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Level 1/Step 1 > Endocrine Keys > Flashcards

Endocrine Keys Flashcards

1
Q

Ventral Medial hypothalamus

A

regulates the sensation of satiety

if a lesion is present the patient will likely be massive (Very MASSIVE)

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2
Q

Ventral Lateral hypothalamus

A

regulates the sensation of hunger

if a lesion is present the patient will likely be lean (Very LEAN)

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3
Q

Dorsomedial nucleus of hypothalamus

A

Regulates
1. Feeding
2. Drinking
3. Body weight
4. Circadian rhythm

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4
Q

Preoptic nucleus synthesizes

A

GnRH

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5
Q

Preoptic nucleus role =

A

Regulation of both temperature and sleep

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6
Q

Arcuate nucleus mediates responses from

A

metabolic hormones
1. Leptin
2. Ghrelin
3. Insulin

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7
Q

Arcuate nucleus will affect functions relating to

A
  1. Metabolism
  2. Feeding
  3. Reproduction
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8
Q

What are the main physiologic conditions that activate the RAAS pathway are

A
  1. Decreased blood pressure
  2. Increased sympathetic tone
  3. Decreased NaCl delivery to macula densa cells
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9
Q

ANP and BNP effects on RAAS =

A
  1. downregulate the RAAS
  2. increasing cGMP –> increased glomerular vasodilation
  3. increasing the GFR due to increased VD
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10
Q

34F presents with
1. nausea
2. emesis
3. lethargy
4. confusion
5. altered mental status
6. seizures

A

SIADH = hyponatremia sx

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11
Q

A patient taking Amphotericin B
with new-onset
1. polydipsia
2. polyuria
3. elevated ADH

Should be tx w/

A

Pt has Peripheral/nephrogenic diabetes insipidus

Tx = Thiazide, amiloride, and indomethacin

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12
Q

Pseudohyponatremia =

A

Pt w/ a serum osmolality of 285 mOsm/kg and low Na+ serum levels (below 130)

This is because of increased oncotic = hyperproteinuria or hyperlipidemia

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13
Q

hypertonic hyponatremia =

A

SUGAR in the blood

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14
Q

Larynx supplied by X = SCAR

A

Superior laryngeal nerve
Cricothyroid

All other muscles
Recurrent laryngeal nerve

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15
Q

1week M
1. hypoplastic mandible
2. low-set ears
3. bifid uvula
4. cleft palate
5. decreased soft-tissue attenuation in the right anterior mediastinum

Congenital defeat?

A

DiGeorge syndrome 22.11.2 microdeletion
neural crest fails to migrate into the derivative pharyngeal/bronchial pouches

1st and 2nd pouches = Thyroid
3rd = inferior parathyroid + thymus
4th = superior parathyroid

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16
Q

1week M
Poor feeding
lethargy
unusual muscle movements
decreased soft-tissue attenuation in right anterior mediastinum

A

DiGeorge Syndrome
hypocalcemia = increased neuromuscular excitability

W/o the 3rd & 4th pouches the pt is not able to produce PTH which helps to increase blood Ca++ levels

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17
Q

The left inferior thyroid artery branches off from which of the following arteries?

A

Left Subclavian

Note
Right side = Brachiocephalic –> Common Carotid + Subclavian

18
Q

32F
tx w/ BB for hyperthyroidism
how is this helpful

A

BB = blocks 5-deiodinase = decreases T4–>T3 conversion

19
Q

34F
takes GC how does this affect the thyroid

A

If pt has graves = decreased Ab production

decreases T4 –> T3 peripherally

20
Q

Which drugs decreases the peripheral conversion of T4-T3

A

Amiodarone + PTU + BB + GC

21
Q

Wolff-Chaikoff effect = excess amounts of iodine

tx would be

A

Lugol’s iodine

this is given in situations where there is acute radiation exposure

22
Q

30F
HTN
Low renin

electrolytes changes?

