyroid chief cells secrete?
PTH
What do stomach chief cells secrete?
pepsin
What is the difference between norepinephrine and epinephrine? (2)
NE: neurotransmitter
epi: hormone
What is primary hyperparathyroidism?
parathyroid adenoma
What is secondary hyperparathyroidism?
renal failure
What is familial hypocaliuria hypercalcemia?
decreased Ca excretion
What if both serum Ca and PO4 decrease?
vitamin D deficiency
What if serum Ca and PO4 change in opposite directions? (3)
PTH problem
if high Ca: hyperparathyroid
otherwise: hypoparathyroid
What is the most common cause of primary hypoparathyroidism?
thyroidectomy
What is pseudohypoparathyroidism? (2)
bad kidney PTH receptor
decreased urinary cAMP
What is pseudopseudohypoparathyroidism? (2)
G-protein defect
no Ca problem
What is hungry bone syndrome?
remove PTH and bone sucks in Ca
What does secretin do? (3)
secretion of bicarb
inhibit gastrin
tighten pyloric sphincter
What does somatostatin do?
inhibits secretin, motilin and CCK
What do T3 and T4 do?
growth and differentiation
What disease has exophthalmos?
Grave’s
What disease has enophthalmos?
Horner’s
What are the hyperthyroid diseases? (5)
Grave's DeQuervain's Silent Plummer's Jod-Basedow
What is Grave’s disease? (4)
hyperthyroid
exophthalmos
pretibial myedema
TSH-receptor Ab
What is DeQuervain’s? (3)
hyperthyroid
viral
painful jaw
What is silent thyroiditis? (2)
hyperthyroid
post-partum
What is Plummer’s? (3)
hyperthyroid
benign adenoma
old person
What is Jod-Basedow?
transient hyperthyroid due to increased iodine
What are the hypothyroid diseases? (5)
Hashimoto's Reidel's struma cretinism euthyroid sick syndrome Wolf-Chaikoff
What is Hashimoto’s? (2)
hypothyroid
antimicrosomial Ab = TPO Ab
What is Reidel’s struma? (2)
hypothyroid
woody neck
What is cretinism? (2)
hypothyroid mom and baby
freak features
What is euthyroid sick syndrome?
low T3 syndrome
What is Wolff-Chaikoff?
transient hypothyroidism
What does testosterone do?
makes external male genitalia
What does Mullerian Inhibiting Factor do?
makes internal male genitalia
What do TPO and thymosin do?
helps T cells mature
What does VIP do?
inhibits secretin, motilin and CCK
How does a VIPoma present?
watery diarrhea
How does a SSoma present?
constipation
What are the hormones with disulfide bonds? (4)
PIGI
P: prolactin
I: inhibin
G: growth hormone
I: insulin
Which hormones have the same alpha-subunits? (3)
LH, FSH
TSH
beta HCG
What hormones produce acidophils? (3)
“GAP”
GH
PRL
What hormones produce basophils? (5)
"B FLAT" FSH LH ACTH TSH
What hormones are released from the posterior pituitary? (2)
ADH (supraoptic nucleus)
oxytocin (paraventricular nucleus)
