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REGUB ERIN > endocrine > Flashcards

endocrine Flashcards

1
Q

Normal remnant of thyroglossal duct

A

foramen cecum

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2
Q

Where is ectopic thyroid tissue found?

A

base of the tongue

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3
Q

Presentation of thyroglossal duct cyst?

A

anterior midline neck mass that moves with swallowing or protrusion of the tongue

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4
Q

Does insulin closs the placenta? Does glucose?

A

No to insulin, yes to glucose

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5
Q

What effect do alpha 2 receptors have on insulin release?

A

Decrease insulin release

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6
Q

What effect do beta 2 receptors have on insulin release?

A

Increase insulin release

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7
Q

What increases growth hormone secretion?

A

exercise, deep sleep, puberty, hypoglycemia

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8
Q

What decreases GH secretion?

A

glucose, somatostatin, somatomedin

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9
Q

Which cell does IGF-1 stimulate?

A

chondrocytes leading to linear bone growth, increased muscle mass and increased organ size

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10
Q

Which organ release Ghrelin?

A

stomach

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11
Q

In which disorder is is there an increase in Ghrelin production?

A

Prader-Willi

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12
Q

Which tissue produces leptin?

A

adipose tissue

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13
Q

Where do endocannabinoids act?

A

nucleus accumbens hypothalamus

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14
Q

symptoms of low cortisol

A

hypoglycemia, nausae/vomiting

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15
Q

Exogenous corticosteroids may cause reactivation of TB and candidiasis, why?

A

they supress IL-2 production

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16
Q

What effect does pH have on calcium levels?

A

Increased pH ->albumin binds more Ca -> LESS free calcium

Decreased pH -> albumin binds less Ca -> more free calcium

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17
Q

Effect of Phosphate on PTH secretion

A

Increased phosphate -> increase PTH

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18
Q

What effect does PTH have on osteoblasts?

A

-induces them to secrete M-CSF and Rank-L ->activation of osteoclasts

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19
Q

Which enzyme converts T4 to T3?

A

5’deiodinase

20
Q

Which drugs block the enzyme 5’deiodinase?

A

glucocorticoids, Beta-blockers, PTU

21
Q

Wolff-Chaikoff effect

A

excess iodine temporarily turns off thyroid peroxidase -> decreased T3/T4 production

22
Q

why can amiodarone cause hyporthyroidism?

A

amiodarone mimics T4 and results in less conversion of T4 to T3

23
Q

What effect does thyroid hormone have on lipids?

A

breaks down lipids (increased lipolysis) - increases LDL receptors

24
Q

What causes an increase in TBG?

A

pregnancy, OCP use (estrogen increased TBG)

25
Q

What decreases TBG?

A

hepatic failure, steroid use, nephrotic syndrome

26
Q

HCG has the same alpha subunit as what?

A

TSH

27
Q

What is Nelson syndrome?

A

Bilateral adrenalectomy for Cushing Disease removes cortisol feedback and results in enlargement of ACTH - secreting pituitary adenoma

28
Q

Neuroblastomas are associated with which oncogene?

A

N-myc

29
Q

What will be seen on histology of a neuroblastoma

A

homer-wright rosettes

30
Q

What is MIBG?

A

Its a therapy where MIBG is taken up by neuroblastoma cells. It has radioactive iodine and is taken up by tumour cells regardless of where they are. Note that thyroid must be protecte

31
Q

Carcinoid syndrome may cause a deficiency of what ?

A

Niacin which leads to pellagra (due to tryptophan defiency)

32
Q

Tumour markers for carcinoid tumour

A

chromogranin A and synaptophysin

33
Q

What is the whipple triad?

A

low blood glucose, symptoms of hypoglycemia, and resolution of symptoms after normalization of glucose levels (seen with an insulinoma)

34
Q

Presentation of glucagonoma

A

Dermatitis, diabetes, DVT, decling weight, Depression

35
Q

somatostatinoma presentation

A

diabetes/glucose intolerance, steatorrhea, gallstones, achlorhydria

36
Q

What test do you use for zollinger-ellison syndrome?

A

Positive secretin test - secretin normally inhibits gastrin levels but in the case of a tumour it will remain elevated after secretin administered

37
Q

Presentation of VIPoma?

A

secretory diarhhea

38
Q

HLA types seen in hashimotos thyroiditis?

A

HLA-DR3, HLA-DR5

39
Q

Postpartum thyroidits histology

A

lymphocytic infiltrate with occasional germinal center formation

40
Q

which HLA subtypes is graves disease assocaited with?

A

HLA-DR3 and HLA-DR8

41
Q

histology found in graves disease

A

tall, crowded follicular cells with scalloped colloid

42
Q

Thyroid storm presentation

A

agitation, delirium, fever, diarrhea, coma, tachyarrhythmia, increased LFTs

43
Q

Treatment of thyroid storm

A

Propranolol, propylthiouracil, corticosteorids (prednisolone), potassium iodide

44
Q

What should be administered in someone exposed to a nuclear accident?

A

potassium iodide (saturates the thyroid gland with stable iodine) and prevents uptake of radioactive iodine in the air which could increase risk of cancer, hypothyroidism, etc.

45
Q

how does follicular carcinoma spread?

A

hematogenously

46
Q

What muation is anaplasic carcinoma of the thyroid associated with?

A

TP53

47
Q

Euthryoid sick syndrome explain

A

low TSH, low T3/T4
Occurs in crtically ill patients and looks like central hypothyroidism BUT they have increased RT3 because clearance will be impaired

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