Endocrine-Made Ridiculously Simple

Question 1

When the thyroid itself over-secretes thyroid hormone (T3 & T4)

Answer 1

Primary Hyperthyroidism

Question 2

When the pituitary over-stimulates the thyroid to secrete thyroid hormone (T3 & T4)

Answer 2

Secondary Hyperthyroidism

Question 3

If the thyroid itself were to secrete lots of hormone “without being told to” this would increase negative feedback on the pituitary which would _____ TSH secretion?

Answer 3

Decrease

Question 4

Primary hyperthyroidism, the TSH will be (High or Low)?

Answer 4

LOW

Question 5

If the hyperthyroidism is secondary, i.e. caused by the over-secretion of TSH by the pituitary, the TSH will be (High or Low)?

Answer 5

HIGH

Question 6

What is the key to distinguishing between primary and secondary hyperthyroidism?

Answer 6

TSH

Question 7

A thyroid nodule that becomes independent of the pituitary and over-secretes thyroid hormone

Answer 7

Toxic nodule

Question 8

Autoimmune disorder that causes hyperthyroidism; autoantibodies bind to the TSH receptors in the thyroid and act just like TSH, stimulating the thyroid to release thyroid hormone.

Answer 8

Graves’ Disease

Question 9

The most common cause of hyperthyroidism

Answer 9

Graves’ Disease

Question 10

Clinical features include Graves’ ophthalmology (inflammation of extra ocular muscles and periorbital tissue leading to bulging of eyes, ptosis), and pretibial myxedema (non-pitting edema on the anterior knee)

Answer 10

Graves’ Disease

Question 11

An enlarged thyroid is also known as a….

Answer 11

goiter

Question 12

High metabolism (weight loss), tachycardia (sometimes a-fib), dyspnea, heat intolerance, hot skin, increased appetite, tremor, and nervousness are some clinical signs of:

Answer 12

hyperthyroidism

Question 13

Clinically, ophthalmology, pretibial myxedema, diffuse goiter, and/or thyroid bruit (rushing sound over thyroid on auscultation) will point toward a dx of:

Answer 13

Graves’ Disease

Question 14

If the thyroid itself is the root of the problem and not producing any thyroid hormone, this DECREASES negative feedback on the pituitary, so in primary hypothyroidism, the TSH level will be ____?

Answer 14

INCREASED

Question 15

In secondary hypothyroidism, the pituitary is the problem: the pituitary is not secreting an adequate amount of TSH, so the TSH will be ____?

Answer 15

DECREASED

Question 16

The MC cause of hypothyroidism:

Answer 16

Hashimoto’s thyroiditis

Question 17

autoimmune disease where the antibodies are directed against TPO and TG, resulting in lymphocyte infiltration of the thyroid gland which causes it to cease function

Answer 17

Hashimoto’s thyroiditis

Question 18

____ deficiency causes hypothyroidism because ____ is necessary for thyroid hormone synthesis

Answer 18

Iodine

Question 19

Symptoms include weight gain, cold intolerance, fatigue, weakness, bradycardia, hypoventilation, constipation, myalgias, arthralgias, and/or anemia; goiter may be present

Answer 19

hypothryoidism

Question 20

Secretes aldosterone, glucocorticoids, sex hormones, norepinephrine, and epinephrine

Answer 20

Adrenal glands

Question 21

Secretes epinephrine

Answer 21

adrenal medulla

Question 22

Stress response hormones that increase BP and glucogenesis and decrease the immune response

Answer 22

glucocorticoids

Question 23

Cortisol secretion is stimulated by secretion of ___ by the anterior pituitary which is triggered by secretion of ___ from the hypothalamus

Answer 23

1) ACTH

2) CRH

Question 24

Clinical manifestations of cortisol ELEVATION:

Answer 24

Cushing’s Syndrome

Question 25

Can cause hypernatremia, hypokalemia, and hypertension

Answer 25

Hyperaldosteronsim

Question 26

One or both adrenal glands are hyperactive; causes include adrenal adenoma and adrenal carcinoma

Answer 26

primary hyperaldosteronism

Question 27

The adrenal glands are over-stimulated ; causes include hyperkalemia, hyponatremia, and hypotension

