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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 are the findings of prolactinoma
Amenorrhea - galactorrhea - low libido - infertility from dec GnRH - - bitemporal heminanopia from imgingement of optic chiasm
DM1
Hyperglycemia - glucosuria - osmotic diureses - lyte depletion
Inc cortisol after low dose - dec cortisol after high dose
2. DM1 complication - most important - pathogenesis
Inc in ACTH because low levels of cortisol
DKA - inc insulin requirements from inc stress (infxn) - excess fat breakdown and inc ketogenesis from FFA made into ketone bodies
FSH - LH - ACTH - TSH - CRH - hCG - ADH (V2) - MSH - PTH - + calcitonin - GHRH and glucagon
Bidirectional - beta cells - liver kidney - small intestine
3. When does graves typically present
Chromaffin cells - catecholamines
During stress - childbirth
Carcinoid syndrome
Beta - hydroxybutyrate > acetoacetate
4. How do you diagnose GH abnl?
Inc cortisol after low and high dose
Hyperglycemia - inc H+ - dec bicarb leading to anion gap acidosis - inc blood ketone levels - leukocytosis - hyperkalemia - but depleted intracellular K
Inc serum IGF-1 - failure to suppress serum GH following oral glucose tolerance test
Pancreas - pituitary and PTH
5. thyroid cancer in older patients with poor prognosis
Follicular carcinoma of thyroid
Tonic DA from hypothalamus inhibits - prolactin causes DA synthesis and increases own inhibition - TRH stimulates prolactin
Undifferentiated/anaplastic
Inhib
6. What other diseases or syndromes are associated with pheochromocytoma
Removal of pituitary adenoma and octreotide
Hyperthyroid early in course - thyrotoxicosis during follicular rupture
Neurofibramtosis - MEN types 2A and 2B
Chvostek's sign
7. In which DM is there a stronger genetic association
Thyroid hormones T3/T4
DM2
Surgery to remove tumor - sprinolactone - (K sparing diuretic)
Inc plasma amino acids - nitrogen loss in urine
8. What are the 2 P's of MEN 2A
Pancreas - pituitary and PTH
Raises free testosterone and they gey hirsutism
Pheochromocytoma
Pheochromocytoma and PTH
9. What is the fxn of vitamin D
Hyperglycemia - glucosuria - osmotic diureses - lyte depletion
Osteitis fibrosa cystica
Stress - exercise and hypoglycemia
Inc absorption of dietary Ca and phosphate - inc bone resorption of Ca and phosphate
10. What are the 4 fxns of PTH
Caused by aldosterone secreting tumor - resulting in HTN - hypokalemia - metaboolic alkalosis low plasma renin - B/L or unilateral
Milk production in females and spermatogenesis in males (by inhibiting GnRH synthesis and release
Amenorrhea - galactorrhea - low libido - infertility from dec GnRH - - bitemporal heminanopia from imgingement of optic chiasm
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
11. What does NEG cause in small vessels
Diffuse thickening of the BM
Parafollicular cells of thyroid (C cells) - dec bone resorption of Ca
Small cell lung cancer and bronchial carcinoids
GH - large tognue - deep furrows - deep voice - large hands/feet - coarse fascial features - impaired glucose tolerance
12. self - limiting hypothyroidism following a flu - like illness - dz - hist - and findings
Dec in pit ACTH production - no skin hyperpigmentation and no hyperkalemia
Subactute thyroiditis - granulomatous inflammation - elev ESR - jaw pain - ealy inflammation - tender thyroid
Mucormycosis - Rhizopus infxn - cerebral edema - cardia arrhythmias - HF
ANP - NO and EDRF
13. How is PTH regulated
Adenoma - hypercalcemia - hypercalciuria - hypophosohatemia - inc PTH - inc alk phos - inc cAMP in urine - often asymptomatic present as weakness and contipation - groans
Stim
Dec free serum Ca inc PTH secretion - dec free serum Mg dec PTH secretion
5- HIAA
14. Do pts with neuroblastoma develop HTN
Less likely
GH - prolactin also IL-2
TSH receptor leading to inc release of T3 and T4 - hot nodules are rarely malignant
Parafollicular cells of thyroid (C cells) - dec bone resorption of Ca
15. In which type of DM is insulin always necessary
Blood pressure - dec bone formation - anti - inflammatory - dec immune fxn - inc gluconeogenesis - lipolysis - proteolysis
Inhibits glucagon release
Type 1
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
16. Neuroblastoma does not come with...
Dec cortisol after lose dose
HTN
Dec in DM1 - variable in DM2 with possible amyloid
Stim
17. What is the TX for DKA
Dec free serum Ca inc PTH secretion - dec free serum Mg dec PTH secretion
Stress induced catecholamine surge leading to death by arrhythmia - graves
Antibodies against TSH receptors - II
Fluids - insulin - and K - glucose if necessary to prevent hypoglycemia
18. in which DM is glucose intolerance severe and Which is more mild to moderate
Inside
5- HIAA
DM1 = severe - DM2 = mild to moderate
Waterhouse friderichsen - n meningitidis septicemia
19. What is seen in the urine in carcinoid syndrome
Raises free testosterone and they gey hirsutism
5- HIAA
Riedel's - fixed hard and painless goiter
Inc cortisol after low dose and high dose
20. pituitary adenoma is what kind of oma?
