Endocrinology Flashcards
What is Necrosis?
Non-programmed cell death = noisy, inflammation, nucleus destroyed first
What is Apoptosis?
Programmed cell death = quiet, no inflammation, nucleus guides it => destroyed last
What is Pyknosis?
Nucleus turns into blobs “pick blobs”
What is Karyohexis?
Nucleus fragments
What is Karyolysis?
Nucleus dissolves
What is somatotrope?
GH
What is a Gonadotrope?
LH, FSH
What is a Thyrotrope?
TSH
What is a Corticotrope?
ACTH
What is a Lactotrope?
PRL
What receptors do protein hormones use?
Cell membrane receptors
What receptors do steroid hormone use?
Nuclear membrane receptors
What are the steroid hormones?
“PET CAD”
*Thyroid hormone acts like a steroid
Progesterone E2 Testosterone Cortisol Aldo vit D
What does Endocrine mean?
Secretion into blood
What does Exocrine mean?
Secretion into non-blood
What is Autocrine?
Works on itself
What is Paracrine?
Works on its neighbor
What is Merocrine?
Cell is maintained => exocytosis
What is Apocrine?
Apex of the cell is secreted
What is Holocrine?
The whole cell is secreted
What organs do not require insulin?
“BRICKLE”
Brain RBC Intestine Cardiac, Cornea Kidney Liver Exercising muscle
What does GnRH do?
Stimulates LH, FSH
What does GRH do?
Stimulates GH
What does CRH do?
Stimulates ACTH
What does TRH do?
Stimulates TSH
What does PRH do?
Stimulates PRL
What does DA do?
Inhibits PRL
What does Somatostatin (SS) do?
Inhibits GH
What does ADH do?
Conserves water, vasoconstricts
What does oxytocin do?
Milk letdown, baby letdown
What does GH do?
IGF-1 release from liver
What does TSH do?
T3, T4 release from thyroid
What does LH do?
Testosterone release from testis, E2 and Progesterone release from ovary
What does FSH do?
Sperm or egg growth
What does PRL do?
Milk production
What does ACTH do?
Cortisol release from adrenal gland
What does MSH do?
Skin pigmentation
What are the stress hormones?
Epi: immediate Glucagon: 20 min Insulin: 30 min ADH: 30 min Cortisol: 2-4 hr GH: 24hr
What does ADH do?
Concentrates urine
What is Diabetes Insipidus?
Too little ADH => urinate a lot
What is Central DI?
Brain not making ADH
What is Nephrogenic DI?
Blocks ADH receptor, can be caused by Li and Domecocycline
What does the Water Deprivation test tell you?
Water Deprivation => DI
*fails to concentrate urine
What does giving DDAVP tell you?
DDAVP => Central DI
concentrate >25%
What is SIADH?
Too much ADH => expand plasma volume => pee Na
What is the diference between DI and SIADH?
DI has dilute urine,
SIADH has concentrated urine
What is Psychogenic Polydipsia?
Pathologic water drinking => low plasma osmolarity
What does Aldosterone do?
Reabsorbs Na, secretes H+ /K+
What is a Neuroblastoma?
Adrenal medulla tumor in kids, dancing eyes/feet, secretes catecholamines
What is a Pheochromocytoma?
Adrenal medulla tumor in adult’s, 5P’s
What does zona glomerulosa make?
Aldosterone “salt”
What does Zona Fasiculata make?
Cortisol “sugar”
What does Zona Reticularis make?
Androgens “sex”
What is Conn’s syndrome?
High Aldo (tumor), Captopril test makes it worse
What does ANP do?
Inhibits Aldo, dilates renal artery (afferent arteriole)
What does Calcitonin do?
Inhibits osteoclasts => low serum Ca+2
What is MEN I?
“Wermer’s”: Pancreas, Pituitary, Parathyroid adenoma (high gastrn) “PPP”
What is MEN II?
