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Modules > Endocrine > Flashcards

Endocrine Flashcards

1
Q

Glucagonoma

A

Tumor of the pancreatic a cells

4 Ds: dermatitis (necrolytic migratory erythema); diabetes (hyperglycemia), DVT, and depression

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2
Q

Insulinoma

A
  • Episodic hypoglycemia and mental status changes that improve with glucose
  • Have low glucose, high insulin, and high C peptide (indicating endogenous insulin production)
  • Treat with surgical resection
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3
Q

Gatrinoma / Zollinger Ellision syndrome

A
  • Gastrin producing tumor of pancreas of duodenum that results in treatment resistant peptic ulcers that can extend into jejunum
  • Sx: abdominal pain, diarrhea (malabsorption)
  • Test: exogenous secretin (S cells secreted in duodenum to decrease gastric acid sectretion) does not decrease gastrin levels
  • Associated with MEN 1
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4
Q

Somatistatinoma

A
  • Inhibits gastrin (results in acholhydria) and CCK which promotes contraction of the gall bladder (can lead to stone and steanorrhea)
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5
Q

VIPoma

A

Vasoactive peptide inhibits gastric acid secretion

Watery diarrhea, hypokalemia, and acholorhydria (WDHA syndrome - Watery Diarrhea, Hypokalemia, Acholorhydria)

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6
Q

Which structure connects the thyroid gland with the tongue?

A

thyroglossal duct

reminent in adult is the foramen cecum, a divot at the merge pt of the 3 parts of the tongue

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7
Q

How can you differentiate a thyroglossal duct cyst from a branchial cleft cyst?

A

TGD cyst is midline and motile (will move with swallowing), comes from patent thryoglossal duct
Branchial cleft cyst is lateral and derives from persistent cervical sinus

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8
Q

What are parafollicular cells in the thyroid dervied from and what cancer do they cause?

A

neuroendocrine cells
secrete calcitonin
cause medullary thyroid cancer (v aggressive)

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9
Q

What are the name of the carrier proteins that transport posterior pituitary hormones from the hypothalamus?

A

Neurophysins

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10
Q

GLUT 1

A

Non insulin dependent

Brain, cornea, RBCs

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11
Q

GLUT 2

A

liver, kidney, small intestine, beta islet cells
bi-directional
High Vmax, high Km

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12
Q

GLUT 3

A

Brain

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13
Q

GLUT 4

A 
Insulin dependent (insulin upregulates their presence on cell surface)
Muscle and adipose
Low Km (high affinity), low Vmax
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14
Q

GLUT 5

A

fructose transporter

Spermatocytes, GI tract

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15
Q

What is another name for IGF-1?

A

Somatomedin C

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16
Q

What are the common causes of hypomagnesemia?

A

Diarrhea
Diuretics
Alcohol Abuse
Aminoglycosides (gentamycin, etc)

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17
Q

What are the effect(s) of magnesium on PTH?

A

1) Mild hypomagnesemia causes increase in PTH secretion

2) Gross hypomag causes decrease in PTH secretion

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18
Q

Which hormones use Gas receptors?

A 
FSH, LH, ACTH, TSH [FLAT]
CRH, GHRH
PTH, calcitonin
MSH
ADH (V2)
hCG
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19
Q

What hormones signal through cGMP?

A

ANP, BNP, NO (EDRF)

Think vasodilation

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20
Q

What hormones signal through Gq?

A

GnRH, Oxytocin, ADH (V1), TRH, Histamine (H1), Angiotensin II, Gastrin

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21
Q

What hormones signal via an intracellular receptor?

A

Cortisol, aldosterone, T3/T4, progesterone, estrogen, vitamin D

22
Q

What hormones signal through an intrinsic tyrosine kinase receptor?

A

Insulin, IGF-1, FGF, PDGF, EGF

23
Q

What hormones signal through a receptor associated tyrosine kinase?

