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Medical Phys II > Endocrine Normal/Patho > Flashcards

Endocrine Normal/Patho Flashcards

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USMLE® Step 1 flashcards
1
Q

What hormones are synthesized in the ventral hypothalamus?

A

Releasing hormones

GHRH, TRH, CRH, gnRH, PRH

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2
Q

Where do hormones produced in the ventral hypothalamus go?

A

Anterior pituitary where they release or inhibit hormones

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3
Q

Where is prolactin produced?

A

Anterior pituitary

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4
Q

What does prolactin do?

A

Promotes lactation in the breast

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5
Q

Where is growth hormone produced?

A

Anterior pituitary

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6
Q

What hormones are produced in the anterior pituitary?

A 
Prolactin
Growth hormone (GH)
Thyroid stimulating hormons (TSH) 
Adrenocorticotropic hormone (ACTH)
Follicle stimulating hormone (FSH)
Lutenizing hormone (LH)
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7
Q

What hormone is produced in the hypothalamic (paraventricular nucleus)?

A

Oxytocin

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8
Q

What two areas does oxytocin act on?

A

Uterus- stimulates contraction

Breast- stimulates milk ejection

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9
Q

What two hormones are produced in the hypothalamus?

A

Oxytocin

Antidiuretic hormone ADH

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10
Q

What hormone is produced in the supraoptic nucleus (hypothalamus)?

A

Antidiuretic hormone (ADH)

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11
Q

What does thyroid hormone act on?

A

All body cells except brain, spleen, testes and uterus

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12
Q

Which hormone is synthesized in follicle cells in the thyroid?

A

Thyroid hormone (TH)

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13
Q

What hormone is synthesized in the parafollicular cells within the thyroid gland.

A

Calcitonin

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14
Q

What hormone inhibits bone resorption, stimulates calcium incorporation into bone?

A

Calcitonin

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15
Q

Where is parathyroid hormone (parahormone) syntehsized?

A

Parathyroid gland

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16
Q

What hormone stimulates bone resorption and in the kidneys stimulates reabsorption of caclium and activation of Vit D as well as absorption of calcium in intestinal mucosa?

A

Parathormone

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17
Q

What are 2 glucocorticoids?

A

Cortisol, hydrocortisone

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18
Q

Where are glucocorticoids synthesized?

A

Adrenal cortex

Zona fasciculate mainly

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19
Q

What do glucocorticoids do in the liver?

A

Gluconeogenesis

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20
Q

Where are gonadocorticoids (androgens) synthesized?

A

Adrenal cortex

Zona reticularis mainly

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21
Q

What do gonadocorticoids play a role in?

A

Sexual development during puberty

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22
Q

Where are epi and norepi produced?

A

Adrenal medulla

Chromaffin cells

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23
Q

What are norepi and epi involved in?

A

Flight or fight response

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24
Q

Where is glucagon synthesized?

A

Pancreas- Islets of Langerhans

Alpha cells

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25
Q

What does glucagon do in the liver?

A

Glycogenolysis, gluconeogenesis, release of glucose into the blood

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26
Q

Where is insulin synthesized?

A

Pancreas- Islets of Langerhans

Beta cells

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27
Q

What does insulin do in body cells (muscle and fat)?

A

Stimulates glucose uptake, oxidation

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28
Q

Where are estrogen and progesterone syntehsized?

A

Ovaries

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29
Q

What 2 hormones play a role in female sexual development, oogenesis, menstrual cycle, pregnancy?

A

Estrogen

Progesterone

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30
Q

Where is testosterone synthesized?

A

Testes

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31
Q

What hormone is involved in male sexual development and spermatogenesis?

A

testosterone

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32
Q

What are hormones that stimulate the development and activity of endocrine glands?

A

Tropic hormones

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33
Q

What hormone increases protein synthesis, cell growth, and division?

A

Growth Hormone

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34
Q

What is it called when growth hormone causes an increased glycogen breakdown and leads to a rise in blood glucose.

A

Diabetogenic effect

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35
Q

What 2 hormones control the hypothalamic secretion o GH?

A

GHRH and GHIH

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36
Q

What allows TSH to be released?

A

TRH (thyroid release hormone)

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37
Q

What inhibits TSH?

