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USMLE Step1 > Endocrine > Flashcards

Endocrine Flashcards

1
Q

Medullary Ca thyroid

A

Parafollicular C cells ( calcitonin)

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2
Q

Desmopressin

A

ADH analogue

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3
Q

Orphan Annie

A

Papillary ca

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4
Q

Octreotide is a

A

Somatostatin

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5
Q

Increased 5-HIAA in urine

A

Carcinoid syndrome

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6
Q

24 hr insulin

A

Glargine

Detemir

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7
Q

Post prandial insulin

A

Aspart Lispro Glulisine

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8
Q

Demeclocycline

A

ADH antagonist (tetracycline)

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9
Q

pituitary hormones with similar beta subunits

A

HCG and TSH (LSH and FH closer)

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10
Q

what is tesamorelin

A

GHRH analog used for HIV associated lipodystrophy

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11
Q

alKaLowsis has

A

low calcium

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12
Q

cushings disease

A

ACTH secreting pituitary adenoma (can be suppressed by high dose dexa)

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13
Q

aldosterone action

A

Na and H2O absorption

K and H secretion

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14
Q

what happens to aldosterone in 2 and 3 adrenal insuffinincty

A

preserved

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15
Q

neuroblastoma 3 lab markers

A

HVA and VMA
bomebsin and neuron-speific enolase
N-myc oncogene (N for)

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16
Q

dancing eye and dancing feet diagnosis

A

neuroblastoma

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17
Q

increased metanephrines in urine

A

phaechromocytoma

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18
Q

pre-tibial myxedema seen in

A

graves disease

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19
Q

two assicated blood lab finding ins hypothyroidism

A

CK and cholesterol high

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20
Q

lymphocytic thyroiditis aka

A

hashimoto

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21
Q

de quervain aka

A

sub a/c thyroiditis

VAIN for PAIN

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22
Q

reidel thryoid feels like a

A

stone

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23
Q

HLA associton for hashimoto

A

HLA-DR5

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24
Q

follicle working independently of TSH: what goiter

A

toxic multinodular goiter

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25
Q

cause of death in thyroid storm

A

tachyarrythmia

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26
Q

Jod basedow is the opposite of

A

wolff chaikoff

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27
Q

treatment for thryoid storm

A

propyl thiouracil, propranol, prednisolone (PPP)

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28
Q

for thyroid cancer think of

A

pap smear

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29
Q

shortened 4th and 5th digit what disease

A

psuedohypoparathyroidism (albright hereditary osteodystrophy)
unresponsive kidney to PTH

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30
Q

familial hypocalciuric hypercalcemia MM

A

defective Ca sensor on parathyroid cells

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31
Q

increased cAMP in urine

A

primary hyperparathyroidism

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32
Q

what is renal ostodystrophy

A

bone disease due to 2 or 3 hyperpara due to renal disease

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33
Q

autonomous hyperparathyoridism

A

tertiary

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34
Q

pegvisomant is

A

GH receptor antagonist for acromegaly

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35
Q

lithium be careful about

A

DI and hypthyroidism

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36
Q

HCO3 is - in DKA

A

decreased

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37
Q

necrolytic migratory erythema

A

glucogonoma (DVT and depression in addition to DM)

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38
Q

enzyme def in carcinoid syndrome

A

niacin (tryptophan channeled to 5HT)

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39
Q

zollinger E sndrome location

A

pancreas and duodenum

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40
Q

positive secretin stimulaiton test used for

A

ZE syndrome

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41
Q

MEN codes

A

PPP
PAT
NAT

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42
Q

what class is metformin and SE

A

biguanide and lactic acidosis

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43
Q

what class is chlorpropamide and SE

A

sulphonyl urea (hypoglycemia)

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44
Q

PPAR gamma activated by which anti-DM drug

A

glitazones/thiazoledinediones

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45
Q

eg of alpha glucosidase inhibitors

A

acarbose miglitol

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46
Q

…vaptans are

A

ADH antagonists for SIADH at V2 recetpor

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47
Q

MC and GC activity

A

fludrocortisone

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48
Q

cinacalcet

A

sensitize ca+ sensing receptor of parathyroid cells (will decrease PTH)

