M8 Endocrine Flashcards
Don't Fail Endocrine 🤣😭
T3 has what impact on the cardiac system?
T3 stimulates contractile protein and ion pumps (N+/K+ ATPase; Ca++ ATPase; and ß-adrenergic receptors).
This relationship can lead to heart failure if thyroid levels are imbalanced.
Which of these is not a causitive factor for primary hypothyroidism?
A)Congenital defect
B)Thyroidectomy
C)Iodine deficiency
D)Hashimoto’s
E)None of the above
Answer E (none of the above)
All of the answer choices are consistent with primary hypothyroidism. Other causes include thyroid radiation, anti-thyroid medication.
Which is correct of the three types of diabetes type I? Type 1A is _____, 1B is_____, and 3C is _____.
A)autoimmune, insulin triggered, c-peptide induced
B)alpha, beta, c-peptide
C)amylin, beta, calcitonin
D) autoimmune, idiopathic, chronic pancreatitis
Answer: D
1A: autoimmune
1B: idiopathic
3C: chronic pancreatitis
Ghrelin is ______ (increased/decreased) in obesity.
Decreased
Which cell in the pancreas is responsible for secreting amylin?
A)alpha
B)beta
C)delta
D)F-cells
Answer: B (beta)
Beta cells also secrete insulin
High levels of leptin will increase or decrease appetite?
Inhibit=decrease appetite via neuronal action
Subclinical hypothyroidism is defined as:
Mild thyroid failure with elevated TSH and normal T3/T4.
True or false, amylin is released by the GI?
False (released by the pancreas)
Which is NOT a function of T3/T4?
A) Increase metabolism
B)Increase muscle
C)Produce heat
D)Increase Insulin
E)Regulate RR and oxygen usage
Choice D: increase insulin.
T3/T4 does the opposite by antagonizing insulin.
Other functions of T3/T4 include: regulate CO, HR/contractility, GI secretion, Ca++ mobilization, lipid metabolism/usage, RBC
What lab values are consistent with primary hypothyroidism?
A)Low T3/T4
B)Low TSH
C)High TRH
D)Elevated TSH
E)One or more of the above
Answer choice: E (one or more of the above)
In primary hypothyroidism the issue is from the thyroid gland itself, because the T3/T4 are low** and the feedback mechanism **elevates TSH, but the thyroid will not respond.
Which is not a symptom of primary hypothyroidism?
A)Confusion
B)Decreased renal perfusion
C)High cholesterol
D)Hypernatremia
E)Syncope
Answer: D (hypernatremia)
Primary hypothyroidism is linked to hyponatremia (low sodium).
Other symptoms of primary hypothyroidism include: slowed speech, bradycardia, anemia, decreased appetite, weight gain, cold intolerance, etc
Think low=slowed processes
Where is iodine trapped for use with thyroxine?
A)Pancreas
B)Hypothalamus
C)Anterior pituitary
D)Thalamus
E)None of the above
Choice E: It is trapped in the thyroid gland and its’ uptake is regulated by TSH.
Type ____ diabetes is insulin dependent and type ____ diabetes is insulin resistant.
Type I=insulin dependent
Type II=insulin resistant
Which of the following is not a function of incretin?
A)Stimulate insulin
B)Inhibit glucagon
C)Encourage GI emptying
D)Increase intracellular insulin
E)Control glucose after a meal
Answer C (encourage GI emptying).
Incretin works to control glucose after a meal via stimulating insulin, inhibiting glucagon, slowing GI empty, and increasing intracellular insulin.
True or false, Leptin is released by the GI tract?
True
What transporter does insulin use to move into cell?
GLUT4
Angiotensinogen is _______ (increased/decreased) in obesity.
Increased
The term used when leptin increases in conjunction with adipocyte numbers but the elevated level is not effective at appetite suppression.
Leptin resistance
True or false, ghrelin is released by the GI?
True
As we age what change(s) are seen in the adrenal gland?
a) Higher levels of cortisol circulate
b) TSH increased
c) Adrenal cortex is fibrous
d) Decreased clearance of glucocorticoids
e) Less cortisol used
Answer: A, C, D, E
Note: TSH involves the thyroid not the adrenal
Low thyroid hormone stimulates _________ from ________ (organ/tissue). The THRH will stimulate ___________ to secrete _________(more/less) TSH which will in turn __________(increase/decrease) T3/T4.
Low T3/T4 will stimulate thyroid hormone releasing hormone from the hypothalamus. The THRH will stimulate the anterior pituitary to secrete more TSH which will in turn increase T3/T4.