A

GHIH (growth hormone inhibiting hormone)

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38
Q

What hormone stimulates the adrenal cortex to release steroid hormones?

A

ACTH

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39
Q

The hypothalamic secretion of ACTH is regulated by what?

A

CRH (corticotropic releasing hormone)

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40
Q

High blood glucocorticoid levels ______ CRH release?

A

Decrease

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41
Q

What triggers CRH release?

A

Stressor

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42
Q

WHat hormone stimulates production of gonadal hormones, follicle development in females with FSH, triggers ovulation?

A

LH (lutenizing hormone)

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43
Q

The release of what hormone from the hypothalamus control LH and FSH secretion?

A

GnRH (gonadotropic releasing hormone)

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44
Q

What type cells does prolactin act upon?

A

Lactotropic cells

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45
Q

What two hormones mediate prolactin?

A

PRH and PIH

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46
Q

What prolactin mediating hormone is dominant in males?

A

PIH

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47
Q

PRH is stimulated when ______ is high.

A

Estrogen

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48
Q

What action by a baby stimulates PRH release?

A

Suckling

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49
Q

The release of ADH is stimulated when blood solute concentration is too _____

A

High

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50
Q

The thyroid gland has spherical follicles which are colloid surrounded by _______ cells

A

Follicular

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51
Q

Parafollicular cells produce what?

A

Calcitonin

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52
Q

What cells produce thyroid hormone?

A

Follicular cells

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53
Q

Put in order the steps in TH production
A. Follicle cells endocytose iodinated thyroglobulin
B. Lysosomal enzyme cleave TH from thryoglobulin
C. Follicle cells synthesize thyroblogulin secreted into follicular lumen- becomes part of colloid
D. Exocytosis to secrete TH
E. Tyrosine residues in thyroglobulin are iodinated

A 
C 
E
A
B
D
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54
Q

Is T4 (thyroxine) or T3 the major component of TH in humans?

A

T4

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55
Q

Where is T3 formed?

A

From T4 at target

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56
Q

Is T3 and T4 more active?

A

T3 is 10x more active than T4

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57
Q

What do thyroxine binding globulins (TBGs) do?

A

Bind to T3/T4 for transport in blood.

Need binding proteins so they get to target and don’t slip into other cells first

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58
Q

What are the three actions of TH?

A
  1. Increase basal metabolic rate- increase glucose catabolism
  2. Heat-calorigenic effect (produce heat)
  3. Promotes normal growth and body development
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59
Q

What hormone is an antagonist to paraythyroid hormone?

A

Calcitonin- stimulates calcium uptake from blood

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60
Q

What hormone increases blood calcium levels?

A

Parathyroid hormone (PTH)

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61
Q

What hormone stimulates the activation of vitamin D?

A

Parathyroid hormone

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62
Q

What part of the adrenal (suprarenal) glands is essential for life?

A

Cortex

Medulla is not

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63
Q

What are the three types of corticosteroids?

A

Mineralcorticoids
Glucocorticoids
Gonadocorticoids

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64
Q

What are the two type of adrenal medullary hormones?

A

Nor- & epinephrine

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65
Q

What type of corticosteroid is aldosterone?

A

Mineralcorticoid

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66
Q

What does aldosterone regulate?

A

Renin-angiotensin mechanisms
ACTH release
ANP release

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67
Q

What type cells are found in the adrenal medulla?

A

Chromaffin cells

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68
Q

What do the chromaffin cells do?

A

Release catecholamines in response to sympathetic nervous system stimulation

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69
Q

What is the endocrine portion of the pancreas?

A

Islets of Langerhans

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70
Q

What do the islets of Langerhans secrete?

A

Insulin and glucagon

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71
Q

What are the 3 targets of glucagon and insulin ?

A

Liver
Skeletal muscle
Adipose tissue

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72
Q

What does glucagon stimulate in the liver?

A

Glycogenolysis

Gluconeogensis

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73
Q

What does glucagon stimulate in adipose cells?

A

Conversion of fats into glycerol and fatty acids

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74
Q

What does glucagon do to skeletal muscle?

A

Stimulates protein breakdown

75
Q

Low blood sugar promotes the release of what from the pancreas?

