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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 is the effect of GHRH on GH
Bromocriptine
Medullary thyroid carcinoma with calcitonin and oral/intestinal ganglioneuromatosis (associated with marfanoid habitus)
Stim
11beta - HTN because - 11 deoxycorticosterone is a mineralcorticoid and secreted in excess - masculinization because too much DHEA shuttling
2. What does inc GH in children result In What is the characteristic bone growth
Dehydration and acidosis leading to coma and death
Gigantism - linear bone growth
Inc cortisol after low dose and high dose
Nonenzymatic glycosylation
3. The adrenal cortex derives From What embryonic tissue
Renal osteodystrophy
Inc cortisol after low and high dose
VMA
Mesoderm
4. increase protein catabolism leads to...
Central - pituitary tumor - truama - surgery - histiocytosis X and nephrogenic - hereditary - 2ndary to hypoglycemia - lithium - demeclocycline (ADH antagonist)
Inc plasma amino acids - nitrogen loss in urine
11beta - HTN because - 11 deoxycorticosterone is a mineralcorticoid and secreted in excess - masculinization because too much DHEA shuttling
Lower free testosterone and gynecomastia
5. What is the effect of TRH on TSH and prolactin
Hypo is low - hyper is high on all
Type 1
Diabetes insipidus - lack of ADH - or lack of response to ADH in kidney
Stim
6. What are the endocrine cells of the pancrea
Small (metastatic) bowel tumors - 5HT goes to liver for first pass -
Stress induced catecholamine surge leading to death by arrhythmia - graves
Islets of langerhans are collections of alpha - beta and delta
Hypo is low - hyper is high on all
7. What are the 4 causes of SIADH
ADH - oxytocin - made in the hypothalamus and shipped to posterior pituitary
TSH receptor leading to inc release of T3 and T4 - hot nodules are rarely malignant
Stim
Ectopic ADH in small cell lung cancer - CNS disorder/head trauma - pulmonary diseae - drugs like cyclophosphamide
8. In congenital bilateral hyperplasia what enzyme def would lead to a dec in cortisol - aldosterone and corticosterone - enzyme and why do you have HTN and masculinization
Dec free serum Ca inc PTH secretion - dec free serum Mg dec PTH secretion
11beta - HTN because - 11 deoxycorticosterone is a mineralcorticoid and secreted in excess - masculinization because too much DHEA shuttling
Phenylalaline - tyrosine - L- dopa - dopa - NE - epi
Bromocriptine
9. When diagnosing diabetes insipidus - what happens to the urine osm in the water deprivation test and How do you distinguish between central and nephrogenic
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10. What are the common causes of dec Mg
Diarrhea - aminoglycosides - diuretics - and EtOH
DM1 - HLA- DR3 and DR4
Pot - bellied - pale - puffy faced witih protruding umbilicus and protuberant tongue
Medullary thyroid carcinoma with calcitonin and oral/intestinal ganglioneuromatosis (associated with marfanoid habitus)
11. intense thirst - polyuria and inability to concentrate urine
DM1 - DM2 has islet amyloid deposit
2A and 2B
ATP from glucose metabolism closing K channels and depolarizing cells - required for adipose and skeletal muscle uptake of glucose
Diabetes insipidus - lack of ADH - or lack of response to ADH in kidney
12. What is the pathway of catecholamine production
Prolactinoma
Lumen of follicles - thryglobulin + I2 with MIT and DIT - proteolysis and secrete into blood back through follicular cell
Phenylalaline - tyrosine - L- dopa - dopa - NE - epi
Dehydration and acidosis leading to coma and death
13. What happens in the dexamethasone suppression test in someone with a cortisol producing tumor
Hyperglycemia - inc H+ - dec bicarb leading to anion gap acidosis - inc blood ketone levels - leukocytosis - hyperkalemia - but depleted intracellular K
Inc cortisol after low and high dose
Prolactinoma
Peripheral tissue
14. What thyroid condition is associated with lymphoma
Adenoma - hypercalcemia - hypercalciuria - hypophosohatemia - inc PTH - inc alk phos - inc cAMP in urine - often asymptomatic present as weakness and contipation - groans
Raises free testosterone and they gey hirsutism
Bromocriptine or cabergoline
Hashimotos
15. What does NEG cause in small vessels
Osteitis fibrosa cystica
Toxic multinodular goiter
Diffuse thickening of the BM
DKA - inc insulin requirements from inc stress (infxn) - excess fat breakdown and inc ketogenesis from FFA made into ketone bodies
16. What does pheo tumors secrete - What can they cause and what serum and urinary makers are there
Peroxidase
Removal of pituitary adenoma and octreotide
Epi - norepi - and DA - epidosic HTN - urinary VMA and elevated catecholamines
GnRH - Oxytocin - ADH (V1) - TRH
17. In what organs/systems do you see the effects of small vessel disease
Blood pressure - dec bone formation - anti - inflammatory - dec immune fxn - inc gluconeogenesis - lipolysis - proteolysis
