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Endo/Repro > Test 1 (Week 1) > Flashcards

Test 1 (Week 1) Flashcards

1
Q

If someone presents with a tender thyroid, think ______.

A

subacute granulomatous (De Quervain) thyroiditis

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2
Q

What do cells of the zona reticularis (in adrenal cortex) produce?

A

precursors to androgen hormones (DHEA and DHEA sulfate)

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3
Q

What do cells of the zona fasciculata (in adrenal cortex) produce?

A

glucocorticoids (cortisol)

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4
Q

What is the rate limiting substrate in thyroid hormone biosynthesis?

A

iodide

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5
Q

What’s the mechanism of sampling the thyroid?

A

fine needle aspiration (FNA)

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6
Q

What’s the most common cause of primary hyperparathyroidism?

A

parathyroid adenoma

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7
Q

what do cells of the zona glomerulasa (in adrenal cortex) produce?

A

aldosterone

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8
Q

What tissues are insensitive to thyroid hormone?

A

brain, uterus, testes, lymph nodes, spleen BUTt-LeSs

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9
Q

What’s the mnemonic to remember the clinical features of symptomatic hypercalcemia?

A

painful bones, renal stones, abdominal groans, and psychic moans

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10
Q

What should be in an umbilical cord?

A

There should be 2 arteries and 1 vein in the umbilical cord.

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11
Q

Fusion of the _____ and _____ obliterates the uterine cavity.

A

Fusion of the decidua caspularis and decidua parietalis obliterates the uterine cavity

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12
Q

List the anterior pituitary hormones that are glycoproteins with alpha and beta subunits

A

FSH LH TSH

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13
Q

Prolactin release is inhibited by ____.

A

dopamine from hypothalamus

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14
Q

What do thyroid C cells (or parafollicular cells) do?

A

produce the peptide hormone calcitonin which inhibits calcium resorption from bones= lowers blood calcium

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15
Q

The differentiation of minimally invasive follicular carcinoma from adenoma is dependent exclusively on _______.

A

invasion of the capsule

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16
Q

Autoimmune destruction by which type of T cells is seen in Hashimoto’s thyroiditis?

A

CD8+ T cells

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17
Q

What is Levothryoxine?

A

synthetic thyroxine (T4)

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18
Q

_____ secretion appears to be normally under inhibitory control by the hypothalamus.

A

Prolactin secretion appears to be normally under inhibitory control by the hypothalamus.

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19
Q

For Pseudohypoparathyroidism where the maternal allele is mutated, you get Albright hereditary osteodystophy. Is it with or without multi hormone resistance?

A

with multi hormone resistance. therefore, you will also have hypocalcemia, hyperphosphatemia, and elevated PTH. IT’S CALLED Pseudohypoparathyroidism Type 1a

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20
Q

list the basophils in the adenohypophysis

A

corticotropes, gonadotropes, thyrotropes

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21
Q

What is Liotrix?

A

mixture of T4 and T3

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22
Q

premature separation of the placenta from the uterine wall before delivery. heavy bleeding occurs

A

placental abruption

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23
Q

What’s the BMI range for overweight?

A

25.0-29.9

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24
Q

Eclampsia=

A

grand mal convulsions (seizures)

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25
Q

Where are newly synthesized thyroid hormones stored?

A

colloid

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26
Q

Which HLA is Hashimoto thyroiditis associated with?

A

HLA-DR5

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27
Q

The _____ is an upgrowth from the roof of the mouth.

A

Adenohypophysis (forms Rathe’s pouch)

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28
Q

If someone presents with a ‘hard as wood’ thyroid that involves local structures, think _____.

A

Riedel Fibrosing thyroiditis

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29
Q

How do papillary thyroid carcinomas typically spread?

A

via lymphatics

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30
Q

What’s the mechanism of action of Pegvisomant?

