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Jenna's Shit List > Shit - Endo > Flashcards

Shit - Endo Flashcards

1
Q

MSH

A

from intermediate lobe of AP

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2
Q

AP vs PP origins

A 
AP = oral ectoderm
PP = neuroectoderm
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3
Q

Increase C-peptide via

A

Insulinoma

Sulfonyluras (chlorpromazine, tolbutamide, Glimeperide, glipizide, glyburide)

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4
Q

insulin effects on the kidney:

A

increase Na+ resorption

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5
Q

Insulin-independent glucose transporters:

A 
1 = brain, RBC, cornea
2 = liver, panc, kidney, GIT
3 = brain, placenta, neurons
5 = fructose @ spermatocytes, GIT
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6
Q

Adrenergics on insulin release

A 
a2 = decrease insulin release (stronger)
(b2 = increase insulin release)
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7
Q

Effect of drugs that open K+ channels (diazoxide) or cause decreased EC K+ (thiazides)

A

Can;t close b-cell K+ channels .: can’t release insulin .: hyperglycaemia

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8
Q

CRH effects

A

ACTH, MSH, b-endorphins

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9
Q

Tesamorelin

A

GHRH analog to treat lipodystrophy in HIV

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10
Q

GnRH regulated by:

A

prolactin (i.e. breastfeeding stops GnRH release; prolactinoma causes infertility, OP, galactorhea)

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11
Q

delta cells in pancreas secrete + function

A

somatostatin; inhibits GH and TSH release in HPA (also many GIT actions).

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12
Q

Somatostatin role in HPA

A

inhibit GH and TSH release

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13
Q

Somatostatin role in GIT

A 
INHIBITS RELEASE OF:
Gastrin
Cholecystokinin (CCK)
Secretin
Motilin
Vasoactive intestinal peptide (VIP)
Gastric inhibitory polypeptide (GIP)
Enteroglucagon
Decrease rate of GE

Panc:
Insulin
GCG
Exocrine function

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14
Q

TRH effects

A

increases TSH and prolactin release.

[so 1’ or 2’ hypothyroidism would cause hyperprolactinemia]

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15
Q

How is prolactin regulated

A

Increase: TRH
Decrease: DA, Prolactin (increases DA synthesis)

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16
Q

Somatomedin C =

A

IGF-1 (muscle mass, linear growth) [GH = InsResistance]

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17
Q

GH: increased and decreased by:

A

Increased:
GHRH
Sleep
Exercise

Decreased:
somatostatin
glucose
somatomedin negative feedback

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18
Q

Ghrelin function:

A

induce hunger

cause HG release

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19
Q

Conditions that increase ghrelin release

A

Sleep deprivation

Prader-willi

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20
Q

Regulation of AHD

A 
1' = osmo-Rs in hypothalamus (most important job is osmolarity)
2' = hypovolemia
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21
Q

desmolase: other name, job, regulated by

A

= side chain cleavage enzyme
Turns cholesterol to pregnenolone
Increased by ACTH
Inhibited by Ketoconazole

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22
Q

renin levels in CAHs

A 
21 = high
17 = low
11 = low
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23
Q

Hormone in 11-CAH that causes HTN

A

11-deoxycorticosterone

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24
Q

17-CAH presentation wrt sexes

A 
XX = lack secondary sex characteristics
XY = pseudohermaphroditism, cryptorchidism
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25
Q

Rx CAH

A

Exogenous cortisol to inhibit ACTH release

Other supplements i.e. aldosterone

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26
Q

Functions of cortisol:

A

BP: upregulates a1-Rs, acts as aldosterone at high conc
Insulin resistance
Gluconeo, lipolysis, proteolysis
Decrease fibroblast activity (striae)
Decrease immune system (incl. IL-2 production –> candidiasis and reactivation of TB). Neutrophilia
Decreased OBL activity

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27
Q

Ca and pH

A

40% Ca bound by albumin (45% ionized = free)

Increase pH = less H+ = albumin binds more Ca++ = hypocalcemia (tetany, cramps, spasms, paresthesias)

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28
Q

Vit D2 vs D3

A 
D2 = plant foods
D3 = skin
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29
Q

Vit D regulation

A

Increased by: low Ca, low PO4, high PTH

Decreased by: high Vit D (inhibits itself and PTH)

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30
Q

Ca++ regulation cells

A 
Chief = parathyroid (bone, kidney, vitD)
C-cell = calcitonin (bone)
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31
Q

