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Endo > Firecracker Endo I > Flashcards

Firecracker Endo I Flashcards

1
Q

Which hormones use a guanylate cyclase-cGMP mechanism?

A

ANP, NO (EDRF)

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2
Q

Amyloid stroma with sheets of cells are found in what type of thyroid cancer?

A

Medullary

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3
Q

Parafollicular cells synthesize and secrete

A

calcitonin

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4
Q

Medullary thyroid cancer originates from

A

parafollicular (C cells)

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5
Q

Thyroglobulin is a marker for what type of thyroid cancer?

A

well differentiated papillary

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6
Q

Which hormones use an adenylate cyclase – cAMP signaling mechanism?

A

FLAT CHAMP
FSH, LH, ACTH, TSH
CRH, hCG, ADH (V2), MSH, PTH
also: calcitonin, GHRH, glucagon

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7
Q

What is the primary source of ghrelin secretion?

A

P/D1 cells in fundus of stomach

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8
Q

Thyroglobulin is stored in which part of thyroid gland?

A

Colloid

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9
Q

Ghrelin effects

A

1) ↑ GH, cortisol, ACTH & prolactin secretion

2) Food seeking via the vagus nerve of the PNS & the arcuate nucleus of the hypothalamus

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10
Q

What kind of signaling molecules use receptor tyrosine kinases?

A

Growth factors (insulin, IGF-1, FGF, PDGF, etc.) often signal through receptor tyrosine kinases .

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11
Q

Where in the cell does a prohormone become a hormone?

A

Golgi apparatus

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12
Q

What are Orphan Annie eye nuclear inclusions?

A

empty-appearing nuclei w/ uniform staining

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13
Q

What are Psammoma bodies?

A

round concentric collection of calcium

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14
Q

Which hormones use an IP3-Ca2+ mechanism?

A

GOAT

GnRH, Oxytocin, ADH (V1 receptor), and TRH

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15
Q

Which endocrine hormones use the JAK/STAT pathway as an intracellular signaling mechanism?

A

PIG

Prolactin, IL-2 and GH use this mechanism

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16
Q

Where is the thyroid hormone receptor found when it is not bound to hormone?

A

Nuclear: T3/T4

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17
Q

Leptin is released by what cells?

A

Adipose

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18
Q

What do leptin levels correlate with?

A

overall body fat mass

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19
Q

Which steroid hormones have cytosolic receptors?

A

VET CAP

Vitamin D, Estrogen, Testosterone, Cortisol, Aldosterone, Progesterone

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20
Q

What is different about ghrelin levels in Prader-Willi patients?

A

do not decrease after a meal → continuous food-seeking, weight gain

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21
Q

What modification converts a preprohormone to a prohormone?

A

cleavage of a signal peptide from the preprohormone

22
Q

Where does preprohormone synthesis take place?

A

ER

23
Q

How does PTH (parathyroid hormone) affect the renal handling of phosphate?

A

PTH (parathyroid hormone) induces NPT2 endocytosis → ↓ reabsorption of phosphate and ↓ reabsorption of HCO3-

24
Q

Women and people with a history of neck radiation are at highest risk for what type of thyroid cancer?

A

Papillary

25
Q

What are the 3 effects of leptin on energy and fat homeostasis?

A

1) ↓ Food intake
2) ↑ Metabolic rate, activity level, and temperature
3) Inhibition of insulin synthesis and release

26
Q

What is the effect of PTH (parathyroid hormone) on renal Ca2+ absorption?

A

↑ Renal Ca2+ absorption in DCt

27
Q

When hypothyroidism is clinically suspected, what is usually the most sensitive test?

A

serum TSH

28
Q

Can you describe the pathogenesis of exophthalmos (proptosis) in patients with Graves disease?

A

TSI & other ABs cross-react w/ & stimulate orbital preadipocyte fibroblasts (wh/ express TSH Rs) to synthesize hydrophilic glycosaminoglycans

29
Q

Primary hyperthyroidism labs

A

Decreased TSH

Increased T4/&3

30
Q

How does PTH affect urinary phosphate excretion?

