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Flashcards in Endocrine Deck (106)
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1
Q

hormones that signal through cAMP

A

FLAT ChAMP
FSH, LH, ACTH, TSH
CRH, hCG, ADH, MSH, PTH
ant. pit. hormones

2
Q

hormones that signal through IP3

A

GGOAT
GnRH, GHRH, Oxytocin, ADH, TRH
post. pit. hormones

3
Q

steroid receptor hormones

A

VETTT CAP
vit D, estrogen, testosterone, T3/T4
Cortisol, Aldosterone, Progesterone

4
Q

receptor tyrosine kinase hormones

A

PIG

prolactin, immunomodulators (cytokines), GH

5
Q

stimulates bone and muscle growth

A

GH

6
Q

stimulates milk production and secretion

A

prolactin

7
Q

stimulates milk secretion during lactation

A

oxytocin

8
Q

stimulates metabolic activity

A

thyroid hormone

9
Q

increases blood glucose level and decreases protein synthesis

A

glucocorticoids

10
Q

stimulates adrenal cortex to synthesize and secrete cortisol

A

ACTH

11
Q

increases plasma calcium, increases bone resoprtion

A

PTH

12
Q

decreases plasma calcium, increases bone formation

A

calcitonin

13
Q

glucocorticoids

A

zona fasciculata of adrenal cortex

14
Q

oxytocin

A

paraventricular n. of hypothalamus

15
Q

atrial natriuretic hormone (ANH)

A

atria of heart

16
Q

glucagon

A

a cells pancreas

17
Q

vasopression (ADH)

A

supraoptic n of hypothalamus

18
Q

calcitonin

A

parafollicular cells (c-cells)

19
Q

epi and norepi

A

chromaffin cells of adrenal medulla

20
Q

estradiol, estriol, estrone

A

ovaries, placenta, adipose

21
Q

somatostatin

A

d-cells of pancreas

22
Q

mineralocorticoids (aldosterone)

A

zona glomerulosa of adrenal cortex

23
Q

clinical findings in man with high sex hormone binding globulin

A

gynecomastia (low testosterone)

24
Q

clinical findings in woman with low sex hormone binding globulin

A

hirsutism (high testosterone)

25
Q

which ant. pituitary hormones share the a subunit

A

TSH, LH, FSH, hCG

26
Q

most likely clinical presentation of empty sella

A

asymptomatic

might have pit deficiency

27
Q

most common presentation of hyperprolactinemia in female

A

premenopause: hypogonadism-infertility, oligo/amenorrhea
postmenopause: usually asymptomatic
might have galactorrhea in both

28
Q

clinical features of acromegaly

A

increased size hands, feet, head,
coarse facial features
impaired glucose tolerance

29
Q

inability to breastfeed, amenorrhea, cold intolerance

A

Sheehan syndrome

30
Q

infertility, galactorrhea, and bitemporal hemianopsia

A

prolactinoma

31
Q

adrenal gland from what tissue types

A

cortex: mesoderm
medulla: neural crest

32
Q

adrenal secretory products

A

GFR

glomerulosa: aldosterone (mineralocorticoids)
fasciculata: cortisol, sex hormones (glucocorticoids)
reticularis: sex hormones (androgens)

medulla: chromaffin cells secrete catecholamines

33
Q

adrenal steroid metabolism enzyme deficiency shortcut

A

if enzyme begins with #1: HTN
if second number in enzyme is 1: masculinization
ex: 11 hydroxylase def: HTN and masculinization

34
Q

cortisol function

A
BBIIG
maintains Blood pressure
decreases Bone formation
Immunosuppression/anti-Inflammatory
increases Insulin resistance
increases Gluconeogenesis
35
Q

side effects of glucocorticoid use

A

BAM CUSHINGOID
buffalo hump, amenorrhea, moon facies, crazy, ulcers, skin changes, HTN, infection, necrosis of femoral head, glaucoma, osteoporosis, immunosuppression, diabetes

