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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. Neuroblastoma does not come with...
Z- E - insulinomas - VIPomas - glucagonomas are rare
HTN
Antibodies against TSH receptors - II
Medullary thyroid carcinoma with calcitonin and oral/intestinal ganglioneuromatosis (associated with marfanoid habitus)
2. iodine containing hormones that control the body's metabolic rate
BRICK L - brain - RBC - intestine - cornea - kidney - liver
Adenoma - hypercalcemia - hypercalciuria - hypophosohatemia - inc PTH - inc alk phos - inc cAMP in urine - often asymptomatic present as weakness and contipation - groans
Thyroid hormones T3/T4
ADH - oxytocin - made in the hypothalamus and shipped to posterior pituitary
3. Which ketone bodies are more common in DKA
DM1
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
Left adrenal - left adrenal vein - left renal vein - IVC
Beta - hydroxybutyrate > acetoacetate
4. Where are carcinoid tumors often found - What do they secrete and where do they go
Islets of langerhans are collections of alpha - beta and delta
Zollinger Ellison
Hashimotos
Small (metastatic) bowel tumors - 5HT goes to liver for first pass -
5. What diseases can cause primary adrenal insufficiency
Autoimmune - TB - metastasis
Hashimotos thyroiditis
Raises free testosterone and they gey hirsutism
VMA
6. dec glucose uptake leads to...
Pheochromocytoma
Rapid/deep breathing (Kussmal's resps) N/V - abdominal pain - psychosis/delirium - dehydration - FRUITY breath odor -
Hyperglycemia - glucosuria - osmotic diureses - lyte depletion
HTN
7. Which are the basophiles
FLAT
Milk production in females and spermatogenesis in males (by inhibiting GnRH synthesis and release
Caused by aldosterone secreting tumor - resulting in HTN - hypokalemia - metaboolic alkalosis low plasma renin - B/L or unilateral
DM1 = dec - DM2 = variable
8. How is calcitonin regulated
Episodic hyperadrenergic symptoms - pressure - pain (headache) - perspiration - palpitations (tachycardia) - pallor
DR5 - antimicrosomal - antithyroglobulin
Inc in serum Ca causes calcitonin secretion
ANP - NO and EDRF
9. What is secondary adrenal insuff and how can you distinguish it from primary
Inc cortisol after low and high dose
Dec in pit ACTH production - no skin hyperpigmentation and no hyperkalemia
Fluids - insulin - and K - glucose if necessary to prevent hypoglycemia
Inside
10. What are the consequences of thyrotoxicisos - and who is at risk
Pheochromocytoma
Octreotide
Stress induced catecholamine surge leading to death by arrhythmia - graves
Zollinger Ellison
11. How many cortical divisions are involved in primary adrenal insuff
Surgery to remove tumor - sprinolactone - (K sparing diuretic)
All 3 - spares medulla
Retinopathy (hemorrhage - exudates - microanuerysms - vessel proliferation) - glaucoma - nephropathy (noduclar sclerosis - progressive proteinuria - CRF) - arteriosclerosis leading to HTN - kimmelstiel wilson nodules
Episodic hyperadrenergic symptoms - pressure - pain (headache) - perspiration - palpitations (tachycardia) - pallor
12. tapping of the facial nerve leads to contraction of facial muscles
13. What is the difference in PTH vs active vit d
Follicles of thyroid - most T3 formed in the blood
Left adrenal - left adrenal vein - left renal vein - IVC
Inc PTH - dec Ca - dec PO4 cause inc in active form and then it feedback inhibits its own production
PTH = inc ca reabsorption and dec PO4 reabsorption in DIC - active vit D = inc absorption of both in gut
14. Gastrin secreting tumor of pancreas or duodenum
Zollinger Ellison
Def in aldosterone and cortisol leading to hypotension (hyponatremic volume contraction) hyperkalemia - acidosis - and skin hyperpigmentation
Demeclocycline or H2O restriction
Pancreas - pituitary and PTH
15. in congenital bilateral adrenal hyperplasia - what enzyme def is most common and associate with dec cortisol - dec mineralcorticoids - inc sex hormones - enzyme and sx
Inc in ACTH because low levels of cortisol
Inc in serum Ca causes calcitonin secretion
21 hydroxylase - masculinization - hypotension - hyperkalemia - inc plasma renin - volume depletion
DM1 = dec - DM2 = variable
16. What is the number one cause of cushing and What is the ACTH value
Phenylalaline - tyrosine - L- dopa - dopa - NE - epi
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
Central - pituitary tumor - truama - surgery - histiocytosis X and nephrogenic - hereditary - 2ndary to hypoglycemia - lithium - demeclocycline (ADH antagonist)
Iatrogenic - decreased
17. acute adrenal insuff due to adrenal hemorrahge and endotoxic show - DIC - syndrome and organism
