Endocrine Flashcards
1
Q
Medullary Ca thyroid
A
Parafollicular C cells ( calcitonin)
2
Q
Desmopressin
A
ADH analogue
3
Q
Orphan Annie
A
Papillary ca
4
Q
Octreotide is a
A
Somatostatin
5
Q
Increased 5-HIAA in urine
A
Carcinoid syndrome
6
Q
24 hr insulin
A
Glargine
Detemir
7
Q
Post prandial insulin
A
Aspart Lispro Glulisine
8
Q
Demeclocycline
A
ADH antagonist (tetracycline)
9
Q
pituitary hormones with similar beta subunits
A
HCG and TSH (LSH and FH closer)
10
Q
what is tesamorelin
A
GHRH analog used for HIV associated lipodystrophy
11
Q
alKaLowsis has
A
low calcium
12
Q
cushings disease
A
ACTH secreting pituitary adenoma (can be suppressed by high dose dexa)
13
Q
aldosterone action
A
Na and H2O absorption
K and H secretion
14
Q
what happens to aldosterone in 2 and 3 adrenal insuffinincty
A
preserved
15
Q
neuroblastoma 3 lab markers
A
HVA and VMA
bomebsin and neuron-speific enolase
N-myc oncogene (N for)
16
Q
dancing eye and dancing feet diagnosis
A
neuroblastoma
17
Q
increased metanephrines in urine
A
phaechromocytoma
18
Q
pre-tibial myxedema seen in
A
graves disease
19
Q
two assicated blood lab finding ins hypothyroidism
A
CK and cholesterol high
20
Q
lymphocytic thyroiditis aka
A
hashimoto
21
Q
de quervain aka
A
sub a/c thyroiditis
VAIN for PAIN
22
Q
reidel thryoid feels like a
A
stone
23
Q
HLA associton for hashimoto
A
HLA-DR5
24
Q
follicle working independently of TSH: what goiter
A
toxic multinodular goiter
25
cause of death in thyroid storm
tachyarrythmia
26
Jod basedow is the opposite of
wolff chaikoff
27
treatment for thryoid storm
propyl thiouracil, propranol, prednisolone (PPP)
28
for thyroid cancer think of
pap smear
29
shortened 4th and 5th digit what disease
psuedohypoparathyroidism (albright hereditary osteodystrophy)
unresponsive kidney to PTH
30
familial hypocalciuric hypercalcemia MM
defective Ca sensor on parathyroid cells
31
increased cAMP in urine
primary hyperparathyroidism
32
what is renal ostodystrophy
bone disease due to 2 or 3 hyperpara due to renal disease
33
autonomous hyperparathyoridism
tertiary
34
pegvisomant is
GH receptor antagonist for acromegaly
35
lithium be careful about
DI and hypthyroidism
36
HCO3 is - in DKA
decreased
37
necrolytic migratory erythema
glucogonoma (DVT and depression in addition to DM)
38
enzyme def in carcinoid syndrome
niacin (tryptophan channeled to 5HT)
39
zollinger E sndrome location
pancreas and duodenum
40
positive secretin stimulaiton test used for
ZE syndrome
41
MEN codes
PPP
PAT
NAT
42
what class is metformin and SE
biguanide and lactic acidosis
43
what class is chlorpropamide and SE
sulphonyl urea (hypoglycemia)
44
PPAR gamma activated by which anti-DM drug
glitazones/thiazoledinediones
45
eg of alpha glucosidase inhibitors
acarbose miglitol
46
...vaptans are
ADH antagonists for SIADH at V2 recetpor
47
MC and GC activity
fludrocortisone
48
cinacalcet
sensitize ca+ sensing receptor of parathyroid cells (will decrease PTH)
49
hypo-osmotic volume contraction eg
ADRENAL INSUFFICIENTY
50
subperiosteal thinning
primary hyperparathyridism
51
mother and baby virilization
placental aromatase def
52
blood transfusion then hypocalcemia
due to citrate chelation
53
branchical cleft cyst from
persistent cervical sinus
54
will there be HT in neuroblastoma
NO (phaeochromoccytoma-episodic)
55
anterior and post pituitary dev
oral ectoderm (rathke: anterior) and neuroectoderm
56
herediary hypothalamice DI protein
neurohypophysin
57
GH incrase insulin
because resistance
58
beta2 and insulin
enhances(a2 inhibits)
59
GnRH regulated by
prolactin (dop sup prol and prol sup GnRH)
| p316
60
hypogly in non-medical setting
im glucagon (iv dextrose medical)
61
Gherlin secreted from and function
Stomach (hunger and GH release)
62
21 a hydroxylase in glomerulosa
11 deoxy corticosterone (active)
63
future of testosterone
estradiol (Aromatase), dihydrotestosterone (5 a reductase)
64
most common CAH
21 a hydroxylase (salt wasting infancy, precocious puberty childhood, virilization in XX.
