Endocrine Flashcards

1
Q

Posterior pituitary hormones

A

vasopressin (ADH) and oxytocin

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2
Q

Anterior pituitary hormones

A

FLAT PiG

FSH, LH, ACTH, TSH, Prolactin, GH

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3
Q

Organs that don’t need insulin for glucose uptake

A

BRICK L

Brain, RBCs, Intestine, Cornea, Kidney, Liver

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4
Q

Brain and RBCs take up glucose via…

A

GLUT-1 receptor

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5
Q

Secretion of what inhibits prolactin

A

Dopamine

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6
Q

Somatostatin inhibits…

A

GH, TSH

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7
Q

Prolactin inhibits…

A

GnRH

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8
Q

Used in treatment of prolactinoma

A

Dopamine agonists (ex. bromocriptine)

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9
Q

Meds that stimulate prolactin secretion

A

Dopamine antagonists (antipsychotics) and estrogens (OCPs, pregnancy)

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10
Q

17 alpha-hydroxylase deficiency

A

Dec cortisol & sex steroids, Inc mineralocorticoids
HTN, hypoK
XY: male pseudohermaphroditism (outside female, inside male)
XX: lacks secondary sex characteristics

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11
Q

21 hydroxylase deficiency

A

Dec mineralo & cortisol, Inc sex steroids

HypoTN, hyperK, increased renin, volume depletion, masculinization, female pseudohermaphroditism

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12
Q

11 beta-hydroxylase deficiency

A

Dec aldosterone, Inc 11-deoxycorticosterone, Dec cortisol, Inc ss
HTN, masculinization

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13
Q

Fxn of cortisol

A

BBIIG

  1. Maintain BP (upreg alpha-1 receptors on arterioles)
  2. dec Bone formation
  3. Anti-Inflammatory/Immunosuppressive
  4. increase Insulin resistance
  5. increase Gluconeogenesis, lipolysis, proteolysis
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14
Q

Fxn of PTH

A
  • Inc bone resorption of Ca & phosphate
  • Inc kidney reabsorption of Ca in DCT
  • Dec kidney reabsorption of phosphate
  • Inc 1,25-(OH)2 vitamin D production
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15
Q

Fxn of vitamin D (cholecalciferol)

A
  • Inc absorption of dietary Ca and phosphate

- Inc bone resorption of Ca and phosphate

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16
Q

Wolff-Chaikoff effect

A

reduction in thyroid hormone levels caused by xs ingestion of iodine, thus inhibiting thyroid peroxidase and organification

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17
Q

Cushing’s syndrome causes

A
Exogenous (iatrogenic) steroids
Endogenous causes:
1. Cushing's disease (70%)
2. Ectopic ACTH (15%)
3. Adrenal (15%)
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18
Q

Distinguish Cushing’s dz vs ectopic ACTH via…

A

high dose dexamethasone test

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19
Q

Conn’s syndrome

A

aldosterone-secreting adrenal adenoma

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20
Q

Primary hyperaldosteronism sx

A

HTN, hypoK, met alkalosis, low plasma renin

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21
Q

Secondary hyperaldosteronism sx

A

HIGH plasma renin

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22
Q

Secondary hyperaldosteronism 2/2…

A
renal a. stenosis
chronic renal failure
CHF
cirrhosis
nephrotic syndrome
fibromuscular dysplasia
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23
Q

Addison’s disease

A

chronic primary adrenal insufficiency d/t adrenal atrophy or destruction by disease

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24
Q

Addison’s disease sx

A

hypoTN, hyperK, acidosis, skin hyperpigmentation

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25
Q

Waterhouse-Friderichsen syndrome

A

acute primary adrenal insufficiency d/t adrenal hemorrhage associated with N. meningitidis septicemia, DIC, and endotoxic shock

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26
Q

Dx of pheochromocytoma

A

Increased serum metanephrines and 24h urine metanephrine/VMA

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27
Q

Most common tumor of adrenal medulla in adults

A

pheochromocytoma

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28
Q

Pheochromocytoma associated with

A

neurofibromatosis type 1
MEN types 2A and 2B
VHL disease

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29
Q

Treatment of pheo

A

alpha antagonists, especially phenoxybenzamine

30
Q

Pheochromocytoma sx

A
5 Ps:
Pressure (HTN)
Pain (ha)
Perspiration
Palpitations (tachycardia)
Pallor
31
Q

Most common tumor of the adrenal medulla in children

A

neuroblastoma

32
Q

Thyroglossal duct cyst p/w

A

anterior neck mass

33
Q

Types of hypothyroidism

A

Hashimoto’s thyroiditis
Cretinism
Subacute thyroiditis (de Quervain’s)
Riedel’s thyroiditis