A

Prolactin, Immunomodulators (IL2, IL6, etc), GH, G-CSF, EPO, TPO

24
Q

Effects of Sex Hormone Binding Globulin Levels on Men and women

A
  • Increase SHBG in men decreases free testosterone, gynocomastia
  • Decreases in SHBG in women increase free testosterone, cause hirrsuitism
  • Increase SHBG (women) due to pregnancy or OPCs do nothing, free estrogen levels unchanged
25
Q

What are the classic signs associated with a neuroblastoma?

A

kid

26
Q

Differences between neuroblastoma and willms tumor?

A

NB irregular, crosses midline

Wilms: renal tissue, smooth, never crosses midline, slightly older kids >4

27
Q

What are pheos associated with?

A

MEN2A, MEN2B, neurofibromatosis type 1, von Hippel Lindau

28
Q

What is the rule of pheos?

A 
Rule of 10%
Malignant
Kids
Calcify
Extra-renal 
Bilateral
29
Q

What is the pathonomonic presentation of congenital hypothyroidism?

A 
"Cretinism" : 6 Ps, seen in kids 
Pot bellied 
Protruding umbilicus 
Pale
Puffy faced 
Proturberant tongue 
Poor brain development
30
Q

What are the pathnomonic cells seen in Hashimotos thyroiditis?

A

Hurthle cells

31
Q

What is the pathonomonic finding of the histology in Graves disease?

A

Scalloping of the colloid

32
Q

What are the pathonomonic findings in Papillary carcinoma (histology)?

A

Orphan annie eyed nuclei
Nuclear creases/ grooves
Psommoma bodies
(RET and BRAF mutation, kids radiation for acne)

33
Q

What is unique about follicular carcinoma?

A

Hematogenous spread

34
Q

What vitamin deficiency is associated with carcinoid tumors?

A

Niacin (B3) pellagra

Dermatitis, Diarrhea, Dementia

35
Q

What breakdown product do you find in the urine in a patient with a carcinoid tumor?

A

5-HIAA (5-hydroxyindoleacetic acid)

36
Q

What is the rule of 1/3 associated with carcinoid tumors?

A

1/3 metastisize
1/3 present with a second malignancy
1/3 are multiple
Most common malignancy in the small intestine

37
Q

What is the progression of kidney pathology in DM?

A

mesangial expansion –> nodular glomerulosclerosis (KW nodules) + with thick basement membranes

38
Q

What is tolbultamide and what is its main side effect?

A

first generation sulfonalurea (chlorpropamide)

Disulfram like reaction

39
Q

Neuroblastoma key pts

A

MCC adrenal tumor in children
N-Myc
Homer Wright Rosettes
Firm, irregular mass that can cross the midline
Opthoclonus, myoclonus; HVA/VMA in urine, Bombesin, endolase + ,

40
Q

Important disease that are AR inherited?

A

CF, phenylketonuria, thalasemia, sickle cell, lysosomal storage disease, infant polycystic kidney disease, and hemochromatosis

41
Q

What is the mode of inheritance of the MEN diseases?

A

AD

42
Q

HLA DR3 associations

A

DM1, Graves, Hashimotos, SLE

43
Q

HLA DR4 associations

A

Rheumatoid arthritis, DM1

44
Q

HLA DR5 associations

A

Hashimotos, pernicious anemia

45
Q

What is the pathophysiology associated with bone pain due to primary hyperparthyroidism?

A

osteitis fibrosis cystica
lytic bone lesions filled with brown fibrosis from hemmorhage and hemosiderin pick up by macrophages
often seen in the jaw

46
Q

What is the most common cause of hypopit in kids?

A

craniopharyngeoma

47
Q

What cardiac abnormalities are associated with carcinoid tumors?

A

RIGHT SIDED HEART LESIONS

Tricuspid regurg, pulmonic stenosis

48
Q

What are the common symptoms of hypoglycemia?

A

Lethargy, syncope, diplopia

49
Q

Which cancers is bombesin a marker for?

A

Neuroblastoma; small cell lung cancer; gastric carcinoma, pancreatic carcinoma

50
Q

From what cell line does a tumor that stains positive for Bombesin, neuron specific enolase, and chromogranin come from?

A

NEURAL CREST CELLS

51
Q

What does the RET gene code for?

A

Tyrosine kinase receptors

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