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Test your basic knowledge |
Endocrine
Start Test
Study First
Subject
:
health-sciences
Instructions:
Answer 50 questions in 15 minutes.
If you are not ready to take this test, you can
study here
.
Match each statement with the correct term.
Don't refresh. All questions and answers are randomly picked and ordered every time you load a test.
This is a study tool. The 3 wrong answers for each question are randomly chosen from answers to other questions. So, you might find at times the answers obvious, but you will see it re-enforces your understanding as you take the test each time.
1. What causes skin hyperpigmentation in primary adrenal insuff
MSH - a by product of inc ACTH production from POMC
Bound to corticosteroid binding globulin - CGB
FLAT PiG - FSH - LH - ACTH - TSH - Prolactin - GH
Pheochromocytoma
2. Where are T3/T4 made
Lumen of follicles - thryglobulin + I2 with MIT and DIT - proteolysis and secrete into blood back through follicular cell
Zona fasciculata - ACTH - hypothalamic CRH - cortisol/sex hormones
2A and 2B
FLAT PiG - FSH - LH - ACTH - TSH - Prolactin - GH
3. What is the source of thyroid hormone
1 -25 OH2 vitamin D (active form)
Follicles of thyroid - most T3 formed in the blood
Urine specific grav < 1.006 - serum osm > 290
Metanephrine
4. Where can neuroblastomas occur - What do you see elevated in the urine and what oncogene is associated
Octreotide
Anwhere along the sympathetic chaing - HVA - N- myc
Follicular carcinoma of thyroid
Follicles of thyroid - most T3 formed in the blood
5. What vasodilators use the cGMP pathway
Adquate fluid intake - central intranasal desmopressin - for nephrogenic use thiazide (for hypernatremia) - amiloride (for hypokalemia) and indomethacin to dec GFR
Kidney stones and stomach ulcers
Urine specific grav < 1.006 - serum osm > 290
ANP - NO and EDRF
6. What is the depleted intracellular K due to in DKA
Neural crest
Transcellular shif from dec insulin
Medullary thyroid carcinoma - calcitonin
T3/T4 - cytosol
7. What does vitamin D deficiency cause in kids and adults
Renal osteodystrophy
Kids = rickets - adults = osteomalacia
HTN
Correct is slowly
8. Gastrin secreting tumor of pancreas or duodenum
Tonic DA from hypothalamus inhibits - prolactin causes DA synthesis and increases own inhibition - TRH stimulates prolactin
TSH receptor leading to inc release of T3 and T4 - hot nodules are rarely malignant
Zollinger Ellison
Kidney - 1 -25 OH2 vit d
9. What are the 4 fxns of PTH
Polydipsia - polyuria - polyphagia - weight loss - DKA (type1) - hyperosmolor coma (type2) unopposed secretion of GH and epi (exacerbating hyperglycemia
Inc bone resorption of Ca and PO4 - inc kidney reabsorption of Ca in DIC - dec kidney reabsorption of PO4 - inc calcitriol production by stimulated 1alpha - hydroxylase
Stim
Mucormycosis - Rhizopus infxn - cerebral edema - cardia arrhythmias - HF
10. What enzyme is responsible for oxidation and organification of iodide as well as coupling of MIT and DIT
VMA
FLAT
ATP from glucose metabolism closing K channels and depolarizing cells - required for adipose and skeletal muscle uptake of glucose
Peroxidase
11. What are the findings of prolactinoma
VMA
Inc PTH - dec Ca - dec PO4 cause inc in active form and then it feedback inhibits its own production
Inside
Amenorrhea - galactorrhea - low libido - infertility from dec GnRH - - bitemporal heminanopia from imgingement of optic chiasm
12. What does inc GH in children result In What is the characteristic bone growth
