Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

Tim's Cards > Endocrinology II > Flashcards

Endocrinology II Flashcards

1
Q

What does the outer cortex of the adrenal gland produce?

Inner medulla?

A

Cortex - steroid hormones

Medulla - Catecholamines

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

What 3 classes of molecules are made in the Adrenal Cortex?

A

mineralocorticoids
glucocorticoids
androgens

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

What are the 3 steroid hormones of the Adrenal Cortex?

A

Aldosterone - (mineralocorticoid)
Cortisol - (glucocorticoid)
Dehydroepiandrosterone - (androgen)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

What 2 hormones are made in the adrenal medulla?

A

Epinepherine
Norpepinepherine

*the catecholamines

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

Why are cortisol, aldosterone, and adrenal androgens bound to transport proteins in the blood?

A

otherwise would be excreted because of size

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

Describe the Cortisol feedback loop:

A

CRH > ACTH > Cortisol

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

What increases CRH pulses?

A

Illness, surgery, injury, psychiatric stress

any stress

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

How is ACTH released from the Ant. Pituitary?

A

Pulses
Rhythm (diurnal)
highest level 4-6 AM

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

What is the main immediate effect of Cortisol?

A

Increase blood glc

GNG, insulin resistance, glycogen storage, appetite

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

T/F

Cortisol suppresses inflammation, immune response, and wound healing.

A

Yes

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

T/F

Aldosterone is stimulated by ACTH

A

Yes, some

but mostly controlled by the kidney renin-angiotensin system

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

What are the effects of Aldosterone?

A

Holds Sodium
Pumps out Potassium

Maintains blood volume and pressure

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

Will ACTH stimulate all of the hormones of the adrenal cortex?

A

Yes

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

What is the function of DHEA?

A

masculinizing hormone
(pubic hair)

in excess causes hirsutism (male and female)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

T/F

ACTH, cortisol, aldosterone, DHEA can all be found in the plasma and saliva for testing purposes?

A

True

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

What are some causes of primary adrenal insufficiency?

A 
Autoimmune
Infection (TB, cytomegalovirus in HIV) 
Cancer
Hemorrhage
Surgical removal
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

What would be low and what would be high in Primary Adrenal Insufficiency?

A

Glucocorticoid (Cortisol), Mineralocorticoid (Aldosterone), and Adrenal androgen (DHEA) lost/low

ACTH high

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q 
What might cause the following:
fatigue
weight loss, nausea
abdominal pain
low glc
illness amplified
A

Low cortisol

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

What might cause the following:
low Na, high K
low BP

A

Low aldosterone

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

What causes hyperpigmentation?

A

high ACTH

*note - in patients see especially in mucous lining of the mouth

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

What does ACTH do at high concentrations?

A

stimulates melanocytes

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

What are the symptoms of acute adrenal crisis?

A 
weakness
nausea
vomiting
dehydration
hypotension
hypoglycemia
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

What cortical hormone of the kidney is functionally viable in secondary adrenal insufficiency?

A

Aldosterone

regulated mostly by kidneys

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

What is the treatment for both primary and secondary adrenal insufficiencies?

A

Cortisol and Cortisol

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
Q

What syndrome is defined by an excess of Cortisol?

A

Cushing Syndrome

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
26
Q

What causes Cushing disease?

*as opposed to Cushing Syndrome?

A

Pituitary tumor producing ACTH

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
27
Q

What causes Cushing Syndrome?

A

anything that increases ACTH

adrenal tumor, prescribed glucocorticoids, etc.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
28
Q

What is a classic sign of Cortisol excess?

Cushing Syndrome

A

Purple stretch marks

Moon face

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
29
Q

High glc production, insulin resistance, hyperglycemia, and diabetes can be caused by…

A

Cortisol Excess

30
Q

What does Dexamethasone do?

A

Synthetic glucocorticoid so it suppresses ACTH

31
Q

What 3 levels can you address too much ACTH secretion pharmacologically?

A

block ACTH secretion
inhibit cortisol production
block cortisol receptors

32
Q

What is more important, the Adrenal medulla or cortex?

A

cortex

can survive without epi/norepi

33
Q

What is the tumor of the Adrenal Medulla?

A

Pheochromocytoma

34
Q

High ACTH, low cortisol, hyperpigmentation:

A

Adrenal insufficiency

either autoimmune or TB-related

treat with Cortisol

35
Q

High ACTH, high cortisol, hirsutism, full face.

A

Cushings Disease

caused by tumor

36
Q

What is the RDA for calcium 19-70?