21 a and 11 b (not in 17 a)
65
LAbs in CAH
17 a- ess andostenedione
21a= 17 hydroxy progesterone more renin
11 b= less reninin
66
CAH why size
ACTH
67
steroids and TB
IL 2
68
increased Ph and calcium
more binding to albumin in alkalosis
69
2 actions of vitamin D
increased absorption of both, increased resorption of both, no action in kidney
70
4 actions of PTH
bone both
DCT calcium, PCT Po4 loss
PCT 1 a hydroxylase
71
OCP and pregnancy- free estrogens
unchanged, increased SHBG
72
somatostatin suppress both and why
T3 and GH synergize for bone growth
73
active of thyroid hormone
T3 (T4 to T3 by 5' de iodinase)
74
TBG and estrogen
estrogen increase TBG, OCP and pregnancy
| decrease in hepatic failure and seroids
75
Iodine go to the cell by
Na I symporter
| Inhibited by perchlorate, pertechnate, thiocyanate and P iodide
76
methimazole vs propyl thiouracil
propyl thiouracil- both peroxidase and 5' deiodinase
| Methimazole- only peroxidase
77
cushing disease, CRH test
ACTH and cortisol will increase
| ectopic no increase
78
metyrapone stimulation test
inhibit 11 deoxy cortisol-cortisol
ACTH increase normal
in adrenal insufficiency, ACTH remain decreased
79
addison disease
chronic adrenal insufficiency (primary)
80
hyponatremic volume contraction
primary adrenal insufficency
81
secondary adrenal insufficiency
pituitary ACTH decrease
| spares skin and aldosterone
82
Tertiary adrenal insufficiency
due to treatment, spares aldosterone
83
conn syndrome
primary hyperaldosteronism
84
aldosterone escape(be aware)
no edema and hypernatremia in conn syndrome
85
homer wright rosette
neuroblastoma
86
wilms vs neuroblastoma
neuroblastoma- irregular and cross midline
87
secondary hyperaldosteronism due to
increased renin
88
pheochromocytoma associated conditon
NF type 1, MEN 2A and 2B, van hippel landau disease
89
episodic hypertension/spells
pheochromocytoma
90
panic attack vs pheochromocytoma
BP very high and headache
91
treatment for pheochromocytoma
phenoxybenzamine
92
myxoedema seen in
hypothyroidism
93
4 causes of hypothyroidism
hashimoto, cretin, subacute, reidels
| sub acute = de quervein
94
immunology of hashimoto
antiperoxidase (microsomal), anti thyroglobulin
95
hashimoto histology
```
lymphocytic thyroiditis (germinal center)
Hurthle cells
```
96
hashimoto risk
NHL
97
cretin two features at birth
prolonged jaundice, protruding umbilicus
98
Flu leading to hypothyroidism
sub acute (De quervein) (self limited)
99
only hypothyroidism pain
de quervein (self limited)
100
why reidel is stone like
replaced by fibrous tissue
mimic anaplastic cancer, extend to local tissues
IgG4 mediated
101
histology of de quervein
granulomatous inflammation
102
Graves disease exophthalmos why?
