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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 24 - 25 OH2 vit D
Octreotide
Inactive form
Ectopic ADH in small cell lung cancer - CNS disorder/head trauma - pulmonary diseae - drugs like cyclophosphamide
Toxic multinodular goiter
2. How many cortical divisions are involved in primary adrenal insuff
Milk production in females and spermatogenesis in males (by inhibiting GnRH synthesis and release
Cretinism - whereever there is endemic goiter - sporadic version due to defect in T4 formation or thyroid development
All 3 - spares medulla
FLAT
3. cholecalciferol
DM1
Hurthle cells - lymphocytic infiltrate with germinal centers
Vitamin d
Follicles of thyroid - most T3 formed in the blood
4. What is the effect of GHRH on GH
Carrier protiens in posterior pituitary that carry hormones in circulation - derived from neuroectoderm
Stim
Moderatly enlarged nontender thyroid
Inc absorption of dietary Ca and phosphate - inc bone resorption of Ca and phosphate
5. What are the labs for free T4 - total T4 and T3 uptake for hypo/hyperthyroidism
Type 1
Hypo is low - hyper is high on all
Metanephrine
Diabetes insipidus - lack of ADH - or lack of response to ADH in kidney
6. In which type of DM is ketoacidosis more common
DM1 = severe - DM2 = mild to moderate
TRH from the hypothalamus stimulates TSH release from ant pit which stimulates follicular cells - neg feedback to ant bit dec sens to TRH
Correct is slowly
DM1
7. Do you see C peptide in exogenous insulin intake
No - proinsulin to insulin + C peptide
Cretinism - whereever there is endemic goiter - sporadic version due to defect in T4 formation or thyroid development
Inc cortisol after low dose and high dose
1 -25 OH2 vitamin D (active form)
8. pheochromocytoma rule of 5 P's - What are they
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 reticularis - ACTH hypothalamic CRH - sex hormones - androgens
Cushing's
Episodic hyperadrenergic symptoms - pressure - pain (headache) - perspiration - palpitations (tachycardia) - pallor
9. What are the 3 problems in SIADH
PTH = inc ca reabsorption and dec PO4 reabsorption in DIC - active vit D = inc absorption of both in gut
Excessive water retenion - hyponatremia - urine osm > serum osm
MSH - a by product of inc ACTH production from POMC
Blood pressure - dec bone formation - anti - inflammatory - dec immune fxn - inc gluconeogenesis - lipolysis - proteolysis
10. What does fetal hypothyroidism cause - where do you see this birth defect endemically - and What causes the sporadic form
Bone growth - brain (CNS maturation) - inc Beta 1 receptors - BML - inc glycogenolysis - gluconeogenesis and lipolysis
MSH - a by product of inc ACTH production from POMC
Cretinism - whereever there is endemic goiter - sporadic version due to defect in T4 formation or thyroid development
Inc cortisol after low dose - dec cortisol after high dose
11. What is the most common tumor of the adrenal medulla in adults
Epi - norepi - and DA - epidosic HTN - urinary VMA and elevated catecholamines
Inc cortisol after low dose and high dose
Pheochromocytoma
Neurofibramtosis - MEN types 2A and 2B
12. What does inc GH in children result In What is the characteristic bone growth
Inc in ACTH because low levels of cortisol
Parafollicular C cells - calcitonin histo = sheets of cells in amyloid stroma - associated with MEN 2A/2B
Gigantism - linear bone growth
Ketone bodies
13. In which DM is there an islet cell leukocytic infiltrate and what kind of infiltrate does the other have
DM1 - DM2 has islet amyloid deposit
Stress - exercise and hypoglycemia
1 = juveline - IDDM - 2 = adult - NIDDM
Ketone bodies
14. What are the 5 fxns of thyroid hormone
Inc plasma FFAs - ketogenesis - ketonuria - ketonemia
Fluids - insulin - and K - glucose if necessary to prevent hypoglycemia
Raises free testosterone and they gey hirsutism
