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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. Which are the acidophiles
Prolactin and GH
Dec glucose uptake - inc protein catabolism - inc lipolysis
Zollinger Ellison
Def in aldosterone and cortisol leading to hypotension (hyponatremic volume contraction) hyperkalemia - acidosis - and skin hyperpigmentation
2. What diseases can cause primary adrenal insufficiency
Dec free serum Ca inc PTH secretion - dec free serum Mg dec PTH secretion
Osteitis fibrosa cystica
Autoimmune - TB - metastasis
Prolactin or GH
3. What kind of inheritance to MEN syndromes have
Inc in ACTH because low levels of cortisol
Adenoma - hypercalcemia - hypercalciuria - hypophosohatemia - inc PTH - inc alk phos - inc cAMP in urine - often asymptomatic present as weakness and contipation - groans
AD
Inc serum IGF-1 - failure to suppress serum GH following oral glucose tolerance test
4. What are the urine and serum findings in diabetes insipidus
Urine specific grav < 1.006 - serum osm > 290
Inc cortisol after low dose - dec cortisol after high dose
Alpha = glucagon - beta = insulin - delta = somatostatin
Moderatly enlarged nontender thyroid
5. How can hashimotos present that is not typical hypothyroidism
Zona fasciculata - ACTH - hypothalamic CRH - cortisol/sex hormones
Hyperthyroid early in course - thyrotoxicosis during follicular rupture
Diffuse thickening of the BM
Undifferentiated/anaplastic
6. What hormones are secreted from the adenohypophysis
GH - large tognue - deep furrows - deep voice - large hands/feet - coarse fascial features - impaired glucose tolerance
FLAT PiG - FSH - LH - ACTH - TSH - Prolactin - GH
RBC brain
Z- E - insulinomas - VIPomas - glucagonomas are rare
7. What are the 3 problems in SIADH
Caused by aldosterone secreting tumor - resulting in HTN - hypokalemia - metaboolic alkalosis low plasma renin - B/L or unilateral
Anwhere along the sympathetic chaing - HVA - N- myc
Excessive water retenion - hyponatremia - urine osm > serum osm
Inside
8. What are neurophysins
Ingested from plants
Stim
Surgery to remove tumor - sprinolactone - (K sparing diuretic)
Carrier protiens in posterior pituitary that carry hormones in circulation - derived from neuroectoderm
9. What happens in the dexamethasone suppression test in someone with a cortisol producing tumor
PseudohypoPTH - albright's hereditary osteodystrophy
Inc cortisol after low and high dose
17alpha - HTN - hypokalemia - in males - dec DHT - externally phenotypic females - in females nl genitals but no secondary sex characteristis
Inc serum IGF-1 - failure to suppress serum GH following oral glucose tolerance test
10. What vitamin D conversion takes place in the kidney
Adenoma - hypercalcemia - hypercalciuria - hypophosohatemia - inc PTH - inc alk phos - inc cAMP in urine - often asymptomatic present as weakness and contipation - groans
1 -25 OH2 vitamin D (active form)
Left adrenal - left adrenal vein - left renal vein - IVC
Zona reticularis - ACTH hypothalamic CRH - sex hormones - androgens
11. How is PTH regulated
Adenoma - hypercalcemia - hypercalciuria - hypophosohatemia - inc PTH - inc alk phos - inc cAMP in urine - often asymptomatic present as weakness and contipation - groans
Inactive form
Inc cortisol after low and high dose
Dec free serum Ca inc PTH secretion - dec free serum Mg dec PTH secretion
12. What do pituitary tumors usually secrete in MEN type 1
DM2
Pheochromocytoma and PTH
Heat intolerance - weight loss - inc appetite - hyperactivity - diarrhea - inc reflexes - pretibial myxedema (graves) warm - moist skin - fine hair - chest pain - palpitations - arrhythmias
Prolactin or GH
13. In which DM is polyuria - polydipsia - thirst and weight loss more common
Pheochromocytoma
