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USMLE > Endocrine > Flashcards

Endocrine Flashcards

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USMLE® Step 1 flashcards
1
Q

Mechanism for exercise decreased incidence of T2DM

A

-exercise promotes the translocation of GLUT-4 to cell surface, effectively increasing insulin sensitivity

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2
Q

Hormones in Klinefelter’s syndrome

A
  • 47 XXY

- nonfunctional testes, leads to persistently decreased testosterone–> high GnRH, High FSH and High LH

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3
Q

Hyperthyroid (cardiac effects)

A
  • tachy and arrhythmia

- tx: B-blocker

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4
Q

Acromegaly (screening tests, cause, tx)

A
  • IGF-1
  • oral glucose tolerance test (in NL, growth hormone supresed following glucose load, persistent elevation in acromegaly)
  • typically due to slow growing somatotrophic pituitary adenoma
  • tx: octreotide (somatostatin analog)
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5
Q

SIADH (presenting symptoms)

A
  • actue altered mental status, Sz
  • hyponatremia and decreased serum osm (inappropriate H20 retention)
  • associated with small cell lung cancer (smoking), ectopic ADH production
  • associated with significant HEAD TRUAMA
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6
Q

Multiple Endocrine Neoplasia Type 1a (MEN 1a)

(diamond)

A
  • Pituitary, Pancreas, Parathyroid
  • menin mutation on chromosome 11
  • tumor suppressor gene
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7
Q

Multiple Endocrine Neoplasia Type 2a (MEN 2a)

(square)

A
  • pheochromocytoma, thyroid carcinoma, hyperparathyroid
  • RET gene mutation, chromosome 10, oncogenic gene (mutation causes constitutive activation
  • autosomal dominant
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8
Q

Multiple Endocrine Neoplasia Type 2b (MEN 2b)

(triangle)

A
  • pheo, thyroid carcinoma, oral gangliomas (NOT parathyroid)

- RET mutation, different location

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9
Q

VIPoma

A
  • WDHA… Watery Diarrhea, Hypokalemia, Achlorhydria
  • decreases gastric acid production (achlorhydria)
  • increases cAMP production –> secretory diarrhea, loss of electrolytes
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10
Q

Hashimoto’s Thyroiditis

A
  • autoimmune disorder, antimicrosomal antibodies (antithyroid peroxidase Ab) –> hypothyroid
  • associated with HLA-DR5 and -B5
  • firm goiteric thyroid, with germinal cell formation
  • Horthle cells, (acidophilic) characteristic of disease
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11
Q

Congenital Adrenal Hyperplasia (3 types)

A
  • 17alpha-hydroxylase: decreased sex hormones! (ambiguous genitals for XY, primary amenorrhea XX)
  • 21-hydroxylase: HYPOtension, HYPERkalemia, increased sex hormones (precocious puberty XY, virilization XX)
  • 11beta-hydroxylase: HYPERtension (due to increased 11-deoxycorticosterone, increased sex hormones (virilization)
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12
Q

Sheehan’s syndrome

A
  • postpartum ischemic necrosis of the pituitary
  • pituitary doubles in size during pregnancy, any event causing hypoperfusion (C-section, complicated birth) can cause the pituitary to infarct
  • symptoms vary, can be any associated w/hypopituitarism, but most commonly is inability to breastfeed
  • can present immediately or years later
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13
Q

Calcitonin (effect on calcium)

A

-decreases calcium absorption, too much leads to hypocalcemia

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14
Q

Hypoglycemic unawareness

A

-when paitents are unable to recognize their hypoglycemia, caused by chronic bouts of hypoglycemia leading to decreased response by sympathetic nervous system OR tx with non-selective B-blockers which can inhibit the sympathetic response

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15
Q

Grave’s Disease

A
  • autoantibodies STIMULATE thyrotropin receptor, cause hyperthyroid symptoms
  • always consider in females with amenorrhea and negative pregnancy test
  • pretibial myxedema, weight loss, heat intolerance, sweating etc.
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16
Q

De Quervain’s Thyroiditis

A
  • transient hypothyroidism, following viral infection
  • exquisitely tender thyroid
  • self-limiting, no tx necessary
17
Q

Glucagon (biochemical pathway)

A

-released from alpha cells of pancreas, binds to G-protein coupled receptor, activates adenylyl cyclase, increases cAMP

18
Q

Papillary Carcinoma of the Thyroid

A
  • most common thyroid carcinoma, best prognosis
  • orphan annie (ground glass) nuceli
  • psammoma bodies (calcified spherical bodies)
19
Q

embryologic origin of the tyroid

A
  • floor of the primitive pharynx

- disorder of descending thyroid, leads to persistent thyroglossal duct, which can form cysts and get infected

20
Q

1-alpha-hydroxylase

A

-enzyme in kidney for conversion of 1

21
Q

renal osteodystrophy

A
  • complication of chronic renal failure

- most common secondary cause of hyperthyroidism

22
Q

molar pregnancy

A
  • “snowstorm” appearance
  • markedly elevated B-HCG
  • triad of hyperemesis, vaginal bleeding and hyperthyroid
23
Q

left vs. right adrenal vein

A

-right adrenal vein flows directly into IVC, left flows back to renal vein

24
Q

primary vs. secondary hypoaldosteronism

A
  • POOMC

- primary hypoaldo leads to increase ACTH, therefor primary leads to hyperpigmentation

25
Q

NADPH

A

-reducing agent in fatty acid synthesis, steroid synthesis, reactive oxygen burst in WBC, recycling of glutathione in RBC

26
Q

hormones that act via Gi

A

-somatostatin

27
Q

hormones that act via Gs

A
  • TSH, FSH/LH, ACTH, glucagon, ADH, PTH

- stimulate adenylate cyclase, increase cAMP

28
Q

hormones that act via Gq

A
  • TRH, GnRH, oxytocin, angiotensin II, bradykinin

- phospholipase C and IP3/DAG pathway

29
Q

hormones that act via tyrosine kinase

A

-growth hormone, insulin

30
Q

elevated alk phos…

A

-biliary disease, hepatocellular carcinoma, bone resorption

31
Q

dopamine receptor antagonism in neural tracts (mesolibic, mesocortical, nigrostriatal, tuberoinfundibular)

A
  • mesolimbic: decrease positive symptoms of schizophrenia
  • mesocortical: exacerbate negative symptoms of schizophrenia
  • nigrostriatal: pathway implicated in parkinsons (decrease D2, increase parkinsonism)
  • tuberoinfundibular: increase in prolactin (due to decreased inhibition by DA)

USMLE (17 decks)

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