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First Aid > Endocrine > Flashcards

Endocrine Flashcards

1
Q

What is the remnant of the thyroglossal duct?

A

Foramen Cecum

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2
Q

How does thyroglossal duct cyst present?

A

anterior midline neck mass that moves

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3
Q

What tracer can be used to identify a thyroglossal duct cyst?

A

technitium-99

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4
Q

What is the most common tumor of adrenal medulla in children?

A

Neuroblastoma

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5
Q

Does a neuroblastoma cause hypertension?

A

rarely

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6
Q

How do the left and right adrenal glands drain?

A

just like gonadal veins

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7
Q

What does neurophysin I carry?

A

Oxytocin

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8
Q

What does neurophysin two carry?

A

ADH

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9
Q

What does the posterior pituitary develop from?

A

Neuroectoderm

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10
Q

What are the two acidophilic anterior pituitary hormones?

A

GH and prolactin

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11
Q

What are the four basophilic anterior pituitary hormones?

A

FSH/LH/ACTH/TSH

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12
Q

What embryological layer is the anterior pituitary derived from? Also known as?

A

ectoderm

Rathke’s Pouch

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13
Q

Which four hormones share similar α subunits?

A

FSH/LH/TSH/βHCG

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14
Q

Where in the α-cells is glucagon stored?

A

peripherally

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15
Q

Where in the β-cells is insulin stored?

A

centrally

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16
Q

Where in the Δ-cells is somatostatin stored?

A

interspersed

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17
Q

What is the function of 11β-HSD?

A

cortisol into cortisone or vice-versa

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18
Q

Which isoform of 11β-HSD is found in aldosterone sensitive tissues?

A

11β-HSD2

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19
Q

What compound is found in licorice? Also known as?

A

Glycyrrhetic acid

enoxolone

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20
Q

What enzyme can glycyrrhetic acid/enoxolone inhibit? What does this lead to?

A

11β-HSD2

syndrome of apparent mineralocorticoid excess

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21
Q

In what ratio are insulin and C-peptide released together?

A

equally

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22
Q

What type of activity do insulin receptors possess?

A

tyrosine kinase

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23
Q

What does insulin do to sodium levels?

A

sodium retention

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24
Q

Does insulin cross the placenta?

A

no

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25
Q

Which GLUT receptor is present on β-cells?

A

GLUT2

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26
Q

In which three tissues are GLUT1 found?

A

RBCs/Brain/Cornea

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27
Q

Which six tissues take-up glucose independent of insulin?

A

Brain/RBCs/Intestine/Cornea/Kidneys/Liver

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28
Q

What does Growth Hormone due to insulin release?

A

increase

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29
Q

What do β2 Agonists do to insulin release?

A

increase

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30
Q

What would a prolactinoma do to bones?

A

Osteoporosis

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31
Q

What does hyperthyroidism do to warfarin levels?

A

increase warfarin levels

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32
Q

What does prolactin do to GnRH levels?

A

inhibit GnRH synthesis

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33
Q

Which hypothalamic hormone increases prolactin levels?

A

TRH

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34
Q

What type of drugs can be used to treat a prolactinoma?

A

dopamine agonists

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35
Q

What does prolactin do to dopamine synthesis?

A

increase

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36
Q

Which cytokine does GH mediate its effects through?

A

IGF1

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37
Q

Does GH increase or decrease insulin resistance?

A

increase insulin resistance

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38
Q

What does glucose do to GH release?

A

decrease

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39
Q

Which nuclei synthesizes ADH?

A

Supra-optic

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40
Q

Which ADH receptor isoform mediates fluid volume?

A

V2

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41
Q

Which ADH receptor isoform mediates blood pressure?

A

V1

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42
Q

What drug inhibits desmolase?

A

Ketoconazole

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43
Q

What can androstenedione be metabolized into? What enzyme?

A

Estrone

Aromatase

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44
Q

How can 21α-Hydroxylase Deficiency be differentiated from 17α-Hydroxylase Deficiency?

A

17α-Hydroxylase Deficiency would present with hypertension

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45
Q

Would 17α-Hydroxylase Deficiency present with low or high renin?