A

it’s a pegylated analog of hGH (decreases its renal clearance) that Binds to GH receptors, blocks GH from activating receptors and thus decreases production of insulin-like growth factors (IGF-1)

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31
Q

growth hormone release is stimulated by _____.

A

growth hormone releasing hormone (GHRH) from hypothalamus

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32
Q

What’s the mechanism of action of thionamides?

A

interfere with the organification and coupling steps in the biosynthesis of thyroid hormone

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33
Q

What do corticotropes make?

A

adrenocorticotropin (ACTH) and beta-endorphin

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34
Q

Pars distalis is more ____.

A

cellular

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35
Q

Graves’ disease is an autoimmune disorder that accounts for roughly 60-80% of all cases of _______.

A

HYPERthyroidism Graves’ disease is more common in women than in men.

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36
Q

carpal spasm induced by inflating blood pressure cuff

A

Trousseau sign

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37
Q

What are the most common secretory pituitary tumors?

A

Prolactinomas are the most common secretory pituitary tumors.

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38
Q

What’s the BMI range for normal?

A

18.5-24.9

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39
Q

Which hormone stimulates synthesis and secretion of TSH?

A

Thyrotropin releasing hormone (TRH)

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40
Q

What is Gonadorelin and what is it used for?

A

synthetic GnRH; administered in a pulsatile manner to treat hypogonadotropic hypogonadism

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41
Q

tapping facial nerve results in twitch of eyes, mouth or nose

A

Chvostek sign

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42
Q

What’s another name for somatostatin?

A

growth hormone inhibiting hormone

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43
Q

growth hormone release is inhibited by ____.

A

somatostatin from hypothalamus

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44
Q

What’s the gold standard to evaluate pituitary secretion of growth hormone?

A

Induction of hypoglycemia by administration of insulin; GH secretion is increased with hypoglycemia

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45
Q

What does the pars intermedia produce?

A

ACTH and melanocyte stimulating hormone (MSH); not really a big deal in humans b/c the adenohypophysis can do this too (and better)

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46
Q

From where do the parathyroid glands develop embryologically?

A

3rd and 4th pharyngeal pouches

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47
Q

Approximately 80% of plasma T3 (the thyroid hormone exhibiting the greatest activity) production occurs in the periphery following metabolism of T4 by __________.

A

two 5′ deiodinases, referred to as D1 and D2.

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48
Q

from outside in, what are the 3 zones of the adrenal cortex?

A

zona glomerulosa, zona fasciculata, zona reticularis

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49
Q

Melatonin is inhibitory to gonadotropins (LH and FSH), therefore children with destroyed pineal gland may go through _______.

A

precocious puberty

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50
Q

What are the two clinical signs you can test for if you suspect hypoparathyroidism ?

A

Trousseau and Chvostek sign

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51
Q

List the acidophils of the adenohypophysis

A

somatotropes and lactotropes

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52
Q

end organ resistance to the actions of PTH

A

pseudohypoparathyroidism

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53
Q

What’s the equation for respiratory quotient (RQ)?

A

CO2 produced/ O2 consumed

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54
Q

Which two organelles play a prominent role in steroid hormone production of the adrenal cortex?

A

mitochondria and smooth ER

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55
Q

What are the 3 cell types of the parathyroid gland?

A

adipose cells, chief cells, oxyphil cells

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56
Q

What is used to treat prolactinomas?

A

a dopamine agonist (such as bromocriptine)

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57
Q

used to induce labor

A

oxytocin

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58
Q

Primary lymphoma of the thyroid is strongly associated with:

A

Strongly associated with autoimmune thyroiditis (Hashimoto or lymphocytic) and external beam radiation

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59
Q

The posterior region of the pituitary gland is the ____.

A

neurohypophysis

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60
Q

Desmopressin (DDAVP) is a ____ analog.

A

ADH it’s a long lasting synthetic analog, used in nasal spray form; used to treat diabetes insipidus

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61
Q

characterized by a well defined well circumscribed capsule w/o invasion

A

follicular adenomas

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62
Q

What’s the MOA of Cabergoline?

