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Pathoma > Endocrine > Flashcards

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
Q

antithyroglobulin and antimicrosomal antibodies

A

markers of hashimotos thyroiditis

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26
Q

germinal centers

A

in hashimotos thyroiditis, increase risk for B cell lymphoma

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27
Q

subacute thyroiditis

A
  • transient hyperthyroidism progressing to hypothyroidism
  • does not progress to hypothyroidism
  • tender thyroid
28
Q

Reidel fibrosis thyroiditis

A
  • hard as wood nontender thyroid
  • hypothyroid
  • can invade airways
  • young female
29
Q

uptake of iodine

A
  • increase in graves and nodular

- decreased in adenoma and carcinoma (should then do FNA)

30
Q

follicular adenoma

A
  • fibrous capsule
31
Q

papillary carcinoma

A
  • most common
  • ionizing radiation
  • fingerlike projections
  • orphan annie eye nuclei with nuclear grooves
  • psammoma bodies
  • spreads to lymph nodes
32
Q

follicular carcinoma

A
  • same as adenoma but it invades
  • can not assess only with FNA
  • spread hematogenously
33
Q

four carcinomas that spread to blood

A

RCC, hepatocellular, follicular carcinoma and choriocarcinoma

34
Q

medullary carcinoma

A
  • C cells produce carcinoma
  • hypocalcemia
  • localized amyloidosis
  • malignant cells in amyloid
  • in MEN 2A and 2B
35
Q

RET mutations

A

medullary carcinoma

36
Q

anaplastic carcinoma

A
  • elderly
  • invasion of local structures
  • highly malignant cells
37
Q

PTH actions

A
  • increase in osteoclasts (through blasts)
  • increase in absorption of calcium and phosphate
  • increase in calcium reabsorption and less phosphate reabosorption
38
Q

parathyroid adenoma

A
  • most common
  • kidney stones
  • metastatic calcification (kidney tubules)
  • CNS disturbances
  • acute pancreatitis (enzyme activator)
  • osteitis fibrosis cystica
39
Q

lab findings in high PTH

A
  • 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
Q

most common cause of secondary PTH

A 
renal failure (less phosphate excretion)
- low calcium leading to increase in PTH
41
Q

hypoparathyroidism

A
  • can be caused by digeorge

- low serum calcium and low PTH

42
Q

pseudohypoparathyroidism

A
  • end organ resistance to PTH
  • hypocalcemia with high PTH
  • small 4th and 5th digits
  • problem with Gs protein that senses calcium
43
Q

beta cell location

A

in center of islets

44
Q

DKA

A
  • comes with stress, increase in epinephrine and glucacon
  • anion gap metabolic acidosis
  • hyperkalemia
  • Kussmaul respirations
45
Q

treatment of DKA

A
  • fluids, insulin and potassium
46
Q

mechanism of insulin resistance

A
  • less receptors, more genetically associated
47
Q

amyloid in diabetes

A

in type 2

48
Q

complications of diabetes

A
  • NEG in large vessels = atherosclerosis
  • in small vessels = hyaline arteriolar sclerosis (starts with efferent)
  • NEG of hemoglobin (long term control)
49
Q

osmotic damage from high blood sugar

A
  • glucose converted to sorbitol leading to osmotic damage (by aldose reductase)
  • in Schwann cells
  • pericytes in retina
  • lens of the eye
50
Q

somatostatinoma

A
  • achlorhydria

- cholelithiasis and steatorrhea (inhibition of CCK)

51
Q

clinical features of cortisol

A
  • raises glucose
  • moon facies, buffalo hump and trunk
  • abdominal striae (blocks collagen)
  • HTN (upregulation of alpha 1 receptors)
  • immune suppression
52
Q

mechanisms for blocking immune in carticosteroids

A
  • block phosphlipase A2
  • blocks IL2
  • blocks histamine
53
Q

causes of Cushing

A
  • exogenous
  • primary adrenal adenoma or hypoerplasia
  • ACTH secreting adenoma
  • paraneoplastic ACTH
54
Q

high dose dexamethoasone suppression

A

cant suppress ACTH release from paraneoplasm

55
Q

effects of hyperaldosterone

A
  • hypernatremia, hypokalemia, and metabolic alkalosis
56
Q

findings in primary aldo

A
  • high aldo and low renin (high blood flow)
57
Q

secondary aldo

A
  • activates RAAS leading to high aldo
58
Q

most common CAH

A

21 hydroxylase deficiency

59
Q

findings in CAH

A
  • low coritosol, high sex hormones, high ACTH, low mineralocorticoids
60
Q

11 hydroxylase deficiency

A
  • can still produce weak mineralocorticoids
61
Q

17 hydroxylase deficiency

A

excess mineralocorticoids with no cortisol or sex steroid

62
Q

adrenal insufficiency in kids

A

waterhouse friderichsen syndrome

63
Q

what caner loves to go to adrenal

A

lung

64
Q

POMC

A

start of MSH and ACTH

65
Q

pheochromocytoma

A
  • brown tumor in adrenal medulla
  • episodic hypertension
  • increased metanephrines and VMA
66
Q

treat pheo with…

A

alpha blocker than surgery

67
Q

common location of pheo

A

bladder wall

Pathoma (11 decks)

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