A

Low renin = high aldosterone (Primary hyperaldosterone = Conn disease)

decreased serum K+
decrease pH = increased serum Bicarb
normal - high serum Na+

23
Q

4M
growth spurt
body odor
pigmented hair at the base of the penis

dx & tx

A

decreased 21-hydroxylase –> increased 17-hydroxylase = increased androgens

Tx: blocking ACTH

24
Q

61F
hypoechoic thyroid nodule
increased central blood flow
Clusters of cells w/ large overlapping nuclei
despersed chromatin
intranuclear inclusion bodies & grooves

A

increase BF = cancerous
Papillary Carcinoma

Orphan Annie eye nuclei
Pseudoinclusion
Laminated Ca++ deposits = Psammoma bodies

25
Q

81F
mass that has grown 3x in size rapidly
experiencing hoarseness
pleomorphic cells
irregular giant and spindle cells

A

Anaplastic thyroid carcinoma
TP53 mutation

26
Q

Follicular adenoma vs carcinoma

A

carcinoma = vascular or capsular invasion
RAS mutation
uniform follicles

27
Q

Hypocalcemia
sheets of polygonal cells
amyloid stroma

A

Medullary Carcinoma
MEN2A/B RET mutation

28
Q

Block G____ will increase Insulin levels

A

Blocking Gi = increase insulin levels

29
Q

28F
non-tender goiter
gave birth 3 wks ago
experiencing excessive sweating + palpitations
HTN
low free T4 and high TSH

A

Postpartum thyroiditis in its transient phase TH can be high
Autoimmune destruction = lymphocyte-mediated thyroid follicular damage –> early release of TH
Anti-thyroid peroxidase antibodies

30
Q

40M
increased gastrin levels
prominent gastric folds + multiple ulcers in duodenum + proximal jejunum
History or Family would include?

A

Dx: Zollinger-Ellison syndrome

associated with MEN1

MEN1 = 3 P’s (Pituitary tumors + Pancreatic endocrine tumors + Parathyroid adenoma)

Parathyroid adenoma = increased PTH = increase Ca+ =
constipation + muscle twitching + stones

31
Q

Tamoxifen

A

SERM that can tx gynecomastia

32
Q

Danazol

A

synthetic androgen that acts a partial agonist at androgen receptors

33
Q

Rx that can cause Gynecomastia

A

GnRH agonist
Ketoconazole = 17a-hydroxylase/17,20 lyase inhibitor
5a reductase inhibitors = decrease DHT –> increased testosterone –> increased estrogen
Spironolactone = 17a-hydroxylase/17,20 lyase inhibitor
Bicalutamide = testosterone receptor antagonist

34
Q

14M
Painless nodules on lips & tongue
Long & thin
Joint laxity
Oral inspection = small, soft, flesh-colored papules
TSH normal
Dx

A

Marfanoid habitus = caused by Medullary thyroid cancer which is associated with MEN2B

35
Q

The left superior thyroid artery branches off from which of the following arteries?

A

Left external carotid

Note: right = Braciocephalic –> subclavian + (common carotid –> External carotid)

36
Q

Recent viral infection
Painful thyroid
low T3/T4 levels
High TSH

A

De Quervian thyroiditis = Granulomatous inflammation, multinucleated giant cells, and foamy histiocytes are classically present on histology

37
Q

Low T3/T4
immobile thyroid gland
hoarseness

A

Riedel Thyroiditis

IgG4 systemic disease –> fibrous tissue replacing thyroid tissue + inflammatory infiltrates

38
Q

Decrease T3
Normal T4
High TSH
Increase IL-6

A

Euthyroid Sick Snydrome

39
Q

Toxic multinodular goiter is associated with

A

focal patches of hyperfunctioning cells that work independently of TSH (commonly due to mutated, constitutively activated TSH receptors), leading to elevated T3 and T4 levels.

40
Q

Hürthle cells arise from the thyroid follicular epithelium and are seen on histologic slides along with

A

lymphoid aggregates with germinal centers in patients with Hashimoto’s thyroiditis

Level 1/Step 1 (15 decks)

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