A

–Decreases Dopamine turnover (i.e., increases hypothalamic DA) –Direct action on Dopamine-Receptor to inhibit prolactin release increase dopamine = inhibit prolactin

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63
Q

For Pseudohypoparathyroidism where the paternal allele is mutated, you get Albright hereditary osteodystophy. Is it with or without multi hormone resistance?

A

it is without multi hormone resistance, therefore, your calcium and PTH levels are normal

64
Q

placenta attaches to the lower uterine cavity and covers (partially/completely) the internal cervical os

A

placenta previa

65
Q

What are the side effects of iodide drugs?

A

Iodism: 1) Brassy taste 2) Increased salivation 3) Soreness of teeth and gums 4) Swelling of the eyelids 5) Symptoms resembling upper respiratory infection 6) Severe frontal headache

66
Q

Why are natural hormones usually not good drugs?

A

Inactive Orally Rapidly Degraded

67
Q

Why is the transition of cytotrophoblast cells from epithelial to endothelial and subsequent invasion of maternal spiral arteries so important?

A

it transforms those arteries from small diameter/high resistance, to large diameter/low resistance =blood flow

68
Q

What do gonadotropes make?

A

luteinizing hormone (LH) and follicle stimulating hormone (FSH)

69
Q

On what cells will FSH act and what will they stimulate these cells to do (male and female individually) ?

A

Male: Sertoli cells —> spermatogenesis Female: Follicles —-> estrogen

70
Q

The _____ is a down growth from the floor of the diencephalon.

A

neurohypophysis

71
Q

What are the adverse effects of thionamides?

A

-skin rash -headache, nausea -leukopenia -agranulocytosis (most dangerous)

72
Q

Primary hypothyroidism is a problem with the ___.

A

thyroid itself (like in Hashimoto’s)

73
Q

what immunohistochemical marker will be positive in Pituicytomas ?

A

TTF-1 (will also have PAS+ granules)

74
Q

What is the embryological origin of the adrenal medulla?

A

neural crest

75
Q

List the common thionamides

A

propylthiouracil (PTU), methimazole, and carbimazole

76
Q

What do lactotropes make ?

A

prolactin

77
Q

Patients with Hashimoto thyroiditis are at an increased risk for what cancer?

A

b cell lymphoma

78
Q

Medullary thyroid carcinoma is derived from ____.

A

C cells

79
Q

Tertiary hypothyroidism is a problem at the ___.

A

hypothalamic level (like a hypothalamic tumor or trauma)

80
Q

How do follicular thyroid carcinomas typically spread?

A

hematogenously (often to lungs)

81
Q

What do the hormones produced by cardiovascular muscle endocrine cells do?

A

decrease blood volume and blood pressure

82
Q

What’s the drug of choice for most hypothyroid conditions?

A

Levothyroxine

83
Q

What will large doses of iodide do ?

A

-Inhibits TH release –Rapid decrease in TH levels -Inhibits organification –Decreases synthesis of TH -Decreases the vascularity, size and fragility of thyroid gland –Good prior to surgical removal

84
Q

What’s the function of adrenal medulla cells?

A

produce norepinephrine and epinephrine

85
Q

What’s the most obvious in vivo effect of the thyroid hormones?

A

increase O2 consumption

86
Q

Oxyphil cells are filled with ____.

A

mitochondria

87
Q

How does hyperthyroidism increase sympathetic nervous system activity?

A

increased expression of beta-1 adrenergic receptors

88
Q

a type of brain tumor derived from pituitary gland embryonic tissue (remnants of Rathkes pouch)

A

craniopharyngioma

89
Q

What are the two main thyroid hormone binding proteins in the plasma?

A

Thyroid binding globulin (TBG) and transthyretin (TTR) TBG binds a much greater percentage of T3 and T4 in the plasma than TTR

90
Q

What’s another name for growth hormone?

