Exam 2 Endocrine Flashcards by Heidi G

What do lactotrophs produce?

a. prolactinoma
b. acromegaly
c. gigantism
d. cushing’s disease
e. no effect

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Treatment for prolactinoma

Bromocriptine

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What is bromocriptine?

A dopamine type agonist which inhibits prolactin secretion

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Which of the following is caused by a tumor that occured before the fusion of growth plates?

a. acromegaly
b. gigantism

gigantism

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What makes up the tyrosyl residue?

Thyroglobulin and tyrosine

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Which is more potent?

a. T1
b. T2
c. T3
d. T4

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In primary hyperthyroidism:

a. elevated T3, elevated TSH
b. elevated T3, low TSH
c. low t3, low tsh
d. low t3, high tsh

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In secondary hyperthyroidism:

a. elevated T3, elevated TSH
b. elevated T3, low TSH
c. low t3, low tsh
d. low t3, high tsh

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Tx of graves disease?

thionamides (PTU or methimazole)

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How does thionamides work?

prevent iodine organification

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What is the antibody in hypothyroidism

anti-TPO

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What is Sheehan’s syndrome?

post-partum necrosis that leads to anterior pituitary hormone deficiecny

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Where is thyroid made? What does this have ?

in colloid, which has thyroglobulin

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What do stromal cells secrete?

calcitonin

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Wwhat does calcitonin do?

decreases blood calcium

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What is iodide trapping regulated by?

a. T3/T4
b. TSH
c. thyroglobulin
d. thyroid peroxidase
e. tyrosyl residue

b. TSH

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What is aldosterones primary action?

to maintain ECF volume by promoting sodium retention

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What can aldosterone do if its in excess?

cause HYPOkalemia

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T/F Cortisol helps correct for low glucose levels

True

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What is cortisol secretion stimulated by?

a. Stress
b. Hypoglycemia
c. Hemorrhage
d. ACTH
e. All of the above

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T/F cortisol is an antagonist of insulin

True

It raises serum glucose by antagonizing insulin action in muscles and adipose tissue

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What are the three parts of the cortex of hte adrenal gland and hwat do they secrete?

Glomerulosa- aldosterone
Fasciculata- cortisol
Reticularis- DHEA

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What does the adrenal medulla secrete?

catecholamines!

Ep and Norep

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An aldosteronoma is a tumor of the:

a. fasciculata
b. reticularis
c. medulla
d. entire cortex
e. glomerulosa

e. glomerulosa

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A tumor of the fasciculata causes cushings disease

False, cushings syndrome

What is the most common cause of hypercortisolism?

prednisone therapy (iatrogenic)

How is cushings diagnosed?

A 24 hour free basal urine cortisol of >3x ULN

How do you diagnose pheochromocytoma?

elevated catecholamine products seen in a 24 hour urine collection: - VMA - metanephrines

You find a small incidental adrenal mass that is hormonally inactive and has not grown what is the treatment? a. no further workup required b. surgical removal c. biopsy d. all of the above in a sequence e. none of hte above

What does hypersecretion of the reticularis result in? a. aldosteronoma b. cushings disease c. virilizing adrenal tumor d. pheochromocytoma e. none of hte above

What does the reticularis secrete?

DHEA

A patient with hyperaldosteronism caused by hyperplasia presents to your office. what is the correct tx protocol? a. surgery to remove the adrenal gland b. medication c. stop ofending drugs d. potassium

If a patient walks in with a high renin, high aldosterone levels, what is the most likely diagnosis? a. Hyperaldosteronism b. Aldosteronoma

If a patient walks in with LOW renin levels and high aldosterone levels, what is the most likely diagnosis? a. Hyperaldosteronism b. Aldosteronoma

Whcih cells of the pancreas produce glucagon? a. alpha b. beta c. delta d. F cells

A. alpha

What do F cells produce?

pancreatic polypeptide

Which glucose receptors are insulin dependent? a. Glut 1 b. Glut 2 c. Glut 3 d. Glut 4

Insulin INCREASES all of hte following except: a. glucose as an energy source b. liver uptake of glucose c. glucose incorporation into glycogen in muscle and adipose tissue d. synthesis of FFAs e. gluconeogenesis in the liver

E. decreases

T/F Low glucose levels stimulate insulin

False, high. Bc insulin takes glucose out of the blood and stores it in muscle tissue. so if levels are too high, its going to secrete insulin to take it

What is the glucose tolerance test?

