Endocrinology Flashcards
1
Q
What is a Somatotrope?
A
GH
2
Q
What is a Gonadotrope?
A
LH, FSH
3
Q
What is a Thyrotrope?
A
TSH
4
Q
What is a Corticotrope?
A
ACTH
5
Q
What is a Lactotrope?
A
PRL
6
Q
What receptors do protein hormones use?
A
Cell membrane receptors
7
Q
What receptors do steroid hormones used?
A
Nuclear membrane receptors
8
Q
What are the steroid hormones?
A
PET CAD
- Progesterone
- E2 = estriol
- Testosterone
- Cortisol
- Aldosterone
- D vitamin
*Note: Thyroid hormone acts like a steroid
9
Q
What does endocrine mean?
A
Secretion into blood
10
Q
What does exocrine mean?
A
Secretion into non-blood
11
Q
What is Autocrine?
A
Works on itself
12
Q
What is Paracrine?
A
Works on its neighbor
13
Q
What is Merocrine?
A
Cell is maintained => exocytosis
14
Q
What is apocrine?
A
APEX of the cell is secreted
15
Q
What is Holocrine?
A
The WHOLE cell is secreted
16
Q
What organs do not require insulin?
A
BRICKLE
- brain
- RBC
- intestine
- cardiac, cornea
- kidney
- liver
- exercising muscle
17
Q
What does GnRH do?
A
Stimulates LH, FSH production
18
Q
What does GRH do?
A
Stimulates GH production
19
Q
What does CRH do?
A
Stimulates ACTH production
20
Q
What does TRH do?
A
Stimulates TSH production
21
Q
What does PRH do?
A
Stimulates PRL production
22
Q
What does DA (dopamine) do?
A
Inhibits PRL production
23
Q
What does SS (somatostatin) do?
A
Inhibits GH production
24
Q
What does ADH do?
A
Conserves water
Vasoconstricts
25
What does oxytocin do?
Milk letdown
Baby letdown
26
What does GH do?
IGF-1 release from liver
27
What does TSH do?
T3, T4 release from thyroid
28
What does LH do?
Testosterone release from testis
E2 and Progesterone release from ovary
29
What does FSH do?
Sperm or egg growth
30
What does PRL do?
Milk production
31
What does ACTH do?
Cortisol release from adrenal gland
32
What does MSH do?
Skin pigmentation
33
What are the stress hormones?
Epi - immediate
Glucagon - 20 min
Insulin - 30 min
ADH - 30 min
Cortisol - 2-4 hours
GH - 24 hours
34
What does ADH do?
Concentrates urine
35
What is diabetes insipidus?
Too little ADH => urinate a lot
36
What is Central DI?
Brain not making ADH
37
What is Nephrogenic DI?
Blocks ADH receptor
Can be caused by Lithium and Democycline
38
What does the water deprivation test tell you?
Water deprivation => DI fails to concentrate urine
High specific gravity
High osmolarity
39
What does giving DDAVP (desmopressin) tell you?
Central DI concentrates >25%
40
What is SIADH?
Too much ADH
=> expand plasma vol => pee Na
41
What is the difference b/w DI and SIADH?
DI has dilute urine
SIADH has concentrated urine
42
What is psychogenic polydipsia?
Pathologic water drinking
=> low plasma osmolarity
43
What does Aldosterone do?
Reabsorbs Na
Secretes H/K
44
What is a neuroblastoma?
Adrenal medulla tumor in kids
Dancing eyes/feet
Secretes catecholamines
45
What is a pheochromocytoma?
Adrenal medulla tumor in adults
5 Ps
- pressure (HTN)
- pain (HA)
- perspiration
- palpitations
- pallor
46
What does the zona glomerulosa make?
Aldosterone “salt”
47
What is the primary regulatory control for the zona glomerulosa?
Renin-angiotensin
48
What does the zona fasciculata make?
Cortisol “sugar”
49
What is the primary regulatory control for the zona fasciculata?
ACTH, CRH
50
What does the zona reticularis make?
Androgens “sex”
51
What do chromaffin cells produce?
