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Pathology > Endocrine > Flashcards

Endocrine Flashcards

1
Q

decrease protein synthesis

A

glucocorticoiss

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2
Q

IP3 mechanism

A

GnRH, TRH, oxytocin, vasopressin V1R

H1, ATII, Gastrin

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3
Q

TK mechanism

intrinsic (MAPK):

receptor-associated (JAK/STAT):

A

insulin, IGF-1, PDGF, FGF

GH, prolactin, IL, G-CSF, EPO

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4
Q

cAMP mechanism

A

FSH
LH
ACH
TSH

ADH V2R, glucagon, calcitonin, PTH, hCG, MSH, GHRH, CRH

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5
Q

vasopressin from

A

hypothalamic SON

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6
Q

estriol from

A

placenta

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7
Q

estrone from

A

adipose

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8
Q

estrogen in males from

A

testes

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9
Q

steroid hormone receptors

A

cytoplasm

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10
Q

GH regulation

A

inhibited by pregnancy, glucose, obesity, SS

stimulated by sleep, estrogen, endogenous opioids, low glucose, sleep, exercise, puberty

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11
Q

ADH regulation

A

stimulated by nicotine, opiates

inhibited by ethanol, atrial natriuretic factor, low osmolarity

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12
Q

FSH, LH regulation

A

inhibin —] FSH

progesterone/estrogen –] LH

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13
Q

POMC precursor for

A

ACTH
lipotropin
MSH
B-endorphin

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14
Q

Addison’s

A

primary adrenal insufficiency

hypotension, low Na, high K

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15
Q

somatostatin analogs

A

octreotide, somatostatin LAR, lanreotide-P

use for thryotropinoma, acromegaly
carcinoid syndrome, VIPoma

if need to reduce splanchnic circulation for varicose, ulcers

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16
Q

Sheehan syndrome

A

secondary hypothyroidism
rare hyponatremia
amenorrhea, agalactorrea

from pituitary necrosis

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17
Q

3-B-hydroxysteroid dehydrogenase deficiency

A

Early death, Na loss in urine

No gluco/mineralocorticoids
No sex steroids

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18
Q

17-a-hydroxylase deficiency

A

phenotypic female unable to mature
hypertension

increased mineralocorticoids
no sex steroids or cortisol

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19
Q

21-a-hydroxylase deficiency

A

masculinized with hypotension
salt wasting
high ACTH

increased sex steroids
no cortisol or mineralocorticoids

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20
Q

11-beta-hydroxylase deficiency

A

masculinized with hypertension

increased sex steroids
weak mineralicorticoid deoxycorticosterone
no cortisol, corticosterone, aldosterone

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21
Q

BAM CUSHINGOID

A 
Buffalo hump
Anemia, Amenorrhea**
Moon face
Crazy
Ulcers
Skin
HTN**
Infection
Necrosis femoral head**
Glaucoma
Osteoporosis
Immunosuppressed
Diabetes**
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22
Q

Conn syndrome

A

Primary hyperaldosteronism

HTN, low renin
low K, acidosis

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23
Q

treat hyperaldosteronism

A

spironolactone

eplerenone

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24
Q

treat pheo

A

phenoxybenzamine

phentolamine

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25
Q

treat Graves disease

A

methimazole (block DIT)

  • if 2nd-3rd trim
  • get aplasia cutis

PTU (block T4 to T3, block DIT)

