Test your basic knowledge |

Endocrine

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. How does the body respond to SIADH and What does that cause
Raises free testosterone and they gey hirsutism
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
Dec aldosterone causing hyponatremia which can lead to seizures
PTH = inc ca reabsorption and dec PO4 reabsorption in DIC - active vit D = inc absorption of both in gut

2. What is octreotide
Correct is slowly
5- HIAA
Waterhouse friderichsen - n meningitidis septicemia
Somatostatin analog

3. in which DM is glucose intolerance severe and Which is more mild to moderate
Inc absorption of dietary Ca and phosphate - inc bone resorption of Ca and phosphate
Bone growth - brain (CNS maturation) - inc Beta 1 receptors - BML - inc glycogenolysis - gluconeogenesis and lipolysis
Hyperglycemia - inc H+ - dec bicarb leading to anion gap acidosis - inc blood ketone levels - leukocytosis - hyperkalemia - but depleted intracellular K
DM1 = severe - DM2 = mild to moderate

4. Which steroid receptors are nuclear and where are the others located
Riedel's - fixed hard and painless goiter
T3/T4 - cytosol
21 hydroxylase - masculinization - hypotension - hyperkalemia - inc plasma renin - volume depletion
Dec glucose uptake - inc protein catabolism - inc lipolysis

5. Where is T3 made
Peripheral tissue
Alpha antagonists - esp phenoxybenzamine - nonselective - irreversible - surgery to remove tumor
Prolactinoma
AD

6. What does insulin do in alpha cells
Polydipsia - polyuria - polyphagia - weight loss - DKA (type1) - hyperosmolor coma (type2) unopposed secretion of GH and epi (exacerbating hyperglycemia
Inhibits glucagon release
Diffuse thickening of the BM
11beta - HTN because - 11 deoxycorticosterone is a mineralcorticoid and secreted in excess - masculinization because too much DHEA shuttling

7. How does cortisol travel in the blood
Bound to corticosteroid binding globulin - CGB
Toxic multinodular goiter
DM2
Bidirectional - beta cells - liver kidney - small intestine

8. What is the TX for DKA
DM1
Vitamin d
Fluids - insulin - and K - glucose if necessary to prevent hypoglycemia
Peripheral tissue

9. Recurrent diarrhea - cutaneous flushing - asthatic wheezing - right side valvular disease
Hyperglycemia - inc H+ - dec bicarb leading to anion gap acidosis - inc blood ketone levels - leukocytosis - hyperkalemia - but depleted intracellular K
PTH = inc ca reabsorption and dec PO4 reabsorption in DIC - active vit D = inc absorption of both in gut
Small vessel disease - large vessel disease and osmotic drainage
Carcinoid syndrome

10. What drugs cause shrinkage of prolactinoma
Hyperthyroid early in course - thyrotoxicosis during follicular rupture
Bromocriptine or cabergoline
BRICK L - brain - RBC - intestine - cornea - kidney - liver
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

11. What is the breakdown product of dopamine
HVA
Medullary thyroid carcinoma with calcitonin and oral/intestinal ganglioneuromatosis (associated with marfanoid habitus)
Stim
Dec in DM1 - variable in DM2 with possible amyloid

12. What is the source of D2
GH - prolactin also IL-2
Dec in DM1 - variable in DM2 with possible amyloid
Dec aldosterone causing hyponatremia which can lead to seizures
Ingested from plants

13. What is the source of thyroid hormone
Subactute thyroiditis - granulomatous inflammation - elev ESR - jaw pain - ealy inflammation - tender thyroid
Follicles of thyroid - most T3 formed in the blood
T3/T4 - cytosol
17alpha - HTN - hypokalemia - in males - dec DHT - externally phenotypic females - in females nl genitals but no secondary sex characteristis

14. What diseases can cause primary adrenal insufficiency
Stim
Lumen of follicles - thryglobulin + I2 with MIT and DIT - proteolysis and secrete into blood back through follicular cell
No - proinsulin to insulin + C peptide
Autoimmune - TB - metastasis

15. What is the source of calcitonin and What does it do
Hashimotos thyroiditis
Parafollicular cells of thyroid (C cells) - dec bone resorption of Ca
Tonic DA from hypothalamus inhibits - prolactin causes DA synthesis and increases own inhibition - TRH stimulates prolactin
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

16. increase protein catabolism leads to...
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
Inc plasma amino acids - nitrogen loss in urine
Urine osm doesn't inc - and desmopressin admin distinguishes
Trousseau's sign

17. How is calcitonin regulated
Renal osteodystrophy
Neural crest
Inc in serum Ca causes calcitonin secretion
Dec in DM1 - variable in DM2 with possible amyloid