Cold intolerance - weight gain - dec appetite - lethargy/fatigue - constipation - dec reflexes - myxedema (facial/periorbital) - dry cool skin - coarse brittle hair - bradycardia - dyspnea on exertion
TSH receptor leading to inc release of T3 and T4 - hot nodules are rarely malignant
Gigantism - linear bone growth
Follicles of thyroid - most T3 formed in the blood
13. What is the histology with hashimotos thyroiditis
Hurthle cells - lymphocytic infiltrate with germinal centers
Tonic DA from hypothalamus inhibits - prolactin causes DA synthesis and increases own inhibition - TRH stimulates prolactin
Neural crest
Surgery to remove tumor - sprinolactone - (K sparing diuretic)
14. What is the rule of 1/3s in carcinoid syndrome
Thyroid hormones T3/T4
Neuroendocrine cells of GI tract
TRH from the hypothalamus stimulates TSH release from ant pit which stimulates follicular cells - neg feedback to ant bit dec sens to TRH
1/3 metastasize - 1/3 present with 2nd malignancy - and 1/3 multiple
15. Most common tumor of adrenal medulla in adults - cells - and embyronic origin
Beta - hydroxybutyrate > acetoacetate
Amenorrhea - galactorrhea - low libido - infertility from dec GnRH - - bitemporal heminanopia from imgingement of optic chiasm
Chromaffin cells from NC
Free hormone is active T3 bind more than T4
16. What is the effect of prolactin on GnRH
Inhib
Neural crest
Urine specific grav < 1.006 - serum osm > 290
Mesoderm
17. What stimulus causes beta cells to make insulin
Beta - hydroxybutyrate > acetoacetate
Ectopic ADH in small cell lung cancer - CNS disorder/head trauma - pulmonary diseae - drugs like cyclophosphamide
Inc PTH - dec Ca - dec PO4 cause inc in active form and then it feedback inhibits its own production
ATP from glucose metabolism closing K channels and depolarizing cells - required for adipose and skeletal muscle uptake of glucose
18. What is the tx for SIADH
Medullary thyroid carcinoma - calcitonin
DM1 = severe - DM2 = mild to moderate
Inc cortisol after low dose - dec cortisol after high dose
Demeclocycline or H2O restriction
19. Which substances bind receptor associated tyrosine kinase via the JAK/STAT pathway
Waterhouse friderichsen - n meningitidis septicemia
Accidental surgical excision - autoimmune destruction and DiGeorge syndrome
Autoimmune - TB - metastasis
GH - prolactin also IL-2
20. All three effects of hyperinsulinemia lead to which two clinical features
Undifferentiated/anaplastic
25- OH vitamin D
Osteitis fibrosa cystica
Dehydration and acidosis leading to coma and death
21. where do you see GLUT 4 transporter
Dehydration and acidosis leading to coma and death
Renal osteodystrophy
Insulin responsive - adipose and skeletal muscle
ANP - NO and EDRF
22. intense thirst - polyuria and inability to concentrate urine
Adquate fluid intake - central intranasal desmopressin - for nephrogenic use thiazide (for hypernatremia) - amiloride (for hypokalemia) and indomethacin to dec GFR
FLT - hCG
Hurthle cells - lymphocytic infiltrate with germinal centers
Diabetes insipidus - lack of ADH - or lack of response to ADH in kidney
23. Where is the defect in toxic multinodular goiter
TSH receptor leading to inc release of T3 and T4 - hot nodules are rarely malignant
Cushing's diseaes = ACTH secretion from pit ademona - inc ACTH - ectopic ACTH = non pit tissue secreting ACTH - inc ACTH - adrenal production of cortisol = ademona - carcinoma - nodular adrenal hyperplasia - dec ACTH
Removal of pituitary adenoma and octreotide
Kids = rickets - adults = osteomalacia
24. How does right adrenal gland drain
Dec glucose uptake - inc protein catabolism - inc lipolysis
Hypo is low - hyper is high on all
Right adrenal - right adrenal vein - IVC
Dec aldosterone causing hyponatremia which can lead to seizures