Cold intolerance - weight gain - dec appetite - lethargy/fatigue - constipation - dec reflexes - myxedema (facial/periorbital) - dry cool skin - coarse brittle hair - bradycardia - dyspnea on exertion
DM1
Chromaffin cells from NC
14. What are the 4 causes of SIADH
Epi - norepi - and DA - epidosic HTN - urinary VMA and elevated catecholamines
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
Small (metastatic) bowel tumors - 5HT goes to liver for first pass -
Ectopic ADH in small cell lung cancer - CNS disorder/head trauma - pulmonary diseae - drugs like cyclophosphamide
15. What are the hormones released from the neurohypophysis and where are they made
Insulin responsive - adipose and skeletal muscle
Stim
Peripheral tissue
ADH - oxytocin - made in the hypothalamus and shipped to posterior pituitary
16. What is the general chronic manifestation of DM
Episodic hyperadrenergic symptoms - pressure - pain (headache) - perspiration - palpitations (tachycardia) - pallor
Type 1
Nonenzymatic glycosylation
Inc in ACTH because low levels of cortisol
17. pheochromocytoma rule of 5 P's - What are they
GH - large tognue - deep furrows - deep voice - large hands/feet - coarse fascial features - impaired glucose tolerance
Ingested from plants
Episodic hyperadrenergic symptoms - pressure - pain (headache) - perspiration - palpitations (tachycardia) - pallor
Chromaffin cells - catecholamines
18. In what organs/systems do you see the effects of small vessel disease
Surgery to remove tumor - sprinolactone - (K sparing diuretic)
Inc PTH - dec Ca - dec PO4 cause inc in active form and then it feedback inhibits its own production
Retinopathy (hemorrhage - exudates - microanuerysms - vessel proliferation) - glaucoma - nephropathy (noduclar sclerosis - progressive proteinuria - CRF) - arteriosclerosis leading to HTN - kimmelstiel wilson nodules
Amenorrhea - galactorrhea - low libido - infertility from dec GnRH - - bitemporal heminanopia from imgingement of optic chiasm
19. What are the consequences of thyrotoxicisos - and who is at risk
Zona reticularis - ACTH hypothalamic CRH - sex hormones - androgens
GH - large tognue - deep furrows - deep voice - large hands/feet - coarse fascial features - impaired glucose tolerance
Pheochromocytoma and PTH
Stress induced catecholamine surge leading to death by arrhythmia - graves
20. What are the anabolic effects of insulin
Inc glucose transport - inc glycogen synthesis and storage - inc triglyceride synthesis and storage - inc Na retention in kidney - inc protein synthesis in muscle - inc cellular uptake of K and amino acids
Dec aldosterone causing hyponatremia which can lead to seizures
Urine osm doesn't inc - and desmopressin admin distinguishes
Lower free testosterone and gynecomastia
21. What occurs to beta cells in DM1 vs DM2
10% malignant - 10% bilateral - 10% extra - adrenal - 10% calcify - 10% kids - 10% familial
AD
Dec in DM1 - variable in DM2 with possible amyloid
Osteitis fibrosa cystica
22. What is secondary adrenal insuff and how can you distinguish it from primary
Ingested from plants
Dec in pit ACTH production - no skin hyperpigmentation and no hyperkalemia
Hypocalcemia and tetany
Pheochromocytoma and PTH
23. DM1 complication - most important - pathogenesis
DKA - inc insulin requirements from inc stress (infxn) - excess fat breakdown and inc ketogenesis from FFA made into ketone bodies
Small cell lung cancer and bronchial carcinoids
Inhibits glucagon release
Dec cortisol after lose dose
24. What is the next layer in from ZG - What is its primary control - What does it secrete
DM1 = dec - DM2 = variable
Dec cortisol after lose dose
Inhib
Zona fasciculata - ACTH - hypothalamic CRH - cortisol/sex hormones
25. Which substances bind receptor associated tyrosine kinase via the JAK/STAT pathway
Pot - bellied - pale - puffy faced witih protruding umbilicus and protuberant tongue
