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Endocrine Flashcards

1
Q

insulin cascade on skeletal muscle/fat cells

A
  • binds to receptor (tyrosine kinase activity) –> Pi3K leads to inc GLUT 4 transporters and glycogen, protein and lipid synthesis
  • RAS/MAP kinase pathway leads to cell growth and DNA synthesis
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2
Q

GLUT 4 receptors on

A

skeletal muscle and adipose tissue

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3
Q

GLUT 1 receptors on

A

RBCs, brain, cornea

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4
Q

GLUT 5 receptors on

A

spermatocytes, GI tract

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5
Q

GLUT 2 receptors on

A

B islet cells, liver, kidney, small intestine

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6
Q

glucagon made in the

A

alpha cells of the pancreas

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7
Q

CRH function

A

increases ACTH, MSH, B-endorphin

    • all these hormones are created through cleavage of POMC
    • B endorphin is a pentapeptide that binds to delta and mu receptors
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8
Q

prolactin function

A
  • decreased GnRH secretion

- prolactin itself is inhibited by dopamine

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9
Q

somatostatin function

A
  • decreases GH and TSH secretion
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10
Q

TRH function

A

increases TSH and prolactin secretion

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11
Q

ADH/Diabetes insipidus

A
  • synthesized in the hypothalamus
  • permanent DI occurs when there is damage to the hypothalamus
  • nephrogenic doesnt respond to ADH, central does
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12
Q

cortisol mechanism of increasing blood pressure

A
  • upregulates alpha receptors on arterioles –> increases sensitivity to norepi and epi
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13
Q

PTH secreted by

A

chief cells of parathyroid

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14
Q

low Mg’s effect on PTH

A

decreased Mg increases PTH

severely decreased Mg decreases PTH

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15
Q

calcitonin secreted by

A

parafollicular cells in the thyroid

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16
Q

hormones that use cAMP signalling pathway

A

FLAT ChAMP

- FSH, LH, ACTH, TSH, CRH, hCG, ADH (V2 receptor), MSH, PTH, calcitonin, GHRH and glucagon

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17
Q

hormones that use cGMP pathway

A

NO and ANP

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18
Q

hormones that use IP3 pathway

A

GOAT HAG

- GH, oxytocin, ADH (V1 receptor), TRH, histamine, ang II, gastrin

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19
Q

hormones that act on intrinsic tyrosine kinase receptors

A

insulin, IGF-1, FGF, PDGF, EGF

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20
Q

hormones that act on receptor associated tyrosine kinases

A

prolactin, immunomodulators (IL-2, 6, 8, IFN) and GH

PIG

21
Q

enzyme responsible for oxidation of iodine, iodination of TG and MIT/DIT coupling

A

thyroid peroxidase

22
Q

thyroglossal duct cyst

A

anterior midline neck mass that moves with swallowing or protrusion of the tongue

23
Q

most common tumor of the adrenal medulla in kids vs. adults

A

neuroblastoma vs. pheo

24
Q

post pit

A

ADH and oxytocin

  • derived from neuroectoderm
  • hormones produced in the thalamus, moved to the post pit by neurophysins
25
ant pit
ACTH, GH, TSH, FSH, LH, MSH, prolactin | - derived from oral ectoderm (Rathke pouch)
26
secondary hyperaldosteronism
- due to renal perception of low intravascular volume (overactive RAAS) - renal artery stenosis, CHF, cirrhosis, nephrotic syndrome - treat with spironolactone
27
Waterhouse-Friderichson syndrome
acute primary adrenal insufficiency associated with Neisseria meningitidis septicemia, DIC and endotoxic shock
28
Neuroblastoma
- most common adrenal medulla tumor in kids - arises from neural crest cells - firm, irregular mass that can cross the midline - inc HVA, assocaited with n-myc oncogene
29
pheo
- associated with VHL, MEN 2A and 2B, NF1 - increased urinary VMA - treat with irreversible alpha agonist (phenoxybenzamine) and beta blockers before resection
30
Hashimoto Thyroiditis
- most common cause of hypothyroidism in iodine sufficient areas - anti-thyroid peroxidase, anti-microsomal and anti-thyroglobulin Abs - may be hyperthyroid early in the course - histo: Hurthle cells, lymphoid aggregate with germinal centers - moderately enlarged, non-tender thyroid
31
Subacute/de Quervain/granulomatous thyroiditis
- self limited following flu-like illness - may be hyperthyroid early in course - histo: granulomatous inflammation - inc ESR, jaw pain, VERY tender thyroid
32
Reidel thyroiditis
- thyroid replaced by fibrous tissue, may extend into local tissues, mimicking anaplastic carcinoma (but this is in young people) - IgG2 related systemic disease - fixed, hard, rock-like thyroid
33
Wolff-Chaikoff effect
- excess iodine temporarily inhibits thyroid peroxidase --> decreased iodine organification --> decreased T3/T4 production
34
toxic multinodular goiter
focal patches of hyperfunctioning follicular cells independent of TSH due to mutation in TSH receptor - hot nodules are rarely malignant
35
Jod-Basedow phenomenon
- thyrotoxicosis if a pt with iodine deficiency goiter is made iodine replete
36
papillary thyroid carcinoma
- most common, excellent prognosis - orphan annie nuclei (empty appearing), psammoma bodies, nuclear grooves - inc risk with RET and BRAF mutations, childhood irradiation
37
follicular thyroid carcinoma
- good prognosis, invades thyroid capsule (unlike adenoma) | - spreads hematogenously
38
medullary thyroid carcinoma
- from parafollicular C cells in an amyloid stroma - calcitonin - associated with men 2A and 2B
39
pseudohypoparathyroidism
- Albright hereditary osteodystrophy - AD unresponsiveness of kidney to PTH (end organ resistance to PTH due to Gs mutation) - hypocalcemia, shortened 4th/5th digits, short stature
40
treatment for acromegaly
somatostatin analogs - octreotide | or GH receptor antagonist - pegvisomant
41
treatment for nephrogenic vs. central DI
- central: DDAVP and hydration | - nephrogenic: HCTZ, indomethacin, amiloride and hydration
42
causes and treatment of SIADH
- causes: ectopic ADH (small cell lung cancer), CNS disorders/head trauma, pulmonary disease (COPD, pneumonia), drugs (cyclophosphamide) - treat with fluid restriction, IV hypertonic saline, conivaptan, tolvaptan, demeclocycline
43
Whipple triad
- episodic CNS symptoms associated with insulinoma | - lethargy, syncope and diplopia
44
Zollinger-Ellison Syndrome
- gastrin secreting tumor of the pancreas or duodenum - acid hypersecretion leads to ulcers in the duodenum and jejunum - associated with MEN 1
45
MEN 1
diamond - pituitary tumors (prolactin or GH) - parathyroid tumors - pancreatic endocrine tumors (Z-E, insulinomas, VIPomas, glucagonomas) - commonly presents with kidney stones and stomach ulcers
46
MEN 2A
square - parathyroid hyperplasia - pheo (chromaffin cells) - medullary thyroid carcinoma * * RET proto-oncogene
47
MEN 2B
triangle - oral/intestinal ganglioneuromatosis (mucosal neuromas) - pheo - medullary thyroid carcinoma - marfanoid habitus * * RET proto-oncogene
48
hormones that use steroid receptors
Vit D, Estrogen, Testosterone, T3/T4, cortisol, aldosterone, progresterone VETTT CAP

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