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49
Q

hypo-osmotic volume contraction eg

A

ADRENAL INSUFFICIENTY

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50
Q

subperiosteal thinning

A

primary hyperparathyridism

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51
Q

mother and baby virilization

A

placental aromatase def

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52
Q

blood transfusion then hypocalcemia

A

due to citrate chelation

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53
Q

branchical cleft cyst from

A

persistent cervical sinus

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54
Q

will there be HT in neuroblastoma

A

NO (phaeochromoccytoma-episodic)

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55
Q

anterior and post pituitary dev

A

oral ectoderm (rathke: anterior) and neuroectoderm

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56
Q

herediary hypothalamice DI protein

A

neurohypophysin

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57
Q

GH incrase insulin

A

because resistance

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58
Q

beta2 and insulin

A

enhances(a2 inhibits)

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59
Q

GnRH regulated by

A

prolactin (dop sup prol and prol sup GnRH)

p316

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60
Q

hypogly in non-medical setting

A

im glucagon (iv dextrose medical)

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61
Q

Gherlin secreted from and function

A

Stomach (hunger and GH release)

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62
Q

21 a hydroxylase in glomerulosa

A

11 deoxy corticosterone (active)

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63
Q

future of testosterone

A

estradiol (Aromatase), dihydrotestosterone (5 a reductase)

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64
Q

most common CAH

A

21 a hydroxylase (salt wasting infancy, precocious puberty childhood, virilization in XX.
21 a and 11 b (not in 17 a)

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65
Q

LAbs in CAH

A

17 a- ess andostenedione
21a= 17 hydroxy progesterone more renin
11 b= less reninin

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66
Q

CAH why size

A

ACTH

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67
Q

steroids and TB

A

IL 2

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68
Q

increased Ph and calcium

A

more binding to albumin in alkalosis

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69
Q

2 actions of vitamin D

A

increased absorption of both, increased resorption of both, no action in kidney

70
Q

4 actions of PTH

A

bone both
DCT calcium, PCT Po4 loss
PCT 1 a hydroxylase

71
Q

OCP and pregnancy- free estrogens

A

unchanged, increased SHBG

72
Q

somatostatin suppress both and why

A

T3 and GH synergize for bone growth

73
Q

active of thyroid hormone

A

T3 (T4 to T3 by 5’ de iodinase)

74
Q

TBG and estrogen

A

estrogen increase TBG, OCP and pregnancy

decrease in hepatic failure and seroids

75
Q

Iodine go to the cell by

A

Na I symporter

Inhibited by perchlorate, pertechnate, thiocyanate and P iodide

76
Q

methimazole vs propyl thiouracil

A

propyl thiouracil- both peroxidase and 5’ deiodinase

Methimazole- only peroxidase

77
Q

cushing disease, CRH test

A

ACTH and cortisol will increase

ectopic no increase

78
Q

metyrapone stimulation test

A

inhibit 11 deoxy cortisol-cortisol
ACTH increase normal
in adrenal insufficiency, ACTH remain decreased

79
Q

addison disease

A

chronic adrenal insufficiency (primary)

80
Q

hyponatremic volume contraction

A

primary adrenal insufficency

81
Q

secondary adrenal insufficiency

A

pituitary ACTH decrease

spares skin and aldosterone

82
Q

Tertiary adrenal insufficiency

A

due to treatment, spares aldosterone

83
Q

conn syndrome

A

primary hyperaldosteronism

84
Q

aldosterone escape(be aware)

