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Kaplan Step 1 > Endocrine > Flashcards

Endocrine Flashcards

1
Q

Wolff-Chaikoff effect

A

Thyroid gland downregulation in response to increased iodide

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2
Q

Iodine uptake into thyroid

A

Secondary active transport as a co-transport with Na+

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3
Q

Benefit of potassium iodide (KI) supplement when radioactive exposure

A

Thyroid will preferentially take up the supplemental iodide instead of the radioactive iodide. Additionally, it will down-regulate the thyroid gland (Wolff-Chaikoff Effect)

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4
Q

Transsphenoidal surgical resection due to a pituitary adenoma affects what hormone production?

A

Those from AP: FSH, LH, ACTH, TSH, PRL, GH

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5
Q

Decrease in FSH and LH from AP will present in what way in women?

A

Amenorrhea

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6
Q

Treatment for osteoporosis and function

A

Bisphosphonates (end in -ronate or ronic acid); inhibit osteoclast activity

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7
Q

Prednisone’s effects on bones

A

Can induce osteoperosis or osteopenia due to osteoblast suppression

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8
Q

Fatigue, acne and hirsutism is indicative of increased/decreased levels of what

A

increased levels of sex hormones (androgens)

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9
Q

Partial glucocorticoid resistance causes (increase/decrease) in ACTH and cortisol production

A

Increase

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10
Q

Medullary thyroid carcinoma is derived from what cells? And what does it secrete?

A

Parafollicular C Cells; calcitonin

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11
Q

Parafollicular C cells of the thyroid gland are derived from what embryonically?

A

Neural crest cells

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12
Q

What physical symptoms do patients with medullary thyroid carcinoma present with?

A

Watery diarrhea and flushing (and symptoms of compression such as dysphagia and hoarseness)

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13
Q

Thyroid cancers show hot/cold nodules in imaging. What does that mean?

A

Cold; do not uptake iodine

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14
Q

Hurthle cells are what kind of cells? What disease are they seen in?

A

Follicular cells with eosinophilic cytoplasm; Hashimoto’s hypothyroiditis

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15
Q

Papillary thyroid carcinomas are derived from what cells?

A

Follicular epithelial cells

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16
Q

Follicular thyroid carcinomas are derived from what cells?

A

Follicular epithelial cells

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17
Q

How are calcium levels affected in medullary thyroid carcinoma?

A

Results in calcitonin secretion which can mildly bring down calcium levels, but no truly affected because of functioning PTH

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18
Q

Catecholamines are released from what extra-ganglionic structure? And in response to what hormone?

A

Chrmoffin cells of adrenal medulla; preganglionic sympathetic neurons release Ach

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19
Q

When someone presents with a pheochromocytoma, when MEN is that associated with? Pathology of what other organ should be considered?

A

MEN 2a and 2b;

Medullary thyroid carcinome

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20
Q

Why thyroid carcinoma presents with amyloid? What causes it?

A

Medullary thyroid cancer due to precipitated calcitonin

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21
Q

Apple-green birefringence is associated with what stain? And what does it reveal?

A

Congo Red; amyloid

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22
Q

Increase shoe size, large tongue, axillary skin tags in an adult are associated with (increase/decrease) of what hormone? What is the name of this condition?

A

Increase in growth hormone

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23
Q

What inhibits growth hormone?

A

Somatostatin

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24
Q

What is the analogue of somatostatin?

A

Octreotide

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25
Q

What diabetes medication are most patients started on? How does it work?

A

Metformin; downregulates gluconeogenesis in the liver.

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26
Q

Dysfunction of what organ serves as a contraindication for prescribing metformin?

A

Renal dysfunction

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27
Q

Sulfanylureas are contraindicated for patients with what organ dysfunction?

A

Liver

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28
Q

Angiofibromas and lipomas are associated with what MEN disorder? This MEN can affect which organs?

A

MEN I; Pituitary, Parathyroid, Pancreas

29
Q

Increase PTH, increased Prolactin and involvement of pancreas are concerning for what condition?

A

Parathyroid, Pituitary, Pancreas- concerning for MEN1.

30
Q

Prolactin can inhibit what hormones from the pituitary?

A

GnRH and FSH (this is also done during pregnancy)

31
Q

The 3 levels involved in diabetic ketoacidosis are ______

A

Hyperglycemia, Increased ketones, acidity

32
Q

What is Kussmaul breathing and where is it seen?

A

Deep, labored breathing seen in diabetic ketoacidosis. It is a way to expel more CO2 (and decrease serum H+ concentration)

33
Q

In an androgen receptor defect, what are the levels of LH and testosterone?

A

Normally, they would turn of LH, but a defective receptor interrupts feedback and maintains high levels of LH and testosterone

34
Q

micro vs macro pituitary adenoma

A

Micro tends to cause secretions whereas macro is non-functional. Macro also compresses the pituitary stalk

35
Q

What thyroid disease presents with firm, hard, painless goiter? What does it look like on histology?