36
Q

most common causes of Cushing syndrome

A

exogenous steroid use
ectopic ACTH secretion (small cell lung)
ACTH pit adenoma (Cushing Disease)
cortisol secreting adrenal tumor

37
Q

treatment for nephrogenic DI

A

HCTZ, amiloride, indomethacin

38
Q

HTN, hypokalemia, and metabolic alkalosis

A

hyperaldosteronism

39
Q

hyperaldosteronism

A

Primary: adrenal hyperplasia or aldo adrenal adenoma (Conn’s)
Tx: surgery and/or spironolactone
Secondary: renal perceives low blood volume
Tx: spironolactone

40
Q

hypotension, hyperkalemia, metabolic acidosis

A

adrenal insufficiency

41
Q

Waterhouse-Friderichsen syndrome

A

acute primary adrenal insufficiency due to hemorrhage of adrenal cortex due to N. meningitidis

42
Q

Addison’s disease

A

chronic primary adrenal insufficiency due to adrenal atrophy or destruction by disease

43
Q

pheochromocytoma associated with what other diseases

A

neurofibromatosis type I

MEN 2A and 2B

44
Q

tumors that secrete erythropoeitin and cause polycythemia

A

pheochromocytoma
renal cell carcinoma
heamngioblastoma
hepatocellular carcinoma

45
Q

neuroblastoma

A
child adrenal tumor that does not increase BP
c-myc oncogene
bombesin tumor marker
neurofilament stain
Homer-Wright pseudorossettes
46
Q

tumor locations for the multiple endocrine neoplasia syndromes

A

MEN 1: pituitary, parathyroid, pancreas
MEN 2A: parathyroid, pheochromocytoma, medullary thyroid carcinoma
MEN 2B: pheochromocytoma, medullary thyroid, mucosal neuroma

47
Q

most common tumor of the adrenal

A

benign, non-functioning adrenal adenoma

48
Q

most common tumor of the adrenal medulla (in adults)

A

pheochromocytoma

49
Q

most common tumor of the adrenal medulla (children)

A

neuroblastoma

50
Q

most common cause of primary hyperaldosteronism

A

adrenal adenoma

51
Q

medical treatment for hyperaldosteronism

A

spironolactone or eplerenone

52
Q

medical treatment for pheochromocytoma

A

non-selective a-blocker (phentolamine or phenoxybenzamine)

53
Q

pheochromocytoma, medullary thyroid cancer, and hyperparathyroidism

A

MEN 2A

54
Q

pheochromocytoma, medullary thyroid cancer, and mucosal neuromas

A

MEN 2B

55
Q

Adrenal disease associated with skin hyperpigmentation

A

Addison disease

56
Q

HTN, hypokalemia, metabolic alkalosis

A

hyperaldosteronism (Conn syndrome)

57
Q

function of thyroid hormones

A

bone growth
CNS maturation
increase B1 receptors in heart
increase basal metabolic rate

58
Q

hyperthyroidism symptoms and extremely tender thyroid gland

A

subacute (de Quervain) thyroiditis

59
Q

hyperthyroidism symptoms and pretibial myxedema

A

Graves

60
Q

hyperthyroidism symptoms and pride in recent weight loss, medical professional

A

thyroid hormone abuse

61
Q

hyperthyroidism symptoms and palpation of single thyroid nodule

A

toxic thyroid adenoma

62
Q

hyperthyroidism symptoms and palpation of multiple thyroid nodules

A

toxic multinodular goiter

63
Q

hyperthyroidism symptoms and recent study using IV contrast (iodine)

A

Jod-Basedow phenomenon

64
Q

hyperthyroidism symptoms and eye changes: proptosis, edema, injection

A

Graves

65
Q

hyperthyroidism symptoms and history of thyroidectomy or radioablation of thyroid

