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Diagnostic Imaging #3 > Endocrine > Flashcards

Endocrine Flashcards

1
Q

Do endocrine glands have ducts

A

No

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2
Q

2 Hormones released from the posterior pituitary

A
  1. oxytocin

2. ADH

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3
Q

what are the 6 hormones released from the anterior pituitary

A
  1. TSH (thyroid stimulating)
  2. ACTH
  3. FSH,LH
  4. GH growth hormone
  5. PRL proctin
  6. Dopamine
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4
Q

Where is the parathyrid gland

A

posterior side of the thyroid

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5
Q

effect of Parathyroid hormone

A

Increases Ca in the blood

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6
Q

ACTH causes what to be released from the adrenal cortex

A

glucocorticoids

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7
Q

what is an example of a positive feedback loop

A

Oxycontin and child birth

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8
Q

what ways do hormones circulate

A
  1. free

2. bound to plasma proteins

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9
Q

effect of binding to plasma

A

increased 1/2 life

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10
Q

benefit of having hormones bond to plasma

A

they can serve as a resivore

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11
Q

which hormone is bound to a protein T3 or T4

A

T4

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12
Q

what hormone correlates best with clinical findings (free or bound)

A

free

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13
Q

The secretion of most hormones have what nature

A

pulsatile

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14
Q

Circhoal

A

released every hour

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15
Q

Ultradian

A

-released
> 1 hr
<24 hours

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16
Q

circadian

A

released every 24 hours

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17
Q

Diurnal

A

episodic activity is expressed at defined periods of the day

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18
Q

involves the organ(s) that produce the hormone

what order disease

A

Primary Disease

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19
Q

related to the pituitary which produces trophic hormones

what order disease

A

Secondary Disease

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20
Q

hypothalamic problems what order disease

A

hypothalamic problems

Tertiary Disease

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21
Q
  1. Hashimoto’s thyroiditis
  2. Addison’s disease
  3. Type 1 DM
    are all examples or what order diseases
A

Primary Deficiency Disorder

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22
Q

feeling cold all the time could be what kind of issue

A

hypothyroid

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23
Q

Secondary hypothyroidism
Secondary adrenal insufficiency
(where is the issue)

A

pituitary

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24
Q

Tertiary hypothyroidism

where is the issue

A

issue is in the hypothalamus

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25
Q

Hyperthyroid is also called

A

Graves disease

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26
Q

The primary focus of endocrine testing is

A

hormone measurement

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27
Q

(blank) test to assess hypofunctioning

A

stimulation

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28
Q

(blank) test to assess hyperfunctioning

A

suppression

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29
Q

4 sources for endocrine testing

A
  1. Blood
  2. Urine
  3. Imagine
  4. Tissue
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30
Q

what is more common blood from an artery or vein

A

Vein

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31
Q

where does the blood for an ABG come from

A

artery

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32
Q

capillary puncture gives you what

A

glucose

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33
Q

what gets glocose into the cell

A

Insulin

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34
Q

what organ is the most sensitive to a change in glucose

A

brain

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35
Q

Insulin is made by what organ

A

pancreas

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36
Q

insulin has what effect on blood glucose

A

lowers

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37
Q

what is the opposite of insulin

A

glucagon

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38
Q

Fatty acids packaged for future use

A

Triglycerides (TG)

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39
Q

Source of fuel that is the product of protein breakdown

A

Amino Acids (AA)

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40
Q

Breakdown of glucose to make energy (ATP) for the cell

A

Glycolysis

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41
Q

Generation of glucose from non-carbohydrate substances (such as glycerol from pyruvate, lipids, amino acids, and lactic acid).