A

Glucagon

76
Q

High blood sugar promotes the release of what from the pancreas?

A

Insulin

77
Q

What cells is insulin produced in in the Islets?

A

Beta cells

78
Q

What does insulin stimulate in adipose and skeletal muscle?

A

Glucose uptake
Cellular respiration
Glucose storage

79
Q

What does insulin stimulate in adipose tissue and the liver?

A

Formation of fats

80
Q

What does insulin stimulate in skeletal muscle?

A

AA uptake and protein synthesis

81
Q

What are two meachnisms of hormonal alterations?

A

Receptor associated disorder

Intracellular disorder

82
Q

What are the four types of receptor associated disorders?(water soluble hormones)

A

Decrease in receptor number
Impaired receptor function
Antibodies against receptors
Unusual receptor expression

83
Q

What are the two types of intracellular disorders?

A

Inadequate second messenger synthesis

Abnormal second messenger response

84
Q

Water intoxication, hyponatremia, hypoosmolarity, inappropriately concentrated urine are all associated with what?

A

Syndrome of inappropriate ADH Secretion

85
Q

What is a disorder where insufficient ADH leads to polyuria and polydipsia?

A

Diabetes Insipidus

86
Q

What are the two forms of diabets insipidus?

A

Neurogenic (central)- most common

Nephrogenic (renal)

87
Q

What is neurogenic diabetes insipidus due to?

A

Insufficient ADH, tumors

88
Q

WHat is the neprhogenic form of diabetes insipidus associated with?

A

End-organ failure

89
Q

What is hyperpituitarism generally due to?

A

Adenoma

90
Q

Hypopituitarism may be due to ______.

A

Infarction

91
Q

In what condition are all hormones absent (panhypopituitarism)

A

Sheehan Syndrome

92
Q

A deficit of _____ is possibly life threatening.

A

ACTH

93
Q

What causes acromegaly?

A

Oversecretion of GH

94
Q

What do individuals with acromegaly die of?

A

Cardiac hypertrophy
Hypertension
Atherosclerosis
T2DM

95
Q

_____ tissue proliferates in acromegaly.

A

Connective

96
Q

What causes prolactin hypersecretion?

A

Tumors that secrete prolactin

97
Q

In women, what happens with a prolactinoma?

A

Amenorrhea
Non-puerperal milk production
hirsutism
Osteopenia

98
Q

What will happen in men with a proclatinoma?

A 
Hypogonadism
ED
impaired libido
oligospermia
Diminished ejaculate volume
99
Q

What can cause a secondary form of thyroid dysfunction?

A

Pituitary or hypothalamic alteration

100
Q

What is due to any increased levels of circulating TH?

A

Thyrotoxicosis

101
Q

What is a secondary form of thyrotoxicosis caused by?

A

TSH secreting pituitary adenomas

102
Q

What symptoms will you have with thyrotoxicosis?

A

Increased BMR and goiter

103
Q

Graves Disease is an ____________ disease.

A

Autoimmune

104
Q

What are symptoms of Graves Disease?

A

Hyperthryoidism
Goiter
Opthalmopathy
Dermopathy

105
Q

In Graves Disease, the antibodies mimic _____ and leads to the thyroid pumping out more TH.

A

TSH

106
Q

What occurs in nodular thyroid disease?

A

Thyroid increasing in size due to TSH
Number of follicles increaes
then TSH drop and thyroid shrinks
Some follicular cells may be permanently changed and cause hyperthyroidism

107
Q

What is a hyperthyroid condition that may become deadly?

A

Thyrotoxic Crisis (thyroid storm)

108
Q

Who does a thyroid storm usually happen to.

A

A person with hyperthyroidism under additional stress (CV disorders, infection)

109
Q

What are some symptoms of a thyrotoxic crisis?

A

Hyperthermia, tachycardia, high-output heart failure, N/V/D, delirium

110
Q

What is the most common thyroid disorder?

A

Hypothyroidism

111
Q

In hypothyroidism TH ______ and TSH _____.

A 
TH decreases
TSH increases (goiter)
112
Q

What causes the secondary form of hypothyroidism?

A

Disorders affecting the pituitary or hypothalamus

113
Q

What causes primary hypothyroidism?

