Endocrinology

Question 1

Myxedema

Answer 1

Hypothyroidism

Question 2

Grave’s disease

Answer 2

Hyperthyroidism
Immune antibodies bind to and activate TSH receptors on the thyroid, stimulating increased TRH production, stimulating T3/T4 production

Question 3

T3 and T4

Answer 3

Two forms of thyroid hormone - T3 is more active

Question 4

Galactorrhea

Answer 4

Inappropriate lactation in men; may be caused by high levels of prolactin

Question 5

Prolactin

Answer 5

Default is ‘on’, dopamine released from hypo. prevents production/release
Causes lactogenesis, inhibits ovulation, causes breast development

Question 6

Acromegaly

Answer 6

Excessive growth hormone
S/S - large jaw, prominent forehead, large nose
Happens slowly b/w ages 20 and 50

Question 7

Somatomedin

Answer 7

Insulin-like growth factor
Small proteins produced in the liver w/ growth hormone stimulation
Cause growth effects

Question 8

Somatostatin

Answer 8

Growth hormone inhibiting hormone or somatotropin release-inhibiting factor
Released by hypothalamus and GI tract when eating
Modulates glucose/glucagon response to eating

Question 9

Oxytocin

Answer 9

Posterior pituitary hormone
Causes uterine contraction and milk ejection
Triggered by suckling; sight, sound and smell of infant; cervical dilation; and orgasm
Clinical use - labor induction, reducing pospartum bleeding, ?psych - increasing trust?

Question 10

SIADH

Answer 10

Syndrome of Inappropriate ADH secretion
S/S - low plasma osmolarity (too much H20)
Causes - lymph cell carcinoma

Question 11

Diabetes insipidus

Answer 11

Central DI - pituitary not producing ADH

Nephrogenic - Loss of osmotic gradient in kidneys creates inability to concentrate filtrate

Question 12

Posterior pituitary (neurohypophysis) hormones

Answer 12

Oxytocin

ADH

Question 13

Anterior pituitary (adenohypophysis) hormones

Answer 13

Growth hormone (GHRH)
Thyroid stimulating hormone (TRH)
Follicle stimulating hormone (GnRH)
Luteinizing hormone (GnRH)
Prolactin (PIH/Dopamine - inhibits production)
ACTH (CRH)

Question 14

Cretinism

Answer 14

Hypothyroid disease in childhood/infancy

S/S - floppy musculature, sleeping a lot, protruding tongue, mental retardation

Question 15

Pathway from hypothalamus to thyroid

Answer 15

Hypo — (TRH) —> anterior pituitary — (TSH) —> thyroid — (T3/T3) —>

Question 16

Gluconeogensis

Answer 16

Making glucose from fats and proteins

Question 17

Catecholamines

Answer 17

Epi, Norepi

Question 18

Actions of adrenal glucocorticoids

Answer 18

Cortisol
Increase gluconeogenesis
Decrease insulin sensitivity
Anti-inflammatory
Suppresses immune system, esp. cytotoxic T
Increase GFR
Inhibits bone formation
Maintain vascular responsiveness to catecholamines

Question 19

Actions of adrenal mineralcorticoids

Answer 19

Aldosterone

Increase Na+ reabsorption, K+ secretion, H+ secretion

Question 20

Actions of adrenal androgens

Answer 20

Males - small effect

Females - pubic and axillary hair

Question 21

Pathway from hypothalamus to adrenal gland

Answer 21

Hypo — (CRH) —> Anter. Pit. — (ACTH) —> Adrenal

Question 22

Empty sella syndrome

Answer 22

Pregnant women have overactive pituitary glands (high metabolic rate)
If they lose a lot of blood during birth, decreased blood flow can cause infarction in some or all of the pituitary

Question 23

Primary hormone problem

Answer 23

Sometime wrong with the gland that’s making the hormone

Question 24

Secondary hormone problem

Answer 24

Gland is okay but something is wrong with whatever stimulates it

Question 25

Involution

Answer 25

Shrinking of an organ due to old age or inactivity

Question 26

Type I diabetes

Answer 26

Insulin dependent

Question 27

Type II diabetes

Answer 27

Non-insulin dependent | Tx - weight loss, diet, metformin (increase insulin sensitivity), sulfonylureas (increase insulin production)

Question 28

Effects of insulin

Answer 28

Glucose transport into cell K+ transport into cell (can use insulin to treat hyperkalemia) Increase glycogen production in muscles and liver Increase fat storage

Question 29

Hormones made in the pancreas

Answer 29

Insulin (beta cells) Glucagon (alpha cells) Somatostatin (delta)

Question 30

GIP/GLP-1

Answer 30

Gastric inhibitory peptide/Glucagon-like peptide Some diabetes drugs prolong their presence Oppose the actions of glucagon and stimulates insulin secretion

Question 31

Hypocalcemia S/S

Answer 31

Hyperreflexia Muscle spasms Twitching Trosseau's sign (carpo-pedal spasm w/ BP cuff inflation) Chvostek's sign (facial twitching when you tap on the facial nerve)

Question 32

Hypercalcemia S/S

Answer 32

``` Polyuria Polydipsia Hyporeflexia Constipation Lethargy Coma ```

Question 33

Actions of vitamin D

Answer 33

Increase Ca+2 renal reabsorption, gut absorption and bone deposition

Question 34

Pathway for producing active form of vitamin D

Answer 34

UV light turns 7-dehydrocholesterol to cholecalciferol in skin, livers turns it into 25-OH-cholecaciferol; kidney turns it into 1,25-dihydroxycholecalciferol (active) or 24,25-dihydroxycholecalciferol (inactive)