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USMLE > endocrine - Memory > Flashcards

endocrine - Memory Flashcards

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USMLE® Step 1 flashcards
1
Q

venous drainage of adrenals

A

Similar to testicles; L into L renal vein, R directly into IVC

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2
Q

similarities in the alpha subunit of pituitary hormones

A

FSH, LH, hCG, and TSH

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3
Q

delta cells release

A

somatostatin; can have somatostatinoma with hyper/hypoglycemia, gallstones, steatorrhea, etc.

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4
Q

positive regluators of insulin

A

GH and hyperglycemia; beta agonists

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5
Q

Negative regulators of insulin

A

somatostatin, hypoglycemia and cortisol; alpha-2 agonists inhibit insulin

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6
Q

Prolactin

A

promotes milk production; inhibits GnRH; Negative feedback by stimulating dopamine

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7
Q

GH regulators

A

somatostatin and glucose inhibit; exercise and sleep increase it

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8
Q

GH function

A

increases Linear bone growth through somatomedin and muscle mass. Increases Insulin resistance

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9
Q

Rate limiting enzyme in Adrenal steroid synthesis

A

Desmolase; inhibited by antifungal drug ketoconazole; activated by ACTH

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10
Q

Cortisol mechanism for anti-inflammation

A

inhibits PL-A2 and COX-2, decreases neutrophil adhesion (will see neutrophilia), blocks histamine release, reduces eosinophils, Blocks IL-2 production

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11
Q

Cortisol function

A

upregulates alpha-1 receptors for blood pressure, increases insulin resistance, increases gluconeogenesis

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12
Q

Metyrapone

A

inhibits 11-beta hydroxylase; increases ACTH surge because a decrease in cortisol. The 17-hydroxy corticosteroid will be produced and can be found in urine

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13
Q

Hashimoto Thyroiditis pathogenesis

A

antimicrosomal antithyroglobulin antibodies, HLA-DR5, increased risk of non-hodgkin’s lymphoma

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14
Q

Hashimoto histology

A

Hurthle cells, lymphocytic infiltrate with germinal centers

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15
Q

Hashimoto presentation

A

hypothyroid (can be hyper early), PAINLESS, high antiperoxidase tighters

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16
Q

Cretinism presentation

A

Pot bellied, pale, puffy-faced child with protruding umbilicus and protuberant

17
Q

Subacute Thyroiditis (de Quervain’s)

A

follows flu-like illness, HLA-B35. Histo: granulomatous mixed cellular (vs. hashimoto), no antiperoxidase (vs. hashimoto)

18
Q

Subacute thyrotoxicosis (granulomatous thyroiditis)

A

painful goiter, thyrotoxicosis followed by hypothyroidism.

19
Q

Riedel’s thyroiditis

A

thyroid is replaced by fibrous tissue “hard as rock”. Painless, Anti thyroid peroxidase. Macrophages and eosinophils (vs. hashimoto)

20
Q

toxic multinodular goiter

A

follicles are distended with colloid and lined by flattened epithelium with areas of fibrosis and hemorrhages. The focal patches of hyperfunctioning follicular cells are working independently of TSH due to mutation in TSH receptor.

21
Q

Papillary carcinoma

A

Radiation, psammoma, orphan annie, RET BRAF

22
Q

Follicular Carcinoma

A

Hematogenous spread, invades capsule, hurthle cells, RAS

23
Q

Medullary carcinoma

A

Parafollicular cells. Amyloid calcitonin, MEN 2A 2B, RET

24
Q

Struma Ovarii

A

Thyroid releasing teratoma

25
Q

Hyper PTH clinical

A

Bones, Moans, Grones, and stones; Osteitis fibrosa cystica - cystic bone spaces filled with borwn fibrous tissue.. Bones of pelvic girdle, pectoral girdle, and limbs, subperiosteal thinning, salt an pepper appearance of skin. Increased calcium stimulates gastrin secretion -> peptic ulcers

26
Q

secondary hyper PTH

A

presents with hypocalcemia and is due to renal failure mostly, with increased levels of phosphorous and decreased calcium. The bone lesions in secondary are Renal osteodystrophy

27
Q

Causes of secondary hyperthyroid

A

Testicular cancer or neoplasm releasing hCG which shares alpha subunit with TSH and can increase thyroid

28
Q

how does alkalosis cause functional hypocalcemia

A

More negative charge to albumin so more binding of free calcium which can lead to tetany but total body calcium levels remain same.

29
Q

Treatment for Nephrogenic DI

A

hydrochlorothiazide (paradoxical antidiuretic effect), Indomethacin (prostaglandins inhibit ADH so inhibit prostaglandin synthesis), amiloride

30
Q

Treatment for SIADH

A

Demeclocycline and H2O restriction

31
Q

SIADH sodium and volume status

A

euvolemic hyponatremia; initial increase in volume inhibits renin and reduces aldosterone to deplete excess volume and therefore euvolemia and hyponatremia

32
Q

SIADH causes

A

Ectopic (small cell lung cancer), Lung diseases, CNS disorder, Drugs (cyclophosphamide)

33
Q

Causes of hypopituitarism

A

Sheehan syndrome (hemorrhagic infarct postpartum bleeding; presents w failure to lactate), craniopharyngioma (Rathke’s pouch), empty sella syndrome, pituitary apoplexy (acute bleeding into preexisting adenoma, acute depletion of ACTH and cortisol can lead to cardiovascular collapse)

USMLE (14 decks)

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