Answer 27

secondary hyperaldosteronism

Question 28

Responsible for sodium reabsorption and potassium excretion

Answer 28

Aldosterone

Question 29

Can lead to hyponatremia and hyperkalemia

Answer 29

Hypoaldosteronism

Question 30

Refers to a pathological elevation of cortisol

Answer 30

Cushing's syndrome

Question 31

Over-stimulation of the adrenal glands by an ACTH-secreting tumor in the pituitary

Answer 31

Cushing's Disease

Question 32

Truncal obesity, a moon face, a buffalo hump on back, easy bruising, purple striae, hypertension, edema, weakness, osteoporosis and/or osteonecrosis, hirsuitism, acne, virilization, diabetes, immunosuppression, and/or cognitive effects

Answer 32

Cushing's syndrome

Question 33

If one or both adrenal glands are autonomously hyper-secreting, this hyper-secretion, this hypersecretion will increase negative feedback on pituitary, thus ACTH will be ___

Answer 33

LOW

Question 34

Test that relies on the principal of negative feedback to localize the source of ACTH

Answer 34

Dexamethasone Suppression Test

Question 35

A steroid that mimics cortisol and exert negative feedback on the pituitary, decreasing ACTH output from the pituitary.

Answer 35

Dexamethasone

Question 36

If a low dose dexamethasone suppression test does NOT suppress ACTH, this indicates:

Answer 36

Cushing's syndrome exists

Question 37

When localizing the ACTH source in Cushing's syndrome the pituitary ____ (does/does not) respond to negative feedback and ectopic sites____ (do/do not)

Answer 37

1) does | 2) do not

Question 38

Pathology of one or both adrenal adrenal glands; primary adrenal insufficiency aka=

Answer 38

Addison's Disease

Question 39

Lack of ACTH stimulation from the pituitary=

Answer 39

secondary adrenal insufficiency

Question 40

Lack of CRH from from the hypothalamus

Answer 40

Tertiary adrenal insufficiency

Question 41

Symptoms can include weakness, fatigue, lightheadedness, weightless, dehydration, hair loss, vomiting, hypoglycemia, and/or anemia; hyponatremia and hyperkalemia

Answer 41

Adrenal Insufficiency

Question 42

Can occur when a pt goes through withdrawal after abrupt termination of steroid treatment:

Answer 42

Adrenal insufficiency

Question 43

If both cortisol and aldosterone are low,and ACTH is high this suggests:

Answer 43

Primary adrenal insufficiency

Question 44

Is a rare but extremely dangerous cause of HTN

Answer 44

Pheochromocytoma

Question 45

Catecholamine-secreting tumor that most commonly occurs in the adrenal medulla--> the catecholamines (i.e., norepinephrine and epinephrine) cause vasoconstriction, thus HTN

Answer 45

Pheochromocytoma

Question 46

Dx of this is confirmed by elevated urine levels of catecholamines and their metabolic by-products, called metanephrines.

Answer 46

Pheochromocytoma

Question 47

Follow the "rule of 10s": 10% are bilateral ,10% are not in adrenal gland, and 10% are malignant

Answer 47

Pheochromocytoma

Question 48

What should never be given to a pt with a pheochromocytoma?

Answer 48

Beta blocker

Question 49

ACTH-secreting_____ adenomas lead to increased cortisol secretion (Cushing's Disease)

Answer 49

Pituitary

Question 50

TSH-secreting_____adenomas can cause secondary hyperthyroidism

Answer 50

Pituitary

Question 51

Stimulates release of insulin-like growth factor (IGF)

Answer 51

Growth hormone (GH)

Question 52

What inhibits growth hormone?

Answer 52

Somatostatin

Question 53

Inhibits GnRH secretion from the hypothalamus:

Answer 53

Prolactin

Question 54

Decreased GnRH secretion from the hypothalamus leads to reduced secretion of ___ & ___ from the pituitary?

Answer 54

FSH/LH

Question 55

What is released from the hypothalamus that inhibits prolactin release from the anterior pituitary?