18. In what hormones are the alpha subunit the same
Carrier protiens in posterior pituitary that carry hormones in circulation - derived from neuroectoderm
Hyperglycemia - inc H+ - dec bicarb leading to anion gap acidosis - inc blood ketone levels - leukocytosis - hyperkalemia - but depleted intracellular K
DKA - inc insulin requirements from inc stress (infxn) - excess fat breakdown and inc ketogenesis from FFA made into ketone bodies
FLT - hCG

19. Carcoid tumors are derived From what cells
Neuroendocrine cells of GI tract
Bromocriptine
Inc plasma FFAs - ketogenesis - ketonuria - ketonemia
Stress - exercise and hypoglycemia

20. How many cortical divisions are involved in primary adrenal insuff
Prolactin and GH
All 3 - spares medulla
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
Excessive water retenion - hyponatremia - urine osm > serum osm

21. In which DM is polyuria - polydipsia - thirst and weight loss more common
Urine specific grav < 1.006 - serum osm > 290
DM1
BRICK L - brain - RBC - intestine - cornea - kidney - liver
DM2

22. What is the difference in PTH vs active vit d
PTH = inc ca reabsorption and dec PO4 reabsorption in DIC - active vit D = inc absorption of both in gut
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 free serum Ca inc PTH secretion - dec free serum Mg dec PTH secretion
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

23. What is secondary adrenal insuff and how can you distinguish it from primary
Kids = rickets - adults = osteomalacia
ADH - oxytocin - made in the hypothalamus and shipped to posterior pituitary
Dec in pit ACTH production - no skin hyperpigmentation and no hyperkalemia
11beta - HTN because - 11 deoxycorticosterone is a mineralcorticoid and secreted in excess - masculinization because too much DHEA shuttling

24. In which DM is there a stronger genetic association
Demeclocycline or H2O restriction
Neural crest
DM2
RBC brain

25. What are the urine and serum findings in diabetes insipidus
Osteitis fibrosa cystica
Stim
Ketone bodies
Urine specific grav < 1.006 - serum osm > 290

26. Do you see C peptide in exogenous insulin intake
Chromaffin cells - catecholamines
Prolactin and GH
No - proinsulin to insulin + C peptide
Free hormone is active T3 bind more than T4

27. What other conditions are associated with MEN 2B
Medullary thyroid carcinoma with calcitonin and oral/intestinal ganglioneuromatosis (associated with marfanoid habitus)
Anwhere along the sympathetic chaing - HVA - N- myc
Hypo is low - hyper is high on all
Carcinoid syndrome

28. How can hashimotos present that is not typical hypothyroidism
Hyperthyroid early in course - thyrotoxicosis during follicular rupture
Amenorrhea - galactorrhea - low libido - infertility from dec GnRH - - bitemporal heminanopia from imgingement of optic chiasm
Alpha = glucagon - beta = insulin - delta = somatostatin
Bidirectional - beta cells - liver kidney - small intestine

29. what vit D conversion takes place in the liver
Parafollicular C cells - calcitonin histo = sheets of cells in amyloid stroma - associated with MEN 2A/2B
1/3 metastasize - 1/3 present with 2nd malignancy - and 1/3 multiple
Excessive water retenion - hyponatremia - urine osm > serum osm
25- OH vitamin D

30. Medullary carcinoma forms From what cells and What do they produce - histo and association
Diabetes insipidus - lack of ADH - or lack of response to ADH in kidney
Mucormycosis - Rhizopus infxn - cerebral edema - cardia arrhythmias - HF
Parafollicular C cells - calcitonin histo = sheets of cells in amyloid stroma - associated with MEN 2A/2B
Def in aldosterone and cortisol leading to hypotension (hyponatremic volume contraction) hyperkalemia - acidosis - and skin hyperpigmentation

31. What are the 4 fxns of PTH
Pancreas - pituitary and PTH
FLAT
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
1/3 metastasize - 1/3 present with 2nd malignancy - and 1/3 multiple

32. What causes skin hyperpigmentation in primary adrenal insuff
Nonenzymatic glycosylation
MSH - a by product of inc ACTH production from POMC
Peripheral tissue
1 = juveline - IDDM - 2 = adult - NIDDM

33. What class of drugs are dopamine antagonists
No - proinsulin to insulin + C peptide
Most antipsychotics and all OCPs - estrogen in pregs
Neural crest
Due to dec gut absorption of Ca - inc PO4 due to chronic renal disease (no vit D) hypOcalcemia - hyperphophatemia - inc alk phos - inc PTH