A

Reidel’s Thyroiditis; fibrosis and inflammation of the thyroid gland

36
Q

Nephrogenic DI vs Central DI

A

Central DI: unable to secrete ADH and Nephrogenic DI: ADH unable to act in its receptor

37
Q

Desmopressin administration in Central DI vs Nephrogenic DI

A

Central DI lacks ADH so administering it would resorb more water and increase urine osmolality. No change in nephrogenic because it cannot act on receptor

38
Q

Genotype DR od Diabetes TI

A

DR3 and DR4

39
Q

Layers of adrenal cortex and secretions

A

Glomerulosa: aldosterone Fasciculata: cortisol and reticularis: andorgens; medulla secretes catecholamines

40
Q

Function of aldosterone

A

Na resorption, K+ secretion, H+ secretion

41
Q

What is happening when there is increased thyroid production during early stages of pregnancy? What is it called?

A

The TSH-r is being activated by hCG because it looks similar to TSH. Familial gestations hyperthyroidism.

42
Q

Presence of high insulin with undetectable C-peptide

A

Factitious hypoglycemia; psychological disordere from surreptitious self-injections of insulin

43
Q

How does subacute granulomatous thyroiditis present? What is seen on labs?

A

Very tender, enlarged thyroid gland preceded by viral illness. Self-resolving. aka de Quervain; transient hyperthyroidism and inc ESR

44
Q

What side effects should be considered in methimazole?

A

Agranulocytosis

45
Q

If a patient with hyperthyroidism takes ______ and later presents with low-grade fever and sore throat, what should be considered?

A

Methimazole; agranulocytosis

46
Q

Plasma fractionated metanephrine can be used to diagnose ______

A

pheochromocytoma (neuroendocrine tumor of adrenal medulla secreting catecholamines)

47
Q

Headachesm palpitations, hypertension and anxiety may be caused by a tumor secreting ______

A

catecholamines (pheochromocytoma)

48
Q

Pheochromocytoma is seen in what MEN conditions?

A

MEN 2a and 2b

49
Q

Hashimoto’s Thyroiditis carries an increased risk for what cancer?

A

Non-Hodgkin B cell lymphoma

50
Q

On histology, Hashimoto’s thyroiditis shows what?

A

Lymphocytic infiltrate with germinal centers; Hurthle cells (eosinophilic cytoplasm)

51
Q

What enzyme deficiency prevents cortisol and androgen synthesis?

A

17 alpha hydroxylase

52
Q

What enzyme deficiency prevents cortisol and aldosterone synthesis?

A

21 beta hydroxylase

53
Q

How does GH secretion affect glucose and insulin levels?

A

Increased GH causes more insulin resistance and glucose intolerance. This increases blood glucose levels and produces a compensatory increase in insulin levels

54
Q

Glucose tolerance test in relation to acromegaly

A

Acromegaly is caused by increased GH secretion. Normally, administering oral glucose will decrease the production of GH; however in when patients have acromegaly, GH levels do not drop

55
Q

Acute vs chronic hypomagnesium and effects on PTH

A

Acute hypoMg increases PTH secretion, but chronic hypoMg decreases PTH secretion

56
Q

Trousseau’s sign is ______ and indicates ______

A

Twitching of the hands when a blood pressure cuff is put on the patient and pressure goes above systolic. Hypocalcemia

57
Q

Alcoholism and magnesium

A

Chronic alcoholism leads to hypomagnesemia

58
Q

Cancer of what organ can commonly cause metastases to adrenals?

A

Lung

59
Q

Conn Syndrome

A

Adrenal tumor causes primary hyperaldosteronism

60
Q

What hormone will not be affected by hypopituitarism? Why?

A

Aldosterone; regulated primarily by RAAS

61
Q

Prolactinoma has what effect on other hormones? Presents how?

A

Suppresses normal GnRH; amenorrhea, galactorrhea, infertility in women and loss of libido in med

62
Q

Amorphous proteinaceous material in thyroid is suggestive of what carcinoma? And what is it?

A

Medullary thyroid; amyloid from calcitonin

63
Q

Iodine deficiency is can cause (primary/secondary) hypothyroidism

A

Primary (need iodine to make T3 and T4)

64
Q

How can chronic kidney disease lead to bone pain and fractures (osteopenia)

A

CKD means decreased phosphate excretion resulting in hyperphosphatemia. This can bind and deplete Ca++. The ability to make calcitriol is also damaged in CKD further adding to decrease in calcium.

65
Q

Long standing effects of secondary hyperparathyroidism

A

Osteitis fibrosa cystics - increased osteoclastic resorption of calcified bone to try to normalize calcium in plasma

66
Q

Increasing sensitivity of calcium-sensing receptor has what consequence

A

Decreased PTH secretion. The CaSR works by inhibiting PTH secretion so by increasing its sensitivity, it can become active under low calcium levels and inhibit PTH.

67
Q

Drugs that increase calcium-sensing receptor sensitivity are ______ and function to ______

A

Calcimimetics (cinacalcet); decrease PTH secretion

68
Q

In early stage of diabetes, what can be said about insulin levels and glucose levels?

A

Both are elevated. Insulin resistance results in hyperglycemia and increased serum osmolality

Kaplan Step 1 (8 decks)

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