Retinopathy (hemorrhage - exudates - microanuerysms - vessel proliferation) - glaucoma - nephropathy (noduclar sclerosis - progressive proteinuria - CRF) - arteriosclerosis leading to HTN - kimmelstiel wilson nodules
TRH from the hypothalamus stimulates TSH release from ant pit which stimulates follicular cells - neg feedback to ant bit dec sens to TRH
Removal of pituitary adenoma and octreotide
18. Do pts with neuroblastoma develop HTN
11beta - HTN because - 11 deoxycorticosterone is a mineralcorticoid and secreted in excess - masculinization because too much DHEA shuttling
FLAT PiG - FSH - LH - ACTH - TSH - Prolactin - GH
1 = viral/immune destruction beta cells - 2 = insulin resistance
Less likely
19. nonenzymatic glycosylation leads to what 3 catageories of defects
Small vessel disease - large vessel disease and osmotic drainage
All 3 - spares medulla
Subactute thyroiditis - granulomatous inflammation - elev ESR - jaw pain - ealy inflammation - tender thyroid
Renal osteodystrophy
20. How is thyroid hormone regulated
Kidney stones and stomach ulcers
Antibodies against TSH receptors - II
Autoimmune - TB - metastasis
TRH from the hypothalamus stimulates TSH release from ant pit which stimulates follicular cells - neg feedback to ant bit dec sens to TRH
21. What is a good test for primary hypo/hyperthyroidism and What do you expect to see in both
TRH from the hypothalamus stimulates TSH release from ant pit which stimulates follicular cells - neg feedback to ant bit dec sens to TRH
Bromocriptine
TSH - elevated in hypo - low in hyper
Chief cells of parathyroid
22. What is the effect of CRH on ACTH
Stim
Insulin responsive - adipose and skeletal muscle
DM1
TSH - elevated in hypo - low in hyper
23. Acromegaly in adults results from an incarease In what hormone - and What are the characteristic features
Chvostek's sign
GH - large tognue - deep furrows - deep voice - large hands/feet - coarse fascial features - impaired glucose tolerance
Insulin responsive - adipose and skeletal muscle
Anwhere along the sympathetic chaing - HVA - N- myc
24. What are two examples of ectopic ACTH producing tumors
2A and 2B
TGB - dec in hepatic failure - inc in pregnancy via estrogen
10% malignant - 10% bilateral - 10% extra - adrenal - 10% calcify - 10% kids - 10% familial
Small cell lung cancer and bronchial carcinoids
25. What is the breakdown product of NE
DM2
VMA
Undifferentiated/anaplastic
Adquate fluid intake - central intranasal desmopressin - for nephrogenic use thiazide (for hypernatremia) - amiloride (for hypokalemia) and indomethacin to dec GFR
26. What other diseases or syndromes are associated with pheochromocytoma
Epi - norepi - and DA - epidosic HTN - urinary VMA and elevated catecholamines
Z- E - insulinomas - VIPomas - glucagonomas are rare
Antibodies against TSH receptors - II
Neurofibramtosis - MEN types 2A and 2B
27. autosomal dominant kidney unresponsive to PTH leading to hypocalcemia - shortened 4th/5th digits and short stature
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28. What are the 3 endogenous causes of cushing's syndrome and What are the ACTH values for each
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29. How is calcitonin regulated
PseudohypoPTH - albright's hereditary osteodystrophy
RBC brain
Inhib
Inc in serum Ca causes calcitonin secretion
30. Which are the basophiles
Insulin responsive - adipose and skeletal muscle
Hypocalcemia and tetany
FLAT
17alpha - HTN - hypokalemia - in males - dec DHT - externally phenotypic females - in females nl genitals but no secondary sex characteristis
31. Where is cortisol made?
Heat intolerance - weight loss - inc appetite - hyperactivity - diarrhea - inc reflexes - pretibial myxedema (graves) warm - moist skin - fine hair - chest pain - palpitations - arrhythmias
Zona fasiculata
TSH receptor leading to inc release of T3 and T4 - hot nodules are rarely malignant
Stim
32. What does fetal hypothyroidism cause - where do you see this birth defect endemically - and What causes the sporadic form
Pot - bellied - pale - puffy faced witih protruding umbilicus and protuberant tongue
Zollinger Ellison
Cretinism - whereever there is endemic goiter - sporadic version due to defect in T4 formation or thyroid development
Zona fasiculata
33. What does insulin do in alpha cells
TSH receptor leading to inc release of T3 and T4 - hot nodules are rarely malignant
Inhib
Inhibits glucagon release
Zona reticularis - ACTH hypothalamic CRH - sex hormones - androgens
34. What is the tx for diabetes inspidus - central and nephrogenic
Episodic hyperadrenergic symptoms - pressure - pain (headache) - perspiration - palpitations (tachycardia) - pallor
Chvostek's sign
Adquate fluid intake - central intranasal desmopressin - for nephrogenic use thiazide (for hypernatremia) - amiloride (for hypokalemia) and indomethacin to dec GFR
Inc absorption of dietary Ca and phosphate - inc bone resorption of Ca and phosphate
35. endocrine hormones that use cAMP - FLAT CHAMP - What are they?
