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BOARDS! > Endocrine > Flashcards

Endocrine Flashcards

1
Q

What is the most common type of thyroid ca

A
  • papillary thyroid ca
  • diagnosis via FNA:
    • characteristic cell morphology:
      • large cells with nuclei containing finely dispersed chromatin with a ground-glas appearance (Orphan Annie eye)
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2
Q

What are the FOUR (4) main types of thyroid ca

A
  1. papillay
  2. follicular
  3. medullary
  4. anaplastic
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3
Q

Papillary (1/4) Buzzwords

A
  • major RF: ionizing radiation in childhood
  • Orphan Annie eye
  • psammoma bodies
  • excellent prognosis
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4
Q

Follicular (2/4) Buzzwords

A
  • invasion through the thyroid capsule
  • solitary cold nodule-spread to different lobes and distort thyroid tissue
  • hematogneous mets
    • mets of areas with high blood flow: lungs, liver, bones
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5
Q

Medullary (3/4) Buzzwords

A
  • parafollicular C cells
  • neuroendocrine secretes Calcitonin
      1. INC renal calcium
      1. modify bon resorption
      1. DEC GI absorption
    • inactive at nml physiologic levels
    • high levels: hypocalcemia
    • deposits within tumor as AMYLOID
  • familial: RET oncogene (c10)
    • MEN2A, MEN2B
    • prophylactic thyroidectomy
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6
Q

Anaplastic (4/4) Buzzwords

A
  • undifferentiated, aggressive
  • pleomorphic cells, including irregular giant cells and biphasic spindle cells
  • elderly
  • POOR prognosis
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7
Q

Insuline overall effects

A
  • INC peripheral glucose uptake
  • inhibits lipolysis and ketoacid formation
  • suppresses glucagon release
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8
Q

Insulin target organs (LIVER)

A
  • liver
    • INC glucose uptake
    • INC glycogen synthesis
    • DEC glycogenolysis
    • DEC ketogenesis
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9
Q

Insulin target organs (skeletal muscle)

A

INC glucose uptake

INC protein synthesis

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10
Q

Insulin target organs (adipose tissue)

A
  • INC glucose uptake
  • DEC lipolysis/ketogenesis
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11
Q

Insulin target organs (Pancreas-alpha cells)

A

DEC glucagon synthesis

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12
Q

What are the consequences of inadequate insulin

A
  • HYPERGLYCEMIA
    • polyuria
    • polydipsia
    • lethargy
    • polyphagia or anorexia
  • ketosis/ketoacidosis (liver probs)
  • muscle wasting, weight loss
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13
Q

TPO jobs

A
  1. Iodi-D-e is converted to iodi-N-e (I to I2)
  2. iodination of thyroglobulin tyrosine residue
  3. coupling that forms T3 and T4
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14
Q

what helps ocntrol the balance between gluconeogenesis and glycolysis

A
  • fructose 2,6-bisphosphate
  • via inverse regulation of phosphofructokinase-1 (PFK1) and fructose 1,6-bisphosphate
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15
Q

hereditary orotic aciduria

A
  • rare AR d/o of de novo pyrimidine synthesis
  • CP:
    • physical and mental retardation
    • megaloblastic anemiaelevated urinary orotic acid
  • PP: defect in UMP synthase
  • tx: uridine supplementatio to bypass enzymatic defect and imrpove symptoms as uridine is converted to UMP via nucleoside kinases
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16
Q

what is used to control severe Graves ophthalmopathy

A
  • high-dose glucocorticoids: PRednisone
  • help DEC the severity of inflammation an DEC extra-ocular volume
  • conventional anti-thyroid dx do NOT improve ophthalmopathy
17
Q

What are four important inherited HYPER-lipoproteinemias

A
  1. familial chylomicronemia syndrome (type 1)
  2. familial hypercholesterolemia (type 2a)
  3. familial dysbetalipoproteinemia (type 3)
  4. familial hypertrigyceridemia (type 4)
18
Q

familial chylomicronemia syndrome (type 1)

A
  • AR
  • protein defect:
    • lipopotein lipase
    • ApoC-2
  • elevated lipoproteins: chylomicrons
  • major manifestations:
    • acute pancreatitis
    • lipemia retinalis
    • eruptive xanthomas
19
Q

familial hypercholesterolemia (type 2a)

A
  • protein defect:
    • LDL receptor
    • ApoB-100
  • Elevated lipoprotein: LDL
  • major manifestations:
    • premature atherosclerosis
    • tendom xanthomas
    • xanthelasmas
20
Q

familial dysbetalipoproteinemia (type 3)

A
  • protein defect: ApoE
  • elevated lipoproteins:
    • chylomicron and VLDL remnants
  • major manifestations:
    • premature atherosclerosis
    • tuboeruptive and palmar xanthomas
21
Q

familial hypertrigyceridemia (type 4)

A
  • protein defect: polygenic
  • elevated lipoproteins: VLDL
  • major manifestations:
    • assoc with coronary dz
    • pancreatitis
    • diabetes
22
Q

GlucagonOMA syndrome

A
  • PP: rare tumor arising from alpha-cells of pancreatic islets of Langerhans
  • CP:
    • diabetes mellitus
    • necrolytic migratory erythema
      • painful and pruritic rash
      • affects face, groin, extremities
      • small erythematous papules/plaques form large lesions with ctl clearing of bronze-colored induration
    • anema
  • diagnosis made by detecting elevated serum levels of glucagon

BOARDS! (14 decks)

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