A

low

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46
Q

What hormone causes the hyperplasia during CAH?

A

ACTH

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47
Q

Which adrenergic receptor does cortisol increase the synthesis of?

A

α1

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48
Q

Why does excess cortisol cause abdominal striae?

A

cortisol decreases fibroblast activity

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49
Q

What does cortisol do to circulating neutrophil levels? Why?

A

neutrophilia

decrease adhesion

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50
Q

What does cortisol do to mast cells?

A

blocks histamine release

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51
Q

What does cortisol do to eosinophils?

A

induces apoptosis

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52
Q

Which interleukin does cortisol block?

A

IL2

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53
Q

Why does cortisol cause osteoporosis?

A

blocks osteoblast activity

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54
Q

Which ions does PTH increase the resorption of out of bone?

A

calcium and phosphate

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55
Q

Where in the kidney does PTH promote the reabsorption of calcium?

A

DCT

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56
Q

Where in the kidney does PTH promote the excretion of phosphate?

A

PCT

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57
Q

What cytokine does PTH up-regulate the synthesis of?

A

RANK-L

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58
Q

Does RANK-L bind to osteoblasts or osteoclasts?

A

osteoblasts

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59
Q

What does mildly decreased Magesium do to PTH levels?

A

increase PTH

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60
Q

What does markedly decreased Magesium do to PTH levels?

A

decrease PTH

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61
Q

Does an increase or decrease in pH increase the affinity of albumin for calcium?

A

increase pH = increase affinity

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62
Q

Which 2nd messenger is used by ANP?

A

cGMP

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63
Q

Which 2nd messenger is used by GnRH?

A

IP3

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64
Q

Which 2nd messenger is used by oxytocin?

A

IP3

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65
Q

Which 2nd messenger is used by hCG?

A

cAMP

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66
Q

Which 2nd messenger is used by ADH?

A

cAMP

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67
Q

Which 2nd messenger is used by MSH?

A

cAMP

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68
Q

Which 2nd messenger is used by PTH?

A

cAMP

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69
Q

Which 2nd messenger is used by TRH?

A

IP3

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70
Q

Which 2nd messenger is used by TSH?

A

cAMP

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71
Q

Which 2nd messenger is used by Gastrin?

A

IP3

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72
Q

Which 2nd messenger is used by CRH?

A

cAMP

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73
Q

Which three hormones use RTKs?

A

Prolactin/Cytokines/GH

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74
Q

Which 2nd messenger is used by glucagon?

A

cAMP

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75
Q

Which 2nd messenger is used by GHRH?

A

cAMP

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76
Q

Which 2nd messenger is used by calcitonin?

A

cAMP

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77
Q

Does SHBG bind free estrogen?

A

no

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78
Q

What do decreased levels of SHBG do in women?

A

hirsutism

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79
Q

What do increased levels of SHBG do in men?

A

gynecomastia

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80
Q

Which receptor can thyroid hormone upregulate?

A

β1

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81
Q

Why does excess TSH increase basal metabolic rate?

A

increased expression of Na/K ATPase

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82
Q

What does TSH do to fat levels?

A

increase lipolysis

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83
Q

By which two mechanisms does TSH increase glucose levels?

A

glycogenolysis

gluconeogenesis

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84
Q

When would thyroxine binding globulin levels decrease?

A

hepatic failure

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85
Q

What two situations would thyroxin binding globulin levels increase?

A

pregnancy or OCPs

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86
Q

What enzyme converts T4 into T3 in the periphery?

A

5’-Deiodonase

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87
Q

What is the Wolff-Chaikoff effect?

A

excess iodine interrupts thyroid peroxidase

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88
Q

What enzyme(s) are/is inhibited by propylthiouracil?

A

TPO and 5’-Deiodonase

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89
Q

What enzyme(s) are/is inhibited by methimazole?

A

TPO

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90
Q

‘Taper’ means what drug?

A

Prednisone

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91
Q

What two tumors can secrete ACTH?