A

Defective synthesis

Loss of thyroid tissue

114
Q

What are the four types of primary hypothyroidism?

A

Subacute
Autoimmune (hasimoto disease)
Painless
Postpartum

115
Q

What type of hypothyroidism is due to a gradual autoimmune destruction of the thyroid?

A

Autoimmune (Hashimoto disease)

116
Q

What type of hypothyroidism has a similar course to subactue, and similar pathology to autoimmune?

A

Painless

117
Q

What type of primary hypothyroidism has a similar course to painless?

A

Postpartum

118
Q

What type primary hypothyroidism is due to non-bacterial inflammation of the thyroid- fever, tenderness, enlarged thyroid

A

Subacute

119
Q

What are to hypothyroid conditions?

A

Congenital hypothyroidism

Thyroid carcinoma

120
Q

What is congential hypothyroidism due to?

A

Absent thyroid tissue or TH synthesis defects.

121
Q

What is secondary hyperparathyroidism due to?

A

Chronic disease state

122
Q

In primary hyperparathyroidism inappropriate secretion is due to what?

A

Feedback failure

123
Q

What happens whith hyperparathyroidism

A 
Excessive osteoclast activity
Bone fracture
Kyphosis
Renal effects 
muscle spasms
124
Q

What condition has depressed serum calcium and increased phosphate.

A

Hyperparathyroidism

125
Q

What disease is associated with excessive cortisol? Symptoms include - weight gain, moon face, buffalo hump, changes in skin pigmentation

A

Cushing Disease

126
Q

What condition is due to excessive aldosterone due to primary adrenal disorders or secondary extradrenal stimulus?

A

Hyperaldosteronism

127
Q

What does aldosterone do?

A

Causes you to retain sodium

128
Q

What are some signs/symptoms of hyperaldosteronism?

A

Hypertension
Hypokalemia, renal potassium wasting
Neuromuscular problems
Metabolic alkalosis

129
Q

What is inadequate stimulation of adrenal glands or inability to produce and secrete cortisol?

A

Hypocortisolism

130
Q

What disease leads to primary adrenal insufficiency?

A

Addison disease

131
Q

With Addison’s disease you will have symptoms of what two conditions?

A

Hypocortisolism

Hypoaldosteronism

132
Q

What happens to the adrenal glands in Addison’s Disease?

A

Adrenal hemorrhage

133
Q

Is Addison’s disease autoimmune?

A

yes

134
Q

Excess androgens cause what?

A

Virilization

135
Q

What happens with hypofunction of the adrenal medulla?

A

No known physiological alterations

136
Q

With hyperfunction of the adrenal medulla, there are continuous or episodic release of what?

A

Catecholamines

137
Q

What is hyperfunction of the adrenal medulla usually caused by?

A

Tumors

138
Q

What are some symptoms of hyperfunction of the adrenal medulla?

A

Hypertension
Tachy
Palpitations
Severe headache

139
Q

What is the normal blood glucose range?

A

70-120 mg/dl

140
Q

What are the three classic symptoms of diabetes?

A

Polyuria, polydipsia, polyphagia

141
Q

What are the two distinct types of Type 1 DM?

A

Immune and non-immune

142
Q

T1DM has the strongest associated with ______ alleles.

A

MHC II

143
Q

What are three virus that have been implicated in the environmental cause of T1DM?

A

CMV
mumps
EB

144
Q

______ may trigger autoantibodies in T1DM.

A

BSA (bovine serum albumin)

145
Q

What are two causes of the non-immune form of T1DM?

A

Pancreatitis

Chronic inflammation of the pancreas

146
Q

_____ are found in 85-95% of patients with T1DM.

A

ICAs (islet cell antibodies)

147
Q

______ % of beta cell function must be lost before hyperglycemia occurs.

A

80-90%

148
Q

T1DM patients have a lack of ______ and an excess of ______

A

Lack of insulin

Excess of glucagon

149
Q

In T1DM both _____ and ______ cells function abnormally.

A

Alpha and Beta

150
Q

Insulin normally stimulates _____ and inhibits ______

A

Stimulates lipogenesis

INhibits lipolysis

151
Q

When there is an insulin deficit _____ is enhanced and there is an increase in ______ to the liver.

