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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 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
Zona fasciculata - ACTH - hypothalamic CRH - cortisol/sex hormones
Inactive form
Small (metastatic) bowel tumors - 5HT goes to liver for first pass -
2. What enzyme is responsible for oxidation and organification of iodide as well as coupling of MIT and DIT
DM1 = severe - DM2 = mild to moderate
Central - pituitary tumor - truama - surgery - histiocytosis X and nephrogenic - hereditary - 2ndary to hypoglycemia - lithium - demeclocycline (ADH antagonist)
Peroxidase
1 = viral/immune destruction beta cells - 2 = insulin resistance
3. What is the effect of somatostatin on GH and TSH
Transcellular shif from dec insulin
Autoimmune - TB - metastasis
Inhib
Dec cortisol after lose dose
4. How do T3/T4 travel in blood and what happens to this substance in liver disease and pregnancy
25- OH vitamin D
Hashimotos thyroiditis
Riedel's - fixed hard and painless goiter
TGB - dec in hepatic failure - inc in pregnancy via estrogen
5. What happens in the dexamethasone suppresion test in a health individual
RBC brain
Caused by aldosterone secreting tumor - resulting in HTN - hypokalemia - metaboolic alkalosis low plasma renin - B/L or unilateral
Hashimotos
Dec cortisol after lose dose
6. What does fetal hypothyroidism cause - where do you see this birth defect endemically - and What causes the sporadic form
Trousseau's sign
FLT - hCG
Cretinism - whereever there is endemic goiter - sporadic version due to defect in T4 formation or thyroid development
Dehydration and acidosis leading to coma and death
7. uniform follicles in thyroid with good prognosis
Follicular carcinoma of thyroid
Removal of pituitary adenoma and octreotide
Pancreas - pituitary and PTH
Hypocalcemia and tetany
8. In which DM is polyuria - polydipsia - thirst and weight loss more common
Fluids - insulin - and K - glucose if necessary to prevent hypoglycemia
DM1
Mesoderm
Zona reticularis - ACTH hypothalamic CRH - sex hormones - androgens
9. What vasodilators use the cGMP pathway
Inc plasma FFAs - ketogenesis - ketonuria - ketonemia
Nonenzymatic glycosylation
Inc cortisol after low dose - dec cortisol after high dose
ANP - NO and EDRF
10. self - limiting hypothyroidism following a flu - like illness - dz - hist - and findings
Follicular carcinoma of thyroid
Right adrenal - right adrenal vein - IVC
Subactute thyroiditis - granulomatous inflammation - elev ESR - jaw pain - ealy inflammation - tender thyroid
Rapid/deep breathing (Kussmal's resps) N/V - abdominal pain - psychosis/delirium - dehydration - FRUITY breath odor -
11. What is the tx for gigantism/acromegaly
Removal of pituitary adenoma and octreotide
Hashimotos thyroiditis
Amenorrhea - galactorrhea - low libido - infertility from dec GnRH - - bitemporal heminanopia from imgingement of optic chiasm
PTH = inc ca reabsorption and dec PO4 reabsorption in DIC - active vit D = inc absorption of both in gut
12. What are the 4 fxns of PTH
Inhib
T3/T4 - cytosol
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
Ectopic ADH in small cell lung cancer - CNS disorder/head trauma - pulmonary diseae - drugs like cyclophosphamide
13. What are the 2 P's of MEN 2A
Medullary thyroid carcinoma - calcitonin
1 -25 OH2 vitamin D (active form)
Pheochromocytoma and PTH
Hashimotos
14. What are the labs for free T4 - total T4 and T3 uptake for hypo/hyperthyroidism
Hypo is low - hyper is high on all
Medullary thyroid carcinoma - calcitonin
Chromaffin cells from NC
Bone growth - brain (CNS maturation) - inc Beta 1 receptors - BML - inc glycogenolysis - gluconeogenesis and lipolysis
15. What is the tx for hyperaldosteronism
Surgery to remove tumor - sprinolactone - (K sparing diuretic)
Rugal thickening and acid hypersecretion causing recurrent ulcers - associated with MEN type 1
DM1 - HLA- DR3 and DR4
Hashimotos thyroiditis
16. What does adrenal insufficiency cause
Def in aldosterone and cortisol leading to hypotension (hyponatremic volume contraction) hyperkalemia - acidosis - and skin hyperpigmentation
Parafollicular C cells - calcitonin histo = sheets of cells in amyloid stroma - associated with MEN 2A/2B
DR5 - antimicrosomal - antithyroglobulin
