Endocrine Flashcards
What hormone is secreted during the most common pituitary tumor?
Prolactin
In what two ways does a prolactinoma present in females?
galacotrrhea and amenorrhea
In what two ways does a prolactinoma present in males?
decreased libido and headache
What type of drug is used to eliminate the side effects of a prolactinoma? Which two specifically?
dopamine agonists
bromocriptine or cabergoline
Why can acromegaly cause diabetes?
GH increases gluconeogenesis
An increase in what two hormones are used to diagnose acromegaly?
GH and IGF1
What does oral glucose do to GH levels?
suppress
What drug is used to treat acromegaly?
Octreotide
What is a craniopharyngioma?
pituitary tumor derived from embryonic tissue
What is Sheehan Syndrome?
pregnancy related infarction of the pituitary gland
How does Sheehan Syndrome often present?
Loss of pubic hair
What twp things herniate during Empty Sella Syndrome?
arachnoid and CSF
What two drugs are known to cause nephrogenic diabetes insipidus?
lithium and demeclocycline
What drug is used to treat SIADH?
demeclocycline
Where is a thyroglossal duct cyst located?
base of tongue
Via which protein does hyperthyroidism increase basal metabolic rate?
Na+/K+ ATPase
Which adrenergic receptor can hyperthyroidism upregulate in order to increase sympathetic nervous system activity?
beta-1
What arrhythmia does hyperthyroidism produce in the elderly?
Afib
Would hyperthyroidism increase or decrease the risk of osteoporosis?
increase
Would hyperthyroidism produce hypocholesterolemia or hypercholesterolism?
hypocholesterolemia
Would hyperthyroidism produce hypoglycemia or hyperglycemia? Why?
hyperglycemia
thyroid hormone causes GNG and glycogenolysis
Which immunoglobulin produces the effects seen in Graves?
IgG
Which receptor do fibroblasts behind the eye express?
TSH receptor
What material is deposited behind the eye during Graves?
glycosaminoglycans
Name three physical manifestations of thyroid storm?
Arrhythmia
vomiting
hyperthermia
What haplotype is associated with Hashimoto Thyroiditis/
HLA-DR5
What two autoantibodies are present during Hashimotos?
anti-thyroglobulin
anti-thyroid peroxidase
What specific cells are found during Hashimoto Thyroiditis? Color?
Hurthle cells
Eosinophilic
What structure is formed during Hashimotos?
germinal cents
What color are Hurthle cells?
eosinophilic
What type of neoplasm is present during Hashimotos?
B-cell Marginal zone lymphoma
How would a B-cell lymphoma present during Hashimotos?
enlarging thyroid gland during course of disease
What type of inflammation is present during De Quervain Thyroiditis?
Granulomatis
What type of infection does De Quervain Thyroiditis follow?
viral
How does De Quervain Thyroiditis present?
transient hyperthyroidism
Does Riedel Fibrosing Thyroiditis present as hypo or hyper thyroidism?
Hypothyroidism
What disease can Riedel Fibrosing Thyroiditis mimmic?
anaplastic carcinoma
Are thyroid nodules more likely to be benign or malignant?
Benign
What specific technique is used to biopsy a thyroid nodule?
fine needle aspiration
A fibrous capsule surrounds what two thyroid neoplasms?
follicular adenoma
follicular carcinoma
What is the most common type of thyroid carcinoma?
Papillary carcinoma
Radiation in childhood is a risk factor for which thyroid neoplasm?
Papillary carcinoma
Histologically, how is follicular carcinoma differentiated from follicular adenoma?
follicular carcinoma penetrates through fibrous membrane
Which thyroid neoplasm spreads via the blood?
follicular
What cell overproliferates during medullary carcinoma? Hormone released?
