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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. How do you diagnose GH abnl?
Inc serum IGF-1 - failure to suppress serum GH following oral glucose tolerance test
Inhib
Ketone bodies
Less likely
2. What class of drugs are dopamine antagonists
Medullary thyroid carcinoma - calcitonin
GnRH - Oxytocin - ADH (V1) - TRH
HTN - weight gain - moon facies - truncal obesity - buffalo hump - hyperglycemia - skin thinning and striae - osteoporosis - amenorrhea - immune suppression
Most antipsychotics and all OCPs - estrogen in pregs
3. What are the clinical findings of cushing's
Neural crest
Gigantism - linear bone growth
HTN - weight gain - moon facies - truncal obesity - buffalo hump - hyperglycemia - skin thinning and striae - osteoporosis - amenorrhea - immune suppression
Chief cells of parathyroid
4. In which type of DM is ketoacidosis more common
TGB - dec in hepatic failure - inc in pregnancy via estrogen
DM1
Retinopathy (hemorrhage - exudates - microanuerysms - vessel proliferation) - glaucoma - nephropathy (noduclar sclerosis - progressive proteinuria - CRF) - arteriosclerosis leading to HTN - kimmelstiel wilson nodules
Insulin responsive - adipose and skeletal muscle
5. iodine containing hormones that control the body's metabolic rate
Thyroid hormones T3/T4
Stim
Hurthle cells - lymphocytic infiltrate with germinal centers
RBC brain
6. What is the rule of 10s in pheochromocytoma
Epi - norepi - and DA - epidosic HTN - urinary VMA and elevated catecholamines
Medullary thyroid carcinoma with calcitonin and oral/intestinal ganglioneuromatosis (associated with marfanoid habitus)
Insulin responsive - adipose and skeletal muscle
10% malignant - 10% bilateral - 10% extra - adrenal - 10% calcify - 10% kids - 10% familial
7. What does the brain use for fuel in starvation
Ketone bodies
Subactute thyroiditis - granulomatous inflammation - elev ESR - jaw pain - ealy inflammation - tender thyroid
Stim
Diabetes insipidus - lack of ADH - or lack of response to ADH in kidney
8. What kind of inheritance to MEN syndromes have
AD
Stress - exercise and hypoglycemia
DM1
Zona reticularis - ACTH hypothalamic CRH - sex hormones - androgens
9. What does the stomach show in Zollinger Ellison
Ketone bodies
Excellent prognosis - risk with childhood radiation - papillary carcinoma
Rugal thickening and acid hypersecretion causing recurrent ulcers - associated with MEN type 1
GnRH - Oxytocin - ADH (V1) - TRH
10. Where do you see GLUT 2 transporter
Dec in pit ACTH production - no skin hyperpigmentation and no hyperkalemia
Stress - exercise and hypoglycemia
Cretinism - whereever there is endemic goiter - sporadic version due to defect in T4 formation or thyroid development
Bidirectional - beta cells - liver kidney - small intestine
11. in which DM is glucose intolerance severe and Which is more mild to moderate
DM1 = severe - DM2 = mild to moderate
Inc absorption of dietary Ca and phosphate - inc bone resorption of Ca and phosphate
FSH - LH - ACTH - TSH - CRH - hCG - ADH (V2) - MSH - PTH - + calcitonin - GHRH and glucagon
Polydipsia - polyuria - polyphagia - weight loss - DKA (type1) - hyperosmolor coma (type2) unopposed secretion of GH and epi (exacerbating hyperglycemia
12. What are the urine and serum findings in diabetes insipidus
Inside
TSH - elevated in hypo - low in hyper
Urine specific grav < 1.006 - serum osm > 290
Alpha antagonists - esp phenoxybenzamine - nonselective - irreversible - surgery to remove tumor
13. Where are carcinoid tumors often found - What do they secrete and where do they go
Beta - hydroxybutyrate > acetoacetate
17alpha - HTN - hypokalemia - in males - dec DHT - externally phenotypic females - in females nl genitals but no secondary sex characteristis
Small (metastatic) bowel tumors - 5HT goes to liver for first pass -
Cretinism - whereever there is endemic goiter - sporadic version due to defect in T4 formation or thyroid development
14. What 3 things does insuline def and glucagon excess lead to...
Dec glucose uptake - inc protein catabolism - inc lipolysis
Subactute thyroiditis - granulomatous inflammation - elev ESR - jaw pain - ealy inflammation - tender thyroid
Diarrhea - aminoglycosides - diuretics - and EtOH
Pheochromocytoma
15. What does vitamin D deficiency cause in kids and adults
Kids = rickets - adults = osteomalacia
Rapid/deep breathing (Kussmal's resps) N/V - abdominal pain - psychosis/delirium - dehydration - FRUITY breath odor -
Metanephrine
Autoimmune - TB - metastasis
16. What are the clinical findings of graves
GnRH - Oxytocin - ADH (V1) - TRH
Proptosis - EOM swelling - pretibial mxyedema - diffuse goiter
HVA
2A and 2B
17. What are the 2 P's of MEN 2A
Bound to corticosteroid binding globulin - CGB
Heat intolerance - weight loss - inc appetite - hyperactivity - diarrhea - inc reflexes - pretibial myxedema (graves) warm - moist skin - fine hair - chest pain - palpitations - arrhythmias
Pheochromocytoma and PTH
Vitamin d
18. What is the tx for gigantism/acromegaly
Gigantism - linear bone growth
Bone growth - brain (CNS maturation) - inc Beta 1 receptors - BML - inc glycogenolysis - gluconeogenesis and lipolysis
Removal of pituitary adenoma and octreotide
GH - large tognue - deep furrows - deep voice - large hands/feet - coarse fascial features - impaired glucose tolerance
19. What regulates vit D
Inc PTH - dec Ca - dec PO4 cause inc in active form and then it feedback inhibits its own production
Small (metastatic) bowel tumors - 5HT goes to liver for first pass -
Rugal thickening and acid hypersecretion causing recurrent ulcers - associated with MEN type 1
17alpha - HTN - hypokalemia - in males - dec DHT - externally phenotypic females - in females nl genitals but no secondary sex characteristis
20. All three effects of hyperinsulinemia lead to which two clinical features
Hyperglycemia - glucosuria - osmotic diureses - lyte depletion
Moderatly enlarged nontender thyroid
Follicles of thyroid - most T3 formed in the blood
Dehydration and acidosis leading to coma and death
21. How does PTH stimulate Ca relase from bone
HTN - weight gain - moon facies - truncal obesity - buffalo hump - hyperglycemia - skin thinning and striae - osteoporosis - amenorrhea - immune suppression
During stress - childbirth
Trousseau's sign
Direct stimulation of osteoblasts - which indirectly stimulates osteoclastic cells via RANK L (down regulates OPG that usually blocks RANK L from binding RANK)
22. 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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23. intense thirst - polyuria and inability to concentrate urine
Retinopathy (hemorrhage - exudates - microanuerysms - vessel proliferation) - glaucoma - nephropathy (noduclar sclerosis - progressive proteinuria - CRF) - arteriosclerosis leading to HTN - kimmelstiel wilson nodules
TSH receptor leading to inc release of T3 and T4 - hot nodules are rarely malignant
All 3 - spares medulla
Diabetes insipidus - lack of ADH - or lack of response to ADH in kidney
24. What is the fxn of vitamin D
Inc absorption of dietary Ca and phosphate - inc bone resorption of Ca and phosphate
Autoimmune - TB - metastasis
Alpha = glucagon - beta = insulin - delta = somatostatin
PseudohypoPTH - albright's hereditary osteodystrophy
25. GOAT goes IP3
Small (metastatic) bowel tumors - 5HT goes to liver for first pass -
Kidney stones and stomach ulcers
GnRH - Oxytocin - ADH (V1) - TRH
ANP - NO and EDRF
26. Where is cortisol made?
Zona fasiculata
Chvostek's sign
Hypo is low - hyper is high on all
Peripheral tissue
27. How is calcitonin regulated
Inc in serum Ca causes calcitonin secretion
Autoimmune - TB - metastasis
Inc cortisol after low dose - dec cortisol after high dose
HVA
28. How is prolactin secretion regulated
Tonic DA from hypothalamus inhibits - prolactin causes DA synthesis and increases own inhibition - TRH stimulates prolactin
Excessive water retenion - hyponatremia - urine osm > serum osm
17alpha - HTN - hypokalemia - in males - dec DHT - externally phenotypic females - in females nl genitals but no secondary sex characteristis
Kidney - 1 -25 OH2 vit d
29. Which are the acidophiles
Prolactin and GH
Inactive form
DM2
Lower free testosterone and gynecomastia
30. What is 24 - 25 OH2 vit D
Inactive form
Renal osteodystrophy
Follicular carcinoma of thyroid
Prolactinoma
31. 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
Ketone bodies
Subactute thyroiditis - granulomatous inflammation - elev ESR - jaw pain - ealy inflammation - tender thyroid
Rugal thickening and acid hypersecretion causing recurrent ulcers - associated with MEN type 1
32. What are the 3 endogenous causes of cushing's syndrome and What are the ACTH values for each
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33. When is the onset of DM1 vs DM2 causing what kind of DM