Bone growth - brain (CNS maturation) - inc Beta 1 receptors - BML - inc glycogenolysis - gluconeogenesis and lipolysis
Pheochromocytoma
Waterhouse friderichsen - n meningitidis septicemia
Inhib
18. What is the TX for DKA
Growth factors - IGF-1 - FGF - and PDGF all MAP kinase pathway
HTN
Fluids - insulin - and K - glucose if necessary to prevent hypoglycemia
Dec in DM1 - variable in DM2 with possible amyloid
19. The adrenal medulla derives From What embryonic tissue
Neural crest
Peripheral tissue
AD
ADH - oxytocin - made in the hypothalamus and shipped to posterior pituitary
20. what vit D conversion takes place in the liver
Bound to corticosteroid binding globulin - CGB
Dec in pit ACTH production - no skin hyperpigmentation and no hyperkalemia
25- OH vitamin D
Stim
21. The adrenal cortex derives From What embryonic tissue
Anwhere along the sympathetic chaing - HVA - N- myc
Mesoderm
Chief cells of parathyroid
Rugal thickening and acid hypersecretion causing recurrent ulcers - associated with MEN type 1
22. What kind of ligands bind intrinsice tyrosine kinase
Parafollicular cells of thyroid (C cells) - dec bone resorption of Ca
Growth factors - IGF-1 - FGF - and PDGF all MAP kinase pathway
Dec free serum Ca inc PTH secretion - dec free serum Mg dec PTH secretion
Mucormycosis - Rhizopus infxn - cerebral edema - cardia arrhythmias - HF
23. How does cortisol travel in the blood
Follicles of thyroid - most T3 formed in the blood
Heat intolerance - weight loss - inc appetite - hyperactivity - diarrhea - inc reflexes - pretibial myxedema (graves) warm - moist skin - fine hair - chest pain - palpitations - arrhythmias
Bound to corticosteroid binding globulin - CGB
Peripheral tissue
24. What MEN syndromes are associated with the ret gene
Inc in serum Ca causes calcitonin secretion
DR5 - antimicrosomal - antithyroglobulin
2A and 2B
Pheochromocytoma and PTH
25. Where can neuroblastomas occur - What do you see elevated in the urine and what oncogene is associated
Prolactin and GH
Chvostek's sign
Anwhere along the sympathetic chaing - HVA - N- myc
Excellent prognosis - risk with childhood radiation - papillary carcinoma
26. What is the source of D2
Ingested from plants
GH - prolactin also IL-2
Parafollicular C cells - calcitonin histo = sheets of cells in amyloid stroma - associated with MEN 2A/2B
Cretinism - whereever there is endemic goiter - sporadic version due to defect in T4 formation or thyroid development
27. In what hormones are the alpha subunit the same
FLT - hCG
Neuroendocrine cells of GI tract
T3/T4 - cytosol
Most antipsychotics and all OCPs - estrogen in pregs
28. What are the 2 P's of MEN 2A
Pheochromocytoma and PTH
Due to dec gut absorption of Ca - inc PO4 due to chronic renal disease (no vit D) hypOcalcemia - hyperphophatemia - inc alk phos - inc PTH
Hashimotos
Removal of pituitary adenoma and octreotide
29. All three effects of hyperinsulinemia lead to which two clinical features
11beta - HTN because - 11 deoxycorticosterone is a mineralcorticoid and secreted in excess - masculinization because too much DHEA shuttling
Dehydration and acidosis leading to coma and death
Inc cortisol after low and high dose
Inc in ACTH because low levels of cortisol
30. What do pituitary tumors usually secrete in MEN type 1
Fluids - insulin - and K - glucose if necessary to prevent hypoglycemia
Ingested from plants
Prolactin or GH
Undifferentiated/anaplastic
31. What is the effect of GHRH on GH
Thyroid hormones T3/T4
Stim
Dec in pit ACTH production - no skin hyperpigmentation and no hyperkalemia
Most antipsychotics and all OCPs - estrogen in pregs
32. What happens in the dexamethasone suppression test in somoeone with an ectopic ACTH producing tumor
Inc cortisol after low dose and high dose
Undifferentiated/anaplastic
Neural crest
Inc cortisol after low and high dose
33. What are two examples of ectopic ACTH producing tumors
Epi - norepi - and DA - epidosic HTN - urinary VMA and elevated catecholamines
No - proinsulin to insulin + C peptide
Proptosis - EOM swelling - pretibial mxyedema - diffuse goiter
Small cell lung cancer and bronchial carcinoids
34. What is the most external latery of the adrenal cortex - What is its primary control and What does it secrete
Mucormycosis - Rhizopus infxn - cerebral edema - cardia arrhythmias - HF
Zona glomerulosa - renin - angiontensin - aldosterone
Stim
During stress - childbirth
35. What does the stomach show in Zollinger Ellison
Pot - bellied - pale - puffy faced witih protruding umbilicus and protuberant tongue
