Endocrinology Flashcards
1
Q
What is Necrosis?
A
Non-programmed cell death. Nucleus destroyed first
2
Q
What is Apoptosis?
A
Programmed cell death, no inflammation, and cell membrane dissolved first. Nucleus guides death & destroyed last
3
Q
What is Pyknosis?
A
Nucleus turns into blobs. (shrinkage)
4
Q
What is Karyorrhexis?
A
Nucleus fragments
5
Q
What is Karyolysis?
A
Nucleus dissolves
6
Q
What is a Somatotrope?
A
Growth hormone
7
Q
What is a Gonadotrope?
A
LH and FSH
8
Q
What is a Thyrotrope?
A
TSH
9
Q
What is a Corticotrope?
A
ACTH
10
Q
What is a Lactotrope?
A
PRL – Prolactin
11
Q
What receptors do Protein Hormones use?
A
Cell membrane receptors
12
Q
What receptors do Steroid Hormones use?
A
Nuclear membrane receptors (except cortisol cytoplasmic receptor)
13
Q
What are the Steroid Hormones?
A
Progesterone, Estradiol (E2), Testosterone, Cortisol, and Aldosterone
14
Q
What does Endocrine mean?
A
Secreted into bood
15
Q
What does Exocrine mean?
A
Secreted into a duct
16
Q
What is Autocrine?
A
Works on itself. (except T-cell activation)
17
Q
What is Paracrine?
A
Works on its neighbor. (except sweat gland)
18
Q
What is Merocrine?
A
Cell is maintained. (exocytosis)
19
Q
What is Apocrine?
A
Apex of the cell is secreted
20
Q
What is Holocrine?
A
The whole cell is secreted. (except sebaceous gland)
21
Q
What organs do not require insulin to absorb glucose?
A
“BRICKLE”: Brain, RBC, Intestine, Cardiac / Cornea, Kidney, Liver and Exercising muscle
22
Q
What is the function of GnRH?
A
Stimulates release of LH & FSH
23
Q
What is the function of GRH?
A
Stimulates GH release
24
Q
What is the function of CRH?
A
Stimulates ACTH release
25
What is the function of TRH?
Stimulates TSH release
26
What is the function of PRH?
Stimulates Prolactin (PRL) release
27
What does Dopamine (DA) do?
Inhibits Prolactin (PRL) release
28
What does Somatostatin (SS) do?
Inhibits growth hormone (GH) release
29
What does Antidiuretic hormone (ADH) do?
Conserves water (V2 aquaporin receptors) and vasoconstriction
30
What does Oxytocin do?
Milk letdown and uterine contractions
31
What does Growth Hormone (GH) do?
Stimulates Insulin Growth Factor-1 (IGF-1) release from the liver
32
What is the function of TSH (Thyroid stimulating hormone)?
Stimulates release of T3 and T4 from the thyroid.
T3= Triiodothyronine
T4= Thyroxine
33
What is the fucntion of LH (Luteinizing hormone)?
Stimulates Testosterone release from the testis, Androgens and Progesterone release from the ovary
34
What is the function of FSH
Male: sperm, MIF, inhibin B
Female: Stimulates Estradiol (E2)
35
What is the function of Prolactin (PRL)?
Milk production
36
What is the function of ACTH (Adrenocorticotropic hormone)?
Stimulates Cortisol and Androgen releases from the adrenal gland
37
What is the fucntion of MSH (melanocyte-stimulating hormones)?
Provides skin pigmentation
38
What are the Stress Hormones and when do they appear?
Immediately Epinephrine, Glucagon (20 minutes), Insulin & ADH (30 minutes), Cortisol (2-4 hours), and growth hormone (24 hours)
39
What is the Primary Diabetes Insipidus (DI)?
Too much water (urinates a lot)
40
What is Central (neurogenic) diabetes insipidus?
Brain not making or producing enough ADH
41
What is Nephrogenic diabetes insipidus?
ADH (V2 aquaporin) is blocked or broken. Lithium association and Demeclocycline
42
What does the Water Deprivation Test tell you?
If the patient fails to concentrate urine, they do not have Primary DI
43
What does giving DDAVP during the Water deprivation tests tell you?
>50% increase (central complete DI),
10-50% increase (central partial DI),
<10% (psychogenic polydipsia),
no change (nephrogenic DI)
44
What is SIADH?
Too much ADH present causes plasma volume to expand Serum Na+ less than 120
45
What is the difference between DI and SIADH?
