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Quick Notes for Step 1 > Endocrine > Flashcards

Endocrine Flashcards

1
Q

PPAR-y

A

Nuclear receptor that is bound by –glitazones (TZD’s)

  • Transcriptional Regulator
  • Increases GLUT4 gene expression (adipocytes)
  • Weight gain and edema are a side effect
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2
Q

Sulfonureas

A

Bind regulatory subunit of Katp channel on pancreatic Beta cells to close them (calcium influx → insulin release)

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3
Q

Aldosterone in Addison’s (Primary Adrenal Insufficiency):

A
  • Low aldosterone: Decreased serum Na and Bicarb

Decreased Na reabsorption) & Increased serum K and Cl (Decreased H+ and K+ excretion

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4
Q

Decreased Deep Tendon Reflexes with _______

A

Hypothyroidism

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5
Q

Reverse T3

A

Inactive form of thyroid hormone that is generated with peripheral conversion of T3 to T4

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6
Q

Diabetics should _______

A

Inspect feet daily because risk of infections

- May have peripheral arterial disease (due to atherosclerotic femoral arteries)

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7
Q

Pseudohypoparathyroidism

A

High PTH, low Ca due to resistant PTH receptors

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8
Q

Hashimoto’s Thyroiditis

A

Looks like germinal centers on histology

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9
Q

High levels of vitamin D

A

Increase both Ca and PO4, and decrease PTH

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10
Q

Craniopharyngioma

A
  • Bitemporal hemianopsia
  • Calcified, resembles tooth enamel
  • Solid, cystic, and calcified; filled with machinery oil liquid
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11
Q

Kallman’s Syndrome

A

No GnRH because failed to migrates from olfactory placode, anosomia

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12
Q

Waterhouse-Friedrichsen

A

Acute primary adrenal insufficiency due to n. meningitides

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13
Q

Neurophysins

A

Carrier proteins for oxytocin and ADH

- Produced by hypothalamus

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14
Q

Alpha2 and Somatostatin: Effect on Insulin

A

Decrease insulin release

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15
Q

TZD’s (glitazones)

A

PPARgamma → decreases insulin resistance

- Transcriptional regulation

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16
Q

DPP4 inhibitors

A

-gliptins

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17
Q

Increased secretion of insulin:

A

Sulfonureas and DPP4

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18
Q

Increased sensitivity of insulin

A

Metformin and TZDs (glitazones)

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19
Q

Ophthalmopathy in Grave’s treated w/

A

Glucocorticoids

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20
Q

JAK/STAT receptor signaling pathway used by:

A

Growth Hormone and Prolactin

21
Q

Osteitis fibrosa cystica

A

(resorption of subperiosteum)

  • Seen with Primary hyperparathyroidism
  • Stones, bones, groans, psychiatric overtones
22
Q

Neuroblastoma

A
  • Tumor of adrenal medulla in young children

- Non-rhythmic conjugate eye movements and myoclonus aw/ paraneoplastic syndrome

23
Q

Pregnancy, Hormone replacement therapy, and OCPs effect on Thyroid Hormones

A

Increased TBG (thyroid binding globulin) so total T3 and T4 are increased but free is normal

24
Q

Hypothyroidism

A

May have myopathy with myoedema (bump rises when muscle tapped with a reflex hammer), will have elevated CK

25
Q

DKA

A

HYPERkalemia because potassium inside cells is low (K+ normally taken up with glucose) and potassium outside is normal or increased (potassium sent out of cells), total potassium is low because of lose K+ in urine; sodium is low
- Tx: must replace potassium

26
Q

Complete androgen insensitivity syndrome

A

X linked mutation, breast development and bind pouch vagina, cryporchid testes (karyotype is XY)

27
Q

Papillary Thyroid Cancer

A

MC; orphan annie eyes, psamomma bodies, internuclear grooves and inclusions
- Don’t confused with Follicular Adenoma or Carcinoma

28
Q

Anorexia and GnRH

A

Lose pulsatile secretion of GnRH → amenorrhea and osteoporosis (if long-term)

29
Q

Transient vs Permanent Central DI

A
  • Isolated damage to posterior pituitary → transient central DI
  • Damage to the hypothalamic nuclei will be permanent
30
Q

Intrinsic Tyrosine Kinase

A

insulin and growth factors (eg. FGF, EDGF, etc)

- MAP kinase

31
Q

Receptor- Associated Tyrosine Kinase

A

growth hormone, prolactin, cytokines

- JAK/STAT

32
Q

C-peptide

A

Formed from pro-insulin (cleaved off) and packed into a secretory granule with insulin (equimolar concentration)
- Not present with exogenous insulin

33
Q

IGF-1

A

Produced by liver due to GH stimulation

34
Q

Insulin Activates:

A
  • Directly activates glycogen synthase

- Indirectly inactivates glycogen phosphorylase (via protein phosphatase 1)

35
Q

Thyroid Hormone increases ________ in Heart

A

B1 receptors

36
Q

Thyroid Receptors in _______

A

Nucleus (unlike most steroid hormone receptors which are cytoplasmic)

37
Q

Hypothyroidism

A
  • Hypercholesterolemia (due to downregulation of LDL receptors)
  • Also an increased risk of non-hodgkins
  • Hurthle cells; follicles (germinal centers)
38
Q

DeQuervain vs Reidel

A
  • DeQuervain: post-viral hypothyroidism (painful), jaw pain

- Reidel (fibrosing) is not painful

39
Q

Jod Basedow Phenomenon

A

Thyrotoxicosis if patient with iodine deficiency is given iodine

40
Q

Tx for Growth Hormone excess

A

If it is not cured by resection:

- Pegvisomant (GH receptor antagonist) or octreotide (somatostatin analog)

41
Q

__________ is given intravenously to treat DKA

A

Regular insulin

  • onset 30 min
  • peaks at 2-4 hours
  • lasts 5-8
42
Q

HPA Axis Suppression by Exogenous Steroids

A

All 3 parts are suppressed (hypothal, pituitary, and adrenals) which means that CRH, ACTH, and cortisol will be low in an adrenal crisis if steroids are stopped abruptly

43
Q

Klinefelters: Gonadotropins and Hormones

A

High LH and FSH
Low testosterone
Azoospermia
Hyalinized semeniferous tubules

44
Q

hCG and TSH

A

similar in structure so patients with testicular germ cell tumors or gestational trophoblastic disease may develop high hCG that can stimulate TSH receptors and cause hyperthyroidism

45
Q

Proptosis w/ Graves

A

Due to increased GAGs (glycosaminoglycan) depositing by orbital fibroblasts –> edema and enlargement of extraocular muscles

46
Q

Metryapone

A

Inhibits 11 B hydroxylase

- Decreases cortisol synthesis and if HPA axis is intact ACTH should increase

47
Q

Uniform polygonal or spindle-shaped cells w/ extracellular amyloid deposits (stains with Congo red)

A

Medullary Thyroid cancer

- extracellular amyloid deposits formed by calcitonin released from neoplastic parafollicular C-cells

48
Q

Beta-blocker use with Thyrotoxicosis

A

Decreases Sympathetics

Also decreases rate of peripheral T4 conversion to T3

49
Q

TNFa induced insulin resistance

A

due to activation of serine kinase (which phosphorylates insulin receptor)

Quick Notes for Step 1 (18 decks)

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