A

small cell lung

bronchial carcinoid

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92
Q

What does lack of inhibition by dexamethasone mean?

A

ectopic ACTH production

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93
Q

What is another name for Primary Hyperaldosteronism?

A

Conn Syndrome

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94
Q

Would Conn Syndrome have low or high plasma renin?

A

low

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95
Q

What drug would be used in Conn Syndrome?

A

Spironolactone

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96
Q

What causes Secondary Hyperaldosteronism?

A

Renal perception of low intravascular volumes

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97
Q

Would Secondary Hyperaldosteronism present with high or low plasma renin?

A

high

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98
Q

What is the treatment for Secondary Hyperaldosteronism?

A

spironolactone

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99
Q

What is secondary adrenal insufficiency?

A

decreased response to ACTH

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100
Q

What cells does a neuroblastoma originate from?

A

neural crest

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101
Q

Which does not cross the midline, Wilms or Neuroblastoma?

A

Wilms = not cross midline

Neuroblastoma = can cross

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102
Q

What is an easy mechanism to diagnose Neuroblastoma?

A

homovanillic acid in urine

103
Q

What gene is neuroblastoma associated with?

A

N-myc

104
Q

What is the tumor marker for Bombesin?

A

Neuroblastoma

105
Q

What is homovanillic acid a breakdown product of?

A

Dopamine

106
Q

What cells does a pheochromocytoma originate from?

A

neural crest

107
Q

Which three diseases can result in a pheochromocytoma?

A

VHL

MEN2A

MEN2B

108
Q

What is found in the urine during a pheochromocytoma?

A

VMA

109
Q

What is VMA a breakdown product of?

A

epinephrine and norepinephrine

110
Q

Which is given first during a pheochromocytoma, α-blockers or β-blockers?

A

α-blockers

111
Q

Why does hypothyroidism present with hypercholesterolemia?

A

thyroid hormone upregulates LDL receptor

112
Q

Why does hyperthyroidism present with hypocholesterolemia?

A

increase LDL receptor expression

113
Q

What are the two autoantibodies present during Hashimotos?

A

anti-thyroglobulin

anti-thyroid peroxidase

114
Q

What is the HLA haplotype most often found during Hashimotos Thyroiditis?

A

HLA-DR5

115
Q

Is Hashimotos a tender or nontender thyroid?

A

non-tender

116
Q

What structure is present during Hashimotos Thyroiditis?

A

germinal centers

117
Q

What type of inflammation is present during de Quervain thyroiditis?

A

granulomatous

118
Q

Is de Quervain painful or painless?

A

painful

119
Q

What is the course of thyroid hormone release during DeQuervains?

A

transient hyper

followed by hypo

120
Q

Does Riedel Thyroiditis present with hypothyroidism or hyperthyroidism?

A

hypothyroidism

121
Q

What disease can mimmick Anaplastic Carcinoma?

A

Riedel Thyroiditis

122
Q

Is Riedel Thyroiditis painful or painless?

A

painless

123
Q

Is Riedel Thyroiditis tender or nontender?

A

nontender

124
Q

Which disease, Riedel or de Quervain, may present as hyperthyroidism early in the disease course?

A

de Quervain

125
Q

What is the Jod-Basedow Phenomenon?

A

thyrotoxicosis if a person with an iodine deficiency goiter is made iodine sufficient

126
Q

Would hyperthyroidism have increase or decreased bone turnover?

A

increased

127
Q

What three drugs are used to treat thyroid storm?

A

Propylthiouracil

Propranalol

Prednisolone

128
Q

Which two genes can lead to papillary cacinoma of the thyroid?

A

RET and BRAF

129
Q

Biggest risk factor for Papillary Thyroid Cancer?

A

childhood irradiation

130
Q

Difference between Follicular Carcinoma and Follicular Adenoma?

A

carcinoma invades capsule

131
Q

Which thyroid cancer secretes calcitonin?

A

Medullary

132
Q

What is the buzzword phase for Medullary Carcinoma of Thyroid?

A

malignant cells in amyloid stroma

133
Q

Marker of excess PTH in urine?