A

no edema and hypernatremia in conn syndrome

85
Q

homer wright rosette

A

neuroblastoma

86
Q

wilms vs neuroblastoma

A

neuroblastoma- irregular and cross midline

87
Q

secondary hyperaldosteronism due to

A

increased renin

88
Q

pheochromocytoma associated conditon

A

NF type 1, MEN 2A and 2B, van hippel landau disease

89
Q

episodic hypertension/spells

A

pheochromocytoma

90
Q

panic attack vs pheochromocytoma

A

BP very high and headache

91
Q

treatment for pheochromocytoma

A

phenoxybenzamine

92
Q

myxoedema seen in

A

hypothyroidism

93
Q

4 causes of hypothyroidism

A

hashimoto, cretin, subacute, reidels

sub acute = de quervein

94
Q

immunology of hashimoto

A

antiperoxidase (microsomal), anti thyroglobulin

95
Q

hashimoto histology

A 
lymphocytic thyroiditis (germinal center)
Hurthle cells
96
Q

hashimoto risk

A

NHL

97
Q

cretin two features at birth

A

prolonged jaundice, protruding umbilicus

98
Q

Flu leading to hypothyroidism

A

sub acute (De quervein) (self limited)

99
Q

only hypothyroidism pain

A

de quervein (self limited)

100
Q

why reidel is stone like

A

replaced by fibrous tissue
mimic anaplastic cancer, extend to local tissues
IgG4 mediated

101
Q

histology of de quervein

A

granulomatous inflammation

102
Q

Graves disease exophthalmos why?

A

increased glycosamino glycans from retrooribital fibroblasts (same for pre tibial myxedema- dermal fibroblasts)

103
Q

3 conditons of hyperthroidism

A

Graves
Toxic MNG
Job basedow

104
Q

Treatment for Graves disease

A

Radioactive iodine

105
Q

exophthalmos treatment

A

prednisolone

106
Q

thyroidectomy- superior laryngeal artery goes with

A

superior laryngeal nerve

recurrent laryngeal nerve with inferior thyroid

107
Q

nothing to say about

A

follicular carcinoma of thyroid

108
Q

histology of papillary carcinoma

A

orphan annie, psammoma, nuclear grooves

109
Q

risk of papillary carcinoma

A

childhood irradiation, RET and BRAF mutation

110
Q

congo red and thyroid cancer

A

medullary ca

nest of polygonal cells with amyloid

111
Q

thyroid cancer with finely dispersed chromatin with ground glass appearance

A

orphan annie

112
Q

pseudohypoparathyroidism aka

A

albright hereditary osteodystrophy

unresponsiveness to hormone

113
Q

PTH independent hypercalcemia

A

excess ingestion and cancer

114
Q

familial hypocalciuric hypercalcemia

A

parathyroid does not know increased calcium levels

calcium absorption normal though serum caclcium high. PTH is normal to high

115
Q

primary, sec, ter hyperparathyroid names

A

osteitis fibrosa cystica
renal osteodystrophy
autonomous

116
Q

code for osteitis fibrosa cystica

A

stones, bones, groans, psychiatric overtones

117
Q

increased C AMP in urine

A

osteitis fibrosa cystica

118
Q

dopamine agonists

A

bromocryptine and cabergolline

119
Q

pituitary adenoma and sex drive

A

low libido

120
Q

untreated proalctinoma in female

A

decreased estrogen - causes osteoporosis and vaginal dryness

121
Q

two treatment for acromegaly

A

somatostatin (octreotide)

pegvisomant (GH receptor antagonist)

122
Q

acromegaly and cancer

A

increased risk of colorectal polyp

123
Q

cause of death in gigantism

A

heart failure

124
Q

hyperosmotic volume contraction

A

DI urine sp gravity 290

125
Q

causes of nephrogenic DI

A

lithium and demeclocycline

126
Q

treatment for nephrogenic DI

A

thiazide and amiloride, indomethacin

127
Q

euvolmeic hyponatremia

A

SIADH(aldo decreases= euvolemia)

128
Q

SIADH (Sir CPM)