25. In which DM is there a stronger genetic association
Mucormycosis - Rhizopus infxn - cerebral edema - cardia arrhythmias - HF
Parafollicular C cells - calcitonin histo = sheets of cells in amyloid stroma - associated with MEN 2A/2B
FSH - LH - ACTH - TSH - CRH - hCG - ADH (V2) - MSH - PTH - + calcitonin - GHRH and glucagon
DM2
26. What does fetal hypothyroidism cause - where do you see this birth defect endemically - and What causes the sporadic form
Beta - hydroxybutyrate > acetoacetate
Hyperglycemia - glucosuria - osmotic diureses - lyte depletion
Dec in pit ACTH production - no skin hyperpigmentation and no hyperkalemia
Cretinism - whereever there is endemic goiter - sporadic version due to defect in T4 formation or thyroid development
27. How many cortical divisions are involved in primary adrenal insuff
DM1 = severe - DM2 = mild to moderate
Stim
DM1 - HLA- DR3 and DR4
All 3 - spares medulla
28. What is the effect of GHRH on GH
Islets of langerhans are collections of alpha - beta and delta
Hyperglycemia - inc H+ - dec bicarb leading to anion gap acidosis - inc blood ketone levels - leukocytosis - hyperkalemia - but depleted intracellular K
Stim
1 = juveline - IDDM - 2 = adult - NIDDM
29. What do pituitary tumors usually secrete in MEN type 1
Rapid/deep breathing (Kussmal's resps) N/V - abdominal pain - psychosis/delirium - dehydration - FRUITY breath odor -
Ingested from plants
Pancreas - pituitary and PTH
Prolactin or GH
30. What is the effect of TRH on TSH and prolactin
Kids = rickets - adults = osteomalacia
Less likely
Stim
AD
31. Acromegaly in adults results from an incarease In what hormone - and What are the characteristic features
Kidney perception of low intravascular volume results in overactive renin - angiotensin system - due to renal artery stenosis - CRF - CHF - cirrhosis or nephrotic syndrome - associated with HIGH plasma renin
Polydipsia - polyuria - polyphagia - weight loss - DKA (type1) - hyperosmolor coma (type2) unopposed secretion of GH and epi (exacerbating hyperglycemia
Nonenzymatic glycosylation
GH - large tognue - deep furrows - deep voice - large hands/feet - coarse fascial features - impaired glucose tolerance
32. most common thyroid cancer - ground glass nuclei - psammona bodies - nuclear grooves - prognosis and risk
Ectopic ADH in small cell lung cancer - CNS disorder/head trauma - pulmonary diseae - drugs like cyclophosphamide
Excellent prognosis - risk with childhood radiation - papillary carcinoma
TGB - dec in hepatic failure - inc in pregnancy via estrogen
Moderatly enlarged nontender thyroid
33. What are the 3 P's of MEN type 1 (Werners)
Pancreas - pituitary and PTH
Lower free testosterone and gynecomastia
DR5 - antimicrosomal - antithyroglobulin
Inhib
34. What are the findings of hypoPTH
BRICK L - brain - RBC - intestine - cornea - kidney - liver
During stress - childbirth
Hypo is low - hyper is high on all
Hypocalcemia and tetany
35. pituitary adenoma is what kind of oma?
Bone growth - brain (CNS maturation) - inc Beta 1 receptors - BML - inc glycogenolysis - gluconeogenesis and lipolysis
Prolactinoma
ANP - NO and EDRF
Def in aldosterone and cortisol leading to hypotension (hyponatremic volume contraction) hyperkalemia - acidosis - and skin hyperpigmentation
36. What HLA association is with hashimotos and what kind of autoantibodies
DR5 - antimicrosomal - antithyroglobulin
Right adrenal - right adrenal vein - IVC
Kids = rickets - adults = osteomalacia
HTN - weight gain - moon facies - truncal obesity - buffalo hump - hyperglycemia - skin thinning and striae - osteoporosis - amenorrhea - immune suppression