A

too much exogenous thyroid hormone

66
Q

treatment of hyperthyroidism

A

Propylthiouracil (PTU): inhibits peroxidase and 5’-deiodinase is peripheral tissue
methimazole: inhibits peroxidase

67
Q

most common type of thyroid cancer

A

papillary

68
Q

second most common type of thyroid cancer

A

follicular

69
Q

activation of receptor tyrosine kinases in thyroid cancer

A

papillary and medullary

70
Q

hashimoto thyroiditis is a risk factor

A

b cell lymphoma

71
Q

cancer arising from parafollicular C cells

A

medullary

72
Q

associated with RAS or PAX8-PPAR gamma 1 rearrangement

A

follicular

73
Q

associated with RET or NTRKI or BRAF mutation

A

papillary

74
Q

enlarged thyroid cells with ground-glass nuclei

A

papillary carcinoma of thyroid

75
Q

lactic acidosis is rare but worrisome side effect

A

metformin

76
Q

most common side effect is hypoglycemia

A

sulfonylureas

77
Q

recommended first-line treatment for most DB II patients

A

metformin

78
Q

not safe in settings of hepatic dysfunction or CHF

A

TZDs

79
Q

should not be used in patients with elevated serum creatinine

A

metformin

80
Q

should not be used in patients with cirrhosis or inflammatory bowel disease

A

a-glucosidase inhibitors

81
Q

not associated with weight gain

A

metformin, DDP-4 inhibitors, GLP-1 analogs

82
Q

metabolized by liver; excellent choice in patients with renal disease

A

TZDs

83
Q

MOA: closes K channel on B cells -> depolarization -> Ca influx -> insulin release

A

sulfonylureas

84
Q

MOA: inhibits a-glucosidase at intestinal brush border

A

a-glucosidase inhibitors

85
Q

MOA: agonist at PPARy receptors -> improved target cell response to insulin

A

TZDs

86
Q

MOA: decreases hepatic gluconeogenesis

A

metformin

87
Q

good for weight loss

A

GLP-1 agonists

88
Q

avoid in hypoglycemia

A

sulfonylureas

89
Q

best treatment for anyone with organ failure (renal, liver, heart)

A

insulin

90
Q

standard treatment for DKA

A

IV fluids, IV insulin, K replacement

91
Q

standard treatment for type I DM

A

insulin

92
Q

standard treatment for type II DM

A

low carb diet and weight loss, oral hypoglycemic, insulin

93
Q

five categories for diagnosis of metabolic syndrome

A
abdominal obesity (waist circumference)
increased triglycerides
decreased HDL
BP >130/85
increased fasting glucose
94
Q

liver disease associated with obesity

A

nonalcoholic steatohepatitis (NASH)

95
Q

3 functions of vit D

A

increase bone resorption of Ca and PO4

increase Ca and PO4 absorption in intestines

96
Q

cell produces PTH and calcitonin

A

PTH: chief cells of parathyroid
calcitonin: parafollicular C cells of thyroid

97
Q

signs of hypocalcemia

A

Chvostek’s

Trousseau’s

98
Q

primary hyperparathyroidism

A

solitary parathyroid adenoma

parathyroid hyperplasia

99
Q

most common cause of hypercalcemia

A

primary hyperparathyroidism

100
Q

most common cause of primary hyperparathyroidism

A

parathyroid adenoma

101
Q

most common cause of secondary hyperparathyroidism

A

chronic renal failure

102
Q

most common cause of hypoparathyroidism

A

accidental parathyroidectomy

103
Q

facial muscle spasm when tapping on the cheek

A

Chvostek’s sign

104
Q

parathyroid, pancreatic, and pituitary tumors

A

MEN 1

105
Q

hyperparathyroidism

A

stones, bones, groans and psychiatric overtones

106
Q

differences in serum markers for primary and secondary hyperparathyroidism

A

primary: increased Ca, PTH, alk phop decreased PO4
secondary: decreased CA, increased PTH, alk phos and PO4