DI: diluted urine
SIADH: concentrated urine
46
What is the Psychogenic Polydipsia?
Pathologic water drinking will have low plasma osmolality
47
What does Aldosterone do?
Reabsorbs Na+ and three waters
48
What does Atrial Natriuretic Peptide do?
Inhibits aldosterone and dilates the afferent arteriole
49
What is a Neuroblastoma?
Adrenal medulla tumor in kids, dancing eyes and feet and secretes catecholamine's
50
Whatis Pheochromocytoma?
Adrenal medulla tumor in adults, they will have five P's: Palpitations, Perspiration, Pallor, Pressure (HTN), and Pain (headache)
51
What are the layers of the Adrenal Cortex and what do they produce?
```
Zona Glomerulosa (Aldosterone),
Zona Fasciculate (Cortisol),
Zona Reticularis (Androgens)
```
52
What is Conn's Syndrome?
High Aldosterone (primary tumor), Cpatopril test makes it worse, and increase's secretin hormone
53
What does Calcitonin do?
Inhibits Osteoclasts and binds to calcium
54
What is Multiple Endocrine Neoplasia I?
"Wermer's" 3 P's: Pancreas, Pituitary, Parathyroid adenoma
55
What is Multiple Endocrine Neoplasia II (2A)?
"Sipple's" Pheochromocytoma, Medullary Carcinoma of the Thyroid, Parathyroid Adenoma. (tumor marker RET)
56
What is Multiple Endocrine Neoplasia III (2B)?
Pheochromocytoma, Medullary Carcinoma of the Thyroid, Mucosal Neuromas/ Marfanoid body habitus. (tumor marker RET)
57
What does CCK (Cholecystokinin) do?
Stimulates bile release and gallbladder contraction, inhibits gastric motility (closes sphincters), and made by I-cell of duodenum
58
What does cortisol do?
Gluconeogenesis by proteolysis and thins the skin, prevents and immune response, and decrease bone mass
59
What is Addison's disease?
Autoimmune destruction of adrenal cortex, causes hyperpigmentation (looks tan), and increased ACTH
60
What is Waterhouse-Friderichsen syndrome (WSF) or Hemorrhagic Adrenalitis or Fulminant Meningococcemia?
Adrenal hemorrhage most commonly due to Meningococcus Neisseria Meningitides
61
What can cause Cushing's syndrome?
High cortisol produced from an adrenal tumor
62
What is Cushing's disease?
High ACTH due to pituitary tumor or Small cell carcinoma of the lungs
63
When performing a low does dexamethasone test, a depression in ACTH levels occur, what does that tell you?
Patient is either depressed, obese, or it's a normal variant, if the low dose Dexamethasone test does not suppress...
64
When performing a high dose dex. Test, if positive...
Patient has a pituitary tumor
65
Negative high dose Dex. and High ACTH levels?
Ectopic ACTH- small cell CA of the lungs
66
Negative high dose Dex. and low ACTH levels?
Adrenal CA (high cortisol)
67
What are the Survival Hormones?
Cortisol: permissive under stress.
TSH: permissive under normal
68
What does epinephrine (Epi) do?
Drives gluconeogenesis and glycogenolysis
69
What does erythropoietin (EPO) do?
Makes RBC's (prolong RBC life)
70
What does Gastrin do?
Stimulates parietal cells to release intrinsic factor (IF) and H+
71
What does Growth Hormone (GH) do?
Stimulates growth, sends Somatomedin to growth plates, Gluconeogenesis by proteolysis
72
What is achondroplasia (Laron Dwarf)?
Patient with abnormal FGF receptors in exremities. (abnormal FGF3)
73
What is the receptor problem with Midgets?
Patient with decreased Somatomedin receptor sensitivity
74
What is Acromegaly?
Growth hormone tumor producing increased IGF-1 causing: bone growth in adults, coarse facial features, large furrowed tongue, deep husky voice, jaw protrusion
75
What is Gigantism?
Childhood form of Acromegaly
76
What does Gastric Inhibitory Peptide (GIP) do?
Increases insulin action, responsible for post-prandial hypoglycemia
77
What does Glucagon do?
Active in Gluconeogenesis, Glucogenolysis, Lipolysis, and Ketogenesis
78
What does Insulin do?
Pushes glucose into cells and K+ follows
79
What is Type 1 Diabetes Mellitus?
Anti-islet cell antibody /GAD (Glutamic Acid Decarboxylase) antibody.
80
What is Type 2 Diabetes Mellitus and associations?
Insulin receptor insensitivity, HONK coma, Acanthosis Nigricans
81
How does DKA present?
Kussmaul respirations, fruity breath (acetone), and altered mental status
82
What is the Dawn Phenomenon?
Morning hyperglycemia secondary to Growth Hormone
83
What is the Somogyi Effect?
Morning hyperglycemia secondary to evening hypoglycemia
84
What is factitious hypoglycemia?
Exogenous insulin use, labs show elevated insulin and decreased C-peptide
85
What is an Insulinoma?
Insulin secreting tumor, labs show increased insulin and C-peptide
86
What is Erythrasma?
Rash in the skin folds, coral-red under Wood's Lamp
87
What is Metabolic Syndrome X?
"Pre-DM" due to HTN, Dyslipidemia, Hyperinsulinemia, and Acanthosis Nigricans
88
What are the Foot Ulcer Risk Factors?
Poor glycemic control (HbA1C >7), smoking, bony abnormalities, previous ulcers
89
What conditions cause weight gain?
Obesity, Hypothyroidism, Depression, Cushing's, Anasarca
90
What does motilin do?
Stimulates segmentation, primary peristalsis, and migrating motor complexes (MMC)
91
What does PTH do?
Stimulates osteoblast to activate osteoclasts, stimulates the reabsorption of Ca+ and the excretion of phosphate in the kidneys, and activation of vitamin D
92
What does Vitamin D do?
Helps in calcium absorption from the GI tract
93
What does the parathyroid cells secrete?
PTH
94
What do stomach chief cells secrete?
Pepsin
95
What is the difference between norepinephrine and epinephrine?
NE: Neurotransmitter
EPI: Hormone
96
What diagnosis has primary hyperparathyroidism?
Parathyroid Adenoma
97
What diagnosis has secondary hyperparathyroidism?
Renal failure
98
What is familial Hypocalciuria Hypercalcemia?
Patients with decreased calcium excretion
99
What disease process is present when both Serum Ca2+ and Serum Phosphate (PO4-) are decreased?
Vitamin D deficiency
100
What type of problem is there if serum Ca2+ and Serum PO4- change in same directions?
This is a secondary problem
101
What is the most common cause of primary hypoparathyroidism?
Thyroidectomy
102
What is pseudo-hypoparathyroidism?
Bad kidney, PTH receptor, decreased urinary, cAMP
103
What is pseudo-pseudo-hypoparathyroidsm?
G-Protein defect, and there is no calcium problem
104
What is Hungry Bone Syndrome?
Removal of PTH and the bone sucks in calcium
105
What does secretin do?
Secretion of bicarbonate, inhibit gastrin, tighten Pyloric Sphincter, and secreted by S-cell Duodenum
106
What does somatostatin do?
Inhibits secretin, motilin, and CCK
107
What is the function of T3 and T4?
Growth and differentiation
108
What disease has exophthalmos?
Grave's disease
109
What other diseases can have exophthalmos?
Horner's and Marfan's
110
What are the hyperthyroid diseases?
```
Grave's
DeQuervain's
Silent Thyroiditis
Plummer's
Jod-Basedow
```
111
What do you see in Grave's Disease?
Exophthalmos, Pretibial myxedema, anti-TSH receptor antibodies
112
What do you see in DeQuervain's disease?
Viral origin, painful jaw, hypothyroid
113
When do you see silent thyroiditis?
Post-partum patients
114
When will you see Plummer's Disease?
Patients with benign adenoma and or patients over 50 yrs. old. In an iodine scan, it looks like a nodular patter
115
What is Jod-Basedow Disease?
Transient hyperthyroidism due to increased iodine
116
What are the hypothyroid diseases?
Hashimoto's, Riedel's, Cretinism, Euthyroid SIck syndrome, Wolff-Chaikoff
117
What is Riedel's Struma?
"Woody" connective tissue in neck, death due to suffocation and must rule out CA
118
What is Cretinism?
Mom and baby are hypothyroid
119
What is Euthyroid Sick Syndrome?
LOW T3 Syndrome and decreased conversion of T4 to T3 (increased T3r)
120
What is Wolff-CHaikoff?
Transient hypothyroidism
121
What is Plummer's Syndrome?
Hyperthyroid adenoma
122
What is Plummer-Vinson Syndrome?
Esophageal webs, Iron-deficiency anemia, dysphagia