Bone growth - brain (CNS maturation) - inc Beta 1 receptors - BML - inc glycogenolysis - gluconeogenesis and lipolysis
15. Where is the defect in toxic multinodular goiter
Stress - exercise and hypoglycemia
Carrier protiens in posterior pituitary that carry hormones in circulation - derived from neuroectoderm
Zona glomerulosa - renin - angiontensin - aldosterone
TSH receptor leading to inc release of T3 and T4 - hot nodules are rarely malignant
16. All three effects of hyperinsulinemia lead to which two clinical features
Small vessel disease - large vessel disease and osmotic drainage
Urine specific grav < 1.006 - serum osm > 290
Insulin responsive - adipose and skeletal muscle
Dehydration and acidosis leading to coma and death
17. what vit D conversion takes place in the liver
Tonic DA from hypothalamus inhibits - prolactin causes DA synthesis and increases own inhibition - TRH stimulates prolactin
Autoimmune - TB - metastasis
25- OH vitamin D
Neurofibramtosis - MEN types 2A and 2B
18. What enzyme is responsible for oxidation and organification of iodide as well as coupling of MIT and DIT
Peroxidase
Toxic multinodular goiter
DM1 = severe - DM2 = mild to moderate
Hashimotos
19. What does NEG cause in small vessels
Metanephrine
Diffuse thickening of the BM
FSH - LH - ACTH - TSH - CRH - hCG - ADH (V2) - MSH - PTH - + calcitonin - GHRH and glucagon
Prolactin or GH
20. In what hormones are the alpha subunit the same
DM1 = dec - DM2 = variable
FLT - hCG
2A and 2B
Heat intolerance - weight loss - inc appetite - hyperactivity - diarrhea - inc reflexes - pretibial myxedema (graves) warm - moist skin - fine hair - chest pain - palpitations - arrhythmias
21. What is the source of calcitonin and What does it do
Neural crest
Parafollicular cells of thyroid (C cells) - dec bone resorption of Ca
Pheochromocytoma and PTH
Ectopic ADH in small cell lung cancer - CNS disorder/head trauma - pulmonary diseae - drugs like cyclophosphamide
22. What is the TX for DKA
Stim
Lumen of follicles - thryglobulin + I2 with MIT and DIT - proteolysis and secrete into blood back through follicular cell
HVA
Fluids - insulin - and K - glucose if necessary to prevent hypoglycemia
23. What is the fxn of vitamin D
Inc absorption of dietary Ca and phosphate - inc bone resorption of Ca and phosphate
PseudohypoPTH - albright's hereditary osteodystrophy
GnRH - Oxytocin - ADH (V1) - TRH
Beta - hydroxybutyrate > acetoacetate
24. What other diseases or syndromes are associated with pheochromocytoma
Inhib
Neuroendocrine cells of GI tract
Neurofibramtosis - MEN types 2A and 2B
Carcinoid syndrome
25. What is the tx for hyperaldosteronism
Inc in serum Ca causes calcitonin secretion
Surgery to remove tumor - sprinolactone - (K sparing diuretic)
Lower free testosterone and gynecomastia
Insulin responsive - adipose and skeletal muscle
26. iodine containing hormones that control the body's metabolic rate
Thyroid hormones T3/T4
Urine specific grav < 1.006 - serum osm > 290
Trousseau's sign
T3/T4 - cytosol
27. 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
Renal osteodystrophy
Inhib
28. How does MEN type 1 usually present
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
Neuroendocrine cells of GI tract
Kidney stones and stomach ulcers
Parafollicular cells of thyroid (C cells) - dec bone resorption of Ca
29. thyroid replaced by fibroid tissue - dz and findings
30. What kind of cells are in the adrenal medulla and What do they secrete
Chromaffin cells - catecholamines
Moderatly enlarged nontender thyroid
Chromaffin cells from NC
Dec cortisol after lose dose
31. What are neurophysins
Demeclocycline or H2O restriction
Cretinism - whereever there is endemic goiter - sporadic version due to defect in T4 formation or thyroid development
Carrier protiens in posterior pituitary that carry hormones in circulation - derived from neuroectoderm
