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UWorld > Set 12 (Endocrine) > Flashcards

Set 12 (Endocrine) Flashcards

1
Q

Prolactinoma: GnRH, FSH/LH

A

Prolactin suppress GnRH!!!

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2
Q

Prevent thyroid absorption of radioactive iodine isotopes

A

Potassium iodide

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3
Q

Permanent DI

A

Damage to hypothalamus

Posterior pituitary = transient

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4
Q

Defense to Candida: local vs systemic

A

Local via T cells

Systemic via NEUTROPHILS

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5
Q

Retroperitoneal hematoma in STABLE patient

A

Pancreatic injury

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6
Q

Solid organs of the RETROperitoneum

A

Pancreas (NOT tail)

Kidney + Adrenal glands

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7
Q

Hollow organs of RETROperitoneum

A

2, 3, 4 of duodenum
Ascending and Descending colon
Bladder + Ureters
Rectum

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8
Q

Splenic artery is a branch of?

A

Celiac trunk

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9
Q

Supply MIDDLE pt of greater curvature of stomach

A

Left gastroepiploic artery (of splenic artery)

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10
Q

Supply UPPER pt of greater curvature of stomach

A

SHORT gastric branch (of splenic artery)

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11
Q

Neurophysins

A

Post-translational processing of Oxytoxin and ADH

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12
Q

Exaggerated response to ADH is a A/E of?

A

Carbamazepine

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13
Q

Non-bloody diarrhea

Perianal fistulae

A

Crohn’s disease

Think: Crohn’s is NOT “ulcerative” thus NOT bloody

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14
Q

Rectum is ALWAYS involved in UC or CD?

A

Ulcerative COLITIS

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15
Q

Essential fructosuria: main method of metabolizing fructose is via?

A

Hexokinase

Fructose –> Fructose-6-phosphate

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16
Q

Aldolase reductase

A

Glucose –> sorbitol

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17
Q

DOC for Giardia lamblia

A

Metronidazole

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18
Q

m/c diarrhea in campers/hikers

A

Giardia lamblia

cysts in stool sample

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19
Q

Albendazole: tx of?

A

Tapeworm (cestode)

Echinococcus granulosus

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20
Q

Mebendazole: tx of?

A

Round worms

Ancylostoma, Ascaris, Enterobius

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21
Q

Boy
Rectal bleeding/intestinal obstruction
Blind pouch connecting to ileum (attached to umbilicus by fibrous band)

A

Meckel’s diverticulum

TRUE diverticula

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22
Q

Alpha helix
+
Hydrophobic amino acids

A

Integral membrane proteins

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23
Q

Metyrapone

A

Block cortisol synthesis (inhibit 11B hydroxylase)

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24
Q

3 UNIdirectional enzyme in generation of pyruvate (glycolysis)

A

Hexokinase
Phosphofructokinase
Pyruvate kinase

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25
Q

Gluconeogenesis: 4 enzymes to bypass glycolysis 3 uni-directional enzymes

A

Pyruvate carboxylase
Phosphoenolpyruvate carboxykinase
Fructase 1,6 bisphosphatase
Glucose-6-phosphatase

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26
Q

SER

A

Lipid synthesis
Detox
Carbohydrate metabolism

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27
Q

High serum level of 17-OH progesterone

A

Diagnostic for 21OH deficiency

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28
Q

VIP

A

Increase CHLORIDE loss in stool (Na, K, Water follows)
Increase bicarbonate secretion
Inhibit gastric H+ secretion

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29
Q

Pancreatic cholera or WDHA syndrome

A

Watery diarrhea
Hypokalemia
Achlorhydria
(this is: VIPoma)

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30
Q

Decreased exercize tolerance
Myoglobinuria
Muscle pain w/ physical activity

A

McArdle’s syndrome (type 5 glycogen storage disease)

Myophosphorylase deficiency

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31
Q

G6P –> 6-phosphogluconate

A

G6PD

hexose monophosphate pathway –> maintain NADPH, pentose sugar for nucleotide synthesis

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32
Q

Intestine: NONcaseating granuloma

A

Crohn’s disease

also has: serpiginous ulcerations, cobblestone appearance, transmural inflammatory infiltrate

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33
Q

TZD: main A/E

A

Fluid retention and Weigt gain

Precipitation of CHF

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34
Q

Metformin and Rosiglitazone: MOA

A

Increase target tissue sensitivity to insulin

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35
Q

Sulfonylureas: MOA

A

Insulin secretagogues

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36
Q

PAS+

Diastase-resistant

A

Tropheryma whippelii

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37
Q

Must be checked before TZD tx? Metformin tx?