Catecholamines
52
What is the primary regulatory control for the chromaffin cells?
Preganglionic sympathetic fibers
53
What is Conn’s syndrome?
High aldosterone (tumor)
Captopril test makes it worse
54
What does ANP do?
Inhibits Aldosterone
Dilates renal artery (afferent arteriole)
55
What does calcitonin do?
Inhibits osteoclasts
=> low serum Ca
56
What is MEN I?
Wermer’s
Pancreas
Pituitary
Parathyroid adenoma
High gastrin
57
What is MEN II?
Sipple’s
Pheochromocytoma
Medullary thyroid cancer
PTH
58
What is MEN III?
= MEN IIb
Pheochromocytoma
Medullary thyroid cancer
Oral/GI neuromas
59
What does CCK do?
Gallbladder contraction
Bile release
60
What does cortisol do?
Gluconeogenesis by proteolysis
=> thin skin
61
What is Addison’s disease?
Autoimmune destruction of adrenal cortex
=> hyperpigmentation
Elev ACTH
62
What is Waterhouse-Friderichsen?
Adrenal hemorrhage
63
What is Cushing’s Syndrome?
High cortisol
(Pituitary tumor or adrenal tumor or small cell lung carcinoma)
64
What is Cushing’s disease?
High ACTH
(Pituitary tumor)
65
What is Nelson’s syndrome?
Hyperpigmentation after adrenalectomy
66
If the low-dose Dexamethasone test suppresses, what does that tell you?
Normal
Obese
Depressed
67
If the low-dose Dexamethasone test does not suppress, what does that tell you?
Cushing’s
=> do high dose test
68
If the high-dose Dexamethasone test suppresses, what does that tell you?
Pituitary tumor
=> ACTH
(call brain surgeon)
69
If the high-dose Dexamethasone test does not suppress, what does that tell you?
Adrenal adenoma
=> Cortisol
(Call general surgeon)
Small cell lung cancer
=> ACTH
(Call thoracic surgeon)
70
What are the survival hormones?
Cortisol: permissive under stress
TSH: permissive under normal conditions
71
What does epinephrine do?
Gluconeogenesis
Glycogenolysis
72
What does erythropoietin do?
Makes RBCs
73
What does Gastrin do?
Stimulates parietal cells
=> IF and H+
74
What does growth hormone do?
Growth
Sends somatomedin to growth plates
Gluconeogenesis by proteolysis
75
What is a pygmie?
No somatomedin receptors
76
What is achondroplasia (= Laron dwarf)?
Abnormal FGF receptors in extremities
77
What is a Midget?
Decreased somatomedin receptor sensitivity
78
What is acromegaly?
Adult bones stretch = “my hat doesn’t fit”
Course facial features
Large furrowed tongue
Deep husky voice
Jaw protrusion
Elev IGF-1 b/c of GH tumor
79
What is gigantism?
Childhood acromegaly
80
What does GIP do?
Enhances insulin action
=> post-prandial, hypoglycemia
81
What does glucagon do?
Gluconeogenesis
Glycogenolysis
Lipolysis
Ketogenesis
82
What does insulin do?
Pushes glucose into cells
83
What is Type I DM?
Anti-islet cell Ab
Glutamic acid decarboxylase Ab
Coxsackie B
Low insulin
DKA
Polyuria
Polydipsia
Polyphagia
84
What is Type II DM?
Insulin receptor insensitivity
High insulin
HONK coma = Hyperglycemic Hyperosmolar NonKetotic
Acanthosis
85
How does DKA present?
Kussmaul respirations
Fruity breath (acetone)
Altered mental
86
What is the Dawn phenomenon?
Morning hyperglycemia, secondary to GH
87
What is the Somogyi Effect?
Morning hyperglycemia, secondary to evening hypoglycemia
88
What is factitious hypoglycemia?
Insulin injection
- elev insulin
- decr C-peptide
89
What is an insulinoma?
Tumor
- elev insulin
- elev C-peptide
90
What is Erythrasma?
Rash in skin folds
Coral-red Wood’s lamp
91
What is Syndrome X (= metabolic syndrome)?
