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Step 1 > Endocrine random facts > Flashcards

Endocrine random facts Flashcards

1
Q

What can you use to treat HIV associated lipodystrophy?

A

Tesamorelin (a GHRH analog)

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2
Q

What are epinephrine’s effects on the pancreas?

A

Stimulates both beta-2 and alpha-2, but alpha-2 inhibitory effect predominates so overall inhibitory effect. Pretreatment with an alpha-2 blocker would cause epinephrine’s effect on beta-2 to be predominant and increase insulin secretion

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3
Q

How are prolactin and the thyroid hormones related?

A

TRH increases prolactin secretion (eg. in primary or secondary hypothyroidism)

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4
Q

What is the other name for IGF-1?

A

Somatomedin C

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5
Q

What is the effect of growth hormone on blood sugar?

A

GH increases insulin resistance (diabetogenic)

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6
Q

What do ghrelin and leptin do?

A

Ghrelin stimulates hunger and GH release and is produced by the stomach. Leptin is the satiety hormone produced by adipose tissue. Sleep deprivation leads to decreased leptin production

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7
Q

What regulates ADH?

A

Osmoreceptors in hypothalamus (primary), hypovolemia (secondary)

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8
Q

How does cortisol increase blood pressure?

A
  1. Upregulates alpha-1 receptors on arterioles leading to increased sensitivity to norepinephrine and epinephrine, 2. At high concentrations, can bind to mineralocorticoid receptors
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9
Q

Why does excess cortisol give you striae?

A

Decreases fibroblast activity

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10
Q

Relationship between pH and calcium homeostasis

A

Increase in pH causes an increased affinity of albumin to bind to calcium which causes hypocalcemia (cramps, pain, paresthesias, carpopedal spasm)

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11
Q

What type of cells secrete PTH?

A

Chief cells of the parathyroid

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12
Q

Where in the kidney does PTH cause the excretion of Ca and PO4?

A

Ca in the DCT, PO4 in the PCT

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13
Q

Where is calcitonin from?

A

Parafollicular cells of the thyroid

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14
Q

Which hormones act through cAMP?

A

FSH, LH, ACTH, TSH, CRH, hCG, ADH (V2 receptor), MSH, PTH, calcitonin, GHRH, glucagon

FLAT ChAMP (plus a few more)

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15
Q

Which hormones act through cGMP?

A

ANP, BNP, NO (EDRF)

Think vasodilators

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16
Q

Which hormones act through IP3?

A

GnRH, Oxytocin, ADH (V1 receptor), TRH, Histamine (H1 receptor), Angiotenin II, Gastrin
GOAT HAG

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17
Q

Which hormones act through an intracellular receptor?

A

Vitamin D, Estrogen, Testosterone, T3/T4, Cortisol, Aldosterone, Progesterone
VETTT CAP

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18
Q

Which hormones act through an intrinsic tyrosine kinase?

A

Insulin, IGF-1, FGF, PDGF, EF

MAP kinase pathway

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19
Q

Which hormones act through a receptor-associated tyrosine kinase?

A

Prolactin, Immunomodulators (eg, cytokines IL-2, IL-6, IFN), GH, G-CSF, Erythropoietin, Thrombopoietin,
JAK/STAT pathway

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20
Q

What converts T4 to T3

A

5’-deiodinase

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21
Q

What is the enzyme responsible for oxidation and organification of iodide as well as coupling of monoiodotyrosine (MIT) and di-iodotyrosine (DIT)?

A

Peroxidase (propylthiouracil inhibits both peroxidase and 5’deiodinase. Methiazole inhibits peroxidase only)

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22
Q

What is the Wolff-Chiakoff effect?

A

Excess iodine temporarily inhibits thyroid peroxidase leading to decreased iodine organification and decreased T3/T4 production

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23
Q

What should you think of if you see Homer-Wright pseudo rosettes?

A

Neuroblastoma

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24
Q

Presentation of neuroblastoma?

A

Irregular mass crossing the midline OR opsoclonus-myoclonus syndrome (“dancing eyes-dancing feet”). HVA and VMA increased in the urine. Bombazine and neuron-specific annuals positive

25
Q

What mutation is neuroblastoma associated with?

A

Overexpression of N-myc oncogene

26
Q

Treatment for pheo?