Right adrenal - right adrenal vein - IVC
GH - prolactin also IL-2
Hyperthyroid early in course - thyrotoxicosis during follicular rupture
26. In graves dz - what pathological antibody is produced - and what kind of hypersens rxn is it?
Inhib
Antibodies against TSH receptors - II
VMA
Zona glomerulosa - renin - angiontensin - aldosterone
27. What is the effect of TRH on TSH and prolactin
Zona glomerulosa - renin - angiontensin - aldosterone
Growth factors - IGF-1 - FGF - and PDGF all MAP kinase pathway
Type 1
Stim
28. How is thyroid hormone regulated
TRH from the hypothalamus stimulates TSH release from ant pit which stimulates follicular cells - neg feedback to ant bit dec sens to TRH
Chief cells of parathyroid
Sun exposure in skin
DM1 = severe - DM2 = mild to moderate
29. Acromegaly in adults results from an incarease In what hormone - and What are the characteristic features
Proptosis - EOM swelling - pretibial mxyedema - diffuse goiter
GH - large tognue - deep furrows - deep voice - large hands/feet - coarse fascial features - impaired glucose tolerance
Inhibits glucagon release
DM1 = dec - DM2 = variable
30. endocrine hormones that use cAMP - FLAT CHAMP - What are they?
Riedel's - fixed hard and painless goiter
FSH - LH - ACTH - TSH - CRH - hCG - ADH (V2) - MSH - PTH - + calcitonin - GHRH and glucagon
Small vessel disease - large vessel disease and osmotic drainage
Cushing's
31. What is seen in the urine in carcinoid syndrome
Heat intolerance - weight loss - inc appetite - hyperactivity - diarrhea - inc reflexes - pretibial myxedema (graves) warm - moist skin - fine hair - chest pain - palpitations - arrhythmias
Inc cortisol after low dose - dec cortisol after high dose
5- HIAA
Octreotide
32. Where is low serum phosphorus sensed to maintain phosphorus homeostasis - and what substance is key for increasing serum levels of phosphorus
VMA
Kidney - 1 -25 OH2 vit d
Ectopic ADH in small cell lung cancer - CNS disorder/head trauma - pulmonary diseae - drugs like cyclophosphamide
Waterhouse friderichsen - n meningitidis septicemia
33. what vit D conversion takes place in the liver
25- OH vitamin D
PTH = inc ca reabsorption and dec PO4 reabsorption in DIC - active vit D = inc absorption of both in gut
Removal of pituitary adenoma and octreotide
Zona glomerulosa - renin - angiontensin - aldosterone
34. What MEN syndromes are associated with the ret gene
Type 1
2A and 2B
Inc plasma FFAs - ketogenesis - ketonuria - ketonemia
Hyperthyroid early in course - thyrotoxicosis during follicular rupture
35. What stimulus causes beta cells to make insulin
ATP from glucose metabolism closing K channels and depolarizing cells - required for adipose and skeletal muscle uptake of glucose
Bromocriptine or cabergoline
DKA - inc insulin requirements from inc stress (infxn) - excess fat breakdown and inc ketogenesis from FFA made into ketone bodies
Inc plasma amino acids - nitrogen loss in urine
36. Where are the beta cells located in the islets
Inside
DM2
T3/T4 - cytosol
Rapid/deep breathing (Kussmal's resps) N/V - abdominal pain - psychosis/delirium - dehydration - FRUITY breath odor -
37. In which type of DM is insulin always necessary
Chromaffin cells from NC
Type 1
Bromocriptine or cabergoline
GnRH - Oxytocin - ADH (V1) - TRH
38. What is the effect of DA on prolactin
Ketone bodies
Stim
Inhib
Urine specific grav < 1.006 - serum osm > 290
39. Is there an association with obesity in DM1 or DM2
Follicles of thyroid - most T3 formed in the blood
BRICK L - brain - RBC - intestine - cornea - kidney - liver