A

1000 mg

37
Q

What 2 things does Vitamin D increase absorption of from the gut?

A

Calcium and Phosphorous

38
Q

What are the 2 sources of Vitamin D?

A

sunlight (cholecalciferol - D3)

plants (ergocalciferol - D2)

39
Q

What type of Vitamin D is usually measured?

A

Storage form in Liver

40
Q

Vitamin D is a ______ hormone that increases absorption of both ____ and ____.

A

Steroid

Calcium, Phosphorous

41
Q

Name 4 Calcium regulating hormones.

A

PTH
PTHrP
Calcitonin
Vitamin D

42
Q

T/F

PTH is a slow acting hormone

A

False

controls Calcium on timescale of around a minute

43
Q

Why does PTH decrease Phosphorous?

A

Its actions in the kidney preserve Calcium and secrete phosphorous

44
Q

What does PTH increase?

A

Calcium and Vitamin D

45
Q

What is the difference between PTH and PTHrP?

A

PTHrP increases Calcium (like PTH) but does NOT activate Vitamin D.

net effect: increase Ca, decrease PO4, PTH

46
Q

What can cause hypercalcemia?

A

Too much PTH, Vitamin D, or PTHrP

47
Q

What can cause hypocalcemia?

A

Not enough PTH or Vitamin D

Resistance to PTH, Vitamin D

48
Q

What are the major causes of hypercalcemia?

A

high PTH or PTHrP (tumor)

high Vitamin D

49
Q

What are the symptoms of hypercalcemia?

A

high PTH or PTHrP (tumor)

high Vitamin D

50
Q

What are the symptoms of Hypercalcemia?

A

Stones, groans, moans, overtones, bones

51
Q

Primary Hyperparathyroidism:

Ca Phos 1,25D PTH

A

high, low, high, high

52
Q

What are the causes of Hypocalcemia?

A

low PTH
low Vitamin D
low Calcium intake

53
Q

What is the main symptom of Hypocalcemia?

A

neuromuscular irritability

54
Q

What are low PTH effects on:

Ca Phos 1,25D

A

low, high, low

55
Q

Low Ca, Phos, and high PTH
Unmineralized bone
diagnosis?

A

Rickets

Childhood Vitamin D deficiency

56
Q

What does severe Vitamin D deficiency lead to in adults?

A

Osteomalacia

  • diffuse bone pain
  • everything low but PTH
57
Q

What indicates Renal Failure?

A

low Ca, 1,25D

high Phos, PTH

58
Q

What is the difference between Primary and Secondary Hyperparathyroidism?

A

Primary - failure at parathyroid (too much PTH causes high calcium)

Secondary - low vitamin D or kidney failure
*high PTH secondary to low calcium

59
Q

RANK/RANKL are part of what system?

A

Immune

60
Q

What is a major osteoclast inhibitory factor?

A

Osteoprotegerin

61
Q

Is low weight a risk factor in bone fracture?

A

Yes - incidental to frailty

(somewhat counterintuituve)

62
Q

Can Glucocorticoids cause fractures?

A

Yes

could’ve been designed as evil for bones

63
Q

What are some preventions/treatments for osteoporosis?

A

Calcium and Vitamin D
Exercise
Osteoclast inhibition
Osteoblast stimulation

64
Q

What are treatments that inhibit osteoclasts?

A

Denosumab (RANKL antibody)
Calcitonin
Bisphosphonates
Estrogen/SERMS

(also, Calcium supplements)

65
Q

What does SERM stand for and what do they do?

A

Selective Estrogen Receptor Modulators

Act at Estrogen Receptors in bone but NOT in breast/uterus

*effective osteoclast suppressor

66
Q

How do bisphosphonates work?

A

Bind Ca++ to bone
Increase osteocyte death
Long half life

67
Q

What is a possible dental side effect of Bisphosphonates?

other side effects?

A

Jaw osteonecrosis
(probably due to high turnover)

Atypical femoral fractures
(uncommon)

68
Q

What two treatments are associated with jaw osteonecrosis and atypical femur fractures?

A

Denosumab and Bisphosphonates

69
Q

When can exercise increase bone density?

A

Only when very intense

  • otherwise will stabilize bone density
70
Q

What is a counter-intuitive treatment for bone loss?

A

hPTH (PTH analog)

  • stimulates osteoclasts, but osteoblasts and osteocytes more.
  • effective, expensive, and shown to cause horrible bone cancer when given in high doses to rats

Tim's Cards (140 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions