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Endocrinology Flashcards

1
Q

where does the thyroid originate?

what is it derived from

A

pharynx floor

endoderm

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2
Q

remnant of thyroglossal duct

A

foramen cecum

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3
Q

ectopic thyroid tissue

A

tongue

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4
Q

what are the parafollicular cells of the thyroid derived from?

A

neural crest cells

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5
Q

zona glomerulosa
zona fasciculate
zona reticularis
medulla

A

aldosterone
cortisol
sex hormones
catecholamines

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6
Q

posterior pituitary

A

ADH, oxytocin

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7
Q

pituitary derivatives

A

anterior - oral ectoderm

posterior - neuroectoderm

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8
Q

alpha subunit in anterior pituitary

A

subunit common to TSH, LH, FSH, hCG

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9
Q

beta subunit in anterior pituitary

A

determines hormone specificity

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10
Q

POMC –>

A

ACTH + MSH

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11
Q

acidophilic anterior pituitary release

A

GH, PRL

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12
Q

islets of langerhans cells and function

A

a - glucagon
b - insulin
d - somatostatin

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13
Q

where is insulin precursor synthesised?

A

RER

preproinsulin

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14
Q

high insulin low C-peptide

A

exogenous insulin

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15
Q

effects of insulin

A

triglyceride synthesis (+decrease lipolysis)
Na retention
protein synthesis
increase K+ and a.a. uptake

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16
Q 
GLUT
1
2
3
4
5
A

RBC, brain, cornea, placenta
b islet cells, liver, kidney, small intestine
brain, placenta
adipose, striated muscle - insulin dependent
fructose - spermatocytes, GI tract - insulin dependent

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17
Q

better to injest glucose

A

bigger insulin release because GLP-1 is released after meals

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18
Q

glucagon inhibition

A

insulin, hyperglycaemia, somatostatin

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19
Q

somatostatin affect on pituitary

A

decreases GH and TSH

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20
Q

TRH effect on pituitary

A

TSH and prolactin stimulation

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21
Q

Dopamine effect on the pituitary

A

decreases prolactin and TSH

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22
Q

CRH effect on pituitary

A

increases ACTH, MSH, B-endorphin

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23
Q

how does prolactin inhibit itself?

A

increases dopamine

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24
Q

prolactinoma Rx

A

dopamine agonist - bromocriptine

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25
prolactin stimulation
dopamine antagonists - antipsychotics | estrogens
26
GH stimulates
IGF-1
27
when does GH stimulation increase?
exercise, deep sleep, puberty, hypoglycaemia
28
Rx xs GH secretion
somatostatin analogs - octreotide
29
what is GH stimulated by?
ghrelin
30
V1 and V2 receptors
1 - serum osm | 2 - bp
31
nephrogenic DI mutation
V2 receptor
32
Rx central DI
desmopressin acetate (ADH analog)
33
17-a hydroxylase
pregnenolone/progesterone -->17-hydroxy version
34
17-a-hydroxylase defeciency
more aldosterione, decreased others | raised bp, low K+
35
decerased androstenedione
17a-hydroxylase deficiency
36
ambiguous genitalia, undescended testes | female version
17a-hydroxylase deficiency | lacks secondary sexual development
37
21-hydroxylase deficiency
decreased Aldosterone and cortisone, increased sex hormones
38
high renin and 17-hydroxy-progesterone
21-hydroxylase deficiency
39
salt wasting, precocious puberty
21-hydroxylase deficiency
40
11-B hydroxylase deficiency
increased aldosterone, cortisol increased sex hormones, bp decreased renin
41
what causes striae
fibroblast activity increase
42
cortisol decrease in immune response
``` inhibits leukotrienes and prostaglandins inhibits WBC adhesion --> neutrophilia blocks histamine release form mast cells reduces eosinophils blocks IL-2 production ```
43
raised pH and calcium
higher affinity to albumin --> hypocalcemia
44
vitamin D2 | D3
2 - plants, fungi, yeast | 3 - sunlight, fish, plants
45
vitamin D on PTH
increases PTH
46
PTH effects
increases Ca reabsorption increases vitamin D3 production PO4 from bone, PO4 lost in kidney
47
How does PTH affect bone?
increases RANK-L
48
raised PO4 on PTH
increases PTH
49
Mg effect on PTH
low - raises PTH | very low - decreases PTH
50
Calcitonin action
decreases Ca | opposes PTH
51
T3 function
brain maturation, bone growth, B adrenergic, Basal metabolic rate increase
52
changes is TBG leevls
decreased in hepatic failure, steroid use | increased in pregnancy or OCP use (E increases TBG)
53
Grave's disease
thyroid stimulating immunoglobulin
54
wolff-chaikoff effect
XS iodine temporarily inhibits thyroid peroxidase decreasing T3/4 production
55
propylthiouracil inhibits
thyroid peroxidase + 5'-deiodinase
56
methimazole inhibits, use, s.e
thyroid peroxidase hyperthyroid rash, agranulocytosis, aplastic anaemia, hepatotoxicity, tetarogenic
57
``` function thyroid peroxidase 5'-deiodinase ```
helps thyroid globulin bind T3 | releases T3 from thyroid globulin
58
hormones using cGMP
BNP, ANP, EDRF (NO) | vasodilators
59
hormones using IP3
GnRH, Oxytocin, ADH, TRH, Histamine, Angiotensin II, Gastrin | HAG GOAT
60
intracellular hormone receptors
adrenal hormones, T3/4, vitamin D
61
non receptor tyrosine kinase hormones
prolactin, immunomodulators, GH, G-CSF, Erythropoeitin, thrombopoeitin PIGGlET
62
metformin class, mechanism | s.e.
biguanides decreases GNG, increases glycolysis, increases peripheral glucose uptake weight loss, lactic acidosis
63
1st gen sulfonureas, mechanism, s.e
-amide closes K channel in B cells, increases inc=sulin release hypoglycaemia, weight gain, disulfiram like effects
64
2nd gen sulfonureas, s.e
glimepiride, glipizide, glyburide | hypoglycaemia
65
pioglitazone mechanis, s.e
increases insulin sensitivity binds PPAR-y | weight gain, edema, hepatotoxicity, HF, fracture risk
66
meglitinides, mechanism, s.e
-glinide, stimulates insulin release | hypoglycaemia, weight gain
67
GLP-1 analogs, mechanism, s.e
exenatide, liraglutide (sc) increases insulin release, decreases gluon release, decreases gastric emptying nausea/vomiting, pancreatitis, weight loss
68
DPP-4 inhibitors, mechanism, s.e
-gliptin, deactivates GLP-1 | urinary/resp infections
69
pramlintide
amylin analog, SC injection, decreases gastric emptying and glucagon hypoglycaemia, nausea
70
SGLT-2 inhibitors
-gliflozin, blocks glucose reabsorption in kidney, UTI, vaginal yeast infection, hyperkalaemia, dehydration, hOtn
71
acarbose, miglitol
a-glucosidase inhibitors inhibit brush border and glucose absorption GI disturbance
72
levothyroxine s.e.
tachy, heat intolerance, tremors, arrhythmia
