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Endocrine Flashcards

1
Q

What is the adrenal cortex derived from?

A

Mesoderm

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2
Q

What is the adrenal medulla derived from?

A

Neural crest cells

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3
Q

What is the zona glomerulosa regulated by and what does it produce?

A

AT II

Mineralocorticoids (aldosterone)

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4
Q

What is the zona Fasciculata regulated by and what does it produce?

A

ACTH, CRH

Glucocoriticoids (cortisol)

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5
Q

What is the zona Reticularis regulated by and what does it produce?

A

ACTH, CRH

Androgens (DHEA)

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6
Q

What are the cells of the adrenal medulla?

A

Chromaffin cells

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7
Q

What is the adrenal medulla regulated by and what does it produce?

A

Preganglionic SNS

Catecholamines (epi/norepi)

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8
Q

What are the insulin dependent transporters and in what tissues would you find them?

A

GLUT4: adipose tissue, striated muscle

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9
Q

What are the insulin independent transporters and in what tissues would you find them?

A

GLUT1: RBCs, brain, cornea, placenta
GLUT2 (bidirectional): β islet cells, liver, kidney, small intestine
GLUT3: brain, placenta
GLUT5 (fructose): spermatocytes, GI tract

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10
Q

What tonically inhibits prolactin?

A

Dopamine from the hypothalamus

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11
Q

Function of Ghrelin

A 
Stimulates hunger (orexigenic effect) and GH release (via GH secretagog receptor)
Produced by stomach
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12
Q

Function of Leptin

A

Satiety hormone. Produced by adipose tissue.

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13
Q

Function of endocannabinoids

A

Act at cannabinoid receptors in hypothalamus and nucleus accumbens, two key brain areas for the homeostatic and hedonic control of food intake: ↑ appetite

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14
Q

ADH

A

Synthesized in hypothalamus; released by post pit

Regulates serum osmolarity (V2-r)and BP (V1-r)

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15
Q

17 alpha hydroxylase def leads to what?

A

Incr: mineralocorticoids (aldosterone), BP
Decr: cortisol, sex hormones, [K]

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16
Q

21-hydroxylase def leads to what?

A

Incr: sex hormones, [K], renin
Decr: aldosterone, cortisol, BP

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17
Q

Mechanism of Ca homeostasis

A

↑ in pH -> ↑ in affinity of albumin for Ca -> hypocalcemia

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18
Q

Function of vitamin D

A

↑ absorption of dietary Ca2+ and PO43−

Enhances bone mineralization

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19
Q

Function of PTH

A

↑ bone resorption of Ca2+ and PO43−
↑ kidney reabsorption of Ca2+ in DCT
↓ reabsorption of PO43− in PCT
↑ calcitriol production by stimulating kidney 1α hydroxylase in proximal convoluted tubule

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20
Q

Source of PTH

A

Chief cells of parathyroid

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21
Q

Source of calcitonin

A

Parafollicular cells (C cells) of thyroid

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22
Q

Function of calcitonin

A

↓ bone respiration of Ca (tones done serum Ca)

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23
Q

Endocrine hormones that signal via cAMP

A

FSH, LH, ACTH, TSH, CRH, hCG, ADH (V2-receptor), MSH, PTH, calcitonin, GHRH, glucagon, histamine (H2-receptor)
(FLAT ChAMP)

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24
Q

Endocrine hormones that signal via cGMP

A

BNP, ANP, EDRF (NO)

BAD GraMP

25
Q

Endocrine hormones that signal via IP3

A

GnRH, Oxytocin, ADH (V1-receptor), TRH, Histamine (H1-receptor), Angiotensin II, Gastrin
(GOAT HAG)

26
Q

Endocrine hormones that signal via intracellular receptors

A

Progesterone, Estrogen, Testosterone, Cortisol, Aldosterone, T3/T4, Vitamin D

27
Q

Endocrine hormones that signal via Receptor tyrosine kinase

A

(MAP kinase)

Insulin, IGF-1, FGF, PDGF, EGF

28
Q

Endocrine hormones that signal via Nonreceptor tyrosine kinase

A

(Jak/STAT)

Prolactin, Immunomodulators (eg, cytokines IL-2, IL-6, IFN), GH, G-CSF, Erythropoietin, Thrombopoietin

29
Q

Oxidation, organification and coupling in T3/T4 synthesis is carried out by?

A

Thyroid peroxidase

30
Q

Thyroid peroxidase is blocked by?