Rugal thickening and acid hypersecretion causing recurrent ulcers - associated with MEN type 1
Gigantism - linear bone growth
Central - pituitary tumor - truama - surgery - histiocytosis X and nephrogenic - hereditary - 2ndary to hypoglycemia - lithium - demeclocycline (ADH antagonist)
36. What is a good test for primary hypo/hyperthyroidism and What do you expect to see in both
GH - large tognue - deep furrows - deep voice - large hands/feet - coarse fascial features - impaired glucose tolerance
Inc in serum Ca causes calcitonin secretion
TSH - elevated in hypo - low in hyper
HTN
37. What is the tx for hyperaldosteronism
Prolactinoma
Islets of langerhans are collections of alpha - beta and delta
DM1 - HLA- DR3 and DR4
Surgery to remove tumor - sprinolactone - (K sparing diuretic)
38. 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
Inc cortisol after low and high dose
Cushing's
Adenoma - hypercalcemia - hypercalciuria - hypophosohatemia - inc PTH - inc alk phos - inc cAMP in urine - often asymptomatic present as weakness and contipation - groans
39. In which type of DM is insulin always necessary
Type 1
Iatrogenic - decreased
5- HIAA
Less likely
40. What other diseases or syndromes are associated with pheochromocytoma
Inc plasma amino acids - nitrogen loss in urine
Neurofibramtosis - MEN types 2A and 2B
Due to dec gut absorption of Ca - inc PO4 due to chronic renal disease (no vit D) hypOcalcemia - hyperphophatemia - inc alk phos - inc PTH
Inc serum IGF-1 - failure to suppress serum GH following oral glucose tolerance test
41. most common thyroid cancer - ground glass nuclei - psammona bodies - nuclear grooves - prognosis and risk
Inc plasma FFAs - ketogenesis - ketonuria - ketonemia
Excellent prognosis - risk with childhood radiation - papillary carcinoma
Dec aldosterone causing hyponatremia which can lead to seizures
Bound to corticosteroid binding globulin - CGB
42. What does pheo tumors secrete - What can they cause and what serum and urinary makers are there
Removal of pituitary adenoma and octreotide
Renal osteodystrophy
Carcinoid syndrome
Epi - norepi - and DA - epidosic HTN - urinary VMA and elevated catecholamines
43. How does PTH stimulate Ca relase from bone
Carcinoid syndrome
Zona fasiculata
DM1 = dec - DM2 = variable
Direct stimulation of osteoblasts - which indirectly stimulates osteoclastic cells via RANK L (down regulates OPG that usually blocks RANK L from binding RANK)
44. What is the common etiology of primary hyperPTH and What are the expected changes in serum and urine - How does it present
Neuroblastoma
Prolactin and GH
Islets of langerhans are collections of alpha - beta and delta
Adenoma - hypercalcemia - hypercalciuria - hypophosohatemia - inc PTH - inc alk phos - inc cAMP in urine - often asymptomatic present as weakness and contipation - groans
45. What is the most common cause of hypothyroidism
Pheochromocytoma and PTH
Anwhere along the sympathetic chaing - HVA - N- myc
Hashimotos thyroiditis
Pot - bellied - pale - puffy faced witih protruding umbilicus and protuberant tongue
46. When is the onset of DM1 vs DM2 causing what kind of DM
ANP - NO and EDRF
Dec glucose uptake - inc protein catabolism - inc lipolysis
1 = juveline - IDDM - 2 = adult - NIDDM
Stim
47. What hormones are secreted from the adenohypophysis
Inc in ACTH because low levels of cortisol
Diabetes insipidus - lack of ADH - or lack of response to ADH in kidney
Inc cortisol after low dose - dec cortisol after high dose
FLAT PiG - FSH - LH - ACTH - TSH - Prolactin - GH
48. What is the rule of 10s in pheochromocytoma
TGB - dec in hepatic failure - inc in pregnancy via estrogen
10% malignant - 10% bilateral - 10% extra - adrenal - 10% calcify - 10% kids - 10% familial
Chvostek's sign
Anwhere along the sympathetic chaing - HVA - N- myc
49. self - limiting hypothyroidism following a flu - like illness - dz - hist - and findings
Somatostatin analog
DR5 - antimicrosomal - antithyroglobulin
Subactute thyroiditis - granulomatous inflammation - elev ESR - jaw pain - ealy inflammation - tender thyroid
Bone growth - brain (CNS maturation) - inc Beta 1 receptors - BML - inc glycogenolysis - gluconeogenesis and lipolysis
50. What are the two types of diabetes insipidus and What causes them
Central - pituitary tumor - truama - surgery - histiocytosis X and nephrogenic - hereditary - 2ndary to hypoglycemia - lithium - demeclocycline (ADH antagonist)
GH - large tognue - deep furrows - deep voice - large hands/feet - coarse fascial features - impaired glucose tolerance
Islets of langerhans are collections of alpha - beta and delta
DR5 - antimicrosomal - antithyroglobulin