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endocrine1 Flashcards

1
Q

Down syndrome assoc w what endocrine abnormality

A

hypothyroidism

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2
Q

Lab values in Primary Hyperaldosternoism
Na
K
HCOe

A

Normal Na, Decreased K, increased HCO3

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3
Q

which fat correlates strongly w insulin resistance

A

visceral fat: measure wast circumference

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4
Q

insulin resistance: what are dyslipidemia values

A

high TG, low HDL;

LDL do not increase w insulin resistance

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5
Q

two treatments of Nephrogenic diabetes insipidus

A

thiazide diuretics (induce mild hypovolemia, increasing prox tubule sodium and water reabsorption) or indomethacin (decerease synthesis of Prostgalndins, which inhibit ADH)

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6
Q

rapid withdrawal of corticosteriods

A

adrenal insufficiency

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7
Q

FGF23 inhibts what activity

A

1-alpha hydroxylase

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8
Q

which hormone responsible for spermatogenesis

A

FSH

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9
Q

GLUT family tranport proteins steroselective for

A

D-glucose

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10
Q

zinc deficiency symptoms

A

erythematous skin lesions, hypogonadism, impaired taste and smell, night blindness, impaired wound healing.

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11
Q

Kallman syndrome associated with which amenorrhea

A

primary

remember secondary is normal mesntruation in puberty followed by menstrual dysrgulation

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12
Q

hot flashes in what hormone deficiency

A

estrogen

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13
Q

A boy with 21 hydroxylase deficiency; excess testosterone. how to treat

A

treat with glucocorticoids to cause ACTH supppression; this reduces excess androgen production

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14
Q

21 hydroxylase defiency; virizilating effects in amles are due to

A

DHEA and androstenedione; not testosterone

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15
Q

long term use of glucocorticoids leads to what

A

bilateral adrenocortical atrophy

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16
Q

Digeorge syndrome results from

A

maldevelopment of third (affewcts inferior parathyroid and thymus) and fourth (affects superior parathyroid) pharyngeal/branchial pouches. Consequent parathyroid and thymic hypoplasia:

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17
Q

Chvostek’s sign

A

twitch of nose and lips when tapping on facial nerve

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18
Q

infant unusual flexion of left wrist and thumb and extension of fingers w blood pressure measurement

A

trousseau sign

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19
Q

failure of anteiror neuropore to close

A

anencepahly

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20
Q

invaginated oral ectoderm that develops into anterior pituitary

A

rathke pouch

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21
Q

depression on tongue that represents embrylogical remnant of superior end of obliterated thyrglossal duct

A

foramen cecum

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22
Q

hypertelorism, short palpebral fissures, micrognathia, bifid uvula, cleft palate

A

digeorge syndroem

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23
Q

external branch of what nerve is at risk of injury during thyroidectomy due to proximity to superior thryoid artery and vein

A

superior laryngeal nerve

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24
Q

external branch superior laryngeal nerve innervates what muscle

A

cricothyroid muscle

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25
Q

remaining laryngeal muscles innervated by

A

recurrent laryngeal nerves which also provide snesory innervation to larynx below vocal folds

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26
Q

why are pt’s taking exogenous insulin vulnerable to exercise induced hypoglycemia

A

insulin continue to be rleeased from injection site despite falling glucose levels in exercise

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27
Q

hypokalemia symptoms

A

paresthesias and muscle weakness

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28
Q

diarrhe and flushing seen in

A

carcinoid syndrome: derived from neuroendcorine cells of GI tract

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29
Q

nephrogenic DI resistance to ADH in the

A

kidneys

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30
Q

how is damage to hypothalamus different than posterior pituitary in DI

A

damage to hypothalamus: permanent central DI because damage to hypothalamic nuclei results in loss of vasopressinergic neruons
In posterior pituitary: transeitn central DI: hypothalamic nuclei are intact and axonal regeneration and hypertrophy allow adquate ADH release into circulation

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31
Q

Fusion is joining of cell lines; mature thryoid is formed by fusion of thyroid follicular cells and parafollicular C cells

A

true

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32
Q

lingual thyroid contains no

A

C cells due to failure of migration

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33
Q

insulin resistance in adipose cells hinders antilipolytic effects of insulin: this leads to