A

cAMP

134
Q

Will levels of ALP be increased or decreased during Primary Hyperparathyroidism?

A

increased

135
Q

What causes Osteitis Fibrosis Cystica?

A

Hyperparathyroidism

136
Q

Three buzz words for excess calcium?

A

stones

groans

psychiatric overtones

137
Q

Will levels of ALP be increased or decreased during Secondary Hyperparathyroidism?

A

increased

138
Q

What would happen to vitamin D levels during Secondary Hyperparathyroidism?

A

decreased vitamin D

139
Q

What is Tertiary Hyperthyroidism?

A

autonomous PTH secretion

140
Q

What is the mode of inheritance for Pseudohypoparathyroidism?

A

autosomal dominant

141
Q

What would be observed on physical examination during Pseudohypoparathyroidism?

A

shortened 4th and 5th digits

142
Q

What is the most common hormone secreted from a Pituitary Adenoma? Benign or malignant?

A

Prolactinoma

Benign

143
Q

What two drugs are used to treat a prolactinoma?

A

Bromocriptine

Cabergoline

144
Q

Two most common physical features during Acromegaly?

A

large tongue and deep voice

145
Q

What is the most common cause of death during acromegaly?

A

Cardiac

146
Q

What are the two mechanisms to Dx acromegaly?

A

increased IGF1

high GH after oral glucose

147
Q

What is the growth hormone receptor antagonist?

A

Pegvisomant

148
Q

What are two drugs that can cause Nephrogenic Diabetes Insipidus?

A

Lithium

Demecocycline

149
Q

What three drugs are used to treat nephrogenic diabetes insipidus?

A

HCTZ/Amiloride/Indomethacin

150
Q

Which anti-neoplastic can cause SIADH?

A

cyclophosphamide

151
Q

What is Sheehan Syndrome?

A

ischemic infarction of pituitary after pregnancy

152
Q

How does Sheehan Syndrome often present?

A

failure to lactate

153
Q

In what population is Empty Sella Syndrome most common?

A

obese women

154
Q

Is Hyperosmolar Coma Type 1 or Type 2 Diabetes?

A

Type two

155
Q

What is the most common cause of death in Diabetes?

A

Myocardial Infarction

156
Q

What molecule damages cells during Type 2 DM?

A

Sorbitol

157
Q

What are three main tissues that express Aldose Reductase?

A

lens

Retina

Schwann Cell

158
Q

What is the enzyme that when present can damage tissues during Type 2 DM?

A

Aldose Reductase

159
Q

What is the enzyme that when absent can damage tissues during Type 2 DM?

A

Sorbitol Dehydrogenase

160
Q

Which form of Diabetes has a stronger genetic predisposition?

A

Type 2

161
Q

What is the most common ketone during DKA?

A

β-hydroxybutyrate

162
Q

Would DKA present with hyperkalemia or hypokalemia?

A

Hyperkalemia

163
Q

What fungal infection can devastate T1DM patients?

A

Rhizopus

164
Q

What is Whipples Triad regarding an Insulinoma?

A

Lethargy

Syncope

Diplopia

165
Q

What type of cells give rise to Carcinoid Tumors?

A

Neuroendocrine

166
Q

What vitamin can be depleted by a carcinoid tumor?

A

Niacin

167
Q

Which MEN would Zollinger-Ellison Syndrome present with?

A

MEN1

168
Q

Which three tumors are present during MEN1?

A

pituitary

parathyroid

pancreas

169
Q

What is the mode of inheritance for all MEN Sydromes?

A

Autosomal Dominant

170
Q

What is another name for MEN1?

A

Wermer Syndrome

171
Q

What is another name for MEN2A?

A

Sipple Syndrome

172
Q

What three tumors are present during MEN2A?

A

Medullary Thyroid

parathyroid

pheochromocytoma

173
Q

RET gene is associated with what MEN Syndromes?

A

MEN2A and MEN2B

174
Q

What three tumors are present during MEN2B?

A

oral/intestinal ganglioneuromas

Medullary thyroid

pheochromocytoma

175
Q

What MEN Syndrome is associated with Marfinoid Habitus?