  • if 1st trim
  • get liver and agranulocytosis
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26
Q

increase thyroid binding globulins

A

pregnancy and OCP

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27
Q

hyperthyroidism after IV contrast use

A

Jed-Baselow phenomenon

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28
Q

HLA B35

A

subacute thyroiditis

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29
Q

Hashimoto HLA’s

A

HLA DR5

HLA B5

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30
Q

Papillary thyroid cancer

A

RET, BRAF, NRTK1, tobacco, radiation
Orphan Annie nuclei
psammoma bodies

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31
Q

follicular thyroid cancer

A

RAS

PA8-PPAR1

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32
Q

medullary thyroid cancer

A

TK, RET

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33
Q

GLUT2

A

small intestine

liver, B cells, renal

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34
Q

DM1 HLA

A

HLA DR3-DQ2

HLA DR4-DQ8

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35
Q

glargine

A

24 hr insulin

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36
Q

glulisine

A

ultra short insulin

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37
Q

aspart

A

ultra short insulin

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38
Q

glargine

A

24 hr insulin

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39
Q

NPH

A

18 hr insulin, peak at 6 hr

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40
Q

regular insulin peak

A

3 hr

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41
Q

DPP-4 inhibitors

A

saxagliptin

good for elderly/organ dysfunction

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42
Q

GLP-1 agonists

A

dulaglutide

cause acute pancreatitis

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43
Q

SGLT-2 inhibitors

A

empagliflozin

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44
Q

a-glucosidase inhibitors

A

miglitol and acarbose

less gut digestion, diarrhea
miglitol is hepatotoxic

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45
Q

inhibit PPARy-receptor

A

pioglitazone
rioglitazone

edema and hepatotoxicity
good for renal dysfunction

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46
Q

sulfonylureas require

A

good renal function

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47
Q

obesity cancers

A

non-Hodgkin

multiple myeloma

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48
Q

leptin

A

inhibits lateral hypothalamus

stimulates ventromedial

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49
Q

lipodystrophy

A

from low leptin

from protease inhibitors

50
Q

drugs causing weight gain

A

mirtazepine
progestins
insulin, sulfonylureas, TZD’s
atypical antopsychotics

51
Q

for metabolic syndrome Dx

A

TAG >150
HDL 130/85
waist >35 female
glucose >100, >140

52
Q

hypercalcemia causes are:

A 
vitamin A intoxication
thiazide diuretics
granulomatous disease increase vit D
PT adenoma/hyperplasia
breast metastasis to bone
multiple myeloma
53
Q

primary hyperparathyroidism

A 
proximal muscle weakness
itchy
keratitis
HT
uremia
polydipsia
osteitis fibrosa cystica
OA
peptic ulcers
pancreatitis
54
Q

osteitis fibrosa cystica

A 
radial middle phalanges
tapered distal clavicle
salt and pepper skull
bone cysts
brown tumors of long bones
55
Q

hypocalcemia causes are:

A

Albright hereditary osteodystophy
-short, obese, short 3/4th digits, OFC

DiGeorge, acute pancreatitis

56
Q

secondary hyperparathyroidism

A

low Ca
high Ph

high alkphos

possibly from low vitamin D
usually chronic renal failure

57
Q

acromegaly

A

cardiac failure
large tongue
secondary DM from gluconeogenesis

58
Q

treat SIADH

A

demeclocycline

59
Q

hypercalcemia
hypocholesterolemia
hyperglycemia
afib

A

hyperthyroidism

60
Q

arrhythmia
hyperthermia
vomiting
hypovolemic shock

A

thyroid storm

61
Q

Hurthle cells

A

Hashimoto - eosinophilic, lining of follicle

62
Q

achlorhydria
cholelithiasis
steatorrhea

A

somatostatinoma - low gastrin/CCK

63
Q

VIPoma symptoms

A

hypokalemia
achlorhydria
watery diarrhea

64
Q

causes of Addison’s

A

TB = worldwide
lung/other metastatic cancer
autoimmune

65
Q

pheo syndromes

A

NF1
VHL
MEN2A/2B

66
Q

basophils in pituitary

A 
FSH
LH
ACTH
TSH
"B-FLAT"
67
Q

cornea GLUT

A

GLUT1

68
Q

insulin effects

A

increases kidney Na retention

increases uptake of K, AA

69
Q

prolactin regulation

A

TRH increases

70
Q

tesamorelin

A

GHRH analog

for HIV associated lipodystrophy

71
Q

somatomedin C

A

IGF1

72
Q

ghrelin changes

A

increase with Prader Willi
increase with sleep loss
made by stomach

73
Q

V1 receptor

A

BP via ADH

74
Q

ADH regulation

A

osmoreceptors in hypothalamus

75
Q

increase in 17-OH-progesteron

A

21-hydroxylase deficiency

76
Q

calcium homeostasis

A

40% on albumin - increase with higher pH

45% free ionized

77
Q

increases macrophage CSF and RANKL

A

PTH

78
Q

very low serum Mg

A

decreases PTH

79
Q

V1 ADH type

A

IP3

80
Q

H1 R type

A

IP3

81
Q

IGF1 type

A

TK to MAPK

82
Q

GH type

A

RTK to JAK/STAT

83
Q

Aldosterone type

A

intracellular R

84
Q

ATII type

A

IP3

85
Q

V2 ADH type

A

cAMP

86
Q

TRH type

A

IP3

87
Q

Vit D type

A

intracellular R

88
Q

prolactin type

A

RTK to JAK/STAT

89
Q

GnRH type

A

IP3

90
Q

oxytocin type

A

IP3

91
Q

T3 helps in

A

brain maturation

92
Q

metyrapone stimulation test

A

blocks 11-deoxycortisol to cortisol

no compensatory increase in ACTH with adrenal insufficiency

93
Q

opsoclonus myoclonus

A

neuroblastoma - Nmyc

HVA and VMA, bombesin, neuron enolase

94
Q

90% pheos are

A

benign unilateral adrenal non-calcifies in adults

95
Q

pheo syndromes

A

NF1

VHL

96
Q

Hurthle cells

A

Hashimoto, near germinal centers

97
Q

jaw pain and ESR high

A

de Quervain subacute thyroiditis

98
Q

IgG4 related

A

autoimmune pancreatitis
retroperitoneal fibrosis
noninfectious aortitis
Riedel (rock) thyroiditic

99
Q

fever, diarrhea, tachyarrhythmia, high ALP

A

thyroid storm

give propranolol, PTU, prednisolone

100
Q

Ligated inferior thyroid artery

A

Cut recurrent laryngeal nerve

101
Q

lymphatic invasion thyroid cancer

hematogenous invasion thyroid cancer

A

papillary - irradiation, BRAF, RET

medullary

102
Q

Ca levels in hyperparathyroidism

A

low with secondary
- hyperP in renal failure, hypo P usually

high with primary

high with tertiary
- chronic renal disease causes high PTH

103
Q

hypocalciuric hypercalcemia

A

PT cell Ca receptor defect
mild hypercalcemia
increased/normal PTH

104
Q

increased ALP, cAMP in urine

A

hyperparathyroidism

105
Q

pegvisomant

A

GH receptor antagonist for acromegaly

106
Q

DI labs

A

urine gravity 290

central - >50% increase urine osmolal with vasopressin

107
Q

low aldosterone

A

SIADH

108
Q

treat SIADH

A

conivaptan
tolvaptan
demeclocycline

109
Q

most common death in diabetes

A

MI from large vessel disease

110
Q

severe glucose intolerance

A

type 1 DM

111
Q

IAPP deposits

A

type 2 DM

112
Q

most common ketone body

A

BHB

113
Q

changes in diabetic ketoacidosis

A 
leukocytosis
heart failure
cerebral edema
low bicarb
mucormycosis - Rhizopus
114
Q

dermatits
hyperglycemia
DVT
depression

A

glucagonoma

115
Q

high urine 5-HIAA

A

carcinoid syndrome

116
Q

carcinoid syndrome 2/3

A

2/3 are non-metastatic, single, with no second malignancy

usually SI

117
Q

treat carcinoid

A

octreotide

118
Q

positive secretin stimulation test

A

Zollinger Ellison
may be in MEN1
no inhibition of gastrin release

119
Q

MEN1 gene

A

menin tumor suppressor

120
Q

PTU SE`

A

liver failure
ANCA+ vasculitis

use in first trimester

Pathology (8 decks)

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