37. In graves dz - what pathological antibody is produced - and what kind of hypersens rxn is it?
Hyperglycemia - glucosuria - osmotic diureses - lyte depletion
All 3 - spares medulla
HTN - weight gain - moon facies - truncal obesity - buffalo hump - hyperglycemia - skin thinning and striae - osteoporosis - amenorrhea - immune suppression
Antibodies against TSH receptors - II
38. Which is the active form or thyroid
Sun exposure in skin
Free hormone is active T3 bind more than T4
Dec cortisol after lose dose
GH - prolactin also IL-2
39. What happens in the dexamethasone suppresion test in a health individual
Dec cortisol after lose dose
Prolactinoma
Riedel's - fixed hard and painless goiter
GnRH - Oxytocin - ADH (V1) - TRH
40. Do pts with neuroblastoma develop HTN
Central - pituitary tumor - truama - surgery - histiocytosis X and nephrogenic - hereditary - 2ndary to hypoglycemia - lithium - demeclocycline (ADH antagonist)
FLT - hCG
Less likely
Epi - norepi - and DA - epidosic HTN - urinary VMA and elevated catecholamines
41. What is important to remember when correcting hyponatremia
Correct is slowly
11beta - HTN because - 11 deoxycorticosterone is a mineralcorticoid and secreted in excess - masculinization because too much DHEA shuttling
FSH - LH - ACTH - TSH - CRH - hCG - ADH (V2) - MSH - PTH - + calcitonin - GHRH and glucagon
Hyperglycemia - inc H+ - dec bicarb leading to anion gap acidosis - inc blood ketone levels - leukocytosis - hyperkalemia - but depleted intracellular K
42. What is the most common tumor of the adrenal medulla in adults
All 3 - spares medulla
Amenorrhea - galactorrhea - low libido - infertility from dec GnRH - - bitemporal heminanopia from imgingement of optic chiasm
Pheochromocytoma
21 hydroxylase - masculinization - hypotension - hyperkalemia - inc plasma renin - volume depletion
43. Which ketone bodies are more common in DKA
TRH from the hypothalamus stimulates TSH release from ant pit which stimulates follicular cells - neg feedback to ant bit dec sens to TRH
RBC brain
Beta - hydroxybutyrate > acetoacetate
DM1
44. How do you diagnose GH abnl?
Iatrogenic - decreased
Episodic hyperadrenergic symptoms - pressure - pain (headache) - perspiration - palpitations (tachycardia) - pallor
Inc serum IGF-1 - failure to suppress serum GH following oral glucose tolerance test
Proptosis - EOM swelling - pretibial mxyedema - diffuse goiter
45. What class of drugs are dopamine antagonists
Polydipsia - polyuria - polyphagia - weight loss - DKA (type1) - hyperosmolor coma (type2) unopposed secretion of GH and epi (exacerbating hyperglycemia
Most antipsychotics and all OCPs - estrogen in pregs
Stress - exercise and hypoglycemia
Inc cortisol after low dose and high dose
46. What is the difference in PTH vs active vit d
Pancreas - pituitary and PTH
Zona fasiculata
PTH = inc ca reabsorption and dec PO4 reabsorption in DIC - active vit D = inc absorption of both in gut
Direct stimulation of osteoblasts - which indirectly stimulates osteoclastic cells via RANK L (down regulates OPG that usually blocks RANK L from binding RANK)
47. What are the common pancreatic endocrine tumors in MEN type 1
Kidney perception of low intravascular volume results in overactive renin - angiotensin system - due to renal artery stenosis - CRF - CHF - cirrhosis or nephrotic syndrome - associated with HIGH plasma renin
Dec in DM1 - variable in DM2 with possible amyloid
Lower free testosterone and gynecomastia
Z- E - insulinomas - VIPomas - glucagonomas are rare
48. increase protein catabolism leads to...
GH - prolactin also IL-2
Surgery to remove tumor - sprinolactone - (K sparing diuretic)
Bound to corticosteroid binding globulin - CGB
Inc plasma amino acids - nitrogen loss in urine
49. What 3 things does insuline def and glucagon excess lead to...
Zona fasiculata
Cushing's
Hashimotos
Dec glucose uptake - inc protein catabolism - inc lipolysis
50. In which DM is polyuria - polydipsia - thirst and weight loss more common
Hyperthyroid early in course - thyrotoxicosis during follicular rupture
Kidney perception of low intravascular volume results in overactive renin - angiotensin system - due to renal artery stenosis - CRF - CHF - cirrhosis or nephrotic syndrome - associated with HIGH plasma renin
Subactute thyroiditis - granulomatous inflammation - elev ESR - jaw pain - ealy inflammation - tender thyroid
DM1