A

MEN2B

176
Q

What are the three rapid acting insulins?

A

Lispro

Aspart

Glulisine

177
Q

What are the two long-acting insulins?

A

Glargine

Detemir

178
Q

What is the toxicity of Metformin?

A

lactic acidosis

179
Q

What type of patients cannot receive metformin?

A

renal failure

180
Q

What are the two first generation sulfonylureas?

A

Tolbutamide

Chlorpropamide

181
Q

What are the toxicities of first generation sulfonylureas?

A

Disulfarim like reaction

hypoglycemia in pt’s with renal failure

182
Q

What are the three second generations sulfonylureas? Main toxicity?

A

Glipizide/Glyburide/Glimeperide

hypogycemia

183
Q

What is the MOA of -litazones?

A

increase PPAR txn to increase insulin receptor density

184
Q

What are the four toxicities of the litazones?

A

edema

weight gain

hepatotoxicity

HF

185
Q

What are the two α-glucosidase Inhibitors?

A

Miglitol

Acarbose

186
Q

What are the two functions of Amylin?

A

decreases gastric emptying

inhibit glucagon release

187
Q

What drug is the Amylin analogue? Main toxicity?

A

Pramlintide

hypoglycemia

188
Q

What are the two MOAs of GLP1?

A

increase insulin

decrease glucagon

189
Q

What are the GLP1 analogues?

A

Liraglutide

Exenatide

190
Q

What are the two MOAs of DPP-4 Inhibitors?

A

increase insulin

decrease glucagon

191
Q

What is the common suffix for DPP-4 Inhibitors?

A

-gliptin

192
Q

What drug is used to treat hyperthyroidism during pregnancy?

A

Propylthiouracil

193
Q

Which anti-thyroid can hepatotoxicity?

A

Propylthiouracil

194
Q

What drug can be used during Turner Syndrome?

A

GH

195
Q

What drug control uterine hemorrhage?

A

Oxytocin

196
Q

What is the MOA of demeclocycline?

A

ADH antagonist

197
Q

Treat Iatrogenic Cushings Osteoporosis with what drug?

A

bisphosphonates

198
Q

Is fludricortisone a more powerful glucocorticoid or mineralocorticoid?

A

mineralocorticoid

199
Q

The Meglitinides have a similar MOA to what diabetic drug?

A

sulfonylureas

200
Q

Which metabolite can build up during metformin therapy causing lactic acidosis? Why?

A

lactate

cant be shunted to GNG

201
Q

What are the two toxicities of DPP4 Inhibitors?

A

urinary and respiratory infections

202
Q

What are the three toxicities of GLP1 analogues?

A

nausea

vomiting

pancreatitis

203
Q

What gene is effected during MDOY?

A

glucokinase

204
Q

What are the four D’s of a Glucoganoma?

A

Dermatitis

Diabetes

DVT

Depression

205
Q

In what cells is Leptin produced?

A

adipocytes

206
Q

What neurotransmitter does Leptin suppress the secretion of?

A

Neuropeptide Y

207
Q

What are the two characteristics of a Lipid Panel of a Diabetic?

A

High triglycerides

low HDL

208
Q

There is an insensitivity to what hormone during Laron Syndrome?

A

GH

209
Q

What is the first line Tx for gestational diabetes? Second?

A

Insulin

Glyburide

210
Q

What three drugs, other than lithium, can cause Nephrogenic Diabetes Insipidus?

A

Conivaptan

Tolvaptan

Demeclycycline

211
Q

What is the most common cause of death in acromegaly?

A

heart failure

212
Q

Familial Hypocalciuric Hypercalcemia features a defective receptor for what?

A

Calcium sensor

213
Q

Which diuretic can block lithium uptake?

A

Amiloride

214
Q

What is the cause of Familial Primary Hypoparathyroidism?

A

constant activating of calcium receptor

215
Q

What is the pathogenesis of Pseudohypoparathyroidism?

A

unresponsiveness of kidney to PTH

216
Q

How do calcimimmetics function? What is the Calcimimmetic?