A

Gluconeogenesis

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42
Q

Long term storage molecule of glucose which is stored and synthesized mainly in the liver and muscles

A

glycogen

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43
Q

where is glycogen stored (2)

A
  1. Liver

2. Muscle

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44
Q

Formation of glycogen from glucose

A

Glycogenesis

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45
Q

Glycogenolysis

A

Breakdown of glycogen into glucose for use as fuel

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46
Q

Breakdown of triglycerides to fatty acids and further degradation which leads to production of ketones and energy

A

Lypolysis

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47
Q

Islets of Langerhans make up what percent of the pancreas

A

2%

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48
Q

98% of the pancreas is what

A

digestive enzymes (exocrine glands)

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49
Q

Insulin secreted by what cells

A

beta cells

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50
Q

RBCs absorb glucose without insulin,

A
  1. Brain
  2. Liver
  3. Kidney
  4. RBCs
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51
Q

glucagon secreted by what cells

A

alpha

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52
Q

released in response to rising amino acid levels in blood

A

Glucagon

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53
Q

The body wants to keeo blood glucose at what level

A

90-100 (mg/DL)

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54
Q

glucose > 100 mg, Dl

A

HYPERGLYCEMIA

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55
Q

gluclose 70-100 Mg/Dl

A

NORMOGLYCEMIA (Euglycemia)

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56
Q

LOW Blood Glucose (< 70 mg/dL)

A

HYPOGLYCEMIA

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57
Q

Immune system sees its own cells as foreign and attacks and destroys β-cells of the pancreas

A

DM type I

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58
Q

Cannot use insulin effectively (insulin resistance) so glucose builds up in the blood

A

DM type II

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59
Q

If there is urine in the blood what must blood glucose be

A

180 mg/Dl

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60
Q

bed wetting could be a sign of what condition

A

DM type I

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61
Q

Blood test that represents the amount of glycosylated hemoglobin – the average blood sugar level for the 120 day period before the test

A

Hemoglobin A1c

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62
Q

Hemoglobin A1c works because its involved with what type of cell

A

RBC

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63
Q

How long does A1C look back

A

120 days

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64
Q

Pre-diabetes qualification

A

100 to 126 mg/dl on the FBG test, OR
140-199 mg/dl on the OGTT, OR
Hemoglobin A1c between 5.7 – 6.4%

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65
Q

overweight is what BMI

A

25

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66
Q

In the absence of criteria (risk factors), testing for diabetes should begin at age

A

45 years old

67
Q

If results are normal, testing should be repeated at least at (?) intervals

A

3 year

68
Q

Sweet taste of the urine, distinguished diabetes mellitus from diabetes insipidus (what is this)

A

(frequent urination due to ADH)

69
Q

Cut off for DM A1C

A

6.5% (pre: 5.7-6.4)

70
Q

Fasting plasma glucose for DM

A

> 126 mg/ Dl (pre: 100-126)

71
Q

2 hour plasma glucose for DM

A

> 200 mg/DL (pre: 140-199)

72
Q

random glucose for DM

A

> 200 mg/ DL

73
Q

A positive result (ketonuria) is associated with

A

diabetic ketoacidosis

74
Q

Horseness can be a symptome of what

A

enlarges thyroid

75
Q

what percent of T3 and T4 are bound to a protein

A

> 99%

76
Q

TSH is released by the

A

puititary

77
Q

In the early phases of developing thyroid disease, (what)is the first marker to reflect the disorder

A

TSH

78
Q

Low TSH =

A

hyperfunctioning

79
Q

High TSH =

A

hypofunctioning

80
Q

what does ordering a “TSH with reflex” mean

A

They check the TSH if that is abnormal they will check T4

81
Q

Total T4 or T3 is an (inadequate OR adequate) indicator of thyroid status

A

inadequate

82
Q

What can effect levels of T3 T4 (another hormone)

A

estrogen therapy

83
Q

what is a better indicator T3 or T4

A

T4

84
Q

Acute thyroiditis
Graves’ disease
Thyroid cancer
(these conditions will cause you to look into what)

A

Thyroglobulin (Tg)

85
Q

Monitoring of Tg levels is frequently used to evaluate the effectiveness of treatment for (what)

A

thyroid cancer

86
Q

Thyrotropin Receptor Blocking Antibodies elevated in what condition

A

Hashimoto’s disease

87
Q

TSH Receptor Antibodies elevated in what condition

A

Graves disease

88
Q

Very good modality for evaluating nodule activity

A

Thyroid Nuclear Medicine Scan

89
Q

Hypothyroidism – causes what kind of uptake in the Thyroid Nuclear Medicine Scan

A

decreased uptake

90
Q

Non-specific term for enlargement of the thyroid.

