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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 3 things does insuline def and glucagon excess lead to...
VMA
Amenorrhea - galactorrhea - low libido - infertility from dec GnRH - - bitemporal heminanopia from imgingement of optic chiasm
Dec glucose uptake - inc protein catabolism - inc lipolysis
BRICK L - brain - RBC - intestine - cornea - kidney - liver
2. What are neurophysins
Carrier protiens in posterior pituitary that carry hormones in circulation - derived from neuroectoderm
Neural crest
Toxic multinodular goiter
Stim
3. When diagnosing diabetes insipidus - what happens to the urine osm in the water deprivation test and How do you distinguish between central and nephrogenic
4. What is the effect of CRH on ACTH
PTH = inc ca reabsorption and dec PO4 reabsorption in DIC - active vit D = inc absorption of both in gut
Hypo is low - hyper is high on all
Stim
FLT - hCG
5. most common thyroid cancer - ground glass nuclei - psammona bodies - nuclear grooves - prognosis and risk
Inactive form
Riedel's - fixed hard and painless goiter
Mucormycosis - Rhizopus infxn - cerebral edema - cardia arrhythmias - HF
Excellent prognosis - risk with childhood radiation - papillary carcinoma
6. What is the tx for diabetes inspidus - central and nephrogenic
Adquate fluid intake - central intranasal desmopressin - for nephrogenic use thiazide (for hypernatremia) - amiloride (for hypokalemia) and indomethacin to dec GFR
DKA - inc insulin requirements from inc stress (infxn) - excess fat breakdown and inc ketogenesis from FFA made into ketone bodies
Pancreas - pituitary and PTH
Amenorrhea - galactorrhea - low libido - infertility from dec GnRH - - bitemporal heminanopia from imgingement of optic chiasm
7. What are the common causes of dec Mg
Inhib
Excellent prognosis - risk with childhood radiation - papillary carcinoma
Diarrhea - aminoglycosides - diuretics - and EtOH
Dec aldosterone causing hyponatremia which can lead to seizures
8. in the congenital bilateral adrenal hyperplasias which enzyme deficiency is characterized by dec in sex hormones - dec in cortisol - and inc in mineralcorticoids - enzyme and sx
Inhibits glucagon release
Bromocriptine
17alpha - HTN - hypokalemia - in males - dec DHT - externally phenotypic females - in females nl genitals but no secondary sex characteristis
Inc in ACTH because low levels of cortisol
9. What is the next layer in from ZG - What is its primary control - What does it secrete
Mesoderm
Dec glucose uptake - inc protein catabolism - inc lipolysis
Zona fasciculata - ACTH - hypothalamic CRH - cortisol/sex hormones
Inc absorption of dietary Ca and phosphate - inc bone resorption of Ca and phosphate
10. Which kind of cells don't need insulin to take up glucose
Ectopic ADH in small cell lung cancer - CNS disorder/head trauma - pulmonary diseae - drugs like cyclophosphamide
Hyperglycemia - inc H+ - dec bicarb leading to anion gap acidosis - inc blood ketone levels - leukocytosis - hyperkalemia - but depleted intracellular K
No - proinsulin to insulin + C peptide
BRICK L - brain - RBC - intestine - cornea - kidney - liver
11. where do you see GLUT 4 transporter
Insulin responsive - adipose and skeletal muscle
Kidney stones and stomach ulcers
GnRH - Oxytocin - ADH (V1) - TRH
Neurofibramtosis - MEN types 2A and 2B
12. In which DM is there a stronger genetic association
Parafollicular C cells - calcitonin histo = sheets of cells in amyloid stroma - associated with MEN 2A/2B
Caused by aldosterone secreting tumor - resulting in HTN - hypokalemia - metaboolic alkalosis low plasma renin - B/L or unilateral
DM2
Alpha = glucagon - beta = insulin - delta = somatostatin
13. The adrenal cortex derives From What embryonic tissue
Bound to corticosteroid binding globulin - CGB
Gigantism - linear bone growth
Mesoderm
Hypocalcemia and tetany
14. What is the effect of GHRH on GH
Parafollicular C cells - calcitonin histo = sheets of cells in amyloid stroma - associated with MEN 2A/2B
Stim
Kids = rickets - adults = osteomalacia
Insulin responsive - adipose and skeletal muscle
15. Which ketone bodies are more common in DKA
DM1 - DM2 has islet amyloid deposit
Tonic DA from hypothalamus inhibits - prolactin causes DA synthesis and increases own inhibition - TRH stimulates prolactin
Beta - hydroxybutyrate > acetoacetate
FLAT PiG - FSH - LH - ACTH - TSH - Prolactin - GH
16. What is the TX for carcinoid syndrome
Octreotide
Kids = rickets - adults = osteomalacia
Medullary thyroid carcinoma - calcitonin
Hurthle cells - lymphocytic infiltrate with germinal centers
17. What is the tx for gigantism/acromegaly
Subactute thyroiditis - granulomatous inflammation - elev ESR - jaw pain - ealy inflammation - tender thyroid
Zona glomerulosa - renin - angiontensin - aldosterone
Removal of pituitary adenoma and octreotide
Rapid/deep breathing (Kussmal's resps) N/V - abdominal pain - psychosis/delirium - dehydration - FRUITY breath odor -
18. Where is low serum phosphorus sensed to maintain phosphorus homeostasis - and what substance is key for increasing serum levels of phosphorus
Stress - exercise and hypoglycemia
Z- E - insulinomas - VIPomas - glucagonomas are rare
Kidney - 1 -25 OH2 vit d
Hashimotos
19. What causes primary hyperaldosteronism (Conn's syndrome) and What are the lab findings
Inc plasma amino acids - nitrogen loss in urine
Caused by aldosterone secreting tumor - resulting in HTN - hypokalemia - metaboolic alkalosis low plasma renin - B/L or unilateral
FLAT PiG - FSH - LH - ACTH - TSH - Prolactin - GH
Accidental surgical excision - autoimmune destruction and DiGeorge syndrome
20. nonenzymatic glycosylation leads to what 3 catageories of defects
Thyroid hormones T3/T4
HTN
Inc plasma FFAs - ketogenesis - ketonuria - ketonemia
Small vessel disease - large vessel disease and osmotic drainage
21. What is the most common tumor of the adrenal medulla in children
1 = viral/immune destruction beta cells - 2 = insulin resistance
17alpha - HTN - hypokalemia - in males - dec DHT - externally phenotypic females - in females nl genitals but no secondary sex characteristis
Neuroblastoma
Bound to corticosteroid binding globulin - CGB
22. Why do congential adrenal enzyme deficiences end up with hyperplasia and not hypoplasia
Waterhouse friderichsen - n meningitidis septicemia
Ectopic ADH in small cell lung cancer - CNS disorder/head trauma - pulmonary diseae - drugs like cyclophosphamide
Inc in ACTH because low levels of cortisol
Ketone bodies
23. What is the most common tumor of the adrenal medulla in adults
Stress induced catecholamine surge leading to death by arrhythmia - graves
During stress - childbirth
Pheochromocytoma
AD
24. What HLA association is with hashimotos and what kind of autoantibodies
Carcinoid syndrome
1 = viral/immune destruction beta cells - 2 = insulin resistance
DR5 - antimicrosomal - antithyroglobulin
Def in aldosterone and cortisol leading to hypotension (hyponatremic volume contraction) hyperkalemia - acidosis - and skin hyperpigmentation
25. How many cortical divisions are involved in primary adrenal insuff
All 3 - spares medulla
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
ATP from glucose metabolism closing K channels and depolarizing cells - required for adipose and skeletal muscle uptake of glucose
26. How does the body respond to SIADH and What does that cause
Inactive form
DM1
Dec aldosterone causing hyponatremia which can lead to seizures
Ketone bodies
27. What does NEG cause in small vessels
Inc cortisol after low and high dose
HVA
Diffuse thickening of the BM
Riedel's - fixed hard and painless goiter
28. What is the general chronic manifestation of DM
Pheochromocytoma and PTH
Inc serum IGF-1 - failure to suppress serum GH following oral glucose tolerance test
Nonenzymatic glycosylation
BRICK L - brain - RBC - intestine - cornea - kidney - liver
29. What kind of ligands bind intrinsice tyrosine kinase
21 hydroxylase - masculinization - hypotension - hyperkalemia - inc plasma renin - volume depletion
Inhib
Growth factors - IGF-1 - FGF - and PDGF all MAP kinase pathway
Inc in serum Ca causes calcitonin secretion
30. What happens in the dexamethasone suppresion test in a health individual
Dec cortisol after lose dose
Peroxidase
Bromocriptine or cabergoline
Bone growth - brain (CNS maturation) - inc Beta 1 receptors - BML - inc glycogenolysis - gluconeogenesis and lipolysis
31. What do the three endocrine cells of the pancreas secrete
Alpha = glucagon - beta = insulin - delta = somatostatin
Inactive form
Pheochromocytoma
Inhib
32. What is the rule of 1/3s in carcinoid syndrome
Gigantism - linear bone growth
1/3 metastasize - 1/3 present with 2nd malignancy - and 1/3 multiple
Def in aldosterone and cortisol leading to hypotension (hyponatremic volume contraction) hyperkalemia - acidosis - and skin hyperpigmentation
Excessive water retenion - hyponatremia - urine osm > serum osm
33. What are the 3 P's of MEN type 1 (Werners)
11beta - HTN because - 11 deoxycorticosterone is a mineralcorticoid and secreted in excess - masculinization because too much DHEA shuttling
Hyperglycemia - inc H+ - dec bicarb leading to anion gap acidosis - inc blood ketone levels - leukocytosis - hyperkalemia - but depleted intracellular K
Pancreas - pituitary and PTH
Hyperthyroid early in course - thyrotoxicosis during follicular rupture
34. When is the onset of DM1 vs DM2 causing what kind of DM
Urine osm doesn't inc - and desmopressin admin distinguishes
Alpha antagonists - esp phenoxybenzamine - nonselective - irreversible - surgery to remove tumor
1 = juveline - IDDM - 2 = adult - NIDDM
MSH - a by product of inc ACTH production from POMC
35. What does the brain use for fuel in starvation
Ketone bodies
Peroxidase
DM1 = dec - DM2 = variable
Hypocalcemia and tetany
36. iodine containing hormones that control the body's metabolic rate
Thyroid hormones T3/T4
FLT - hCG
Excellent prognosis - risk with childhood radiation - papillary carcinoma
Heat intolerance - weight loss - inc appetite - hyperactivity - diarrhea - inc reflexes - pretibial myxedema (graves) warm - moist skin - fine hair - chest pain - palpitations - arrhythmias
37. in congenital bilateral adrenal hyperplasia - what enzyme def is most common and associate with dec cortisol - dec mineralcorticoids - inc sex hormones - enzyme and sx
21 hydroxylase - masculinization - hypotension - hyperkalemia - inc plasma renin - volume depletion
Neural crest
DKA - inc insulin requirements from inc stress (infxn) - excess fat breakdown and inc ketogenesis from FFA made into ketone bodies
5- HIAA
38. What happens to women with dec SHBG
Raises free testosterone and they gey hirsutism
Octreotide
Dec glucose uptake - inc protein catabolism - inc lipolysis
Epi - norepi - and DA - epidosic HTN - urinary VMA and elevated catecholamines
39. Where do you see the GLUT 1 transporter
RBC brain
Hyperthyroid early in course - thyrotoxicosis during follicular rupture
Renal osteodystrophy
BRICK L - brain - RBC - intestine - cornea - kidney - liver
40. What is the fxn of prolactin
HTN
Inhib
Prolactin or GH
Milk production in females and spermatogenesis in males (by inhibiting GnRH synthesis and release
41. What does adrenal insufficiency cause
DM1 = dec - DM2 = variable
Direct stimulation of osteoblasts - which indirectly stimulates osteoclastic cells via RANK L (down regulates OPG that usually blocks RANK L from binding RANK)
Def in aldosterone and cortisol leading to hypotension (hyponatremic volume contraction) hyperkalemia - acidosis - and skin hyperpigmentation
Insulin responsive - adipose and skeletal muscle
42. All three effects of hyperinsulinemia lead to which two clinical features
Waterhouse friderichsen - n meningitidis septicemia
Dehydration and acidosis leading to coma and death
Transcellular shif from dec insulin
Pot - bellied - pale - puffy faced witih protruding umbilicus and protuberant tongue
43. The adrenal medulla derives From What embryonic tissue
Adenoma - hypercalcemia - hypercalciuria - hypophosohatemia - inc PTH - inc alk phos - inc cAMP in urine - often asymptomatic present as weakness and contipation - groans
Neural crest
Rugal thickening and acid hypersecretion causing recurrent ulcers - associated with MEN type 1
Pheochromocytoma
44. Neuroblastoma does not come with...
Accidental surgical excision - autoimmune destruction and DiGeorge syndrome
HTN
Excellent prognosis - risk with childhood radiation - papillary carcinoma
Kidney stones and stomach ulcers
45. Which substances bind receptor associated tyrosine kinase via the JAK/STAT pathway
GH - prolactin also IL-2
Adquate fluid intake - central intranasal desmopressin - for nephrogenic use thiazide (for hypernatremia) - amiloride (for hypokalemia) and indomethacin to dec GFR
Pheochromocytoma
Undifferentiated/anaplastic
46. What drugs cause shrinkage of prolactinoma
Accidental surgical excision - autoimmune destruction and DiGeorge syndrome
1 = juveline - IDDM - 2 = adult - NIDDM
Bromocriptine or cabergoline
Kids = rickets - adults = osteomalacia
47. What occurs to beta cells in DM1 vs DM2
Dec in DM1 - variable in DM2 with possible amyloid
ATP from glucose metabolism closing K channels and depolarizing cells - required for adipose and skeletal muscle uptake of glucose
Octreotide
Small vessel disease - large vessel disease and osmotic drainage
48. Recurrent diarrhea - cutaneous flushing - asthatic wheezing - right side valvular disease
Most antipsychotics and all OCPs - estrogen in pregs
Carcinoid syndrome
Chvostek's sign
Somatostatin analog
49. Do pts with neuroblastoma develop HTN
Free hormone is active T3 bind more than T4
Less likely
1/3 metastasize - 1/3 present with 2nd malignancy - and 1/3 multiple
Chvostek's sign
50. focal patches of hyperfxning follicular cells working independently of TSH
Lumen of follicles - thryglobulin + I2 with MIT and DIT - proteolysis and secrete into blood back through follicular cell
Toxic multinodular goiter
Left adrenal - left adrenal vein - left renal vein - IVC
Inhib