A

increase responsiveness of Calcium sensor

Cincalacet

217
Q

What two symptoms can calcitonin produce during Medullary Carcinoma of Thyroid?

A

flusing and diarrhea

218
Q

Do neoplastic thyroid cells produce hormone?

A

no

219
Q

What are two causes of low ALP?

A

Hypothyroidism

Pernicious anemia

220
Q

Which two drugs compete with Na/I for uptake?

A

perchlorate

pertechtenate

221
Q

What is the mechanism by why beta-blockers can treat hyperthyroidism?

A

decreases peripheral conversion of T4 to T3

222
Q

Other than thyroid hormone, which two hormones may increase during Thyroid Storm?

A

ALP and Catecholamines

223
Q

What causes the increased ALP during Thyroid Storm?

A

bone turnover

224
Q

What are the Four IgG4 Related Diseases?

A

Riedel Thyroiditis

Autoimmune pancreatitis

Retroperitoneal fibrosis

non-infectious Arthritis

225
Q

What is the name of Hypothyroid Myopathy? What lab will be seen?

A

Hoffman Syndrome

increased creatine kinase

226
Q

Hurthle Cells are associated with what disease?

A

Hashimoto

227
Q

What are Cretinism kids short?

A

thyroid hormone is required for GH release

228
Q

GH works synergistically with what other hormone?

A

TSH

229
Q

Is sodium increased or normal during Conn Syndrome? Why?

A

normal

aldosterone escape = increased ANP

230
Q

What enzyme is inhibited by Tetyrapone?

A

11-beta-Hydroxylase

231
Q

Would Cushings Disease result in adrenal cortical hyperplasia or hypertrophy?

A

hyperplasia

232
Q

Which two types of hormones use Intrinsic Tyrosine Kinase?

A

Insulin and Growth Factors

233
Q

What is the 2nd messenger of Intrinsic Tyrosine Kinase?

A

MAP Kinase

234
Q

Which three hormones use Receptor Associated Tyrosine Kinases?

A

Prolactin

Growth Hormone

Cytokines

235
Q

What is the 2nd messenger of Receptor Associated Tyrosine Kinases?

A

JAK/STAT

236
Q

Which two drugs can deplete magnesium?

A

aminoglycosides and diuretics

237
Q

Which social factor can deplete calcium?

A

alcohol

238
Q

Which precursor does the sun work on in the synthesis of vitamin D?

A

7-dehydrocholesterol

239
Q

Which precursor does the sun work on in the synthesis of vitamin D?

A

7-dehydrocholesterol

240
Q

What two reactions does Anastrozole inhibit?

A

Androstenedione into Estrone

Testosterone into Estradiol

241
Q

Which two hormones function at the level of the principal cells in the kidney?

A

ADH and Aldosterone

242
Q

What ion is not handled effectively during Hypothyroid Myopathy? Which organelle?

A

Calcium

SR

243
Q

Does estrogen increase or decrease prolactin secretion?

A

increase

244
Q

Does estrogen increase or decrease prolactin secretion?

A

increase

245
Q

What is the GHRH Analogue? Used to treat?

A

Tesamorelin

fet redistribution of HIV

246
Q

What is the GHRH Analogue?

A

Tesamorelin

247
Q

Which two hormones does Somatostatin inhibit?

A

GH and TSH

248
Q

Other than somatostatin, which hormone can down-regulate insulin signaling?

A

TNF

249
Q

Which two sugars does SGLT reabsorb?

A

glucose and galactose

250
Q

Which ion does insulin promote the retention of?

A

sodium

251
Q

Where are the two locations of GLUT4?

A

skeletal tissue and adipose

252
Q

What compound in licorice can interfere with water and sodium handling? What enzyme does this interfere with?

A

Glycyrrhetic acid

11-beta-HSD2

253
Q

What compound in licorice can interfere with water and sodium handling?

A

Glycyrrhetic acid

254
Q

Which drug can produce a similar effect to Glycyrrhetic acid ?

A

Enoloxone

First Aid (21 decks)

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