A

somatotrophin

91
Q

Secondary hypothyroidism is a problem at the ___.

A

pituitary level (like hypopituitarism)

92
Q

What would you use GH antagonists for treating?

A

GH secreting pituitary adenomas–> treat acromegaly and gigantism

93
Q

The anterior region of the pituitary gland is the _____.

A

adenohypophysis

94
Q

How does hyperthyroidism increase the basal metabolic rate?

A

increased synthesis of Na-K ATPase

95
Q

Secretion of vasopressin is inhibited by _____.

A

ethanol Ethanol is an “anti” anti-diuretic i.e., it has a diuretic effect.

96
Q

placenta attaches to the myometrium

A

placenta accreta

97
Q

A single umbilical artery occurs in 1/200 babies and these have a 20% chance of having _______ defects

A

cardiac and other vascular

98
Q

Where do you get human chorionic gonadotropin from and what is the hormone it contains?

A

urine of pregnant women; LH only

99
Q

Which cells of the parathyroid gland produce parathyroid hormone?

A

chief cells

100
Q

nests of cells in the pars nervosa. involutes in humans

A

pars intermedia

101
Q

Insufficient Migration of ______ Leads to Preeclampsia.

A

cytotrophoblast cells

102
Q

placenta penetrates into the myometrium

A

placenta increta

103
Q

What’s the blood supply to the pars nervosa (neurohypophysis) ?

A

inferior hypophyseal arteries (branch from internal carotids)

104
Q

What’s the BMI range for thin?

A

less than 18.5

105
Q

Describe the physical findings in Albright hereditary osteodystrophy (AHO). What causes it?

A

short stature, obesity, short metacarpal and metatarsal bones and variable mental deficits genetic imprinting

106
Q

placenta perforates the myometrium and can attach to rectum or bladder

A

placenta percreta

107
Q

What’s the second most common thyroid malignancy? What is it associated with?

A

follicular carcinoma iodine deficiency

108
Q

What lab value do you look at if you suspect medullary carcinoma of the thyroid?

A

calcitonin

109
Q

The histologic diagnosis of papillary thyroid carcinoma is solely defined by its ‘characteristic nuclear features’. What are some of these features?

A

-elongation -fine grooves -fine powdery chromatin (nucleus looks glassy) - chromatin clearing and margination -pseudoinclusions don’t occur uniformly in all papillary cancers. will only see 3-4 of these

110
Q

Which thyroid hormone is not produced in the periphery?

A

T4

111
Q

Which amino acid is the most potent stimulator of growth hormone secretion?

A

arginine

112
Q

PTH increases serum calcium by acting at targets in the ____, _____, and ____.

A

bone, kidney, GI tract

113
Q

What’s the blood supply to the pars distalis?

A

superior hypophyseal arteries (branch from internal carotids)

114
Q

_____ and ____ are somatostatin analogs.

A

Octreotide and Lanreotide

115
Q

What’s the mechanism of action of Mesasermin? What are its uses?

A

MOA: it’s a recombinant human IGF-1 which stimulates IGF-1 receptors Uses: in children with growth failure unresponsive to GH due to deficient IGF-1

116
Q

What does the neurohypophysis (posterior pituitary) release?

A

oxytocin and vasopressin

117
Q

What’s the most common cause of secondary hyperparathyroidism?

A

chronic renal failure

118
Q

Defects in ______ structure may indicate that villous tissue has remained behind in the uterus/poor perfusion. This can lead to prolonged postpartum hemorrhage.

A

cotyledon

119
Q

contains only FSH from urine of post menopausal women

A

urofollitropin; LH is removed

120
Q

Where do urofollitropin and hMG (menotropins) come from?

A

urine of post menopausal women

121
Q

On what cells will LH act and what will they stimulate these cells to do (male and female individually) ?