Inc cortisol after low dose - dec cortisol after high dose
DM1 - HLA- DR3 and DR4
1 = juveline - IDDM - 2 = adult - NIDDM
No - proinsulin to insulin + C peptide
34. What is the 1 P of MEN 2B
Metanephrine
5- HIAA
Neurofibramtosis - MEN types 2A and 2B
Pheochromocytoma
35. In what organs/systems do you see the effects of small vessel disease
Growth factors - IGF-1 - FGF - and PDGF all MAP kinase pathway
Sun exposure in skin
1 -25 OH2 vitamin D (active form)
Retinopathy (hemorrhage - exudates - microanuerysms - vessel proliferation) - glaucoma - nephropathy (noduclar sclerosis - progressive proteinuria - CRF) - arteriosclerosis leading to HTN - kimmelstiel wilson nodules
36. What is secondary hyperPTH due to and What are the expected serum values
Due to dec gut absorption of Ca - inc PO4 due to chronic renal disease (no vit D) hypOcalcemia - hyperphophatemia - inc alk phos - inc PTH
During stress - childbirth
Alpha antagonists - esp phenoxybenzamine - nonselective - irreversible - surgery to remove tumor
Milk production in females and spermatogenesis in males (by inhibiting GnRH synthesis and release
37. What is secondary adrenal insuff and how can you distinguish it from primary
Lumen of follicles - thryglobulin + I2 with MIT and DIT - proteolysis and secrete into blood back through follicular cell
Inc plasma FFAs - ketogenesis - ketonuria - ketonemia
Dec in pit ACTH production - no skin hyperpigmentation and no hyperkalemia
Ectopic ADH in small cell lung cancer - CNS disorder/head trauma - pulmonary diseae - drugs like cyclophosphamide
38. Cortisol fxn is BBIIG
Urine osm doesn't inc - and desmopressin admin distinguishes
Pancreas - pituitary and PTH
Blood pressure - dec bone formation - anti - inflammatory - dec immune fxn - inc gluconeogenesis - lipolysis - proteolysis
Dec free serum Ca inc PTH secretion - dec free serum Mg dec PTH secretion
39. What vitamin D conversion takes place in the kidney
Medullary thyroid carcinoma with calcitonin and oral/intestinal ganglioneuromatosis (associated with marfanoid habitus)
Inc in ACTH because low levels of cortisol
1 -25 OH2 vitamin D (active form)
ADH - oxytocin - made in the hypothalamus and shipped to posterior pituitary
40. What is the histology with hashimotos thyroiditis
Hurthle cells - lymphocytic infiltrate with germinal centers
5- HIAA
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
Hypocalcemia and tetany
41. What does pheo tumors secrete - What can they cause and what serum and urinary makers are there
Epi - norepi - and DA - epidosic HTN - urinary VMA and elevated catecholamines
1 -25 OH2 vitamin D (active form)
17alpha - HTN - hypokalemia - in males - dec DHT - externally phenotypic females - in females nl genitals but no secondary sex characteristis
DM2
42. What does insulin do in alpha cells
HTN
Cushing's
Inhibits glucagon release
Sun exposure in skin
43. What are neurophysins
Chromaffin cells - catecholamines
Carrier protiens in posterior pituitary that carry hormones in circulation - derived from neuroectoderm
MSH - a by product of inc ACTH production from POMC
Undifferentiated/anaplastic
44. What kind of cells are in the adrenal medulla and What do they secrete
Chromaffin cells - catecholamines
DM1 = dec - DM2 = variable
PTH = inc ca reabsorption and dec PO4 reabsorption in DIC - active vit D = inc absorption of both in gut
Bromocriptine
45. Do pts with neuroblastoma develop HTN
Less likely
Inhibits glucagon release
Zona fasciculata - ACTH - hypothalamic CRH - cortisol/sex hormones
Correct is slowly
46. dec glucose uptake leads to...
Cretinism - whereever there is endemic goiter - sporadic version due to defect in T4 formation or thyroid development
Inc plasma amino acids - nitrogen loss in urine
TGB - dec in hepatic failure - inc in pregnancy via estrogen
Hyperglycemia - glucosuria - osmotic diureses - lyte depletion
47. What are two examples of ectopic ACTH producing tumors
Small cell lung cancer and bronchial carcinoids
Tonic DA from hypothalamus inhibits - prolactin causes DA synthesis and increases own inhibition - TRH stimulates prolactin
Nonenzymatic glycosylation
Alpha = glucagon - beta = insulin - delta = somatostatin
48. What is the number one cause of cushing and What is the ACTH value
Iatrogenic - decreased
Inc cortisol after low dose - dec cortisol after high dose
Small cell lung cancer and bronchial carcinoids
Bone growth - brain (CNS maturation) - inc Beta 1 receptors - BML - inc glycogenolysis - gluconeogenesis and lipolysis
49. In which DM is there a stronger genetic association
DM2
Removal of pituitary adenoma and octreotide
TGB - dec in hepatic failure - inc in pregnancy via estrogen
Nonenzymatic glycosylation
50. Gastrin secreting tumor of pancreas or duodenum
Inc plasma amino acids - nitrogen loss in urine
Zollinger Ellison
Undifferentiated/anaplastic
Antibodies against TSH receptors - II