Answer 55

Dopamine

Question 56

Drives glucose INTO cells

Answer 56

Insulin

Question 57

Used for when glucose is "gone"; it causes release of glucose into the blood for the tissues that need it

Answer 57

Glucagon

Question 58

Released from beta cells of the pancreas after a big meal

Answer 58

insulin

Question 59

Stimulates glucose uptake into cells and its storage as glycogen, fat, and protein

Answer 59

insulin

Question 60

Goal of this is to reduce blood sugar levels, so it promotes both glucose storage and its breakdown

Answer 60

Insulin

Question 61

Secreted during a fast when blood sugar is low

Answer 61

Glucagon

Question 62

Decreases glycolysis and increases gluconeogenesis (glucose formation) & glycogenolysis (breakdown of glycogen to release glucose):

Answer 62

Glucagon

Question 63

Goal is to mobilize glucose stores from the liver so that glucose can be sent to the brain and heart and used for energy production in these organs

Answer 63

Glucagon

Question 64

In this disorder, there is either a decreased insulin secretion or insensitivity to insulin

Answer 64

Diabetes Mellitus

Question 65

Without insulin's effects, glucose cannot be moved into the cells, and ____ can occur

Answer 65

Hyperglycemia (increased blood sugar)

Question 66

An autoimmune process that destroys the beta cells of the pancreas, leading to LOSS of insulin production

Answer 66

Type 1 DM

Question 67

Underlying pathophysiology is insulin RESISTANCE

Answer 67

Type 2 DM

Question 68

Increases insulin secretion to compensate for peripheral tissue resistance but eventually this mechanism fails

Answer 68

Type 2 DM

Question 69

3 hormones that regulate calcium concentration

Answer 69

PTH, Vitamin D, & Calcitonin

Question 70

2 hormones that RAISE serum calcium levels:

Answer 70

PTH & Vitamin D

Question 71

Hormone that DECREASES serum calcium levels:

Answer 71

Calcitonin

Question 72

Secrete PTH in response to LOW blood calcium levels:

Answer 72

Parathyroid gland(s)

Question 73

Increases blood calcium by stimulating osteoclasts to break down bone, increase reabsorption of calcium by kidneys, and increase conversion of inactive vitamin D to active vitamin D

Answer 73

PTH

Question 74

Causes elevated blood calcium & decreased blood phosphate (but increased urine phosphate)

Answer 74

PTH

Question 75

Increases absorption of calcium and phosphate by the gut; increases bone resorption and increases phosphate reabsorption in the kidneys

Answer 75

Vitamin D

Question 76

Antagonist hormone to PTH & Vitamin D

Answer 76

Calcitonin

Question 77

Decreases blood calcium by using calcium to build bone, and decreases renal reabsorption of calcium

Answer 77

Calcitonin

Question 78

Secreted by C-cells in the thyroid in response to high calcium levels

Answer 78

Calcitonin

Question 79

Excess secretion of PTH by parathyroid gland(s); MC cause is parathyroid adenoma; Incr in PTH will raise serum calcium levels

Answer 79

Hyperparathyroidism

Question 80

Labs: incr. Ca, PTH, decr. phosphate; incr urine phosphate and urine calcium

Answer 80

Hyperparathyroidism

Question 81

NOT related to pituitary; A decrease in serum calcium causes an increase in PTH secretion; can occur secondary to Vit. D deficiency or renal failure; result of hypOcalcemia

Answer 81

Secondary hyperparathyroidism

Question 82

Decrease in bone mass; common in elderly (from estrogen deficiency), and pts with elevated cortisol (Cushing's, exogenous steroid tx); calcium and Vit D intake can help prevent

Answer 82

Osteoporosis

Question 83

Thickened, weakened bones; repeated bone resorption & bone formation leading to a disorganized/weaker bone

Answer 83

Paget's Disease

Question 84

Phase of Paget's disease: overactivity of osteoclasts and massive bone resorption

Answer 84

Lytic (hot) phase

Question 85

Phase of Paget's disease: compensatory osteoblast response mixed with continued osteolytic activity in which bone is reformed in unorganized fashion

Answer 85

Intermediate phase

Question 86

Phase of Paget's disease: continued disorganized bone formation

Answer 86

Sclerotic (cold) phase

Question 87

Management of osteoporosis & Paget's disease

Answer 87

bisphosphonates