“Sipple’s”: Pheo, Medullary thyroid cancer, PTH
What is MEN III?
“MEN IIb”: Pheo, Medullary thyroid cancer, Oral/GI neuromas
What does CCK do?
Gallbladder contraction, bile release
What does Cortisol do?
Gluconeogenesis by proteolysis=>thin skin
What is Addison’s disease?
Autoimmune destruction of adrenal cortex => hyperpigmentation, ^ACTH
What is Waterhouse Friderichsen?
Adrenal Hemorrhage
What is Cushings syndrome?
High cortisol (pituitary tumor or adrenal tumor or small cell lung CA)
What is Cushing’s disease?
High ACTH (pituitary tumor)
What is Nelson’s syndrome?
Hyperpigmentation after adrenalectomy
If the low dose dexamenthasone test suppresses, what does that tell you?
Normal, obese, or depressed
If the low dose dexamenthasone test does not suppress, what does that tell you?
Cushing’s => do high dose test
if the high dose dexamenthasone test suppresses, what does that tell you?
Pituitary tumor=> ACTH (call brain surgeon)
if the high-dose dexamenthasone test does not suppress, what does that tell you?
Adrenal adenoma=> Cortisol (call general surgeon)
Small cell lung cancer=> ACTH (call thoracic surgeon)
What are the survival hormone?
Cortisol: permissive under stress
TSH: permissive under normal
What does Epinephrine do?
Gluconeogenesis, glycogenolysis
What does Erythropoietin do?
Makes RBCs
What does Gastrin do?
Stimulates parietal cells => IF, H+
What does Growth Hormone do?
Growth, sends somatomedin to growth plates, gluconeogenesis by proteolysis.
What is a Pygmie?
No somatomedin receptors
What is Achondroplasia=Laron Dwarf?
Abnormal FGF receptors in extremities
What is a Midget?
lower somatomedin receptor sensitivity
What is a Acromegaly?
Adult bones stretch “my hat doesn’t fit”, coarse facial features, large furrowed tongue, deep husky voice, jaw protrussion, ^IGF-1b/c of GH tumor
What is Gigantism?
childhood acromegaly
What does GIP do?
Enhances insulin action=> post-prandial hypoglycemia
What does Glucagon do?
Gluconeogenesis, glycogenolysis, lipolysis, ketogenesis
What does Insulin do?
Pushes glucose into cells
What is Type I DM?
Anti-islet cell Ab, GAD Ab, Coxsackie B, low insulin, DKA, polyuria, polydipsia, polyphagia
What is Type II DM?
Insulin receptor insensitivity, high insulin, HONK coma, acanthosis nigricans
How does DKA present?
Kussmaul respirations
What is the Dawn phenomenon?
Morning hyperglycemia 2 to GH
What is the Somogyi Effect?
Morning hyperglycemia 2o to evening hypoglycemia
What is Factitious Hypoglycemia?
Insulin injection (^ insulin, lowers C-peptide)
What is an Insulinoma?
Tumor (^insulin, ^Cpeptide)
What is Erythrasma?
Rash in skin folds, coral red wood’s lamp
What is syndrome x= metabolic syndrome?
“Pre DM” => HTN, dyslipedemia, hyperinsulinemia, acanthosis nigricans
What are foot ulcer risk factors?
DM/Glycemic control
Male smoker
Bony abnormalities
Previous ulcers
What conditions cause weight gain?
Obesity Hypothyroidism Depression Cushings Anasarca
What does Motilin do?
Stimulates segmentation (1o peristalsis, MMC)
What does Oxytocin do?
Milk ejection, baby ejection
What does PRL do?
Milk production
What does PTH do?
Chews up bone
What does Vit D do?
Builds bone
What do parathyroid chief cells secrete?
PTH
What do stomach chief cells secrete?
Pepsin
What is the difference between Norepinephrine and Epinephrine?
NE: Neurotransmitter
Epi: Hormone
What is 1o hyperparathyroidism?