A

Metformin: creatinine (renal function)
TZD: hepatic function

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38
Q

Colitis-associated carcinomas are more likely to be?

A

Arise from NON-polylpoid dysplastic lesions
Multifocal
Early p53, Late APC gene mutation
HIGHER grade

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39
Q

Sporadic colorectal carcinoma: gene mutation

A

Early APC, Late p53

However, UC: opposite sequence

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40
Q

Phenylethanolamine-N-methyltransferase

A

Norepinephrine –> Epinephrine

Under control of cortisol

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41
Q

Epinephrine or Norepinephrine: synthesized mainly by ADRENAL

A

Epinephrine = adrEnal

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42
Q

PEPCK requires?

A

GTP

which can be made in the succinyl CoA –> succinate step in TCA

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43
Q

Tamoxifen: SERM

A

Breast: anti-estrogenic.
Endometrium: increased incidence of endometrial cancer.
Bone: useful for osteoporosis (estrogen AGONIST)
Favorable effect on serum lipid profile though increased incidence of thromboembolic disease.

(Good for breast, bone, lipid)
(Bad for endometrium, thromboembolic dz)

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44
Q

Hyperammonemia and brain

A

Depletion of glutaMATE and alpha-ketoglutarate in Ammonia detoxification (no Krebs b/c alpha-keto depleted)

Accumulation of glutaMINE.

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45
Q

H. pylori typically found in GREATEST cc in?

A

PREpyloric area of gastric antrum

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46
Q

Sheets of malignant cells in an amyloid stroma.

A

Medullar thyroid carcinoma.

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47
Q

Chronic inflammation w/ germinal centers and Hurthle cells

A

Hashimoto’s thyroiditis

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48
Q

Hard, fixed thyroid

Extensive fibrosis

A

Riedel’s thyroiditis

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49
Q

Granulomatous thyroiditis

A

Subacute thyroiditis (de Quervain’s)

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50
Q

Mild abdominal cramping w/ low fever and diarrhea
Then: salmon-colored “rose spots” and HSM
Then: hemorrhagic diarrhea and sepsis

A

Salmonella typhyi/parathyphi

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51
Q

IgA protease

A

N. meningitidis

IgA normally bind and inhibit action of pili and fimbriae that mediate attachment to mucosa

52
Q

Acid alpha gluosidase deficiency

A 
Pompe disease (type 2 glycogen storage dz)
(Hepatomegaly, Cardiomegaly, Risk for cirrhosis)
53
Q

High levels of delta-aminolevulinic acid

A 
Lead poisoning
(Succinyl-CoA + glycine + pyridoxal phosphate)
54
Q

Biotin: cofactor for?

A

Carboxylation rxn

acetyl-CoA carboxylase, pyruvate carboxylase

55
Q

Hyper-prolactinemia is A/E of which anti-psychotic med?

A

Risperidone

56
Q

Amenorrhea
HYPOestrogenism
Elevated serum gonadotropin levels
<40

A

Premature ovarian failure

57
Q

Estrogen and Thyroid hormone

A

Estrogen –> increase TBG

Increase TBG –> increase TOTAL T4 and T3, free T4 and T3=normal!

58
Q

Linitis plastica

A

“Leather bottle stomach” = signet-ring carcinoma of stomach.

diffuse involvement of stomach wall

59
Q

Schilling test

A

Diagnose PERNICIOUS anemia (IF deficient)

Determines cause of abnormal vitB12 absorption.

60
Q

Celiac dz involves what area?