increased glycosamino glycans from retrooribital fibroblasts (same for pre tibial myxedema- dermal fibroblasts)
103
3 conditons of hyperthroidism
Graves
Toxic MNG
Job basedow
104
Treatment for Graves disease
Radioactive iodine
105
exophthalmos treatment
prednisolone
106
thyroidectomy- superior laryngeal artery goes with
superior laryngeal nerve
| recurrent laryngeal nerve with inferior thyroid
107
nothing to say about
follicular carcinoma of thyroid
108
histology of papillary carcinoma
orphan annie, psammoma, nuclear grooves
109
risk of papillary carcinoma
childhood irradiation, RET and BRAF mutation
110
congo red and thyroid cancer
medullary ca
| nest of polygonal cells with amyloid
111
thyroid cancer with finely dispersed chromatin with ground glass appearance
orphan annie
112
pseudohypoparathyroidism aka
albright hereditary osteodystrophy
| unresponsiveness to hormone
113
PTH independent hypercalcemia
excess ingestion and cancer
114
familial hypocalciuric hypercalcemia
parathyroid does not know increased calcium levels
| calcium absorption normal though serum caclcium high. PTH is normal to high
115
primary, sec, ter hyperparathyroid names
osteitis fibrosa cystica
renal osteodystrophy
autonomous
116
code for osteitis fibrosa cystica
stones, bones, groans, psychiatric overtones
117
increased C AMP in urine
osteitis fibrosa cystica
118
dopamine agonists
bromocryptine and cabergolline
119
pituitary adenoma and sex drive
low libido
120
untreated proalctinoma in female
decreased estrogen - causes osteoporosis and vaginal dryness
121
two treatment for acromegaly
somatostatin (octreotide)
| pegvisomant (GH receptor antagonist)
122
acromegaly and cancer
increased risk of colorectal polyp
123
cause of death in gigantism
heart failure
124
hyperosmotic volume contraction
DI urine sp gravity 290
125
causes of nephrogenic DI
lithium and demeclocycline
126
treatment for nephrogenic DI
thiazide and amiloride, indomethacin
127
euvolmeic hyponatremia
SIADH(aldo decreases= euvolemia)
128
SIADH (Sir CPM)
correct hyponatremia slowly
129
SIADH treatment
fluid restriction and vaptans
| hypertonic saline
130
3 causes of low pituitary hormones
sheehan, empty sella, apoplexy
131
apoplexy clinical features
meningeal irritation, headache, ophthalmoplegia
132
type 2 DM complication
hyperosmolar coma
133
common cause of death in DM
MI
134
DM 2 types of pathogenesis
```
glycation (retina and kidney)
osmotic damage (lens and schwann cells)
```
135
glycation in kidney
nodular glomerulosclerosis (kimmel steil wilson)
136
lipotoxicity
insulin resistance (serine phosphorylation) and decreased insulin secretion
137
type 1 and 2 DM genetics
weak for type 1 and strong for type 2
| HLA DR3 and DR4 for type 1
138
histology of type 1 and type 2
leukocyte infiltrate in type 1,
| IAPP (islet amylod polypeptide) in type 2
139
respiration in DKA
kussmaul (rapid and deep)
140
glucagonoma clinical features
dermatitis (necrolytic migratory erythemaaaaaa), DM, DVT, depression
141
carcinoid tumor serete
serotonin (neuroendocrine cells enterochromaffin cells)
142
4 clinical features of carcinoid syndrome
diarrhea, flushing, wheezing, TR
143
carcinoid syndrome wo situations
extraintestinal, metastasis
| intestine- most common malignancy
144
secretin stimulation test for
gastrinoma (ZEsyndrome)
| gastrin remains elevated
145
mucosal neuroma and marfanoid habitus
MEN 2B
146
PAT and NAT
A pheochromocytoma, T medullary thyroid cancer of thyroid
147
gestational DM treatment
insulin
148
insulin class
```
postprandial = ALG and regular
basal = determir, glargine, NPH
```
149
lispro
reversal of lysine and proline
150
insulin for DKA
regular (short acting)
151
name 3 standard drugs for DM
Biguanides (metformin), sulphonylureas (---ide),
| Glitazones/thiazolidine diones
152
2 DM drugs that enhance insulin sensitivity
biguanides (metformin) and glitazones
153
DM drug CI in renal disease
biguanides (cause lactic acidosis) and GI upset
154
sulphonylurea side effect
first gen= disulphiram
| 2nd gen= hypoglycemia (increased in renal failure)
155
advantage of glipizide
short acting, decrease incidence of hypoglycemia
156
glitazones side effect
weight gain and heart failure
157
classify new DM drugs
GLP1 agonists, inhibitors of DPP4, kidney, intestine
158
GLP1 agonist
exenatide, liraglutide
159
inhibitor of GLP 1 lysis
gliptins
160
kidney absortion
flozins (SGLT2)
161
intestine absorption
alpha glucosidase = acarbose, miglitol
162
flushins
flozins (SGLT2)
163
glitazones MOA
PPARgamma enhance adiponectin
| increase insulin sensitivity
164
pregnancy antithyroid
PTU
| aplasia cutis with methimazole
165
PTU toxicity
hepatotoxicity, ANCA vasculitis
166
use of octreotide
acromegaly, carcinoid syndrome, glucagonoma, gastrinoma, varices
167
ADH antagonists
vaptans and demeclocycline
168
local steroid side effect
thinning of skin
169
cincalcet is opposite to
familial hypocalciuric hypercalcemia
| PTH decrease
170
thyroid enzyme inhibited by
beta blockers
| deiodinase
171
subperiosteal thinning and salt and pepper skull
hyperparathyroidism
172
meglitinide is functionally similar to
sulphonylurea