Neural crest
32. Neuroblastoma does not come with...
Urine specific grav < 1.006 - serum osm > 290
Raises free testosterone and they gey hirsutism
DR5 - antimicrosomal - antithyroglobulin
HTN
33. acute adrenal insuff due to adrenal hemorrahge and endotoxic show - DIC - syndrome and organism
Inc serum IGF-1 - failure to suppress serum GH following oral glucose tolerance test
Waterhouse friderichsen - n meningitidis septicemia
DM1
Hyperthyroid early in course - thyrotoxicosis during follicular rupture
34. What are the clinical findings with hashimotos
Antibodies against TSH receptors - II
Left adrenal - left adrenal vein - left renal vein - IVC
Zollinger Ellison
Moderatly enlarged nontender thyroid
35. How can hashimotos present that is not typical hypothyroidism
ADH - oxytocin - made in the hypothalamus and shipped to posterior pituitary
T3/T4 - cytosol
1 = juveline - IDDM - 2 = adult - NIDDM
Hyperthyroid early in course - thyrotoxicosis during follicular rupture
36. What are the 4 causes of SIADH
Alpha antagonists - esp phenoxybenzamine - nonselective - irreversible - surgery to remove tumor
25- OH vitamin D
Inc cortisol after low and high dose
Ectopic ADH in small cell lung cancer - CNS disorder/head trauma - pulmonary diseae - drugs like cyclophosphamide
37. How does the left adrenal gland drain
Pheochromocytoma and PTH
Riedel's - fixed hard and painless goiter
Left adrenal - left adrenal vein - left renal vein - IVC
GnRH - Oxytocin - ADH (V1) - TRH
38. Recurrent diarrhea - cutaneous flushing - asthatic wheezing - right side valvular disease
Kidney stones and stomach ulcers
MSH - a by product of inc ACTH production from POMC
Dec cortisol after lose dose
Carcinoid syndrome
39. What are the urine and serum findings in diabetes insipidus
Urine specific grav < 1.006 - serum osm > 290
Parafollicular C cells - calcitonin histo = sheets of cells in amyloid stroma - associated with MEN 2A/2B
Somatostatin analog
Epi - norepi - and DA - epidosic HTN - urinary VMA and elevated catecholamines
40. What happens in the dexamethasone suppression test in someone with a cortisol producing tumor
Diarrhea - aminoglycosides - diuretics - and EtOH
Inhib
Inc cortisol after low and high dose
Carrier protiens in posterior pituitary that carry hormones in circulation - derived from neuroectoderm
41. tapping of the facial nerve leads to contraction of facial muscles
42. What are the labs of DKA
Follicular carcinoma of thyroid
Left adrenal - left adrenal vein - left renal vein - IVC
Cretinism - whereever there is endemic goiter - sporadic version due to defect in T4 formation or thyroid development
Hyperglycemia - inc H+ - dec bicarb leading to anion gap acidosis - inc blood ketone levels - leukocytosis - hyperkalemia - but depleted intracellular K
43. focal patches of hyperfxning follicular cells working independently of TSH
Due to dec gut absorption of Ca - inc PO4 due to chronic renal disease (no vit D) hypOcalcemia - hyperphophatemia - inc alk phos - inc PTH
Toxic multinodular goiter
GH - large tognue - deep furrows - deep voice - large hands/feet - coarse fascial features - impaired glucose tolerance
T3/T4 - cytosol
44. In which DM is polyuria - polydipsia - thirst and weight loss more common
DM1
FLAT PiG - FSH - LH - ACTH - TSH - Prolactin - GH
Inc PTH - dec Ca - dec PO4 cause inc in active form and then it feedback inhibits its own production
Zona reticularis - ACTH hypothalamic CRH - sex hormones - androgens
45. What is the rule of 1/3s in carcinoid syndrome
No - proinsulin to insulin + C peptide
Subactute thyroiditis - granulomatous inflammation - elev ESR - jaw pain - ealy inflammation - tender thyroid
Islets of langerhans are collections of alpha - beta and delta
1/3 metastasize - 1/3 present with 2nd malignancy - and 1/3 multiple
46. 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
11beta - HTN because - 11 deoxycorticosterone is a mineralcorticoid and secreted in excess - masculinization because too much DHEA shuttling
Hashimotos
Lower free testosterone and gynecomastia
Demeclocycline or H2O restriction
47. where do you see GLUT 4 transporter
Insulin responsive - adipose and skeletal muscle
Waterhouse friderichsen - n meningitidis septicemia
Inactive form
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
48. What is the next layer in from the ZF - What is its primary control and What does it secrete
PTH = inc ca reabsorption and dec PO4 reabsorption in DIC - active vit D = inc absorption of both in gut
Zona reticularis - ACTH hypothalamic CRH - sex hormones - androgens
Hypo is low - hyper is high on all
TSH - elevated in hypo - low in hyper
49. What are the findings of hypoPTH
Small (metastatic) bowel tumors - 5HT goes to liver for first pass -
Pancreas - pituitary and PTH
Hypocalcemia and tetany
1/3 metastasize - 1/3 present with 2nd malignancy - and 1/3 multiple
50. The adrenal medulla derives From What embryonic tissue
Transcellular shif from dec insulin
Neural crest
Heat intolerance - weight loss - inc appetite - hyperactivity - diarrhea - inc reflexes - pretibial myxedema (graves) warm - moist skin - fine hair - chest pain - palpitations - arrhythmias
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