Parathyroid adenoma
What is 2o hyperparathyroidism?
Renal failure
What is Familial Hypocalciuria Hypercalcemia?
lowers Ca excretion
What if both serum Ca and PO4 decrease?
Vit D deficiency
What if serum Ca and PO4 change in opposite directions?
PTH problem
High Ca => hyper PTH
Low Ca=> hypoPTH
What is the most common cause of 1o hypoparathyroidism?
Thyroidectomy
What is Pseudohypoparathyroidism?
Bad kidney PTH receptor, decreases urinary cAMP
What is Pseudopseudohypoparathyroidism?
G protein defect no Ca+2 problem
What is Hungry Bone syndrome?
Remove PTH -> bone sucks in Ca+2
What does Secretin do?
Secretion of bicarb, inibit gastrin, tighten pyloric sphincter
What does Somatostatin do?
Inhibits secretin, motilin, CCK
What do T3 and T4 do?
Growth, differentiation
What disease has Exophthalmos?
Grave’s
What disease has Enophthalmos?
Horner’s
What are the Hyperthyroid disease?
Grave's DeQuervain's Silent thyroiditis Plummer's Jod-Basedow
Grave’s
Exophthalmos, peritibial myxedema, TSHr Ab
DeQuervain’s
Viral, painful jaw
Silen thyroiditis
Post-partum
Plummer’s
Benign adenoma, old person
Jod-Basedow
Transient hyperthyroidism due to ^ I
What are the Hypothyroid disease?
Hashimotos Reidel Struma Cretin Euthyroid sick syndrome Wolff-Chaikoff
Hashimoto’s
Antimicrosomal Ab=TPO Ab
Reidel’s struma
Woody neck
Cretin
Freaky features, hypothyroid Mom and Baby
Euthyroid sick syndrome
Low T3, syndrome
Wolff-Chaikoff
Transient hypothyroidism
What is Plummer’s syndrome?
Hyperthyroid adenoma
What is Plummer-Vinson syndrome?
Esophageal webs
What does Testosterone do?
Makes external male genitalia
What does Mullerian Inhibiting Factor do?
Makes internal male genitalia
What do TPO and Thymosin do?
Help T cells mature
What does VIP do?
Inhibits secretin, motilin, CCK
How doesa VIPoma present?
Watery diarrhea
How does a SSoma present?
Constipation
What are the hormones with disulfide bonds?
“PIGI”
PRL
Insulin
GH
Inhibin
Which hormones have the same alpha subunits?
LH, FSH
TSH
B-HCG
What hormones produce acidophils?
“GAP”
GH
PRL
What hormonones produce basophils?
“B FLAT”
FSH
LH
ACTH
TSH
Signaling Pathway of cAMP
FLAT ChAMP
FSH, LH, ACTH, TSH, CRH, hCG, ADH (V2 receptor), MSH, PTH, calcitonin, GHRH, glucagon
Signaling Pathway of cGMP
- Think Vasodilators*
ANP, BNP, NO (EDRF)
Signaling Pathway of IP3
GOAT HAG
GnRH, Oxytocin, ADH, (v1 receptor), TRH, Histamine (H1 receptor), Angiotensin II, Gastrin, Vasopressin?*
Signaling Pathway of Intracellular receptor (steroid receptor)
VETTT CAP
Vit D, Estrogen, Testosterone, T3/T4, Cortisol, Aldosterone, Progesterone
Signaling Pathway Intrinsic tyrosine kinase
MAP kinase pathway (think growth factors)
Insulin, IGF-1, FGF, PDGF, EGF
Signaling pathways of Receptor associated tyrosine kinase
JAK/STAT pathway (Think acidophils and cytokines)
PIGGLET
Prolactin, Immunomodulators (e.g. cytokines Il2, IL 6, IFN), GH, G-CSF, Erytropoietin, Thromobopoietin