PARAFOLLICULAR C-cells
calcitonin
What is the mechanism by which calcitonin lowers blood calcium?
increases renal secretion
What is the histological description of medullary carcinoma of thyroid?
malignant cells in amyloid stroma
What protein forms the amyloid during medullary carcinoma of thyroid?
calcitonin
What three cancers arise during MEN2A?
medillary carcinoma of thyroid
parathyroid adenoma
pheochromocytoma
What does detection of RET gene require?
prophylactic thyroidectomy
Is anaplastic carcinoma malignant or benign?
malignant
What population does anaplastic carcinoma most effect?
elderly
What do osteoclasts release?
calcium and phosphate
What does PTH promote in the kidney?
reabsorption of calcium and phosphate
What is the cause of Primary Hyperthyroidism?
excess release of PTH
What is Osteitis Fibrosa Cystica? Due to?
excessive reabsorption of bone leading to fibrosis and cystic spaces
excessive PTH
What marker would be seen in the urine during times of excessive PTH?
cAMP
What is the cause of Secondary Hyperparathyroidism?
renal failure leading to decreased phosphate excretion
What is the cause of Pseudohyperparathyroidism?
end organ resistance to PTH
What would two things be noticed on physical examination during pseudoparathyroidism? Inheritance?
short 4th and 5th digits and short stature
autosomal dominant
Which two haplotypes are associated with Type 1 DM?
DR3 and DR4
What cause Type 2 DM?
decreased insulin receptors
What three cell types does glucose freely enter without facilitated diffusion?
Schwann cells
retinal pericytes
lens
What rxn is catalyzed by aldose reductase?
glucose into sorbitol
Which four neoplasms are associated with MEN1?
pituitary adenoma
parathyroid
pancreatic
Would hyperaldosteronisim present with hypertension or hypotension?
hyper
Would hyperaldosteronisim present with hypokalemia or hyperkalemia?
hypokalemia
What acid-base abnormality would Hyperaldosteronism present with?
metabolic alkalosis
What is another name for an Adrenal Adenoma?
Conn syndrome
Would Conn Syndrome result in increased or decreased levels of plasma renin?
decreased
What two drugs are used to treat Conn Syndrome?
spironolactone or eplerenone
What causes Secondary Hyperaldosteronsim?
anything that activates RAAS
What would the levels of renin be in Secondary Aldosteronism?
High
What renal syndrome mimmics Hyperaldosteronism? Class of drugs used to treat?
Liddle Syndrome
Potassium Sparing Diuretics
In what three ways does Liddle Syndrome present?
HTN
hypokalemia
metabolic alkalosis
What class of drugs is used to treat Liddle Syndrome?
potassium sparing diuretics
What causes Liddle Syndrome?
decrease in degradation of sodium channels in collecting tubules
Why does Cushing Syndrome produce muscle weakness?
excess cortisol breaks down muscle to produce amino acids
Is insulin high or low during Cushings?
high
What does high insulin in Cushings promote?
central adiposity
Why does Cushings present with HTN?
cortisol sensitizes vessels to catecholamines
Would Cushings present with hyperkalemia or hypokalemia? Why?
hypokalemia
cortisol adtivates MR
What acid/base abnormality would Cushings present with?
metabolic alkalosis
Why does Cushings present with abdominal striae?
excess cortisol impairs collagen synthesis
Does high dose dexamethosone suppress pituitary adenoma?
yes
Does high dose dexamethosone suppress ectopic production?
no
What causes congenital adrenal hyperplasia?
defects in cortisol production
How would 21-Hydroxylase deficiency present in terms of sodium?
hyponatremia
How would 21-Hydroxylase deficiency present in terms of potassium?
hyperkalemia
How would 21-Hydroxylase deficiency present in terms of blood pressure?
severe hypotension
How would 21-Hydroxylase deficiency differ from 11-Hydroxylase deficiency?
11-Hydroxylase deficiency would present with HTN
Which molecule is used to screen for all forms of CAH?
17-hydroxyprogesterone
Which cancer metastisizes to the adrenal?
lungs
Would Addisons disease present with Hypotension or Hypertension?
hypotension
Would Addisons disease present with Hyponatremia or Hypernatremia?
hyponatremia
Would Addisons disease present with Hypokalemia or Hyperkalemia?
hyperkalemia
Would Addisons disease present with acidosis or alkalosis?
acidosis
Where are chromaffin cells derived from?
neural crest
What is the organ of Zuckerkandl?
chromaffin organ located at bifurcation or aorta
Is a pituitary adenoma a tumor or the anterior or posterior pituitary?
anterior
What hormone mediates the growth of tissues during acromegaly?