73
ADH antagonists e.g, use
-vaptan,demelocycline, SIADH
74
GH used for
Turner's
75
octreotide use
acromegaly, carcinoid, gastrinoma, glucagonoma, eosophageal varicies
76
fludrocortisone
aldosterone analog
77
inhibits NF-kb
glucocorticoids
78
cinacalcet use, s.e.
hyperparathyroidism, hypocalcemia | sensitises Ca receptors in parathyroid
79
cushing disease
ACTH secreting pituitary adenoma
80
weak, tired, muscle aches, weight loss
adrenal insufficiency
81
metyrapone stimulation test, does, for
blocks cortisol synthesis, adrenal insufficiency
82
skin pigmentation, hypotension, hyperkalaemia
adrenal insufficiency
83
causes of Addison's
autoimmune, TB
84
Waterhouse-Freidrichsen syndrome
acute primary adrenal insufficiency due to adrenal hemorrhage from septicemia with n.meningitidis, DIC or endotoxic shock
85
difference between primary and secondary adrenal insufficiency
2nd - no skin pigmentation or hyperkalaemia
86
Conn syndrome
primary hyperaldosteronism
87
Kulchitsky cells
neuroendocrine tumours
88
uptake APUD
kulchitsky cells
89
adrenal tumour in children
neuroblastoma
90
dancing eyes, dancing feet
neuroblastoma in children
91
HVA and VMA in urine
neuroblastoma
92
Homer-Wright rosettes
neuroblastoma, medulloblastima
93
phaeochromocytoma cells, derivative
chromaffin cells, neural crest
94
Rule of 10s phaeochromocytoma
10%... | malignant, bilateral, extra-adrenal, calcify, kids
95
phaeochromocytoma Rx
a-antagonists, B blockers after | phenoxybenzamine
96
thyroid myopathy
both - weakness | raised CK in hypothyroidism
97
hashimoto's causes
hypothyroidism | may start hyperthyroid
98
pot-belly, puffy face, protuberant tongue, poor brain development
cretinism | congenital hypothyroidism
99
tender thyroid, post flu like illness, hyper--> hypothyroid
de Quervians | subacute granulomatous thyroiditis
100
hypersensitivity thyroid
Graves - IgG type II
101
scalloped colloid, crowded folicular epithelial cells
Grave's disease
102
thyroid storm
hyperthyroid not treated properly, stress then makes situation much worse
103
Jod-Basedown
iodine deficient --> hyperthyroid when given iodine | Opposite of Wolff-Chairkoff
104
empty nuclei with central clearing, psammoma bodies, nuclear grooves
papillary carcinoma
105
RAS mutation, uniform follicles invading capsule
follicular carinoma
106
RET + BRAS
papillary
107
RET
medullary | MEN 2
108
sheets of cells in amyloid stroma
medullary carcinoma
109
pseudohypoparathyroidism type 1A
kidney unresponsive to PTH | albright hereditary osteodystropy
110
short 4th and 5th digits
pseudohypoparathyroidism type 1A
111
cause pseudohypoparathyroidism type 1A
Gs protien a subunit defect | imprinted from mother
112
pseudohypoparathyroidism NOT type 1A
no end organ PTH resistance | defective Gs a1 subunit from father
113
defective Ca sensing R
familial hypocalciuric hypercalcemia
114
difference between primary and secondary hyperparathyroidism
1 - hypercalcemia | 2 - hypocalcemia
115
where does pituitary adenoma come from?
lactotrophs
116
Nelson syndrome
enlargement of ACTH secreting pituitary adenoma after bilateral adrenalectomy for refractory Cushing disease
117
test for acromegaly
GH doesn;t decrease following oral glucose tolerance test
118
causes of nephrogenic DI
ADH R mutation, secondary to hypercalcemia, hypokalaemia, lithium, demelocycline
119
Rx nephrogenic DI
HCTZ, indomethacin, amiloride
120
hyponatermia with Na in urine
SIADH
121
kimmelsteil-wilson nodules
nodular glomerulosclerosis
122
diabetes progressive proteinuria give
ACE inhibitors
123
fasting plasma glucose, 2 hours glucose tolerance
126 | 200
124
complication on DKA
mucormycosis (Rhizopus), cerebral edema, arrhythmia, HF
125
dermatitis, diabetes, DVT, declining weight, depression
glucagonoma
126
whipple triad
low blood glucose, symptoms of hypoglycemia, resolution after normalised glucose levels
127
diabetes, glucose intolerance, steatorrhoea, gallstones
somatostatinoma
128
carcinoid secretes
5-HT
129
5-HIAA in urine, niacin deficiency
carcinoid syndrome
130
xollinger-ellison syndrome
gastrin secretin tumour
131
MEN 1
Pituitary, Parathyroid, Pancreas
132
MEN 2A
Parathyroid, Pheochromocytoma, medullary thyroid carcinoma
133
MEN 2B
pheochromocytoma, medullary thyroid carcinoma, mucosal neuroma, marfinoid P MMM

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