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Endocrine Flashcards

1
Q

pituitary adenoma

A
  • benign tumor of anterior pituitary
  • bitemporal hemianopsia
  • hypopituitarism
  • headache
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2
Q

most common pituitary adenoma

A

prolactinoma

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3
Q

prolactinoma

A
  • galactorrhea and amenorrhea

- decreased libido

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4
Q

treatment of prolactinoma

A

dopamine agonists

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5
Q

growth hormone adenoma

A
  • gigantism and acromegaly

- secondary diabetes

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6
Q

IGF-1

A

increased from GH

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7
Q

rare adenomas

A

TSH/LH/FSH

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8
Q

causes of hypo pituitary

A
  • craniopharyngioma
  • pituitary adenoma
  • Sheehan syndrome (during pregnancy - infarction)
  • empty sella
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9
Q

Sheehan syndrome clinical

A

no lactation and loss of pubic hair

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10
Q

diabetes insipidus

A
  • ADH deficiency

- due to hypothalamic or posterior pituitary problem

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11
Q

diabetes insipidus features

A
  • polyuria and polydipsia

- high serum osmolaity

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12
Q

desmopressin

A

ADH analog

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13
Q

causes of SIADH

A
  • small cell carcinoma
  • COPD
  • cyclophosphamide
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14
Q

demeclocycline

A

blocks effect of ADH

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15
Q

effects of hyperthyroid

A
  • increase in BMR (most Na/K ATPase)

- increase in sympathetic system (more B1 receptors)

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16
Q

sugars and fat in hyperthyroid

A
  • hypocholesterolemia and hyperglycemia (gluconeogenesis and glycongenolysis)
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17
Q

Graves disease

A
  • antibody stimulating TSH receptor
  • goiter diffuse
  • exophthalmos and pretibial myxedema (due to TSH receptor)
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18
Q

scalloping of colloid

A

graves disease

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19
Q

treatment of graves

A
  • beta blockers
  • thioamide (block peroxidase)
  • radioactive iodine
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20
Q

multinodular goiter

A

iodine deficiency

  • nontoxic
  • can become toxic goiter
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21
Q

cretinism

A

hypothryod in kids

  • short stature
  • enlarged tongue
  • caused by thyroid agenesis
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22
Q

most common enzyme deficient in thyroid

A

thyroid peroxidase

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23
Q

myxedema

A
  • inhypothyroidism

- in layrnx and tongue

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24
Q

hashimoto thyroiditis

A
  • HLA-DR5
  • can progess as hyperthyroidism (destruction causes leakage)
  • increase in TSH
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25
antithyroglobulin and antimicrosomal antibodies
markers of hashimotos thyroiditis
26
germinal centers
in hashimotos thyroiditis, increase risk for B cell lymphoma
27
subacute thyroiditis
- transient hyperthyroidism progressing to hypothyroidism - does not progress to hypothyroidism - tender thyroid
28
Reidel fibrosis thyroiditis
- hard as wood nontender thyroid - hypothyroid - can invade airways - young female
29
uptake of iodine
- increase in graves and nodular | - decreased in adenoma and carcinoma (should then do FNA)
30
follicular adenoma
- fibrous capsule
31
papillary carcinoma
- most common - ionizing radiation - fingerlike projections - orphan annie eye nuclei with nuclear grooves - psammoma bodies - spreads to lymph nodes
32
follicular carcinoma
- same as adenoma but it invades - can not assess only with FNA - spread hematogenously
33
four carcinomas that spread to blood
RCC, hepatocellular, follicular carcinoma and choriocarcinoma
34
medullary carcinoma
- C cells produce carcinoma - hypocalcemia - localized amyloidosis - malignant cells in amyloid - in MEN 2A and 2B
35
RET mutations
medullary carcinoma
36
anaplastic carcinoma
- elderly - invasion of local structures - highly malignant cells
37
PTH actions
- increase in osteoclasts (through blasts) - increase in absorption of calcium and phosphate - increase in calcium reabsorption and less phosphate reabosorption
38
parathyroid adenoma
- most common - kidney stones - metastatic calcification (kidney tubules) - CNS disturbances - acute pancreatitis (enzyme activator) - osteitis fibrosis cystica
39
lab findings in high PTH
- high PTH and calicuim - low phosphate - increase in cAMP (messenger system) in urine - increase in serum alkaline phosphatase (increased in bone lay down through blasts)
40
most common cause of secondary PTH
``` renal failure (less phosphate excretion) - low calcium leading to increase in PTH ```
41
hypoparathyroidism
- can be caused by digeorge | - low serum calcium and low PTH
42
pseudohypoparathyroidism
- end organ resistance to PTH - hypocalcemia with high PTH - small 4th and 5th digits - problem with Gs protein that senses calcium
43
beta cell location
in center of islets
44
DKA
- comes with stress, increase in epinephrine and glucacon - anion gap metabolic acidosis - hyperkalemia - Kussmaul respirations
45
treatment of DKA
- fluids, insulin and potassium
46
mechanism of insulin resistance
- less receptors, more genetically associated
47
amyloid in diabetes
in type 2
48
complications of diabetes
- NEG in large vessels = atherosclerosis - in small vessels = hyaline arteriolar sclerosis (starts with efferent) - NEG of hemoglobin (long term control)
49
osmotic damage from high blood sugar
- glucose converted to sorbitol leading to osmotic damage (by aldose reductase) - in Schwann cells - pericytes in retina - lens of the eye
50
somatostatinoma
- achlorhydria | - cholelithiasis and steatorrhea (inhibition of CCK)
51
clinical features of cortisol
- raises glucose - moon facies, buffalo hump and trunk - abdominal striae (blocks collagen) - HTN (upregulation of alpha 1 receptors) - immune suppression
52
mechanisms for blocking immune in carticosteroids
- block phosphlipase A2 - blocks IL2 - blocks histamine
53
causes of Cushing
- exogenous - primary adrenal adenoma or hypoerplasia - ACTH secreting adenoma - paraneoplastic ACTH
54
high dose dexamethoasone suppression
cant suppress ACTH release from paraneoplasm
55
effects of hyperaldosterone
- hypernatremia, hypokalemia, and metabolic alkalosis
56
findings in primary aldo
- high aldo and low renin (high blood flow)
57
secondary aldo
- activates RAAS leading to high aldo
58
most common CAH
21 hydroxylase deficiency
59
findings in CAH
- low coritosol, high sex hormones, high ACTH, low mineralocorticoids
60
11 hydroxylase deficiency
- can still produce weak mineralocorticoids
61
17 hydroxylase deficiency
excess mineralocorticoids with no cortisol or sex steroid
62
adrenal insufficiency in kids
waterhouse friderichsen syndrome
63
what caner loves to go to adrenal
lung
64
POMC
start of MSH and ACTH
65
pheochromocytoma
- brown tumor in adrenal medulla - episodic hypertension - increased metanephrines and VMA
66
treat pheo with...
alpha blocker than surgery
67
common location of pheo
bladder wall

Pathoma (11 decks)

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