34
Q

Most common cause of hypothyroidism

A

Hashimoto’s thyroidtis

35
Q

Hashimoto’s thyroiditis associated with…

A

HLA-DR5, increased risk of non-Hodgkin’s lymphoma

36
Q

Cretinism due to

A

severe fetal hypothyroidism

37
Q

Cretinism sx

A

pot-bellied, pale, puffy-faced child with protruding umbilicus and protuberant tongue, short stature with skeletal abnormalities, MR, coarse facial features

38
Q

Subacute thyroiditis

A

self-limited granulomatous thyroiditis that follows a viral infection

39
Q

Riedel’s thyroiditis

A

chronic inflammation with extensive fibrosis of thyroid (hard rock-like)

40
Q

Types of hyperthyroidism

A

Graves’ disease
Thyroid storm
Toxic multinodular goiter

41
Q

Jod-Basedow phenomenon

A

thyrotoxicosis if a pt with iodine deficiency goiter is made iodine replete

42
Q

Thyroid storm

A

stress-induced catecholamine surge leading to death by arrhythmia

43
Q

Most common cause of hyperthyroidism

A

Graves’ disease

44
Q

Types of thyroid cancer

A
Papillary
Follicular
Medullary
Undifferentiated/anaplastic
Lymphoma
45
Q

Most common thyroid tumor with excellent px

A

papillary carcinoma

46
Q

hallmark of papillary carcinoma

A

“ground-glass” nuclei (Orphan Annie), psammoma bodies

47
Q

Medullary carcinoma

A

from parafollicular C cells, which produce calcitonin

48
Q

Medullary carcinoma asso with

A

MEN types 2A and 2B

49
Q

Carcinomas that spread hematogenously

A

RCC (renal v)
HCC (hepatic v)
follicular carcinoma
choriocarcinoma

50
Q

Primary hyperparathyroidism

A

Usu due to adenoma

51
Q

Primary hyperparathyroidism sx

A

stones (ca oxalate renal stones)
bones (bone pain, osteitis fibrosa cystica)
groans (constipation, abd pain)
psych overtones

52
Q

Secondary hyperparathyroidism

A

Most commonly d/t renal insufficiency –> dec phosphate excretion –> serum phosphate binds free Ca –> dec free Ca stimulates PTH production

53
Q

Hypoparathyroidism causes

A
accidental surgical excision (thyroid surgery)
autoimmune destruction
DiGeorge syndrome (failure to develop 3rd/4th pharyngeal pouch)
54
Q

Chvostek’s sign

A

tapping of facial nerve —> contraction of facial muscles (spasm)

55
Q

Trousseau’s sign

A

occlusion of brachial artery with BP cuff –> carpal spasm

56
Q

Prolactinoma sx

A

Females: amenorrhea, galactorrhea
Males: ha, dec libido
Can have bitemporal hemianopia

57
Q

Central diabetes insipidus

A

lack of ADH production

58
Q

nephrogenic diabetes insipidus

A

lack of renal response to ADH

59
Q

SIADH findings

A

Excessive water retention
HypoNa
Urine osmo > serum osmo

60
Q

Causes of SIADH

A

ectopic ADH (small cell lung ca)
CNS d/o, head trauma
Pulmonary dz (ex. COPD, infxn)
Drugs (ex. cyclophosphamide)

61
Q

Tx for SIADH

A

demeclocycline (ADH antagonist)

62
Q

Hypopituitarism causes

A
  1. Nonsecreting pit adenoma, craniopharyngioma
  2. Sheehan’s syndrome
  3. Empty sella syndrome
  4. Brain injury, hemorrhage
  5. Radiation
63
Q

DKA sx

A

Kussmaul respirations (rapid/deep breathing), n/v, abd pain, psychosis, dehydration, fruit breath odor

64
Q

Carcinoid syndrome

A

cause by carcinoid tumors, esp metastatic small bowel tumors –> secrete high levels of 5HT

65
Q

Carcinoid syndrome sx

A

recurrent diarrhea, cutaneous flushing, asthmatic wheezing, R-sided valvular dz

66
Q

Zollinger-Ellison syndrome findings

A

recurrent multiple ulcers

67
Q

MEN 1

A

3P’s (diamond):

Pituitary, parathyroid, pancreas

68
Q

MEN 1 p/w

A

kidney stones and stomach ulcers

69
Q

MEN 2A

A

2Ps (square)
Parathyroid, pheochromocytoma
Medullary thyroid carcinoma

70
Q

MEN 2B

A

1P (triangle)

Pheochromocytoma, medullary thyroid carcinoma, oral/intestinal ganglioneuromatosis