DM2
Undifferentiated/anaplastic
40. What are the clinical findings in cretinism
FSH - LH - ACTH - TSH - CRH - hCG - ADH (V2) - MSH - PTH - + calcitonin - GHRH and glucagon
FLAT PiG - FSH - LH - ACTH - TSH - Prolactin - GH
FLT - hCG
Pot - bellied - pale - puffy faced witih protruding umbilicus and protuberant tongue
41. What are the labs of DKA
HVA
Hyperglycemia - inc H+ - dec bicarb leading to anion gap acidosis - inc blood ketone levels - leukocytosis - hyperkalemia - but depleted intracellular K
GnRH - Oxytocin - ADH (V1) - TRH
1 = juveline - IDDM - 2 = adult - NIDDM
42. Carcoid tumors are derived From what cells
Alpha antagonists - esp phenoxybenzamine - nonselective - irreversible - surgery to remove tumor
Neuroendocrine cells of GI tract
FLT - hCG
Central - pituitary tumor - truama - surgery - histiocytosis X and nephrogenic - hereditary - 2ndary to hypoglycemia - lithium - demeclocycline (ADH antagonist)
43. What is the TX for DKA
Subactute thyroiditis - granulomatous inflammation - elev ESR - jaw pain - ealy inflammation - tender thyroid
Inc cortisol after low and high dose
Dehydration and acidosis leading to coma and death
Fluids - insulin - and K - glucose if necessary to prevent hypoglycemia
44. cystic bone spaces filled with brown fibrous tissue causing pain
Caused by aldosterone secreting tumor - resulting in HTN - hypokalemia - metaboolic alkalosis low plasma renin - B/L or unilateral
Chief cells of parathyroid
Osteitis fibrosa cystica
DM1
45. in congenital bilateral adrenal hyperplasia - what enzyme def is most common and associate with dec cortisol - dec mineralcorticoids - inc sex hormones - enzyme and sx
Zona reticularis - ACTH hypothalamic CRH - sex hormones - androgens
21 hydroxylase - masculinization - hypotension - hyperkalemia - inc plasma renin - volume depletion
Most antipsychotics and all OCPs - estrogen in pregs
Chromaffin cells - catecholamines
46. What does vitamin D deficiency cause in kids and adults
Urine specific grav < 1.006 - serum osm > 290
Kids = rickets - adults = osteomalacia
TGB - dec in hepatic failure - inc in pregnancy via estrogen
Stress induced catecholamine surge leading to death by arrhythmia - graves
47. intense thirst - polyuria and inability to concentrate urine
Alpha = glucagon - beta = insulin - delta = somatostatin
Kids = rickets - adults = osteomalacia
Urine osm doesn't inc - and desmopressin admin distinguishes
Diabetes insipidus - lack of ADH - or lack of response to ADH in kidney
48. What are the common causes of dec Mg
Diarrhea - aminoglycosides - diuretics - and EtOH
Inc cortisol after low dose and high dose
BRICK L - brain - RBC - intestine - cornea - kidney - liver
RBC brain
49. in which DM is glucose intolerance severe and Which is more mild to moderate
DM1 = severe - DM2 = mild to moderate
HTN - weight gain - moon facies - truncal obesity - buffalo hump - hyperglycemia - skin thinning and striae - osteoporosis - amenorrhea - immune suppression
Subactute thyroiditis - granulomatous inflammation - elev ESR - jaw pain - ealy inflammation - tender thyroid
Direct stimulation of osteoblasts - which indirectly stimulates osteoclastic cells via RANK L (down regulates OPG that usually blocks RANK L from binding RANK)
50. Where is the source of PTH
Subactute thyroiditis - granulomatous inflammation - elev ESR - jaw pain - ealy inflammation - tender thyroid
Stress - exercise and hypoglycemia
Hyperglycemia - glucosuria - osmotic diureses - lyte depletion
Chief cells of parathyroid