A

correct hyponatremia slowly

129
Q

SIADH treatment

A

fluid restriction and vaptans

hypertonic saline

130
Q

3 causes of low pituitary hormones

A

sheehan, empty sella, apoplexy

131
Q

apoplexy clinical features

A

meningeal irritation, headache, ophthalmoplegia

132
Q

type 2 DM complication

A

hyperosmolar coma

133
Q

common cause of death in DM

A

MI

134
Q

DM 2 types of pathogenesis

A 
glycation (retina and kidney)
osmotic damage (lens and schwann cells)
135
Q

glycation in kidney

A

nodular glomerulosclerosis (kimmel steil wilson)

136
Q

lipotoxicity

A

insulin resistance (serine phosphorylation) and decreased insulin secretion

137
Q

type 1 and 2 DM genetics

A

weak for type 1 and strong for type 2

HLA DR3 and DR4 for type 1

138
Q

histology of type 1 and type 2

A

leukocyte infiltrate in type 1,

IAPP (islet amylod polypeptide) in type 2

139
Q

respiration in DKA

A

kussmaul (rapid and deep)

140
Q

glucagonoma clinical features

A

dermatitis (necrolytic migratory erythemaaaaaa), DM, DVT, depression

141
Q

carcinoid tumor serete

A

serotonin (neuroendocrine cells enterochromaffin cells)

142
Q

4 clinical features of carcinoid syndrome

A

diarrhea, flushing, wheezing, TR

143
Q

carcinoid syndrome wo situations

A

extraintestinal, metastasis

intestine- most common malignancy

144
Q

secretin stimulation test for

A

gastrinoma (ZEsyndrome)

gastrin remains elevated

145
Q

mucosal neuroma and marfanoid habitus

A

MEN 2B

146
Q

PAT and NAT

A

A pheochromocytoma, T medullary thyroid cancer of thyroid

147
Q

gestational DM treatment

A

insulin

148
Q

insulin class

A 
postprandial = ALG and regular
basal = determir, glargine, NPH
149
Q

lispro

A

reversal of lysine and proline

150
Q

insulin for DKA

A

regular (short acting)

151
Q

name 3 standard drugs for DM

A

Biguanides (metformin), sulphonylureas (—ide),

Glitazones/thiazolidine diones

152
Q

2 DM drugs that enhance insulin sensitivity

A

biguanides (metformin) and glitazones

153
Q

DM drug CI in renal disease

A

biguanides (cause lactic acidosis) and GI upset

154
Q

sulphonylurea side effect

A

first gen= disulphiram

2nd gen= hypoglycemia (increased in renal failure)

155
Q

advantage of glipizide

A

short acting, decrease incidence of hypoglycemia

156
Q

glitazones side effect

A

weight gain and heart failure

157
Q

classify new DM drugs

A

GLP1 agonists, inhibitors of DPP4, kidney, intestine

158
Q

GLP1 agonist

A

exenatide, liraglutide

159
Q

inhibitor of GLP 1 lysis

A

gliptins

160
Q

kidney absortion

A

flozins (SGLT2)

161
Q

intestine absorption

A

alpha glucosidase = acarbose, miglitol

162
Q

flushins

A

flozins (SGLT2)

163
Q

glitazones MOA

A

PPARgamma enhance adiponectin

increase insulin sensitivity

164
Q

pregnancy antithyroid

A

PTU

aplasia cutis with methimazole

165
Q

PTU toxicity

A

hepatotoxicity, ANCA vasculitis

166
Q

use of octreotide

A

acromegaly, carcinoid syndrome, glucagonoma, gastrinoma, varices

167
Q

ADH antagonists

A

vaptans and demeclocycline

168
Q

local steroid side effect

A

thinning of skin

169
Q

cincalcet is opposite to

A

familial hypocalciuric hypercalcemia

PTH decrease

170
Q

thyroid enzyme inhibited by

A

beta blockers

deiodinase

171
Q

subperiosteal thinning and salt and pepper skull

A

hyperparathyroidism

172
Q

meglitinide is functionally similar to

A

sulphonylurea

USMLE Step1 (19 decks)

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