Endocrine Physio

Question 1

lipid soluble hormones

Answer 1

steroids, thyroid hormones
receptors inside the cell -> usually in nucleus
transported by binding to proteins made in the liver

Question 2

water soluble hormones

Answer 2

peptides, proteins

receptors on outer surface of the cell membrane

Question 3

what is the intracellular action of insulin

Answer 3

activates membrane-bound tyrosine-kinase, does not utilize cAMP

Question 4

MEN syndromes: hyperfunction

Answer 4

a group of inheritable syndromes characterized by multiple benign or malignant tumors

Question 5

MEN1

Answer 5

hyperparathyroidism, endocrine pancreas, and pituitary adenomas

Question 6

MEN 2A

Answer 6

medullary carcinoma of the thyroid, pheochromocytomas, hyperparathyroidism

Question 7

MEN 2B

Answer 7

medullary carcinoma of the thyroid, pheochromocytomas, hyperparathyroidism typically ABSENT

Question 8

Sheehan syndrome

Answer 8

the pituitary is enlarged and therefore more vulnerable to infarction
-delivery associated with severe blood loss causes shock which causes arteriolar spasm in the pituitary with subsequent necrosis

Question 9

functions of ANP

Answer 9

increases sodium loss (natriuresis) and water loss (diuresis) by the kidney bc it inhibits aldosterone release as well as the reabsorption of sodium and water in the collecting duct

• ANP tends to antagonize the effects of AT2 and ADH
• ANP is released in response to stretch. The major action of ANP is diuresis and natriuresis

Question 10

V2 receptor antagonists

Answer 10

Conivaptan and tolvaptan -> they stop ADH effect on kidney tubule

Question 11

hyponatremia

Answer 11

involves both solute depletion and water retention but water retention is usually the more important factor
- develops rapidly and severe (

Question 12

central diabetes insipidus

Answer 12

low plasma ADH

-tx with desmopressin

Question 13

nephrogenic diabetes insipidus

Answer 13

high plasma ADH

Question 14

SIADH

Answer 14

inappropriate elevated secretion of ADH. characterized by euvolemia but hyponatremia

Question 15

viscerosomatic reflex of the adrenal regions

Answer 15

T10 bilaterally

Question 16

ACTH controls

Answer 16

the release of cortisol and adrenal androgens in the z. fasciculata and the z. reticularis, respectively

Question 17

what stimulates aldosterone

Answer 17

a rise in angiotensin 2 and/or K+

Question 18

angiotensin II is the main stimulus to the z. glomerulosa and it produces

Answer 18

aldosterone

Question 19

glucagon

Answer 19

promotes glycogenolysis in the liver. w/out cortisol, fasting hypoglycemia rapidly develops. cortisol permits glucagon to break down glycogen and generate glucose from gluconeogensis

Question 20

primary adrenal insufficiency: effects of skin

Answer 20

excessive secretion of ACTH; causes darkening of the skin due to the a-MSH sequence in the ACTH and the B-MSH activity of B-lipotropin

Question 21

what do endorphins modulate

Answer 21

perception of pain

Question 22

actions of angiotensin 2

Answer 22

raises BP, increases Na+ absorption and water volume, increases ADH release from the post pituitary, increases thirst, increases sodium reabsorption in proximal tubule

Question 23

establishing the presence of hypercorisolism

Answer 23

24 hr urine-free-cortisol or 1 mg overnight dexamethasone suppression test
-a single random cortisol test is always the wrong answer

Question 24

high dose dexamethasone test

Answer 24

differentiate pituitary adenoma from ectopic ACTH secretion and adrenal tumors

• pituitary source: cortisol decr
• ectopic ACTH, adrenal tumor: cortisol not suppressed

Question 25

ACTH stimulation test

Answer 25

dx adrenal insufficiency

-give ACTH -> no change in cortisol levels

Question 26

metyrapone testing will always be the wrong answer

Answer 26

.

Question 27

secondary hypercortisolism: ectopic ATCH syndrome

Answer 27

most freq in pts with small cell carcinoma of the lung

• greater secretion of ACTH than in Cushings dz (pituitary microadenoma)
• hyperpigmentation often present
• ectopic site nonsupressible with dexamethasone