A

lipolysis and release of free fatty acids. which also contribute to insulin resistance causing acanthosis nigricans (sign of insulin resistance)

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34
Q

to diagnose inflammatory myosiits you need

A

muscle biopsy: polymyositis, dermatomositis

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35
Q

what is CK in lambert eaton and myastehnia gravis

A

NORMAL

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36
Q

what is CK in hypothyroid myopathy

A

ELEVATED

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37
Q

RET proto oncogene codes for a membrane bound

A

membrane bound tyrosine kinase receptor

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38
Q

Lmyc

A

small cell lung cancer

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39
Q

large, overlapping nuclei containing sparse finely disperesed chromatin
numerous intranuclear inclusion bodies and grooves

A

Papillary carcinoma

40
Q

colloid containing microfollicles

A

benign follicular adenoma

41
Q

which hyperlipoproteinemia is associated with acute pancreatitis

A

familial chylomicronemia syndrome

42
Q

defect in familial chylomicronemia syndrome

A

lipoprotein lipase; APoC II

43
Q

acute pancreatitis, lipemia retinalis (milky-appearing retinal vasculature) and eruptive xanthomas (small yellowish papules surrounded by erythema on extensor surfaces)

A

familial chylomicronemia syndorme

44
Q

which inflammatory cell in sarcoidsois express 1 alpha hydroxylase

A

macropahges

45
Q

lymphoplasmacytic infiltrate w active germinal centers

A

hashimoto’s

46
Q

generalized hyperpigmentation: addison’s disease

A

feedback inhibiton of POMC. as a result POMc cleavage products: including ACTH and MSH secreted in excess. MSH increased melanin synthesis

47
Q

metabolic acidosis winter

A

PaCo2 = 1.5 (serum HCO3) + 8 +/- 2

48
Q

In DKA, low serum bicarbonate due to ketoacidsosi reduces amt of HCO3 filtered by kidney.

A

true;
decreased urinary bicarb loss bc acidosis causes a compensatory increase in renal tubular H+ secretion by a-intercalated cells in collecting duct, promtoing bicarbonate reuptake

49
Q

how does TNFa induce insulin resistnace

A

through activation of serine kinases which phosphorylate serine residues on beta subunits of IR and IRS1; inhibitng tyrosine phosprplyation of IRS-1 by IR and subsequently hindering downstream signaling: resulting in resistance

50
Q

brown adipose tissue found

A 
in neonates: contains several intracytoplasmic fat droplets and many more mitochondria than white adipose cells; used for heatproduction; gives it its brown color (mitochondria)
function to produce heat by uncoupling ox phosphorualtion w protein thermogenin
51
Q

glucagon increases serum glucose by increasing hepatic

A

glycogenolysis and gluconeogenesis

52
Q

bony enlargement of hands and feet

A

gigantism (new shoes needed each month).

this is not seen in klinefleter or marfan

53
Q

Laron dwarfism

A

defects in GH receptor: decreased linear grwoth, high serum GH concentrations and low IGF1

54
Q

why do pt’s w type i dm have low ciruclaing levels of islet amyloid polypeptide

A

bc: type 1 extensive beta cell destruction: so cant produce the amyloid!

55
Q

SIADH caused by what drugs

A

carbamazepine, cyclophsophamide, SSRI

56
Q

in sites other than epiphyseal growth plate: the effect of estrogen on bone is

A

anabolic bc estrogen increases osteoblastic one depostion and decreases osteoclastic bone resorption

57
Q

somatotroph pit adenoam

A

growth hormone

58
Q

corticotroph pituitary adenoma

A

cushing disease

59
Q

testoterone exogenously inhibits

A

GnRH

60
Q

name for islet amyloid polypeptide

A

amylin

61
Q

Intellectual disability, gait or posture abnromality, eczema, musty body odor

A

PKU

Autosomal recessive

62
Q

preproinsulin syntehsized in

A

RER

63
Q

cleaveage of presignal:

A

proinsulin

64
Q

proinsul stored in

A

secretory granules; then exoctyossi after cleavage of proinsulin

65
Q

what cleaves proinsulin into insulin and c peptide

A

endopeptidases in secretory granules

66
Q

stored in granules until extruded in equal amounts

A

insulin and c peptide

67
Q

98% of body’s potassium is stored

A

intracellulary

68
Q

Calcium sensing recetpros are what type of receptors

A

G protein coupled receptros

69
Q

PTH causes osteoblasts to increase production of

A

RANKL and M-CSF
stimulates osteoclastic precurosesr to differentiate into bone resorbing mature osteoclasts

PTH also decrease OPG

70
Q

hba1c levels affected by alterations in RBC survival; conditions that increase RBC turnover (hemolytic anemia) wil cause

A

falsely low hba1c levels

71
Q

DERMAL accumulations of macropahges containing cholesterol and triglycerides

A

xanthelasmas

Could be type 4 or 5 hyperlipidemia

72
Q

I- to I2 is

A

oxidationto iodine

73
Q

iodine reacts w tyrosine residues in thryglobulin to form MIT and DIT

A

iodination

74
Q

peripheral conversion catalyzed by (t4-t3)

A

iodothyronine deiodinase

75
Q

aldosterone secretes

A

potassium and hydrogen ions

76
Q

LH function in women

A

decrease ovarian androgen production

increase sex hormone binding globulin syntehsis by liver decrease free testotsteorne levels

77
Q

eflornithine

A

topical orinthin decarboxylase inhibitor used to decrease rate of facial hair growth

78
Q

electron dense membrane boudn secretory granules

A

adrenal medulla: pheochromocytoma

79
Q

functional hypohtalamic amenorrhea leptin leveels

A

decreased

80
Q

SIADH has what type of hyponatremia

A

euvolemic
remember; increased water reabosrptioN: hypervolemia: supppress RAAS; increase natiruiess: low sodium thus; euvolemic hyponatremia

81
Q

Craniopharyngiomas have three components

A

solid, cystic, calcified

82
Q

insulin increases reabsorption of

A

sodium

83
Q

insulin suppresses glucagon by

A

directly acting on alpha cells; preventing glucagon from intefering w glucose lowering action of insulin

84
Q

if you have decreased cortisol levels ; what does that do to insulin

A

decreased cortisol levels lead to lower insulin requirements in pt’s w aadrenal insufficiency

85
Q

adrenal insuffiency labs

A

hyponatremia
hyperkalemia
hyperchloremia
non anion gap metabolic acidsosi

decreased H+ excretion; causing non agion gap met acidosis: low Hco3 levels; leading to compensatory increase in Cl reteion to matinatin electrical neutrality of eCF.

86
Q

definition of azoospermia

A

no sperm

seen in klinefelter’s and CF

87
Q

endogenous testoerone prodcution

LH FSH, testosterone sperm coutn?

A

LH low
FSH normal
elevated testoterone
low sperm count bc local androgen c oncentriosn in seminiferous tubule are suboptimal for spermatogenesis

88
Q

cryptochordism

LH, FSH, testosterone , sperm levels

A

normal LH and testoerone, elevated fSH, low sperm count

seminiferous tubules damaged: thus elevated FSH levels
Ledyig cells are preserved

89
Q

AP and posteiro pituitary lie in the

A

sella turcica

90
Q

metabolism of ehtanol by alchol dehdyrgonease and aldehyde dehdyrogenase does what to nadh

A

reduces NAd to nadh ; increasing nadh/nad+ ratio

inhibiitng other pathwyas requiring nad+; including reactions required for gluconeneogesnsi

91
Q

disorganized lamellar bone in mosaic pattern

A

paget

normal calcium and phosphours

92
Q

osteoid matrix accumulation around trabeculae

A

vitamin D deficiency

histo: excessive unmineralized osteiod w widened osteoid seamas: low urinary calcium

93
Q

spongiosa filling medullary canals w no mature trabeculae

A

osteopetrosiss

94
Q

subperiosteal resoprtion with cortical thinning

A

Primary hyperparathyroidism

95
Q

you cans ee peptic ulcer diseae in primary hyperprathyroidism

A

true

96
Q

osteoporosis vs primary hyperparaythyroidsm osteoporosis

A

osteoporiss: trabecular thinning w fewer interconnections]]

PHPT: affects cortical (comapct) bone of appendicular skeleton (pectoral girdle, pelvic girdle, limbs)
cortical thinning: subperiosteal erosisons

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