21 hydroxylase - masculinization - hypotension - hyperkalemia - inc plasma renin - volume depletion
FLAT
Prolactinoma
Less likely
21. What is 24 - 25 OH2 vit D
Inc in ACTH because low levels of cortisol
Tonic DA from hypothalamus inhibits - prolactin causes DA synthesis and increases own inhibition - TRH stimulates prolactin
Inactive form
Hyperglycemia - inc H+ - dec bicarb leading to anion gap acidosis - inc blood ketone levels - leukocytosis - hyperkalemia - but depleted intracellular K
22. What are the 4 causes of SIADH
Ectopic ADH in small cell lung cancer - CNS disorder/head trauma - pulmonary diseae - drugs like cyclophosphamide
Zollinger Ellison
DKA - inc insulin requirements from inc stress (infxn) - excess fat breakdown and inc ketogenesis from FFA made into ketone bodies
Thyroid hormones T3/T4
23. What are the labs for free T4 - total T4 and T3 uptake for hypo/hyperthyroidism
25- OH vitamin D
Hypo is low - hyper is high on all
Medullary thyroid carcinoma - calcitonin
Neuroendocrine cells of GI tract
24. autosomal dominant kidney unresponsive to PTH leading to hypocalcemia - shortened 4th/5th digits and short stature
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25. 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
Stim
Blood pressure - dec bone formation - anti - inflammatory - dec immune fxn - inc gluconeogenesis - lipolysis - proteolysis
Inhibits glucagon release
26. The adrenal medulla derives From What embryonic tissue
Neural crest
Less likely
Kidney stones and stomach ulcers
DM1 = dec - DM2 = variable
27. Where is T3 made
Peripheral tissue
Pheochromocytoma
Bound to corticosteroid binding globulin - CGB
Def in aldosterone and cortisol leading to hypotension (hyponatremic volume contraction) hyperkalemia - acidosis - and skin hyperpigmentation
28. Where are the beta cells located in the islets
Inhib
Dec free serum Ca inc PTH secretion - dec free serum Mg dec PTH secretion
Ketone bodies
Inside
29. What are the hormones released from the neurohypophysis and where are they made
PseudohypoPTH - albright's hereditary osteodystrophy
DM1
ADH - oxytocin - made in the hypothalamus and shipped to posterior pituitary
Riedel's - fixed hard and painless goiter
30. What kind of ligands bind intrinsice tyrosine kinase
Pheochromocytoma
Hypocalcemia and tetany
Growth factors - IGF-1 - FGF - and PDGF all MAP kinase pathway
Polydipsia - polyuria - polyphagia - weight loss - DKA (type1) - hyperosmolor coma (type2) unopposed secretion of GH and epi (exacerbating hyperglycemia
31. Gastrin secreting tumor of pancreas or duodenum
Prolactinoma
Zollinger Ellison
Bromocriptine
1/3 metastasize - 1/3 present with 2nd malignancy - and 1/3 multiple
32. What does adrenal insufficiency cause
Def in aldosterone and cortisol leading to hypotension (hyponatremic volume contraction) hyperkalemia - acidosis - and skin hyperpigmentation
Autoimmune - TB - metastasis
Inc PTH - dec Ca - dec PO4 cause inc in active form and then it feedback inhibits its own production
Chief cells of parathyroid
33. How is calcitonin regulated
Inc in serum Ca causes calcitonin secretion
Rapid/deep breathing (Kussmal's resps) N/V - abdominal pain - psychosis/delirium - dehydration - FRUITY breath odor -
Bromocriptine
17alpha - HTN - hypokalemia - in males - dec DHT - externally phenotypic females - in females nl genitals but no secondary sex characteristis
34. most common thyroid cancer - ground glass nuclei - psammona bodies - nuclear grooves - prognosis and risk
Rapid/deep breathing (Kussmal's resps) N/V - abdominal pain - psychosis/delirium - dehydration - FRUITY breath odor -
Excellent prognosis - risk with childhood radiation - papillary carcinoma
DM2
PseudohypoPTH - albright's hereditary osteodystrophy
35. Recurrent diarrhea - cutaneous flushing - asthatic wheezing - right side valvular disease
Diarrhea - aminoglycosides - diuretics - and EtOH
Kidney - 1 -25 OH2 vit d
Carcinoid syndrome
1 = juveline - IDDM - 2 = adult - NIDDM
36. What happens in the dexamethasone suppression test in someone with an ACTH producing pituitary tumor
17alpha - HTN - hypokalemia - in males - dec DHT - externally phenotypic females - in females nl genitals but no secondary sex characteristis
Adenoma - hypercalcemia - hypercalciuria - hypophosohatemia - inc PTH - inc alk phos - inc cAMP in urine - often asymptomatic present as weakness and contipation - groans