IGF-1
In what two classic locations does myxedema produce enlargement?
deeping of voice and tongue
What drug can cause hypothyroidism?
lithium
How does De Quervain Thyroiditis present?
transient hypothyroidism
Is the thyroid tender is De Quervain Thyroiditis?
yes
Is the thyroid tender during Riedel Fibrosing Thyroiditis?
no
Does Riedels or De Quervains invade local structures?
Riedels
Does Anaplastic Carcinoma effect an old or young person?
old
Orphan Eye Nuclei are present during which thyroid neoplasm?
Papillary carcinoma
Psamomma bodies are present during which thyroid neoplasm?
papillary
Which thyroid neoplasm spreads to cervical lymph nodes?
Papillary
Which four carcinomas spread hematogenously?
renal cell
follicular thyroid
HCC
choriocarcinoma
MEN2B also features what neoplasm?
ganglioneuromas of oral mucosa
Does anaplastic carcinoma invade local structures?
yes
Where in the gland do β-cells lie?
center
Which HLA molecules are associated with Type 1 DM?
HLA-DR4 and HLA-DR4
What happens to the islets during Type 1 DM?
inflammation
What type of hypersensitivity reaction is present during Type 1 DM?
Type 4
What do β-cells become filled with during Type 1 DM?
amyloid
What hormone drives the adrenals to undergo hyperlasia?
ACTH
Is Waterhouse-Friderichsen acute or chronic?
acute
Is Addison acute or chronic?
chronic
Why would Addisons disease produce hyperpigmentation?
POMC is cleaved to ACTH and melanocyte stimulating hormone
What color is a pheochromocytoma?
Brown
Where is the most common location of a pheochromocytoma outside of the adrenal gland?
bladder wall
What is the treatment for central diabetes insipidus?
Desmopressin
What are two locations of TSH receptors implicated in Graves Disease?
orbital
shin
Is Riedel Fibrosing Thyroiditis hard or soft?
hard
What are two physical features of cretinism?
enlarged tongue and umbilical hernia
What are Hurthle Cells?
metaplastic cells that line thyroid follicle
What is nephrocalcinosis?
metastatic calcification of renal tubules
Why does high phosphate cause elevated PTH?
free phosphate binds free calcium
What stress hormone stimulates glucagon release?
epinephrine
Which adrenergic receptor does aldosterone upregulate?
alpha-1
By what three mechanisms do glucocorticoids suppress the immune system?
inhibit PLA2
inhibit IL2
INHIBIT HISTAMINE RELEASE
Why would Waterhouse-Friedrichsen Syndrome produce hyperpigmentation?
excess ACTH stimulates melanocytes
What happens to visceral organs during Acromegaly?
grow
By what mechanism does GH produce hyperglycemia?
GH induces gluconeogenesis
Which chemotherapy drug can cause SIADH?
cyclophosphamide
Which ion can thyroid hormone increase?
calcium
Which two specific GAGs increase in the eye durnig hyperthyroidism?
hyaluronic acid
chondroitin sulfate
What causes Thyroid Storm?
increased circulating catecholamines
Would Primary Hyperparathyroidism have an increase or decrease in ALP?
increase
Which two tissues express GLUT4?
skeletal muscle and adipose tissue
What drug can be used to treat Familial Hyperaldosteronism?
Dexamethasone
What causes Liddle Syndrome?
decreased degradation of sodium channels in collecting tubules
What are two common locations of a pheochromocytoma outside of the adrenal gland?
bladder wall
organ of zuckerkandl
Name for diseases that can produce a pheochromocytoma?
MEN 2A and 2B
VHL
NF1
What is the most common cause of death in acromegaly?
cardiac failure
Is Scalloping of the thyroid due to hypothyroidism or hyperthyroidism? Which specific cause?
hyper
Graves
What is the most common enzyme responsible for congenital cretinism?
Thyroid Peroxidase
Would Hashimoto’s transiently present with a hyperthyroidism or hypothyroidism?
hyper
What is the prognosis of Papillary Carcinoma?
excellent
What two complaints could an individual with Anaplastic Carcinoma of the Thyroid present with?
Dysphagia
respiratory compromise
Which has a stronger genetic predisposition, T1DM or T2DM?
T2DM
What color is the adrenal medulla?
brown