A

Alpha blockers THEN beta blockers THEN surgical resection

27
Q

Histologic findings in Hashimoto’s

A

Hurthle cells, lymphoid aggregate with germinal centers

28
Q

Empty-appearing nuclei with central clearing, nuclear grooves

A

Papillary thyroid carcinoma, increased risk with RET and BRAF mutations, childhood irradiation, excellent prognosis

29
Q

Cancer invading the thyroid capsule

A

Follicular carcinoma, good prognosis

30
Q

Sheets of cells in an amyloid stroma

A

Medullary carcinoma, associated with MEN 2A and 2B (RET mutations)

31
Q

Hypocalcemia, shortened 4th/5th digits, short stature

A

Pseudohypoparathyroidism (Albright hereditary osteodystrophy)- unresponsiveness of kidney to PTH. Autosomal dominant

32
Q

Familial hypocalciuric hypercalcemia

A

An AD dx caused by defective Ca sensing receptor on parathyroid cells. PTH cannot be suppressed by an increase in Ca level

33
Q

What type of receptor are Calcium sensing receptors?

A

Transmembrane G-protein coupled receptors

34
Q

What can primary hyperparathyroidism cause?

A

Stoans, bones, groans, and psychiatric overtones. Also osteitis fibrous cystica

35
Q

Cystic bone spaces filled with brown fibrous tissue

A

Osteitis fibrosa cystica (Brown tumor consisting of deposited hemosiderin from hemorrhages, causes bone pain)

36
Q

What is the most common cause of death in kids with gigantism?

A

Heart failure

37
Q

What does acromegaly predispose you to?

A

Increased risk of colorectal polyps and cancer

38
Q

Treatment for nephrogenic DI?

A

HCTZ, indomethacin, amiloride, and hydration

39
Q

What can you use to treat SIADH?

A

Fluid restriction, IV hypertonic saline, conivaptan, tolvaptan, demeclocycline

40
Q

Deficiency of what enzyme in certain organs leads to osmotic damage in diabetes?

A

Sorbitol dehydrogenase (causes cataracts)

41
Q

Most common initial sensory impairment in pts with diabetes

A

A loss of vibrational sense because it affects the Pacinian corpuscles

42
Q

Histology of type 1 and type 2 diabetes

A

Type 1- islet leukocytic infiltrate, Type 2- islet amyloid polypeptide (IAPP) deposits

43
Q

Presentation of glucagonoma

A

Dermatisis (necrolysic migratory erythema), diabetes, DVT, and depression

44
Q

Presentation of carcinoid syndrome

A

Recurrent diarrhea, cutaneous flushing, asthmatic wheezing, right-sided valvular disease

45
Q

Tx for carcinoid syndrome

A

Surgical resection, somatostatin analog (octreotide)

46
Q

How do you test for Z-E syndrome?

A

Secretin stimulation test: positive (in Z-E) if gastrin levels remain elevated after administration of secretin, which normally inhibits gastrin release

47
Q

MOA of biguanides

A

(Metformin) Decreases gluconeogenesis, increases glycolysis, increases peripheral glucose uptake

48
Q

SE of metformin

A

GI upset, lactic acidosis (thus contraindicated in renal insufficiency- check Creatinine!)

49
Q

MOA of sulfonylureas

A

Close K+ channel in beta-cell membrane

50
Q

What are the sulfonylureas?

A

First gen: chlorpropamide, tolbutamide; second gen: glimepiride, glipizide, glyburide

51
Q

SE of thiazolidinediones

A

Weight gain, edema, hepatotoxicity, HF, increased risk of fractures

52
Q

What are the GLP-1 analogs?

A

Exenatide, liraglutide

53
Q

What are the DPP-4 inhibitors?

A

Linapgliptin, saxagliptin, sitagliptin

54
Q

What is pramlintide

A

An amylin analog, decreases gastric emptying, decreases glucagon

55
Q

What is canagliflozin?

A

An SLGT-2 inhibitor. Blocks reabsorption of glucose in the PCT. DE: glucosuria, UTIs, vaginal yeast infections. Monitor BUN/Cr

56
Q

What is are the alpha-glucosidase inhibitors and how do they work?

A

Acarbose, miglitol. Inhibit intestinal brush-border alpha-glucosidases.

57
Q

What hyperthyroid med do you use in pregnancy?

A

PTU

58
Q

What is cinacalcet?

A

It sensitizes Ca-sensing receptor in parathyroid gland to circulating Ca causing decreased PTH. Used for hypercalcemia due to primary or secondary hyperparathyroidism.

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