Endocrine

Question 1

Source of cortisol?

Answer 1

Adrenal zone fasiculata

Question 2

Functions of cortisol

Answer 2

BIG FIB

increase BP
Increase insulin resistance 
Increase in gluconeogenesis
Decrease fibroblast activity
Decrease inflammatory and immune response
Decrease bone formation

Question 3

Name the 3 cortex layers of adrenal gland and primary and secretory controls

Answer 3

Glomerulosa– renin angiotensin– aldosterone
Fasiculata– ACTH, CRH– cortisol sex hormones
Reticularis– ACTH, CRH– sex
“ salt sugar sec, the deeper the sweeter”

Question 4

Most common tumor of adrenals? Symptom?

Answer 4

Pheochromocytoma, episodic hypertension

Question 5

Most common tumor in adrenal medulla in children?

Answer 5

Neuroblastoma

Question 6

Posterior pituitary secretes?

Answer 6

Oxytocin, vasopressin ( adh)

Question 7

Anterior pituitary secretes? Derived from?

Answer 7

FSH, LH, ACTH, TSH, prolactin, GH. Rathkes pouch

Question 8

Islets of langehan. Define what makes up alpha, beta, gamma cells

Answer 8

Alpha- glucagon
Beta- insulin
Gamma- somatostatin

Question 9

Descibe insulin synthesis

Answer 9

Preproinsulin– cleavage of pre signal– pro insulin– cleavage of pro insulin– exocytosis of insulin and c peptide

Question 10

Anabolic effects of insulin

Answer 10

Increase glucose transport in skeletal and adipose
Increase glycogen synthesis and storage
Increase TG synth
Increase Na retention
Increase protein syn
Increase cell uptake 
Decrease glucagon release

Question 11

Describe insulin dependent and independent glucose transporters

Answer 11

Dependent:
Glut 4

Independent:
BRICKL
Brain, rbc, intestine, cornea, kidney, liver

Question 12

respiratory alkalosis

Answer 12

Reduction in arterial Pco2 and increase in pH bc of hyperventilation. Hypoxia, high altitude, anemia, cns disorder, septicemia via gram negatives, pulmonary embolism.

Tx: breathe in bag

Question 13

HYPOthyroidism: cold/heat intolerance? Weight? Activity? Feces? Reflexes? Describe skin/hair?cardiac?

Answer 13

COLD intolerance (decreased heat production). Weight gain with loss of appetite, HYPOactivity lethargy fatigue. Constipation. DECREASE reflexes. Dry cool skin with coarse brittle hair. bradycardia with dyspnea on exertion.

Question 14

HYPERThyroidism: cold/heat intolerance? Weight? Activity? Feces? Reflexes? Describe skin/hair?cardiac?

Answer 14

Heat intolerance (INCREASE heat production). Weight loss with increase appetite. HYPERactivity. Diarrhea. Increase reflexes. Warm moist skin and fine hair. Chest pain, palpitations arrythmias. 
LAB: decrease TSH. Increased T3 T4. Hypercholesterolemia due to increased LDL receptor.

Question 15

Describe hasimotos thyroiditis

Answer 15

Common cause of HYPOthyroidism with iodine deficiencies. Increase risk of NHL.

Question 16

Describe congenital HYPOthyroidism (cretinism)

Answer 16

Severe fetal HYPOthyroidism due to mother hypothyroidism. Remember 6 P’s. Pot-belly, PAle, Puffy faced child, protruding umbilicus , poor brain developement, protuberant tongue.

Question 17

Purpose of iodine?

Answer 17

iodine containing hormones that control body’s metabolic state

Question 18

Name the 4 B’s of T3

Answer 18

Brain maturation
Bone growth
BETA adrenergic effects
Basal metabolic rate INCREASE

Question 19

describe regulation of thyroid hormone

Answer 19

TRH(H-thal)–> stimulates TSH (pituitary)–> stimulates follicular cells. Negative feedback by T3/T4 to anterior pituitary DECREASE sensitivity to TRH.

Question 20

Describe Graves Dz.

Answer 20

HYPERthyroidism. IgG stimulate TSH receptors on the thyroid (diffuse goiter), exopthalmos: proptosis, extraocular muscle swelling, and dermal fibroblasts (pretibial edema).