A

Male: Leydig cells —> testosterone Female: corpus luteum—> induces ovulation, secretion of estrogen and progesterone

122
Q

What cell types are parathyroid glands composed of?

A

chief cells, oxyphil cells (oncocytes), fat

123
Q

What does parathyroid hormone do?

A

a peptide hormone that raises serum calcium by stimulating bone breakdown

124
Q

What histologic findings will be seen in Hashimoto thyroiditis cases?

A

chronic inflammation w/ germinal centers and Hurthle cells

125
Q

What’s the BMI range for obese?

A

30.0-39.9

126
Q

What do somatotropes make?

A

growth hormone (GH)

127
Q

What’s the BMI range for morbid obesity?

A

>40

128
Q

Thyroid hormones are iodinated derivatives of the amino acid _____.

A

tyrosine

129
Q

What does the pineal gland produce?

A

melatonin from serotonin

130
Q

contains FSH and LH from urine of post menopausal women

A

hMG (menotropins)

131
Q

Pineal cells are sensitive to what wavelength of light?

A

indigo blue light (460nm)

132
Q

Fusion of the _____ with the _____ obliterates the chorionic cavity.

A

Fusion of the amnion with the chorion obliterates the chorionic cavity

133
Q

Which part of the pituitary gland uses a portal system for signaling?

A

adenohypophysis

134
Q

What’s the most common thyroid malignancy?

A

papillary carcinoma

135
Q

What’s another name for hyperthyroidism?

A

thyrotoxicosis

136
Q

What are some iodide drugs?

A

-Lugol’s solution -saturated solution of potassium iodide (SSKI) -sodium ipodate

137
Q

What is preeclampsia characterized by?

A

characterized by sudden onset of maternal hypertension and edema

138
Q

What is bromocriptine and what is it used to treat?

A

it’s a dopamine agonist used to treat acromegaly; this is Paradoxical b/c DA agonists usually increase GH in normal individuals.

139
Q

Prolactin release is stimulated by ____.

A

thyrotropin releasing hormone from hypothalamus

140
Q

What do thyrotropes make?

A

thyroid stimulating hormone (TSH)

141
Q

What is papillary carcinoma associated with?

A

radiation exposure (~6%)

142
Q

What’s the function of vasopressin?

A

AKA anti-diuretic hormone; raises blood pressure by water and sodium conservation in the collecting ducts of the kidney

143
Q

Amiodarone is an iodine containing antiarrhythmic that can produce _____.

A

Hypothyroidism AND hyperthyroidism

144
Q

the term for the uterine lining (endometrium) during a pregnancy, which forms the maternal part of the placenta.

A

decidua

145
Q

Describe Hurthle cell adenomas.

A

Composed of predominately or exclusively of oncocytic follicular cells with prominent nucleoli and densely granular eosinophilic cytoplasm.

146
Q

What is somatropin?

A

recombinant human growth hormone

147
Q

Why is radioactive iodine therapy of little or no value in treating hurthle cell variant follicular carcinoma?

A

Hurthle cells are metabolically inactive

148
Q

Presents as a rapidly enlarging neck mass

A

anaplastic carcinoma (100% mortality at 1 year)

149
Q

What are pituicytes?

A

specialized glial cells of the posterior pituitary

150
Q

What causes the hyperthyroidism produced by Graves’ disease ?

A

autoantibodies stimulate TSH receptors on thyroid

151
Q

List the anterior pituitary hormones that are composed of a single chains of amino acids.

A

ACTH GH Prolactin

152
Q

Pars nervosa is ____.

A

fibrous

153
Q

What’s the function of oxytocin?

A

contractions of uterus and mammary gland myoepithelial cells (lactation)

154
Q

What is Liothyronine and what is its potential side effect?

A

synthetic triiodothyronine (T3); potentially cardiotoxic

155
Q

What’s another stupid name for insulin like growth factor 1 (IGF1)?

A

Somatomedin C

Endo/Repro (4 decks)

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