What is the precursor for T3/T4?
A)Albumin
B)Thyroxine-binding globulin (TBG)
C)Thyroglobulin (TG)
D)Glucagon-like peptide 1 (GLP-1)
E)None of the above
Answer Choice: C (thyroglobulin)
Note: thyroxine-binding globulin (TBG) transports T3/T4 to the cell; glucagon-like peptide 1 (GLP-1) is an incretin hormone that’s lower than normal in people with type 2 diabetes; albumin is a protein found within the body.
Which peptide of proinsulin can be measured to see how much insulin is secreted?
A)A peptides
B)B peptides
C)C peptides
D)D peptides
Answer: C (C peptides)
Proinsulin (precursor to insulin) is made of A,B,C peptides. The C peptide is cleaved (A+B bonded with insulin), thus the C levels can be measured to determine how much insulin is secreted.
Peptide YY is ______ (increased/decreased) in obesity.
Decreased
What type of hormone is GLP-1 (glucagon like peptide 1)?
Incretin
GLP-1 is low in DM type 2 and drugs can target the GLP-1 and GIP peptides.
GLP-1 augments glucose-induced insulin secretion and inhibits glucagon secretion.
Age changes with pancreas
Beta cell function decline, cell regeneration decline, growth hormone decrease
Which hormone is less prevalent T3 or T4, and more potent?
T3 is more potent but availability is ~10%
Ghrelin will normally: _______ with hunger and ______after eating.
Increase with hunger, and decrease after eating.
Which disorder causes the pituitary to over-stimulate the thyroid to secrete T3/T4? In this scenario, TSH is elevated and T3/T4 is elevated.
Secondary hyperthyroidism.
Remember: the issue is from outside the thyroid (e.g. in the pituitary)
Which of these is not a symptom of a toxic nodule?
A)Tachycardia
B)Pretibial Myxedema
C)Exopthalmos
D)One or more of the above listed
Answer: D (one ore more of the above listed)
Toxic nodules do not have the eye issues and and pretibial myxedema (those symptoms are consistent with Grave’s disease)
Adiponectin normally does what for insulin sensitivity and inflammation?
Will increase insulin sensitivity and has anti-inflammatory properties (in someone not managing obesity).
Thus, in obese patients it is decreased and linked to insulin issues/ DM2/ inflammation/ CAD.
What life-threatening event occurs with the worsening of hyperthyroid state due to T3/T4 release?
Thyrotoxic crisis (thyroid storm)
Adipokines are produced by?
WAT (White adipose tissue)
Adiponectin is ______ (increased/decreased) in obesity.
Decreased
How many months can the thyroid fail for before symptoms appear?
A)1-2
B)2-3
C)3-4
D)4-5
E) None of the above
Choice: B
The thyroid can fail for 2-3 months due to the stored hormone which will last ~2-3 months.
Which is worse for WAT, visceral or peripheral?
Visceral
Metabolic syndrome requires which of the following for a diagnosis:
A) Hypertension
B) High HDL
C) A1C >6.5
D) None of the above
Answer: A (hypertension)
Metbolic syndrome requires 3 of the following for a diagnosis:
large waist circumference, elevated triglycerides, low HDL, HTN, fasting glucose elevated (100-125)
What causes a thyrotoxic crisis?
A)low blood sugar
B)thyroid infarction
C)infection
D)Low T3/T4
Answer (c): infection
Thyrotoxic crisis can be ignited by: trauma, cardiopulmonary, burn, seizure, sx.
The situation involves a worsening of hyperthyroidism.
What disease process involves a follicular hypertrophy which causes the thyroid to act independently?
A) Grave’s disease
B) Myxedema coma
C)Toxic nodule
D)Thyrotoxic crisis
Answer: C (toxic nodule)
The toxic nodule will cause the thyroid to secrete excess T3/T4
Amylin is responsible for:
A)Releasing growth hormone
B)Supressing glucagon
C)Increasing WAT
D)Delaying gastric emptying
E)One or more of the above
Answer: E
Amylin is responsible for suppressing glucagon, and delaying gastric emptying.
Symptoms of Graves disease include:
A)seizure
B)dyspnea
C) exophalmos
D) bradycardia
Answer choice: C
Graves disease also causes: exophthalmos, periorbital edema, and extraocular muscle weakness.
Seizures are seen with a worsening of hyperthyroidism in what’s deemed a “thyrotoxic crisis/thyroid storm”
Bradycardia, and dyspnea would be seen in hypothyroidism (think low=slow)