A

Goiter

91
Q

Discrete area that is clearly different from the surrounding thyroid tissue.

A

Nodule

92
Q

Hyperfunctioning (hot) nodules are (unlikely or likely) to be cancerous.

A

unlikely

93
Q

Cold nodule shows up what on the thyroid scan

A

white

94
Q

It tells if a nodule is “solid” or a fluid-filled cyst, but it will not tell if a nodule is benign or malignant. (What is)

A

Thyroid ultrasound

95
Q

It is the most reliable test to differentiate the “cold” nodule that is cancerous from the “cold” nodule that is benign. (what is)

A

FNA (fine needle aspiration)

96
Q

Do not let the term “follicular” mislead you. Follicular cells are (what) until proven other wise

A

malignant

97
Q

~75% will be benign with “high confidence”
~20% will be “indeterminate” (~20-40% of these will be cancer)
~5% will diagnose a malignant lesion

A

75% benign
20% unsure (20-40% malignant)
5% malignant

98
Q

PTH does what to blood calcium

A

increases

99
Q 
Muscle contraction
Exocytosis
Blood clotting
Formation of cardiac action potentials
Enzyme activation
Cell signaling
Bone &amp; tooth structure
(what hormone)
A

calcium

100
Q

PTH has (what effects) on intestinal absorption of Ca+2

A

no directs effect

101
Q

PTH stimulates osteoclast or osteoblast

A

osteoclast

102
Q

does PTH involve the hypothalmus

A

no

103
Q

Secreted by thyroid C cells (parafollicular cells)

A

Calcitonin

104
Q

medullary thyroid cancer marker

A

Calcitonin

105
Q

Hyperparathyroidism
Bone malignancies
Prolonged immobilization
Excess vitamin D and calcium in the diet

A

causes of Hypercalcemia

106
Q

Bones, stones, abdominal groans, psychic moans, with fatigue overtones”

A

Hypercalcemia

107
Q 
PTH
Total Calcium
Phosphate
Vitamin D
(what gland is this testing)
A

patathyroid

108
Q

Only about (?)% of total body phosphate is present in the blood

A

1%

109
Q

The main role of vitamin D is to help regulate blood levels of (3)

A
  1. Calcium
  2. Phosphorous
  3. Magnesium
110
Q

Active vitamin D levels (should or should not) be used to DX Vit-D deficiency

A

Not

111
Q

Sestamibi is used to examine what gland

A

parathyroid

112
Q

what is the primary Glucocorticoid

A

cortisol

113
Q

Cortisol secretion is pulsatile, diurnal and under the control of

A

ACTH

114
Q

long term cortisol production will have what effect on the adrenal

A

atrophy

115
Q

when do you want to perform your blood draw to test for cortisol

A

Blood drawn between 8 a.m. and 9 a.m.*

116
Q

Cortisol

  1. > 10
  2. 3-10
  3. < 3
A
  1. Good
  2. unknown
  3. adrenal insufficiency
117
Q

Ideal for suspected hypercortisolism

A

24 Hour UA

118
Q

what do you do with the morning void for a 24 hr UA

A

disregard

119
Q

Differentiate source of adrenal insufficiency (cortisol deficiency)

A

ACTH Stimulation Test
- 250 mcg cosyntropin administered via IV

  • Measure plasma cortisol levels at 30 and 60 minutes
120
Q

Dexamethasone Suppression Test

A

Confirm abnormal excess production

cortisol

121
Q

How many para thyroid glands do we have

A

2-6 (normal is 4)

122
Q

primary Goal of parathyroid hormone

A

increase blood calcium

123
Q

where is parathyroid hormone released

A

parathyroid gland

124
Q

What does reabsorb mean

A

Body takes it back. for example bone Calcium absorption means the body takes it from the bone into the blood stream