Follicles of thyroid - most T3 formed in the blood
1 = juveline - IDDM - 2 = adult - NIDDM
FSH - LH - ACTH - TSH - CRH - hCG - ADH (V2) - MSH - PTH - + calcitonin - GHRH and glucagon
Bromocriptine
36. What is the serum insulin level of DM1 vs DM2
DM1 = dec - DM2 = variable
Free hormone is active T3 bind more than T4
Zona fasciculata - ACTH - hypothalamic CRH - cortisol/sex hormones
Due to dec gut absorption of Ca - inc PO4 due to chronic renal disease (no vit D) hypOcalcemia - hyperphophatemia - inc alk phos - inc PTH
37. What carcinoma is common in MEN 2A and What does it secrete
1/3 metastasize - 1/3 present with 2nd malignancy - and 1/3 multiple
Blood pressure - dec bone formation - anti - inflammatory - dec immune fxn - inc gluconeogenesis - lipolysis - proteolysis
Medullary thyroid carcinoma - calcitonin
Carcinoid syndrome
38. When is the onset of DM1 vs DM2 causing what kind of DM
1 = juveline - IDDM - 2 = adult - NIDDM
TSH receptor leading to inc release of T3 and T4 - hot nodules are rarely malignant
Episodic hyperadrenergic symptoms - pressure - pain (headache) - perspiration - palpitations (tachycardia) - pallor
Inc cortisol after low and high dose
39. bone lesions due to secondary or tertiary hyperPTH due in turn to renal disease
Renal osteodystrophy
Bone growth - brain (CNS maturation) - inc Beta 1 receptors - BML - inc glycogenolysis - gluconeogenesis and lipolysis
1 -25 OH2 vitamin D (active form)
Inhib
40. tapping of the facial nerve leads to contraction of facial muscles
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41. What drugs cause shrinkage of prolactinoma
Def in aldosterone and cortisol leading to hypotension (hyponatremic volume contraction) hyperkalemia - acidosis - and skin hyperpigmentation
Bromocriptine or cabergoline
Small (metastatic) bowel tumors - 5HT goes to liver for first pass -
Inc in ACTH because low levels of cortisol
42. What stimulus causes beta cells to make insulin
Inc serum IGF-1 - failure to suppress serum GH following oral glucose tolerance test
GnRH - Oxytocin - ADH (V1) - TRH
Fluids - insulin - and K - glucose if necessary to prevent hypoglycemia
ATP from glucose metabolism closing K channels and depolarizing cells - required for adipose and skeletal muscle uptake of glucose
43. What is the common etiology of primary hyperPTH and What are the expected changes in serum and urine - How does it present
AD
Medullary thyroid carcinoma with calcitonin and oral/intestinal ganglioneuromatosis (associated with marfanoid habitus)
Adenoma - hypercalcemia - hypercalciuria - hypophosohatemia - inc PTH - inc alk phos - inc cAMP in urine - often asymptomatic present as weakness and contipation - groans
ATP from glucose metabolism closing K channels and depolarizing cells - required for adipose and skeletal muscle uptake of glucose
44. The adrenal medulla derives From What embryonic tissue
Prolactinoma
Hyperglycemia - glucosuria - osmotic diureses - lyte depletion
Neural crest
Zona fasciculata - ACTH - hypothalamic CRH - cortisol/sex hormones
45. What hormones are secreted from the adenohypophysis
GH - large tognue - deep furrows - deep voice - large hands/feet - coarse fascial features - impaired glucose tolerance
5- HIAA
1 = viral/immune destruction beta cells - 2 = insulin resistance
FLAT PiG - FSH - LH - ACTH - TSH - Prolactin - GH
46. Where is low serum phosphorus sensed to maintain phosphorus homeostasis - and what substance is key for increasing serum levels of phosphorus
Kidney - 1 -25 OH2 vit d
Inc plasma amino acids - nitrogen loss in urine
Neuroblastoma
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
47. What is 24 - 25 OH2 vit D
Inactive form
T3/T4 - cytosol
Cushing's
Mesoderm
48. Medullary carcinoma forms From what cells and What do they produce - histo and association
Bromocriptine
Vitamin d
FLAT PiG - FSH - LH - ACTH - TSH - Prolactin - GH
Parafollicular C cells - calcitonin histo = sheets of cells in amyloid stroma - associated with MEN 2A/2B
49. acute adrenal insuff due to adrenal hemorrahge and endotoxic show - DIC - syndrome and organism
Waterhouse friderichsen - n meningitidis septicemia
DM2
FSH - LH - ACTH - TSH - CRH - hCG - ADH (V2) - MSH - PTH - + calcitonin - GHRH and glucagon
Lower free testosterone and gynecomastia
50. What class of drugs are dopamine antagonists
Osteitis fibrosa cystica
Islets of langerhans are collections of alpha - beta and delta
Most antipsychotics and all OCPs - estrogen in pregs
Stim