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Uworld_sitr > Endocrine_2 > Flashcards

Endocrine_2 Flashcards

1
Q

What test should you order before giving metformin

A

Creatine test

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2
Q

What happens to pro insulin in the RER

A

It is added to three disulfide bonds and transported to the Golgi and packed into secretary granules

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3
Q

The cleavage of what by endopeptidases in the secretory granules results in the formation of insulin and c peptide

A

Pro insulin

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4
Q

Uptake of cholesterol happens how

A

Receptor mediated endocytosis (mediated by LDL receptor)

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5
Q

How does glucose get into cells

A

Facilitated diffusion with the use of GLUT transporters

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6
Q

medullary thyroid carcinoma has increased levels of what

A

calcitonin

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7
Q

what are the gremlin mutations seen in MEN 2

A

RET

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8
Q

Marfanoid, mucosal neuroma, pheochromocytoma, medullary thyroid carcinoma?

A

MEN 2B

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9
Q

medullary thyroid carcinoma, pheochromocytoma, parathyroid hyperplasia

A

MEN 2A

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10
Q

hyperparathyroidism, pituitary tumor

and pancreatic tumor

A

MEN 1

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11
Q

RAS mutations are found in what

A

follicular thyroid cancer and some follicular adenomas

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12
Q

what is the treatment for CAD

A

giving low doses of cortisol to suppress ACTH secretion

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13
Q

what is the best marker test for hypothyroidism

A

high TSH ( this will be high before you see low T3 and T4)

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14
Q

why does the metabolism of alcohol for long periods of time cause hypoglycemia

A

Alcohol DH and Acetaldehyde DH reduce NAD to NADH and this increases the NADH/NAD Ratio, making impossible for reactions that need NAD to work, such as gluconeogensis

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15
Q

what binds to potassium in the pancreas to release insulin

A

ATP

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16
Q

protein defect in familial Chylomicronemia Syndrome

A

Lipoprotein Lipase and ApoC-2

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17
Q

major manifestations of Familial Chylomicronemia Syndrome

A

Acute Pancreatitis

Eruptive skin Xanthomas

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18
Q

protein defect in familial hypercholesterolemia

A

LDL receptor

APOB-100

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19
Q

manifestations in familial hypercholesterolemia

A

premature coronary artery disease

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20
Q

protein defect in familial dysbetalipiproteinemia

A

ApoE

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21
Q

manifestation in familial dysbetalipiproteinemia

A

premature coronary artery disease

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22
Q

protein defect in familial hypertriglyceridemia

A

ApoA-V

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23
Q

what is lipoprotein lipase usually bound too

A

heparin sulfate

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24
Q

milky appearing renal vascular is seen in familial chylomicronemia syndrome and is called what

A

lipema retinalis

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25
Q

what are the carrier proteins for OCT and ADH

A

neurophysins

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26
Q

what is the signaling pathway that GH uses to release IGF-1 from the liver

A

Jak Stat Pathway

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27
Q

what is it called when there is an aldosterone secreting tumor and there is a rise in sodium and a fall in hydrogen and potassium

A

Conn syndrome

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28
Q

DKA can cause something in patients that is associated with the respiratory alkalosis they experience to combat the acidosis

A

respiratory failure

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29
Q

biopsy of subacute granulomatous thyroiditis

A

multinuclear giant cels with lymphocytic infiltration

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30
Q

biopsy of papillary thyroid cancer

A

branching papillary structures with concentric calcifications

31
Q

biopsy of the tall cell type papillary thyroid cancer

A

follicular hyperplasia lined by tall epithelial cells usually in older people

32
Q

biopsy of Reidel Thyroiditis

A

extensive fibrosis of the plan that extends into surrounding tissue

33
Q

biopsy of Hashimoto

A

diffuse painless gland enlargement with mononuclear parenchymal infiltration with well developed germinal centers

34
Q

what is usually the main cause of hyperaldosteronism

A

bilatera adrenal hyperplasia

35
Q

main clinical features of hyperaldosteronism

A

hopkalemic alkalosis
muscle weakness and paresthesias
hypertension

36
Q

what is aldosterone escape

A

this is when there is a high HTN because of the salt retention so the GFR increases and so there is never a fluid over load seen in hyperaldosteronism

37
Q

somatostatinomas inhibits what

A 
insulin
cholecystokinin
gastein
glucagon
g.i motility
38
Q

signs of VIPoma

A

watery diarrhea, hypokalemia and impaired gastric acid secretion

39
Q

brown tumor bone cyst in the long bones, salt and pepper skull and subperiosteal erosions in the phalanges of the hands are all sign of what disease

A

osteitis fibrosa cystica

40
Q

what is the classic finding in hypothyroidism associated with the slow reabsorption of calcium by the SR causing the muscle to round when you tap on it

