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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
treat Graves disease
methimazole (block DIT) - if 2nd-3rd trim - get aplasia cutis PTU (block T4 to T3, block DIT) - if 1st trim - get liver and agranulocytosis
26
increase thyroid binding globulins
pregnancy and OCP
27
hyperthyroidism after IV contrast use
Jed-Baselow phenomenon
28
HLA B35
subacute thyroiditis
29
Hashimoto HLA's
HLA DR5 | HLA B5
30
Papillary thyroid cancer
RET, BRAF, NRTK1, tobacco, radiation Orphan Annie nuclei psammoma bodies
31
follicular thyroid cancer
RAS | PA8-PPAR1
32
medullary thyroid cancer
TK, RET
33
GLUT2
small intestine | liver, B cells, renal
34
DM1 HLA
HLA DR3-DQ2 | HLA DR4-DQ8
35
glargine
24 hr insulin
36
glulisine
ultra short insulin
37
aspart
ultra short insulin
38
glargine
24 hr insulin
39
NPH
18 hr insulin, peak at 6 hr
40
regular insulin peak
3 hr
41
DPP-4 inhibitors
saxagliptin good for elderly/organ dysfunction
42
GLP-1 agonists
dulaglutide cause acute pancreatitis
43
SGLT-2 inhibitors
empagliflozin
44
a-glucosidase inhibitors
miglitol and acarbose less gut digestion, diarrhea miglitol is hepatotoxic
45
inhibit PPARy-receptor
pioglitazone rioglitazone edema and hepatotoxicity good for renal dysfunction
46
sulfonylureas require
good renal function
47
obesity cancers
non-Hodgkin | multiple myeloma
48
leptin
inhibits lateral hypothalamus | stimulates ventromedial
49
lipodystrophy
from low leptin | from protease inhibitors
50
drugs causing weight gain
mirtazepine progestins insulin, sulfonylureas, TZD's atypical antopsychotics
51
for metabolic syndrome Dx
TAG >150 HDL 130/85 waist >35 female glucose >100, >140
52
hypercalcemia causes are:
``` vitamin A intoxication thiazide diuretics granulomatous disease increase vit D PT adenoma/hyperplasia breast metastasis to bone multiple myeloma ```
53
primary hyperparathyroidism
``` proximal muscle weakness itchy keratitis HT uremia polydipsia osteitis fibrosa cystica OA peptic ulcers pancreatitis ```
54
osteitis fibrosa cystica
``` radial middle phalanges tapered distal clavicle salt and pepper skull bone cysts brown tumors of long bones ```
55
hypocalcemia causes are:
Albright hereditary osteodystophy -short, obese, short 3/4th digits, OFC DiGeorge, acute pancreatitis
56
secondary hyperparathyroidism
low Ca high Ph high alkphos possibly from low vitamin D usually chronic renal failure
57
acromegaly
cardiac failure large tongue secondary DM from gluconeogenesis
58
treat SIADH
demeclocycline
59
hypercalcemia hypocholesterolemia hyperglycemia afib
hyperthyroidism
60
arrhythmia hyperthermia vomiting hypovolemic shock
thyroid storm
61
Hurthle cells
Hashimoto - eosinophilic, lining of follicle
62
achlorhydria cholelithiasis steatorrhea
somatostatinoma - low gastrin/CCK
63
VIPoma symptoms
hypokalemia achlorhydria watery diarrhea
64
causes of Addison's
TB = worldwide lung/other metastatic cancer autoimmune
65
pheo syndromes
NF1 VHL MEN2A/2B
66
basophils in pituitary
``` FSH LH ACTH TSH "B-FLAT" ```
67
cornea GLUT
GLUT1
68
insulin effects
increases kidney Na retention | increases uptake of K, AA
69
prolactin regulation
TRH increases
70
tesamorelin
GHRH analog | for HIV associated lipodystrophy
71
somatomedin C
IGF1
72
ghrelin changes
increase with Prader Willi increase with sleep loss made by stomach
73
V1 receptor
BP via ADH
74
ADH regulation
osmoreceptors in hypothalamus
75
increase in 17-OH-progesteron
21-hydroxylase deficiency
76
calcium homeostasis
40% on albumin - increase with higher pH | 45% free ionized
77
increases macrophage CSF and RANKL
PTH
78
very low serum Mg
decreases PTH
79
V1 ADH type
IP3
80
H1 R type
IP3
81
IGF1 type
TK to MAPK
82
GH type
RTK to JAK/STAT
83
Aldosterone type
intracellular R
84
ATII type
IP3
85
V2 ADH type
cAMP
86
TRH type
IP3
87
Vit D type
intracellular R
88
prolactin type
RTK to JAK/STAT
89
GnRH type
IP3
90
oxytocin type
IP3
91
T3 helps in
brain maturation
92
metyrapone stimulation test
blocks 11-deoxycortisol to cortisol | no compensatory increase in ACTH with adrenal insufficiency
93
opsoclonus myoclonus
neuroblastoma - Nmyc HVA and VMA, bombesin, neuron enolase
94
90% pheos are
benign unilateral adrenal non-calcifies in adults
95
pheo syndromes
NF1 | VHL
96
Hurthle cells
Hashimoto, near germinal centers
97
jaw pain and ESR high
de Quervain subacute thyroiditis
98
IgG4 related
autoimmune pancreatitis retroperitoneal fibrosis noninfectious aortitis Riedel (rock) thyroiditic
99
fever, diarrhea, tachyarrhythmia, high ALP
thyroid storm | give propranolol, PTU, prednisolone
100
Ligated inferior thyroid artery
Cut recurrent laryngeal nerve
101
lymphatic invasion thyroid cancer hematogenous invasion thyroid cancer
papillary - irradiation, BRAF, RET medullary
102
Ca levels in hyperparathyroidism
low with secondary - hyperP in renal failure, hypo P usually high with primary high with tertiary - chronic renal disease causes high PTH
103
hypocalciuric hypercalcemia
PT cell Ca receptor defect mild hypercalcemia increased/normal PTH
104
increased ALP, cAMP in urine
hyperparathyroidism
105
pegvisomant
GH receptor antagonist for acromegaly
106
DI labs
urine gravity 290 central - >50% increase urine osmolal with vasopressin
107
low aldosterone
SIADH
108
treat SIADH
conivaptan tolvaptan demeclocycline
109
most common death in diabetes
MI from large vessel disease
110
severe glucose intolerance
type 1 DM
111
IAPP deposits
type 2 DM
112
most common ketone body
BHB
113
changes in diabetic ketoacidosis
``` leukocytosis heart failure cerebral edema low bicarb mucormycosis - Rhizopus ```
114
dermatits hyperglycemia DVT depression
glucagonoma
115
high urine 5-HIAA
carcinoid syndrome
116
carcinoid syndrome 2/3
2/3 are non-metastatic, single, with no second malignancy usually SI
117
treat carcinoid
octreotide
118
positive secretin stimulation test
Zollinger Ellison may be in MEN1 no inhibition of gastrin release
119
MEN1 gene
menin tumor suppressor
120
PTU SE`
liver failure ANCA+ vasculitis use in first trimester

Pathology (8 decks)

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