A

↓ Kidney reabsorption of phosphate → ↑ phosphate excretion (phosphaturic effect).
Mnemonic: PTH = Phosphate Trashing Hormone

31
Q

What is thyrotoxicosis?

A

clinical syndrome characterized by high levels of circulating thyroid hormone –> hyper metabolic state with SNS overactivity

32
Q

What drugs inhibit thyroid peroxidase?

A

Thyroid peroxidase is inhibited by propylthiouracil and methimazole

33
Q

How does thyroid carcinoma commonly present?

A

Painless enlargement of the thyroid gland.

More advanced lesions: hoarseness (from recurrent laryngeal nerve involvement), dysphagia and cough.

34
Q

Diagnostic tests for thyroid carcinomas

A

ultrasound, FNA (fine needle aspiration) and radionucleotide scans (scintigrams).

35
Q

thyroid carcinoma on scintigram

A

cold nodules

36
Q

What is the most common cause of hypothyroidism worldwide?

A

Endemic dietary iodine deficiency

37
Q

Children with mental retardation, pot-bellied stomach, protruding umbilicus and protuberant tongue. Faces are pale and puffy.

A

Cretinism

38
Q

Testing of all newborns for hypothyroidism (elevated TSH) is standard of care because mental retardation can be minimized when

A

thyroid hormone is administered in neonatal period.

39
Q

What urinary metabolite reflects PTH action at the proximal tubule?

A

↑ urinary cAMP.

40
Q

What is thyroid ophthalmopathy?

A

↑ SNS → overstimulation of levator palpebrae superioris (a muscle which receives SNS innervation from the internal carotid plexus & contracts reflexively to elevate the upper eyelid) → wide-eyed staring gaze and lid lag

41
Q

For patients with primary hypothyroidism, are the following lab values ↑, ↓, or within normal limits?

  • serum TSH
  • total T4
  • free T4
  • T3 resin uptake
A

up, down, down, down

42
Q

Can you name 3 immunologic mechanisms which may cause thyroid cell death in patients with Hashimoto thyroiditis?

A

1) CD8+ T-cell mediated cell death
2) Cytokines activate TH1 → IFN-γ recruits and activates macrophages → follicle damage
3) Anti-thyroid autoantibodies (anti-Tg and anti-TPO) → ADCC (antibody-dependent cell-mediated cytotoxicity)

43
Q

What are the anti-thryoid antibodies?

A
  • Anti-Tg (thyroglobulin) antibodies

- Anti-TPO (thyroid peroxidase) antibodies

44
Q

With what genes is Hashimoto’s associated?

A

Associated with HLA-DR3 and HLA-DR5

45
Q

Congenital hypothyroidism is most commonly caused by thyroid dysgenesis due to

A

thyroid aplasia/hypoplasia/ectopy

46
Q

8 presenting signs of congenital hypothyoidism

A
  1. hoarse cry
  2. umbilical hernia
  3. jaundice
  4. hypotonia
  5. macroglossia (protruding tongue)
  6. enlarged fontanelles
  7. coarse facial features, dry skin with scarce lanugo, pale body with mottled cool extremities
  8. constipation & somnolence
47
Q

What metabolite detected in the urine reflects PTH-mediated bone resorption?

A

↑ Hydroxyproline excretion

48
Q

What is the net effect of PTH (parathyroid hormone) on serum [Ca2+] and serum [phosphate]?

A

Increases calcium and decreases phosphate

49
Q

What is the treatment of secondary hyperparathyroidism?

A

Calcitriol (vitamin D) and phosphate binders such as aluminum hydroxide or calcium carbonate

50
Q

What is the mechanism of action of high dose iodine supplementation in treatment of hyperthyroidism?

A

blocks release of T4 and T3 into the circulation

Endo (12 decks)

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