Cushing's
17. What is the breakdown product of NE
VMA
Medullary thyroid carcinoma - calcitonin
TRH from the hypothalamus stimulates TSH release from ant pit which stimulates follicular cells - neg feedback to ant bit dec sens to TRH
PTH = inc ca reabsorption and dec PO4 reabsorption in DIC - active vit D = inc absorption of both in gut
18. Medullary carcinoma forms From what cells and What do they produce - histo and association
FLAT
Parafollicular C cells - calcitonin histo = sheets of cells in amyloid stroma - associated with MEN 2A/2B
Neuroblastoma
11beta - HTN because - 11 deoxycorticosterone is a mineralcorticoid and secreted in excess - masculinization because too much DHEA shuttling
19. where do you see GLUT 4 transporter
Def in aldosterone and cortisol leading to hypotension (hyponatremic volume contraction) hyperkalemia - acidosis - and skin hyperpigmentation
Dec in pit ACTH production - no skin hyperpigmentation and no hyperkalemia
Milk production in females and spermatogenesis in males (by inhibiting GnRH synthesis and release
Insulin responsive - adipose and skeletal muscle
20. What thyroid condition is associated with lymphoma
Hypo is low - hyper is high on all
Hashimotos
Neural crest
Hurthle cells - lymphocytic infiltrate with germinal centers
21. Which are the basophiles
ATP from glucose metabolism closing K channels and depolarizing cells - required for adipose and skeletal muscle uptake of glucose
Stim
Follicular carcinoma of thyroid
FLAT
22. What does the brain use for fuel in starvation
Ketone bodies
Iatrogenic - decreased
Autoimmune - TB - metastasis
Pheochromocytoma
23. When does graves typically present
Proptosis - EOM swelling - pretibial mxyedema - diffuse goiter
Renal osteodystrophy
Bromocriptine or cabergoline
During stress - childbirth
24. What MEN syndromes are associated with the ret gene
2A and 2B
Vitamin d
Growth factors - IGF-1 - FGF - and PDGF all MAP kinase pathway
Small cell lung cancer and bronchial carcinoids
25. What is the rule of 1/3s in carcinoid syndrome
FLAT PiG - FSH - LH - ACTH - TSH - Prolactin - GH
Carcinoid syndrome
Prolactin and GH
1/3 metastasize - 1/3 present with 2nd malignancy - and 1/3 multiple
26. Where do you see GLUT 2 transporter
Mesoderm
1 = viral/immune destruction beta cells - 2 = insulin resistance
ANP - NO and EDRF
Bidirectional - beta cells - liver kidney - small intestine
27. occlusion of brachial artery with BP cuff leads to carpal spasm
28. How is calcitonin regulated
Inc in serum Ca causes calcitonin secretion
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
1 = juveline - IDDM - 2 = adult - NIDDM
29. What does NEG cause in small vessels
Pot - bellied - pale - puffy faced witih protruding umbilicus and protuberant tongue
Pheochromocytoma and PTH
Diffuse thickening of the BM
Mesoderm
30. What are the two types of diabetes insipidus and What causes them
Inhib
Central - pituitary tumor - truama - surgery - histiocytosis X and nephrogenic - hereditary - 2ndary to hypoglycemia - lithium - demeclocycline (ADH antagonist)
Diarrhea - aminoglycosides - diuretics - and EtOH
21 hydroxylase - masculinization - hypotension - hyperkalemia - inc plasma renin - volume depletion
31. What do the three endocrine cells of the pancreas secrete
Alpha = glucagon - beta = insulin - delta = somatostatin
Inhib
Stim
Stim
32. In which type of DM is ketoacidosis more common
DM1
Dec free serum Ca inc PTH secretion - dec free serum Mg dec PTH secretion
Rugal thickening and acid hypersecretion causing recurrent ulcers - associated with MEN type 1
Rapid/deep breathing (Kussmal's resps) N/V - abdominal pain - psychosis/delirium - dehydration - FRUITY breath odor -
33. Where do you see the GLUT 1 transporter
RBC brain
Prolactinoma
Subactute thyroiditis - granulomatous inflammation - elev ESR - jaw pain - ealy inflammation - tender thyroid
Prolactin or GH
34. What other conditions are associated with MEN 2B
Medullary thyroid carcinoma with calcitonin and oral/intestinal ganglioneuromatosis (associated with marfanoid habitus)
TGB - dec in hepatic failure - inc in pregnancy via estrogen
Parafollicular cells of thyroid (C cells) - dec bone resorption of Ca
Moderatly enlarged nontender thyroid
35. What other diseases or syndromes are associated with pheochromocytoma
Small (metastatic) bowel tumors - 5HT goes to liver for first pass -
Neurofibramtosis - MEN types 2A and 2B
Bound to corticosteroid binding globulin - CGB
Zona glomerulosa - renin - angiontensin - aldosterone
36. What are the clinical findings of cushing's
HTN - weight gain - moon facies - truncal obesity - buffalo hump - hyperglycemia - skin thinning and striae - osteoporosis - amenorrhea - immune suppression
MSH - a by product of inc ACTH production from POMC
Fluids - insulin - and K - glucose if necessary to prevent hypoglycemia
Inhibits glucagon release
37. Where is T3 made
Caused by aldosterone secreting tumor - resulting in HTN - hypokalemia - metaboolic alkalosis low plasma renin - B/L or unilateral
Dec aldosterone causing hyponatremia which can lead to seizures
Peripheral tissue
Heat intolerance - weight loss - inc appetite - hyperactivity - diarrhea - inc reflexes - pretibial myxedema (graves) warm - moist skin - fine hair - chest pain - palpitations - arrhythmias
38. How does right adrenal gland drain
21 hydroxylase - masculinization - hypotension - hyperkalemia - inc plasma renin - volume depletion
During stress - childbirth
Right adrenal - right adrenal vein - IVC
Zollinger Ellison
39. What are the findings of hypoPTH
Accidental surgical excision - autoimmune destruction and DiGeorge syndrome
GH - large tognue - deep furrows - deep voice - large hands/feet - coarse fascial features - impaired glucose tolerance
Hypocalcemia and tetany
Pheochromocytoma
40. Recurrent diarrhea - cutaneous flushing - asthatic wheezing - right side valvular disease
Direct stimulation of osteoblasts - which indirectly stimulates osteoclastic cells via RANK L (down regulates OPG that usually blocks RANK L from binding RANK)
Carcinoid syndrome
Inc cortisol after low dose - dec cortisol after high dose
Dec glucose uptake - inc protein catabolism - inc lipolysis
41. focal patches of hyperfxning follicular cells working independently of TSH
Islets of langerhans are collections of alpha - beta and delta
Demeclocycline or H2O restriction
Inc plasma FFAs - ketogenesis - ketonuria - ketonemia
Toxic multinodular goiter
42. What is dopamine agonist is used to inhibit prolactin secretion in prolactinoma
Bromocriptine
Peripheral tissue
Excellent prognosis - risk with childhood radiation - papillary carcinoma
Bound to corticosteroid binding globulin - CGB
43. What are the clinical findings of graves
Proptosis - EOM swelling - pretibial mxyedema - diffuse goiter
Inc PTH - dec Ca - dec PO4 cause inc in active form and then it feedback inhibits its own production
HTN
Bound to corticosteroid binding globulin - CGB
44. What happens in the dexamethasone suppression test in somoeone with an ectopic ACTH producing tumor
TSH receptor leading to inc release of T3 and T4 - hot nodules are rarely malignant
Zona fasciculata - ACTH - hypothalamic CRH - cortisol/sex hormones
Inc cortisol after low dose and high dose
Inhibits glucagon release
45. How do you diagnose GH abnl?
Episodic hyperadrenergic symptoms - pressure - pain (headache) - perspiration - palpitations (tachycardia) - pallor
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 serum IGF-1 - failure to suppress serum GH following oral glucose tolerance test
2A and 2B
46. What is the effect of TRH on TSH and prolactin
Stim
Bromocriptine or cabergoline
All 3 - spares medulla
FLT - hCG
47. Which ketone bodies are more common in DKA
Beta - hydroxybutyrate > acetoacetate
Gigantism - linear bone growth
Autoimmune - TB - metastasis
Bromocriptine or cabergoline
48. What is the most common tumor of the adrenal medulla in children
Alpha = glucagon - beta = insulin - delta = somatostatin
Neuroblastoma
Transcellular shif from dec insulin
Small cell lung cancer and bronchial carcinoids
49. Where is the defect in toxic multinodular goiter
Subactute thyroiditis - granulomatous inflammation - elev ESR - jaw pain - ealy inflammation - tender thyroid
TSH receptor leading to inc release of T3 and T4 - hot nodules are rarely malignant
Bromocriptine
1 -25 OH2 vitamin D (active form)
50. What is the breakdown product of epi
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
Dehydration and acidosis leading to coma and death
Bromocriptine
Metanephrine