PTH in kidney

A

PO4 - decrease resorption in PCT
Ca - increase resorption in DCT
Vit D - increase a-1-OHase in PCT

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32
Q

PTH in bone

A

increase Macrophage-CSF and OBL to secrete RANK-L

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33
Q

PTH secretion and Mg levels

A

Low Mg = increased PTH release
VERY low Mg = decreased PTH release

*get low Mg via diarrhea, loops, aminoglycosides, alcohol abuse

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34
Q

Increase SHBG via:

A

pregnancy and OCPs

.: more T bound up .: feminizing

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35
Q

5’deiodinase: role and inhibitors

A

converts T4 to T3 peripherally

Inhibited by:
Propylthiouracil
Glucocorticoids
Amiodarone
Iopanoic acid (contrast agent)
Non-selective b-blockers
36
Q

Wolf-Chaikoff

A

High Iodine temporarily inhibits TPO

37
Q

Competitive inhibitors of NIS

A

Perchlorate
Pertechnetate
Thiocyanate

38
Q

S/S of adrenal insufficiency:

A

Electrolytes: low Na+, high K+, metabolic acidosis (NON-ion gap), high Cl-

weak, fatigue, N/V/D, muscle aches, ORTHOSTATIC HYPOTENSION, weight LOSS, salt/sugar cravings

39
Q

Dx of adrenal insufficiency:

A

ACTH stimulation test

OR

Metyrapone stimulation test (blocks 11-deoxycortisol to cortisol)
Normal = high 11-deoxy an high ACTH
1’ = no 11-deoxy but high ACTH
2’ = now 11-deoxy or ACTH

40
Q

Addison underlying disease

A

Autoimmune, TB, mets

41
Q

When do you see skin pigmentation and when do you see hyperkalemia in adrenal insufficiency

A

1’ = skin and hyperkalemia

2’ and 3’ = NO skin (no ACTH) and NO hyperkalemia (aldosterone synthesis preserved)

42
Q

Na+ levels in hyperaldosteronism

A

NORMAL!
Aldosterone increases Na+ and H2O, so increased GFR causes Na+ loss; so HTN with normal Na+ and no edema = “aldosterone escape”

43
Q

Opsoclonus myoclonus: underlying disease and characteristics

A 
NEUROblastoma
irregular abdominal mass, can cross midline
HVA, VMA, bombesin, neuron-spec enolase
N-myc
HOMER-WRIGHT ROSETTES
44
Q

Homer-Wright Rosettes

A

Neuroblastoma

Medulloblastoma

45
Q

Theo associated with what syndromes:

A

NF-1
VHL
MEN2A
MEN2B

46
Q

Signs and level sin hyperaldosteronism

A

NORMAL Na+
Low K+ [muscle weakness and parenthesias]
Metabolic alkalosis (high HCO3-)
low Cl- (for electroneutrality of bicarb)
hypertension (no edema or hyperNa+)
low renin (if primary)

47
Q

Most sensitive measure for hypothyroidism

A

High TSH

48
Q

Cholesterol levels in hypo and hyper thyroidism

A

Hypothyroid = hyper cholesterolemia (via decreased LDL-R expression)

hyperthyroid = hypocholesterol
[also hyperglycaemia and hypercalcemia (bone resorption)]

49
Q

Myoedema

A

Hit muscle, stays bulged for longer because of slow Ca uptake into SR. Seen in hypothyroidism

50
Q

hashimotos ABs

A

anti-TPO
anti-TG
anti-microsomal

51
Q

Immune gene of hashimotos

A

HLA-DR5

52
Q

umbilical hernia, tongue sticking out

A

cretinism

53
Q

DeQuervains

A

post flu-like
Hyper then hypo
granulomatous inflammation with mixed cell infiltrate and giant cells
High ESR, jaw pain, tender thyroid

54
Q

Reidel Thyroiditis

A

Fibrosis extending i.e. airway (ddx = anaplastic but thats old ppl) = rock/wood-like
young woman
IgG4 related - autoimmune pancreatitis, retroperitoneal fibrosis, non-infectious aortitis

55
Q

Ab for Graves

A

IgG

56
Q

Mutation in TSH-R causes:

A

toxic multinodular goiter - hot nodule, rarely malignant

57
Q

Thyroid storm s/s and rx

A

Stress-induced
Agitation, delerium, fever, diarrhea, vomiting, coma
COD = tachyarrythmia