A

PTU, methimazole

31
Q

What does PTU block?

A

Thyroid peroxidase and 5-deiodinase

32
Q

Etiology of Cushing Syndrome

A

Incr cortisol: exogenous, adrenal ca, ACTH adenoma (called Cushing disease) or paraneoplastic ACTH secretion

33
Q

Cushing presentation

A

Moon facies, HTN, central adiposity, striae, osteoporosis, hyperglycemia, amenorrhea, immunosuppression

34
Q

How do you diagnose Cushing?

A

25 hour cortisol and midnight salivary cortisol

35
Q

High dose dexamethasone test

A

For Cushing
Suppresses cortisol: Cushing disease
No suppression: Ectopic ACTH secretion

36
Q

What is adrenal insufficiency?

A

Inability of adrenal gland to make enough gluco and mineralo corticoids

37
Q

Sx of adrenal insufficiency?

A

weakness, fatigue, orthostatic hypotension, muscle aches, weight loss, GI disturbances, sugar and/ or salt cravings

38
Q

What is the metyrapone stimulation test for?

A

Diagnose adrenal insufficiency
(metyrapone blocks last step of cortisol synthesis)
In 1°: ACTH is elevated, 11-deoxycortisol is low
In 2°/3°: both ACTH and 11-deoxycortisol remain low

39
Q

Cause of primary adrenal insufficiency?

A

De ciency of aldosterone and cortisol production due to loss of gland function

40
Q

Sx of primary adrenal insufficiency?

A

hypotension (hyponatremic volume contraction), hyperkalemia, metabolic acidosis, skin and mucosal hyperpigmentation

41
Q

What is Addison dz?

A

Chronic primary adrenal insufficiency

42
Q

Cause of hyperaldosteronism?

A

Increased secretion of aldosterone from adrenal gland

43
Q

Conn syndrome

A

Primary hyperaldosteronism d/t adrenal adenoma or b/l adrenal hyperplasia

44
Q

What is the most common adrenal medulla tumor in children?

A

Neuroblastoma

45
Q

Presentation of neuroblastoma?

A

Abdominal distension and a firm, irregular mass that can cross the midline; can also present with opsoclonus-myoclonus syndrome
Increased HVA, VMA; homer-wright rosettes, bombesin and NSE positive
APUD tumor

46
Q

What is the most common adrenal medulla tumor in adults?

A

Pheochromocytoma

47
Q

Sx of Pheochromocytoma?

A

secrete epic, norepinephrine and 5-HT: episodic hypertension
(Pressure, Pain (HA), Perspiration, Palpitations (tachyP), Pallor)

48
Q

Presentation of congenital hypothyroid?

A

Pot-bellied, Pale, Puffy-faced child with Protruding umbilicus, Protuberant tongue, and Poor brain development

49
Q

Presentation of Subacute granulomatous thyroiditis (de Quervain)

A

↑ ESR, jaw pain, very tender thyroid

50
Q

Jod-Basedow phenomenon

A

Thyrotoxicosis if a patient with iodine deficiency and partially autonomous thyroid tissue is made iodine replete

51
Q

Nelson syndrome

A

Enlargement of existing ACTH-secreting pituitary adenoma after bilateral adrenalectomy for refractory Cushing disease
Presents with hyperpigmentation, headaches and bitemporal hemianopia

52
Q

MEN 1

A

Pituitary tumors, Pancreatic endocrine tumors, Parathyroid adenomas

53
Q

MEN 2A

A

Parathyroid hyperplasia, Medullary thyroid carcinoma, Pheochromocytoma

54
Q

MEN 2B

A

Medullary thyroid carcinoma Pheochromocytoma

Mucosal neuromas

55
Q

Rx for SIADH?

A 
ADH antagonists (conivaptan, tolvaptan): Block action of ADH at V2-receptor
Demeclocycline: ADH antagonist
56
Q

Fludrocortisone

A

Synthetic analog of aldosterone with little glucocorticoid effects; replace mineralocorticoids in 1° adrenal insuficiency

57
Q

Cinacalcet

A

Sensitizes Ca2+-sensing receptor (CaSR) in parathyroid gland to circulating Ca2+: ↓ PTH

58
Q

SE of antithyroid drugs (thionamides)

A

Agranulocytos
Methimazol: cholestasis
Propylthiouracil: hepatic failure

FA note cards (16 decks)

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