125
Q

Does PTH directly or indirectly effect bone absorption

A

directly

126
Q

Does PTH directly or indirectly effect ca absorption from intestine

A

indirectly (via the effect if Vit- D) this has the largest effect on Ca levels

127
Q

Parathyroid hormones effect on phosphate plasma

A

decrease

128
Q

what is more powerful parathyroid of calcitonin

A

parathyroid

129
Q

4 things to test for with parathyroid

A
  1. PTH
  2. blood calcium
  3. Phosphate
  4. Vit D
130
Q

when testing for Vit D what do you test for

A

Vit D 25

131
Q

Nuclear medicine scan for parathyroid issue uses what chemical

A

sestamibi

132
Q

sestamibi is absorbed by what 4 locations

A
  1. heart
  2. thyroid
  3. salavaery
  4. Para thyroid
133
Q

order of exams when you suspect an issue with the thyroid

A
  1. Blood tests
  2. Nuclear medicine scan
  3. biopsy
134
Q

2 hormones you would use to monitor the effectiveness of thyroid cancer after thyroid removal

A
  1. TG

2. Calcitonin

135
Q

primary cause of hyperparathroidsim

A

hyper functioning ademoma

136
Q

age for hyper functioning adenoma

A

> 40

137
Q

how are most hyper functioning adenoma detected

A

hyper calcemia

138
Q

4 primary reasons for hyper calcemia

A
  1. hyperparathyroid
  2. Bone malignancy
  3. Prolonged immobilization
  4. excessive Vit D supplements
139
Q

3 clinical findings of hyper calcemia

A
  1. hyporeflexive
  2. kidney stones
  3. hypertension
140
Q

primary cause of hypo parathyroidism

A

thyroid ectomy

141
Q

Chvosstek’s sign
trousseus sign
hyperreflexia
are indications of what

A

hypo calcemia

142
Q

with hypocalcemia why do muscles become more exited

A

at the level of the nerve

143
Q

Primary hormone of the glucocorticoid class

A

cortisol

144
Q

cortisol is released in a response to

A

stress

145
Q

what hormone from the pituitary causes cortisol to be released

A

ACTH

146
Q

what hormone cause ACTH to be released

A

CRH from anterior hypothamus

147
Q

fight or flight stimulates what hormone

A

cortisol

148
Q

if you are on a steroid for > 7 days what can happen

A

your body stops producing its own cortisol

adrenal insufficiency

149
Q

5 Lab tests that look into how the cortisol system is doing

A
  1. serum total cortisol
  2. 24 hr UA free cortisol level
  3. Plasma ACTH
  4. ACTH stimulation
  5. dexamethasone suppression
150
Q

what is the initial study if you suspect an issue with the cortisol

A

serum total cortisol levels

151
Q

serum total cortisol levels what do you adjust for

A

albumin

152
Q

what time of day do you draw for serum total cortisol levels

A

8-9 am

153
Q

3 words to describe the release of cortisol

A
  1. pulsitile
  2. diurnal
  3. under control of ACTH
154
Q

what are the 3 ranges for serum total cortisol levels

A

> 10 (no adrenal insufficiency)
3-10 (unsure)
< 3 adrenal insufficiency

155
Q

what do you do with your UA during collection

A

must refriderate

156
Q

what is the 24HR UA test good for

A

hypercortisol ism

157
Q

what is the pattern of ACTH

A

diurnal

158
Q

Plasma ACTH helps distinguish what

A

if the issue is pituitary or adrenal

159
Q

ACTH stimulation tests done if you suspect

A

hypo adrenal

160
Q

describe ACTH stimulation tests

A
  1. inject 250mg/dl syntheric ACTH

2. measure 30-60 min

161
Q

Results of ACTH stimulation

A
  1. if cortisol doubles adrenal is good

2. If cortisol does NOT double: adrenal insufficiency

162
Q

Describe dexamethasne suppression test

A
  1. 1mg dexamethasone at 11pm

2. Draw blood at 8 am

163
Q

Describe dexamethasne suppression test response

A

decrease in cortisol: adrenal is good

no change in cortisol: adrenal is hyper functioning

Diagnostic Imaging #3 (3 decks)

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