A 
Small intestine
(flattening of mucosa w/ loss of villi)
61
Q

Peyer’s patches are found in what region of SI?

A

Ileum

62
Q

Non-neoplastic polyps of colon

A

Hyperplastic
Hamartomatous
Inflammatory

63
Q

Corkscrew esophagus

A

Diffuse esophageal spasm

64
Q

Amatoxin

A

Poisonous mushroom

Potent inhibitor of RNA polymerase II (mRNA)

65
Q

RNA polymerase 1, 2, 3

A

1: rRNA
2: mRNA
3: tRNA

66
Q

Superior mesenteric artery syndrome: affect what portion of duodenum?

A

Transverse (trapped between aorta and SMA)

67
Q

Superior mesenteric artery syndrome occur due to?

A

Diminished mesenteric fat
Pronounced LORDosis
Surgical correction of scoliosis

68
Q

rT3

A

Peripheral conversion of T4 –> T3

T3 can NOT form rT3

69
Q

Uptake of glucose is by means of?

A

Facilitated diffusion (preference for D-glucose)

70
Q

LDL receptor uptake of cholesterol is by means of?

A

Receptor-mediated endocytosis

71
Q

Meissner vs. Auerbach plexus

A

Meissner: subMUCOSAL: SENSORY
Auerbach: myenteric (in muscularis externa): MOTOR

72
Q

Bilious vomiting in infant
Failure to pass meconium
Bowel filled, RECTUM EMPTY

A

Hirschsprung disease

rectum and anus ALWAYS involved

73
Q

Courvoisier sign

A

Palpable but NONtender gallbladder

Pancreatic cancer

74
Q

MOST important environmental risk factor for PANCREATIC cancer.

A

SMOKING!!!

age, chronic pancreatitis, DM, genetics = other risks

75
Q

Opioid analgesic

Biliary colic

A

2/2 contraction of smooth muscle in Sphincter of Oddi

76
Q

Opioid of choice in biliary and pancreatic pain

A

Meperidine

opioid w/ less sphincter of Oddi constriction

77
Q

High cc of fructose 2,6 bisphosphate

A

Inhibit glucoNEOgenesis (and glucogenic conversion fo ALA –> glucose)

Promote glycolysis

78
Q

Lactate dehydrogenase

A

Anaerobic: Pyruvate –> Lactate

REGENERATE NAD+ (required for anaerobic glycolysis to continue)

79
Q

Synthesis of carnitine requires?

A

VitC

Lysine + Methionine

80
Q

Amenorrhea in patients w/ anorexia nervosa

A

Deficiency in HYPOTHALAMIC GnRH release!

81
Q

MHC I vs. MHC II: expressed in ALL nucleated cells

A

MHC I is expressed on everything!
MHC II is only on professional APC
(think: 2 is the helper, so NOT everywhere)

82
Q

MHC I vs. MHC II: antigen presentation

A

1: endogenous pathway (proteasome)
2: acidified lysosome

83
Q

99mmTc-pertechnetate scan

A

Detects presence of gastric mucosa

accumulation in RLQ –> diagonistic for Meckel diverticulum

84
Q

Colicky abdominal pain

“Current jelly” stool

A

Intussusception

85
Q

SCC of esophagus: main risk factors

A

ALCOHOL and TOBACCO (USA)

N-nitroso-containing food (betel nuts)-ASIA

86
Q 
Esophageal web (--> dysphagia)
Iron deficiency anemia 
Beefy-red tongue (atrophic glossitis)
A

Plummer-Vinson syndrome

a/w esophageal SCC

87
Q

Amino acids w/ 3 titratable protons

A

Histidine, Arginine, Lysine
Aspartate, glutamate
Cysteine, Tyrosine

88
Q

Most frequent inborn metabolic error in Japan

A

Deficiency of histidase

89
Q

Cytosine deamination
Adenine deamination
Guanine deamination

A

C –> U
A –> xanthine
G –> hypoxanthine

90
Q

Correct defect in SINGLE bases

A

Base excision repair

glycosylase –> endonuclease –> lyase –> DNA poly –> ligase

91
Q

DOC for HepC

A

Ribavirin and Interferon alpha

(Ribavirin: hypermutation, inhibit RNA polymerase, depletes GTP, defective 5’cap formation, more effective immune response)

