Endocrine

Question 1

Overall affect of Insulin (7)

Answer 1

1. Increase glucose transport into muscle and adipose tissue
2. Increase glycogen sythesis and storage
3. Increase TG synthesis
4. Increase Na retention by kidneys
5. Increase protein syntheis
6. Increase cellular uptake of K and AA
7. Decrease glucagon release

Question 2

Function of Prolactin

Answer 2

Stimulates Milk production

Inhibts ovulation

Question 3

Cortisol funciton is a BIG FIB

Answer 3

• Blood Pressure increased
• Insulin resistance increased
• Gluconeogenesis, lipolysis and proteolysis increased
• Fibroblast activity decreased (causes striae**)
• Inflammatory and Immune responses decreased
• Bone function decreases

Question 4

What are common causes of Decreased Mg causing an Increase in PTH

Answer 4

1. Diarrhea
2. AG
3. Diuretics
4. Alcohol abuse

Question 5

Hormones that use cAMP

FLAT ChAMP

Answer 5

• FSH
• LH
• ACTH
• TSH
• CRH
• hCG
• ADH (V₂)
• MSH
• PTH

Question 6

Hormones that use IP₃

GOAT HAG

Answer 6

• GnRH
• Oxytocin
• ADH (V₁)
• TRH
• Histamine (H₁)
• ATN 2
• Gastrin

Question 7

Hormones that use Steroid receptors

VETTT CAP

Answer 7

• Vit D
• Estrogen
• Testosterone
• T₃/T₄
• Cortisol
• Aldosterone
• Progesterone

Question 8

T₃ function

4 B’s

Answer 8

Brain maturation

Bone growth

β-adrenergic

BMR increased

Question 9

Wolff-Chiakoff effect

Answer 9

Excess iodine temporarily inhibits thyroid peroxidase causing a decrease in T₃/T₄

Question 10

T₄ converted to T₃ via

Answer 10

5’-deiodinase in peripheral tissues

Question 11

What inhibites both Peroxidase and 5’-deiodinase

Answer 11

PTU

Question 12

Methimazole inhibits

Answer 12

Peroxidase

Question 13

Cushing syndrome is an

Answer 13

Increase in Cortisol

Question 14

Cushing syndrome findings (10)

Answer 14

1. HT
2. Weight game
3. moon face
4. Truncal obesity
5. Buffalo hump
6. Hyperglycemia
7. Skin thinning and striae
8. Osteoporosis
9. Amenorrhea
10. Immune suppression

Question 15

Conn syndrome is

Answer 15

Primary Hyperaldosteronism

Question 16

Addison disease is

Answer 16

Chronic primary adrenal insufficiency due to adrenal atrophy or destruction

Involves all 3 cortical divisions sparing medulla

Question 17

Most common tumor of adrenal medulla in children is

Answer 17

Neuroblastoma

Question 18

Most common tumor of the adrenal medulla in adults is

Answer 18

Pheochromocytoma

Question 19

Pheochromocytoma derived from

Answer 19

Chromaffin cells

Question 20

Pheochromocytoma associated with

Answer 20

VHL

RCC

MEN 2A and 2B

Question 21

Signs/Symptoms of Hypothyroidism (8)

Answer 21

1. Cold intolerance (decrease heat production)
2. Weight gain with decreased appetite
3. Hypoactivity, lethargy, fatigue, weakness
4. Constipation
5. Decrease reflexes
6. Myxedema (facial/preorbital)
7. Dry, cool skin with coarse brittle hair
8. Bradycardia

Question 22

Signs/Symptoms of Hyperthyroidism (8)

Answer 22

1. Heat intolerance (increase heat production)
2. Weight loss with increased appetite
3. Hyperactivity
4. Diarrhea
5. Increased reflexes
6. Pretibial myxedema (GRAVES)
7. Warm, moist skin with fine hair
8. Chest pain, palpatations, arrhythmia

Question 23

Hürthle cells seen in

Answer 23

Hashimotos

Question 24

Hashimoto HLA

Answer 24

DR5

Question 25

6 P’s of Cretinism (Congenital hypothyroidism)

Answer 25

1. Pot-bellied
2. Pale
3. Puffy-faced child
4. Protruding umbilicus
5. Protuberant tonge
6. Poor brain

Question 26

Treat Thyroid storm in Graves with 3 P’s

Answer 26

1. Propranolol
2. PTU
3. Prednisolone

Question 27

What is seen in Papillary Carcionoma of Thyroid

Answer 27

Orphan Annie eyed nucleus

Psammoma bodies

Nuclear

Question 28

Amyloid stroma seen in what thype of Thyroid cancer

Answer 28

Medullary

Question 29

Treatment ofr Acromegaly

Answer 29

Octreotide (somatostatin)

Pegvisomant (GH receptor antagonist)

Question 30

What reflects average blood glucose over prior 3 months

Answer 30

HbA_1c

Question 31

Rapid acting Insulin do not LAG

Answer 31

Lispro

Aspart

Glulisine

Question 32

Long acting insulin are

Answer 32

Glargine

Detemir

Question 33

Metformin is oral, first-line thearpy in

Answer 33

Type 2 DM

Question 34

Metformin contraindicated

Answer 34

in renal failure b/c Causes lactic acidosis

Question 35

Sulfonylureas MOA

Answer 35

• Close K channel in β-cell membrane causes cell to depolarize
• Depolarization tirggers insulin release via increase Ca influx

Question 36

First generation Sulfonylureas

Answer 36

Tobutamide

Chlorpropamide

Question 37

Second generation Sulfonylureas

Answer 37

Glyburide

Glimepiride

Glipizide

Question 38

First generation Sulfonylureas toxicity

Answer 38

Disulfiram

Question 39

Second generation sulfonylureas toxicity

Answer 39

Hypoglycemia

Question 40

-glitazone MOA

Answer 40

Increase insulin sensitivity in peripheral tissue by bingin to PPAR-γ nuclear transcription regulator

Question 41

-glitazone toxicity

Answer 41

Weight gain

Edema

Hepatotoxicity

HF

Question 42

Acarbose is

Answer 42

α-glucosidase inhibitor delaying sugar hydrolysis and glucose absorption

Question 43

Pramlintide is

Answer 43

Amylin analog causing decreased glastic emptying and decrease glucagon

Question 44

GLP-1 analogs are

Answer 44

Exenatide

Liraglutide

Question 45

Action of GLP-1 analogs

Answer 45

Increase insulin and decrease glucagon release

Question 46

GLP-1 analogs toxicity

Answer 46

Pancreatitis

Question 47

-Gliptins are

Answer 47

DPP-4 inhibitor

Increases Insulin and decreases glucagon release

Question 48

Octreotide is

Answer 48

Somatostatin analog

Question 49

DDAVP is

Answer 49

ADH analog

Question 50

Demeclocyline is

Answer 50

ADH antagonist