Rx = b-blocker, PTU, corticosteroids

58
Q

Jod-Basedow phenomenon

A

Iodine deficient person made iodine replete presenting with thyrotoxicosis

59
Q

Thyroid artery matched with nerve that can be damaged:

A

Superior thyroid artery = superior laryngeal nerve

  • external = cricothyroid (low-pitched monotone)
  • internal = sensation above vocal cords (aspiration)

Inferior thyroid artery = recurrent laryngeal nerve = all laryndeal muscles (less cricothyroid)
- hoarseness and sensation below vocal cords

60
Q

Papillary thyroid cancer:

A 
Orphan annie
RET or BRAF
Psammoma
Nuclear grooves
childhood iradiation
61
Q

Follicular thyroid cancer

A

Hematogenous mets
RAS
Invasion of thyroid capsule

62
Q

Medullary CA thyroid

A

Calcitonin
C-cells
Amyloid background
RET

63
Q

Undifferentiated/anaplastic Thyroid CA

A

old person
Invades local structures (ddx = riedel’s thyroiditis)
p53

64
Q

Hematogenous CA mets

A

Follicular CA thyroid
ChorioCA
HCC
RCC

65
Q

Pseudohypoparathyroidism =

A

Albright hereditary osteodystrophy

  • kidneys unresponsive to PTH so low Ca and high PO4
  • short 4th and 5th digits, short, AD
66
Q

Albright hereditary osteodystrophy

A

Pseudohypoparathyroidism =

  • kidneys unresponsive to PTH so low Ca and high PO4
  • short 4th and 5th digits, short, AD
67
Q

Familial hypocalciuric hypercalcemia

A

Defective Ca-sensory on parathyroid
Keep resorbing it from bone = hypercalcemia
Dont excrete it in kidneys = hypocalciuria

68
Q

Kidneys unresponsive to PTH vs. defective Ca-sensor on parathyroid

A

unresponsive kidneys = pseudohypoparathyroidism/albrights

defective sensor = familial hypocalciuric hypercalcemia

69
Q

increased cAMP in urine

A

hyperparathyroidism (signalling molecule)

70
Q

2’ hyperPTH levels via kidney failure

A

Low Ca

High PO4

71
Q

Acromegaly s/s, complication, test, rx

A

Large tongue with deep furrows, insulin resistance
Increased risk of colorectal polyps and cancer
Test = GH not suppressed with OGTT
Rx:
- Octerotide (somatostatin analog)
- Pegvisomant (GH-R antagonist)

72
Q

Causes, urine spec. gravity, and rx of central vs nephrogenic DI

A

Central:
- pituitary tumour, hypothalamus problem, trauma, surgery, ischemic encephalopathy, idiopathic
-

73
Q

SIADH: complication, causes, rx

A

Cerebral edema
- fix too quick, get osmotic demyelination syndrome

Via small cell, head trauma, PULMONARY DISEASE, cyclophosphamide, carbamazepine

Rx = IV hypertonic saline (slowly), conivaptan, tolivaptan, demeclocycline

74
Q

Empty sella pt

A

obese woman

75
Q

pregnancy and pituitary problems

A

Sheehans = ischemic infarct post-blood loss

Autoimmune hypophysitis = acute HA, visual field changes, cortisol deficiency in late pregnancy or early post-delivery

76
Q

DM: lipolysis and proteolysis

A

present in TIDM
NOT usually in T2 because some basal insulin to prevent it

Both have increased protein catabolism

77
Q

MCCD DM

A

MI

78
Q

Osmotic damage: what enzymes

A

Have aldose reductase

NO or LOW sorbitol dehydrogenase

79
Q

Gestatoinal DM: hormone and s/s in fetus

A

hPL

Caudal regression syndrome, VSD, transposition of great vessels, neural tube defects, rectal atresia, renal agenesis

80
Q

T1DM HLA link

A

DR-3 and DR-4

81
Q

DKA complications

A

life-threatening mucor, cerebral deem, arrythmias, heart failure

82
Q

Glucagonoma s/s

A 
Dermatitis - necrolytic migratory erythema
Depression
Diabetes
DVT
Diarrhea
Normo normo anemia
83
Q

whipples triad

A

insulinoma

84
Q

carcinoid markers

A 
Neuroendocrine (chromogrannin)
5-HIAA
Niacin deficiency (pellagra)
85
Q

MEN genes

A 
MEN1 = MEN1 = menin tumour supressor
MEN2 = RET = tyrosine kinase

Jenna's Shit List (23 decks)

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