41
Q

what do bile acids do in reference to cholesterol

A

it causes depletion of bile acids so that there has to be an upregualtion of 7 alpha hydroxyls which converts cholesterol to bile acids

42
Q

what is Proprotein Converts Subtilizing Kevin 9 (PCSK9)

A

it increases the degradation of LDL receptors

43
Q

what drug is given to counteract PCSK9 and increase the availability of LDL receptors on the liver membranes, clearing ldl from the blood

A

Alirocumab ( monoclonal antibody)

44
Q

drug used as an anti rejection drug that decreases the proliferation of T cells in the patient. can be used with mycophenalate or azathioprine

A

Tacrolimus

45
Q

how does Epi increase Glucose

A

it limits glucose use by insulin dependent tissues as well as causing gluconeogenesis and glycogenolysis

46
Q

mealtime insulin analogues have an amino acid substitution whre

A

at the c terminal end of the B chain

47
Q

what tends to be elevates in males who only have one testicle and why

A

Inhibit B because there is not there are not enough Sertoli cells to produce it so FSH will be high because there is no negative feedback

48
Q

in aa medical setting what is severe hypoglycemia usually treated with

A

intramuscular glucagon

49
Q

why does the insulin Determi have a prolonged action

A

because it binds to lysine in the insulin molecule and binds to albumin so it can slowly dissociates

50
Q

what can cause an increase in TBG which leads to an increase in thyroid hormone levels

51
Q

delayed puberty and anosmia ( can smell) are signs of what

A

Kallmann Syndrome

52
Q

what is Kallmann Syndrome

A

results from he failure of GnRH secreting neurons to migrate from their origin in the olfactory placed to their normal anatomic location in the hypothalamus (mutation in KAL-1) there is central hypogonadism and anosmia

53
Q

cushing syndrome and SLE both increase the chance for what

A

coronary artery disease

54
Q

what could cause a unilateral atrophy of an adrenal gland

A

a contralateral cortisol producing tumor because it would decrease ACTH which would atrophy the adrenal that had no tumor

55
Q

what do thyroid peroxidase do

A

they cause thyroglobulin iodination

56
Q

what are the three effects of thyroid peroxidase

A
  1. oxidation of iodide (iodide to iodine)
  2. iodination of thyroglobulin
  3. the coupling reaction between 2 iodized tyrosine resides
57
Q

the uptake of iodide from the blood is blocked by what two things

A

perchlorate and pertechnetate

58
Q

extracellular potassium levels that are high and intracellular levels that are low represent what

59
Q

fever and sore throat in someone with Graves Disease who is treated with medical therapy should suggest what

A

thionamide (PPU and methimazole)drug use (Thionamide Induced Agranulocytosis)

60
Q

main drug given for thyroid storm

61
Q

what is a drug that is used to decrease the rate of facial hair growth by inhibiting ornithine decarboxylase which is used in DNA stabilization and repair

A

Eflornithine

62
Q

how do chronically elevated free fatty acid levels contribute to insulin resistance

A

they impair insulin dependent glucose uptake and increase hepatic gluconeogenesis

63
Q

describe the presentation of Metabolic syndrome

A
  • elevated TG
  • central obesity
  • HTN
  • high glucose
  • low HDL
64
Q

hypokalemia, hyperaldosteronima and late puberty are signs of

A

17-alpha hydroxyls def.

65
Q

side chain cleave enzyme causes what

A

a decrease in all adrenal hormones because this stops the first step of cholesterol from becoming pregvnenlone

66
Q

a male born with hypospaisias and a small penis is usually due to a lack of what

67
Q

what is the enzyme that turns progesterone into 11-Deoxycorticosterone and 17-OH progesterone into 11-Deoxycortisol

A

21-hydroxylase ( the most common cause of CAD from bilateral adrenal insufficiency)

68
Q

a high serum level of what is suggestive of 21 hydroxyls deficiency

A

17-hydroxyprogesterone

69
Q

iv infusion of what drug treats DKA

A

regular insulin

70
Q

a redistribution of fat from the face and extremities to the trunk “Lipoatrophy” is a common side effect of what treatment

A

highly active antiretroviral therapy (HAART)

71
Q

what sulfonyureas have a better chance of giving someone hypoglycemia

A

Glyburide and Glimepiride (long acting)

72
Q

what does metyrapone do

A

it blocks cortisol synthesis by inhibiting 11-b-hydroxylase which turns 11-deoxycortisol into cortisol, this will increase ACTH

73
Q

how does TNF alpha induce insulin resistance

A

by activating serine kinases which then phosphorylate serine residues o beta subunits of IR and IRS-1

74
Q

phosphorylation of serine and threonine residues that cause insulin resistance can be done by what things

A
  • TNF-a
  • catecholamines
  • glucagon
  • glucocorticoids

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