A

Lypolysis is enhanced

Increase in free fatty acids to the liver

152
Q

T1DM clinically affects the metabolism of what three things?

A

Fat
Protein
Carbs

153
Q

What is ketoacidosis due to?

A

Increase ketone levels in absence of anti-lipolytic effect of insulin

154
Q

What is a suboptimal response of insulin-sensitive tissues to insulin?

A

Insulin resistance

155
Q

Before clinical symptoms of T2DM, compensatory _________ occurs.

A

Hyperinsulinemia

156
Q

In T2DM, the ratio of alpha to beta cells may be ______. Person may have levels of insulin that are not decreased.

A

Normal

157
Q

What is the most powerful risk factor for T2DM?

A

Obesity

158
Q

What are some theories why with obesity insulin is less able to facilitate glucose entry into cells?

A 
Reduced insulin receptor numbers
Post receptor events altered
Hyperinsulinemia 
Release of free fatty acids
Overeating leads to hyperinsulinemia
Intracellular satiety factors reduce tissue responsiveness to insulin
159
Q

What are 2 acute complications with DM?

A

Hypoglycemia

Diabetic ketoacidosis

160
Q

Hypoglycemia is levels below ____ in newborns and _____ in adults.

A

Below 35 in newborn

Below 45-60 in adults

161
Q

In which type of diabetes in hypoglycemia most common?

A

Type 1 patients on insulin

162
Q

What causes the symptoms of insulin shock or insulin reaction?

A

SNS activation or abrupt cessation of glucose to the brain

163
Q

What develops when there is an absolute or relative deficiency of insulin and an increase in insulin counter-regulatory hormones?

A

Diabetic Ketoacidosis

164
Q

In diabetic ketoacidosis hepatic _____ production increases and peripheral glucose use ______ and ketogensis is _______.

A

Hepatic glucose production
Peripheral glucose use drops
Stimulated

165
Q

What 4 things are often deficient in DKA?

A

Potassium
Sodium
Phosphorus
Magnesium

166
Q

What are some S/S of DKA?

A 
Hyperventilation
Postural dizziness
CNS depression
Ketonuria
Anorexia
Naseau
thirst
167
Q

What causes microvascular disease in diabetic patients?

A

Thickening of capillary basement membrane
Endothelial hyperplasia
Thrombosis
Pericyte degeneration

168
Q

What conditions can microvascular disease in diabetic patients lead to?

A

Blindness
End-stage renal disease
various neuropathies

169
Q

What stage is proliferative diabetic retinopathy?

A

Stage 3

170
Q

What stage is non-proliferative retinopathy?

A

Stage 1

171
Q

What stage is pre-proliferative retinopathy?

A

Stage 2

172
Q

What 2 major problems can retinopathy lead to?

A

Retinal detachment

Hemorrhage into vitreous humor

173
Q

What causes glomeruli injury in diabetic nephropathy?

A

HIgh glucose levels and adverse effects of intraglomerular hypertension

174
Q

What is the first manifestation of diabetic nephropathy?

A

Leakage of albumin

175
Q

What are some later symptoms of diabetic nephropathy?

A

Hypoproteinemia
Reduction in plasma oncotic pressure
Anasarca (widespread edema)
Hypertension

176
Q

Presence of CAD increases with the ______ of diabetes.

A

Duration (not severity)

177
Q

Stroke is _____ times more common in diabetics?

A

2

178
Q

Which type stroke is more common in diabetics?

A

Ischemic

179
Q

What are 2 risk factors for stroke in diabetics?

A

Hypertension

Dyslipidemia

180
Q

What does peripheral artery disease lead to in diabetics?

A

Gangrene and amputations

181
Q

What are the two stages of diabetic neuropathies?

A

Clinical and subclinical

182
Q

What is the difference b/w subclinical and clinical diabetic neuropathies?

A

Clinical- symptoms of clinically detectable neurologic deficits
Subclinical- Evidence of peripheral nerve dysfunction w/o clinical signs

183
Q

What are some reasons diabetics are at higher risk for infections?

A

Impaired vision/ touch
Decrease O2 to tissues
WBC impairment
Pathogens multiply rapidly

Medical Phys II (16 decks)

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