34. What carcinoma is common in MEN 2A and What does it secrete
Zona fasiculata
Riedel's - fixed hard and painless goiter
Medullary thyroid carcinoma - calcitonin
Zona glomerulosa - renin - angiontensin - aldosterone

35. nonenzymatic glycosylation leads to what 3 catageories of defects
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
Small vessel disease - large vessel disease and osmotic drainage
Peripheral tissue
Octreotide

36. What are the consequences of thyrotoxicisos - and who is at risk
Neurofibramtosis - MEN types 2A and 2B
Stress induced catecholamine surge leading to death by arrhythmia - graves
HTN
Riedel's - fixed hard and painless goiter

37. What is the tx for hyperaldosteronism
HTN - weight gain - moon facies - truncal obesity - buffalo hump - hyperglycemia - skin thinning and striae - osteoporosis - amenorrhea - immune suppression
Excellent prognosis - risk with childhood radiation - papillary carcinoma
Mucormycosis - Rhizopus infxn - cerebral edema - cardia arrhythmias - HF
Surgery to remove tumor - sprinolactone - (K sparing diuretic)

38. What is important to remember when correcting hyponatremia
Adquate fluid intake - central intranasal desmopressin - for nephrogenic use thiazide (for hypernatremia) - amiloride (for hypokalemia) and indomethacin to dec GFR
Correct is slowly
Vitamin d
PTH = inc ca reabsorption and dec PO4 reabsorption in DIC - active vit D = inc absorption of both in gut

39. What is the effect of DA on prolactin
Inhib
Mesoderm
2A and 2B
Neural crest

40. What is the tx for pheochromocytoma
Alpha antagonists - esp phenoxybenzamine - nonselective - irreversible - surgery to remove tumor
Toxic multinodular goiter
Excessive water retenion - hyponatremia - urine osm > serum osm
Bound to corticosteroid binding globulin - CGB

41. What is the effect of TRH on TSH and prolactin
FLT - hCG
Moderatly enlarged nontender thyroid
Stim
Anwhere along the sympathetic chaing - HVA - N- myc

42. Neuroblastoma does not come with...
Cold intolerance - weight gain - dec appetite - lethargy/fatigue - constipation - dec reflexes - myxedema (facial/periorbital) - dry cool skin - coarse brittle hair - bradycardia - dyspnea on exertion
Inc in ACTH because low levels of cortisol
RBC brain
HTN

43. What happens to men with inc levels of sex hormone binding globulin
During stress - childbirth
Follicles of thyroid - most T3 formed in the blood
Parafollicular cells of thyroid (C cells) - dec bone resorption of Ca
Lower free testosterone and gynecomastia

44. What is the depleted intracellular K due to in DKA
Inc absorption of dietary Ca and phosphate - inc bone resorption of Ca and phosphate
HTN
TRH from the hypothalamus stimulates TSH release from ant pit which stimulates follicular cells - neg feedback to ant bit dec sens to TRH
Transcellular shif from dec insulin

45. Where is the defect in toxic multinodular goiter
5- HIAA
Phenylalaline - tyrosine - L- dopa - dopa - NE - epi
TSH receptor leading to inc release of T3 and T4 - hot nodules are rarely malignant
1 = juveline - IDDM - 2 = adult - NIDDM

46. When diagnosing diabetes insipidus - what happens to the urine osm in the water deprivation test and How do you distinguish between central and nephrogenic

Warning: Invalid argument supplied for foreach() in /var/www/html/basicversity.com/show_quiz.php on line 183

47. endocrine hormones that use cAMP - FLAT CHAMP - What are they?
DM2
FSH - LH - ACTH - TSH - CRH - hCG - ADH (V2) - MSH - PTH - + calcitonin - GHRH and glucagon
Most antipsychotics and all OCPs - estrogen in pregs
Hashimotos thyroiditis

48. What is the breakdown product of epi
AD
1 = juveline - IDDM - 2 = adult - NIDDM
Metanephrine
Milk production in females and spermatogenesis in males (by inhibiting GnRH synthesis and release

49. Which ketone bodies are more common in DKA
Renal osteodystrophy
Ingested from plants
Beta - hydroxybutyrate > acetoacetate
Stress induced catecholamine surge leading to death by arrhythmia - graves

50. What are the labs for free T4 - total T4 and T3 uptake for hypo/hyperthyroidism
DM2
T3/T4 - cytosol
Hypo is low - hyper is high on all
Rapid/deep breathing (Kussmal's resps) N/V - abdominal pain - psychosis/delirium - dehydration - FRUITY breath odor -