A test that is used to diagnose if someone has type 1 diabetes: if the test results show that there is a 2hr glucose + one other glucose >200 = DM1

How is diabetic ketoacidosis diagnosed? a. Hypoglycemia b. Lack of serum ketones c. Metabolic Acidosis d. Dehydration e. C and D

Which disease has a GREATER risk of a twin developing diabetes? a. DM1 b. DM2 c. same incidence d. There has been no studies showing incidence

b. DM2 = 100%

Glipizide and Glyburide are what class of oral agents? a. Carb blockers b. GLP-1 agonists c. DPP-4 inhibitors d. Sulfonylureas

what is the MOA of amylin?

it decreases gastric emptying suppresses glucagon secretion suppresses gluconeogenesis

What is GLPs main effect?

To stimulate glucose dependent insulin secretion

What is the MOA of DPP-4?

To degrade incretin/GLP-1

How do DPP-4 inhibitors work?

by inhibitind DPP4, they prevent the degradation of GLP1 and thus increases insulin syntheis and release, and decreases glucagon release

What is the FIRST sign of nephropathy?

microalbuminurea

Tartrate-resistant acid phosphatase is a marker enzyme of: a. osteoblasts b. osteoclasts c. osteocytes

B osteoclasts

Is tartrate resistant acid phosphatase increased or decreased in Paget's disease?

Increased

What is the most common complication of Paget's disease?

Fractures

What is the best marker of paget disease activity? a. pyridinoline crosslinks b. procollagen peptides c. alkaline phosphatase d. calcium level

C. Alkaline phosphatase

What is the best anti-osteoclastic agent to treat Paget's disease? a. calcitonin b. bisphosphonates c. Pamidronate

T/F Etidronate is most specific bisphosphonate for resorption

False. alendronate is

What is the antibody for hypothyroidism?

anti-TPO

What is the antibody for hyperthyroidism?

anti-TSH

What are the three phases of subacute thyroiditis?

thyrotoxic hypothyroid euthyroid

What do you treat the thyrotoxic phase of subacute thyroiditis with?

beta blockers!

If you find thyroid cancer in a patient, what is the appropriate action to take?

Perform a total thyroidectomy followed by radioactive iodine therapy • Treat with chronic levothyroxine to prevent hypothyroid symptoms and suppress cancer regrowth.

What is the MOA of PTH and calcitrol?

To release calcium from bone

What is the primary treatment for hyperparathyroidism?

endocrine surgery

What can cause hypoparathyroidism?

a. surgical b. idiopathic c. magnesium d. wilson's disease

With what disease do you see tetany, basal ganglia calcifications, lenticular cataracts? a. hypoparathyroidsm b. hyperparathyroidsm c. hyperthyroidism d. hypothyroidism e. vit D deficiency

a. hypoparathyroidsm

Which of the following casues osteomalacia in adults and rickets in children? a. hypoparathyroidsm b. hyperparathyroidsm c. hyperthyroidism d. hypothyroidism e. vit D deficiency

e. Vit D. deficiency

How do you distinguish between hypoparathyroidism and Vit D deficiency?

Do a PTH test because PTH would be high iwth Vit D deficiecny

T/F Hyperaldosteronism presents with hyperkalemia

False, hypokalemia because potassium is decreased due to the sodium potassium pump absorbing more sodium and excreting more potassium

What is Nelson's syndrome?

The rapid enlargement of a pituitary adenoma that occurs after the removal of both adrenal glands

What are some clinical signs you see with Nelson's syndrome?

increased ACTH stimulation from the pituitary | bitemporal hemianopsia

Where are Glut-2 receptors found? a. Ubiquitous b. Liver & Pancreas c. Skeletal + Cardiac muscle + adipose tissue

Which glucose receptors mediate basal glucose transport?

Glut 1 and 3

T/F The liver is exposed to 2x the insulin concentration than the rest of the peripheral tissues

True

Loss of pulsatility of hypothalamic hormones leads to what?

Impaired anterior pituitary hormone secretion

What is the tx for acromegaly and gigantism?

somatostatin

What is the most critical replacement of missing hormones from target glands?

glucocorticoids

``` Elderly pts don't show symptoms of which disease? A. Panhypopitutarism B. hypothyroidism C. Hyperthyroidism D. Hyperparathyroidism E. hypoparathyroidism ```

Hyperthyroidism

Tx for goiter.

Thionamides

4 types of thyroid cancer

Pfma

``` Which cardiomyopathies have systolic abnormalities. A. Rcm B. HCM C. Dcm D. B and C E. a and b ```

``` Pt walks into your office post MI with an EF of less than 40%. What tx do u recommend ? A. Beta blocker B. digoxin C. Warfarin D. Heparin E. None ```

Digox