Pre-DM =>
- HTN
- dyslipidemia
- hyperinsulinemia
- acanthosis nigricans
92
What are foot ulcer risk factors?
- DM/Glycemic control
- male smoker
- bony abnormalities
- previous ulcers
93
What conditions cause weight gain?
- obesity
- hypothyroidism
- depression
- Cushing’s
- Anasarca (= generalized swelling)
94
What does motilin do?
Stimulates segmentation
- Primary peristalsis
- MMC
95
What does oxytocin do?
Milk ejection
Baby ejection
96
What does PRL do?
Milk production
97
What does PTH do?
Chews up bone
“Phosphate trashing hormone”
98
What does Vit D do?
Builds bone
99
What do parathyroid chief cells secrete?
PTH
100
What do stomach chief cells secrete?
Pepsin
101
What is the difference between norepinephrine and epinephrine?
NE: neurotransmitter
Epi: hormone
102
What is primary hyperparathyroidism?
Parathyroid adenoma
103
What is secondary hyperparathyroidism?
Renal failure
104
What is familial hypocalciuria hypercalcemia?
Decr Ca excretion
105
What if both serum Ca and PO4 decrease?
Vitamin D deficiency
106
What if serum Ca and PO4 change in opposite directions?
PTH problem
- high Ca => hyperPTH
- low Ca => hypoPTH
107
What is the most common cause of primary hypoparathyroidism?
Thyroidectomy
108
What is pseudohypoparathyroidism?
Bad kidney PTH receptor
Decr urinary cAMP
109
What is pseudopseudohypoparathyroidism?
G-protein defect
No Ca problem
110
What is Hungry Bone syndrome?
Remove PTH -> bone sucks in Ca
111
What does secretin do?
Secretion of bicarb
Inhibit gastrin
Tighten pyloric sphincter
112
What does somatostatin do?
Inhibits secretin, motilin, CCK
113
What do T3 and T4 do?
Growth
Differentiation
114
What disease has exophthalmos?
Grave’s disease
115
What disease has enophthalmos?
Horner’s syndrome
116
What are the Hyperthyroid diseases?
Grave’s disease
DeQuervain’s
Silent thyroiditis
Plummer’s
Jod-Basedow
117
What are characteristics of Grave’s disease?
Exophthalmos
Pretibial myxedema
TSH-receptor Ab
118
What are characteristics of DeQuervain’s?
Post-viral
Painful jaw
119
What is a characteristic of silent thyroiditis?
Post-partum
120
What are characteristics of Plummer’s syndrome?
Benign adenoma
Old person
121
What is a characteristic of Jod-Basedow?
Transient hyperthyroidism due to elevated Iodine
122
What are the hypothyroid diseases?
Hashimoto’s
Reidel’s struma
Cretin
Euthyroid sick syndrome
Wolff-Chaikoff
123
What is seen in Hashimoto’s?
Antimicrosomal Ab = TPO Ab
124
What is a manifestation of Reidel’s struma?
Woody thyroid
125
What are manifestations of Cretin?
Freaky features
Hypothyroid mom and baby
126
What is a manifestation of Euthyroid sick syndrome?
Low T3 syndrome
127
What is a manifestation of Wolff-Chaikoff?
Transient hypothyroidism
128
What is Plummer’s syndrome?
Hyperthyroid adenoma
129
What is Plummer-Vinson syndrome?
Esophageal webs
130
What does Testosterone do?
Makes external male genitalia
131
What does Müllerian inhibiting factor?
Makes internal male genitalia
132
What do TPO and thymosin do?
Help T cells mature
133
What does VIP do?
Inhibits secretin, motilin, CCK
134
How does a VIPoma present?
Watery diarrhea
135
How does a SSoma (somatostatinoma) present?
Constipation
136
What are the hormones with disulfide bonds?
PIGI
- PRL
- Insulin
- GH
- Inhibin
137
Which hormones have the same alpha-subunits?
LH, FSH
TSH
ẞ-hCG
138
What hormones produce acidophils?
GaP
- GH
- PRL
139
What hormones produce basophils?
B-FLAT
- FSH
- LH
- ACTH
- TSH