92
Q

Indinavir

A

Viral protease inhibitor

93
Q

Raltegravir

A

Integrase inhibitor

94
Q

Amantadine

A

Impairs UNCOATING of influenza A after host cell endocytosis

95
Q

Enfuvirtide

A

Prevention of viral entry into target cells

96
Q

Thyroid hormone: receptors

A

NUCLEAR receptors

97
Q

NF-kB

A

Cytokine production

98
Q

Watery born gastroenteritis w/ high mortality

Gram-, Oxidase +, highly ALKALINE media

A

Vibrio cholera

99
Q

Esophageal varices

A

Left gastric v.

Esophageal v.

100
Q

Hemorrhoids

A

Superior rectal v.

Middle & Inferior rectal v.

101
Q

Caput medusae

A

Paraumbilical v.

Superficial and Inferior epigastric v.

102
Q

NADPH oxidase deficiency

A

CGD

103
Q

Gonadotroph adenomas

A

usually do NOT overproduce FSH and LH.
(overproduce alpha subunit only)

Thus: present as MASS effect and HYPOgonadism.

104
Q

Most NON-secretory pituitary adenomas arise from?

A

Gonadotrophs

tend to grow slowly

105
Q

Magnesium and PTH

A

Increase magnesium –> increase PTH

SEVERE HYPOmagnesium –> decrease PTH

106
Q

PTU vs. Methimazole

A

BOTH inhibits thyroid peroxidase

ONLY PTU also inhibit peripheral T4 –> T3

107
Q

Annular pancreas is 2/2

A

Abnormal migration of VENTRAL pancreatic bud

108
Q

Pancreas: embryologically from?

A

Ventral and dorsal pancreatic bud from duodenal part of the FOREGUT!

109
Q

X-linked agammaglobulinemia: esp. prone to?

A

Recurrent Lower respiratory tract infection

Giardia lamblia infection

110
Q

D-xylose

A

MONOsaccharide

Differentiates btwn malabsorption of pancreatic vs. GI mucosal etiology

111
Q

Anastrozole

A

Aromatase inhibitor

Aromatase: androgen –> estrogen

112
Q

Peptic ulcers are MOST common in?

A

Duodenum

113
Q

Lactase deficiency: stool osmotic gap

A

LARGE (>100 mOsm/kg)

114
Q

Cobalamin

A

VitB12

115
Q

Bile acid recycled in?

A

Terminal ileum

which is most affected in Crohn’s

116
Q

Primary site of lactate clearance

A

Liver

117
Q

Septic shock: lactic acidosis

A

Septic shock=impaired tissue oxygenation –> decrease oxidative phosphorylation –> shunting toward lactate production

118
Q

Dependent lung consolidation

Superior regions of lower lobe, posterior regions of upper lobe

A

Aspiration pneumonia

119
Q

Adrenal crisis: tx?

A

Stress-dose corticosteroid

vasopressors effect are suboptimal since corticosteroids have PERMISSIVE effect on vasoconstriction

120
Q

HYPOtension, TACHYcardic, HYPOglycemic
Vomiting/abdominal pain/WL
HYPERpigmentation

A

Adrenal crisis

121
Q

Reflux esophagitis: histology

A

Elongation of papillae
Basal cell hypertrophy
Intraepithelial eosinophils
(repeated injury –> Barrett esophagus)

122
Q

Adenoma-carcinoma sequence (colon)

A

APC (increase RISK)
KRAS (polyp)
p53/COX (progression to carcinoma)

123
Q

Calcium oxalate nephrolithiasis: increased risk in UC or CD?

A

Crohn’s disease

124
Q

Biotin is required in?

A

Carboxylation reactions
(Pyruvate carboxylase: pyruvate –> oxaloacetate)
(Proprionyl CoA carboxylase: valine –> succinyl CoA)

125
Q

Excessive raw egg white (avidin) consumption?

A

Biotin deficiency.

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