Inc cortisol after low dose - dec cortisol after high dose
Cretinism - whereever there is endemic goiter - sporadic version due to defect in T4 formation or thyroid development
37. How does right adrenal gland drain
Inc plasma FFAs - ketogenesis - ketonuria - ketonemia
Type 1
Phenylalaline - tyrosine - L- dopa - dopa - NE - epi
Right adrenal - right adrenal vein - IVC
38. What stimulus causes beta cells to make insulin
Osteitis fibrosa cystica
VMA
ATP from glucose metabolism closing K channels and depolarizing cells - required for adipose and skeletal muscle uptake of glucose
DR5 - antimicrosomal - antithyroglobulin
39. What are the clinical findings of graves
Episodic hyperadrenergic symptoms - pressure - pain (headache) - perspiration - palpitations (tachycardia) - pallor
Direct stimulation of osteoblasts - which indirectly stimulates osteoclastic cells via RANK L (down regulates OPG that usually blocks RANK L from binding RANK)
Proptosis - EOM swelling - pretibial mxyedema - diffuse goiter
Ketone bodies
40. 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
Caused by aldosterone secreting tumor - resulting in HTN - hypokalemia - metaboolic alkalosis low plasma renin - B/L or unilateral
Prolactinoma
17alpha - HTN - hypokalemia - in males - dec DHT - externally phenotypic females - in females nl genitals but no secondary sex characteristis
11beta - HTN because - 11 deoxycorticosterone is a mineralcorticoid and secreted in excess - masculinization because too much DHEA shuttling
41. What do the three endocrine cells of the pancreas secrete
Alpha = glucagon - beta = insulin - delta = somatostatin
Right adrenal - right adrenal vein - IVC
TGB - dec in hepatic failure - inc in pregnancy via estrogen
Neurofibramtosis - MEN types 2A and 2B
42. What is the effect of GHRH on GH
Zollinger Ellison
Small vessel disease - large vessel disease and osmotic drainage
Stim
Diarrhea - aminoglycosides - diuretics - and EtOH
43. What are the clinical findings in cretinism
DM1 = dec - DM2 = variable
Pot - bellied - pale - puffy faced witih protruding umbilicus and protuberant tongue
Adenoma - hypercalcemia - hypercalciuria - hypophosohatemia - inc PTH - inc alk phos - inc cAMP in urine - often asymptomatic present as weakness and contipation - groans
Surgery to remove tumor - sprinolactone - (K sparing diuretic)
44. intense thirst - polyuria and inability to concentrate urine
Inc absorption of dietary Ca and phosphate - inc bone resorption of Ca and phosphate
Stress induced catecholamine surge leading to death by arrhythmia - graves
Blood pressure - dec bone formation - anti - inflammatory - dec immune fxn - inc gluconeogenesis - lipolysis - proteolysis
Diabetes insipidus - lack of ADH - or lack of response to ADH in kidney
45. inc lipolysis leads to...
Stim
1 = juveline - IDDM - 2 = adult - NIDDM
Inc plasma FFAs - ketogenesis - ketonuria - ketonemia
Zona glomerulosa - renin - angiontensin - aldosterone
46. What are neurophysins
Carrier protiens in posterior pituitary that carry hormones in circulation - derived from neuroectoderm
Hyperglycemia - inc H+ - dec bicarb leading to anion gap acidosis - inc blood ketone levels - leukocytosis - hyperkalemia - but depleted intracellular K
Urine osm doesn't inc - and desmopressin admin distinguishes
Left adrenal - left adrenal vein - left renal vein - IVC
47. What is the most common tumor of the adrenal medulla in children
Direct stimulation of osteoblasts - which indirectly stimulates osteoclastic cells via RANK L (down regulates OPG that usually blocks RANK L from binding RANK)
TSH receptor leading to inc release of T3 and T4 - hot nodules are rarely malignant
Neuroblastoma
Inc absorption of dietary Ca and phosphate - inc bone resorption of Ca and phosphate
48. nonenzymatic glycosylation leads to what 3 catageories of defects
Type 1
Alpha antagonists - esp phenoxybenzamine - nonselective - irreversible - surgery to remove tumor
Neuroblastoma
Small vessel disease - large vessel disease and osmotic drainage
49. How does cortisol travel in the blood
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
Bound to corticosteroid binding globulin - CGB
Episodic hyperadrenergic symptoms - pressure - pain (headache) - perspiration - palpitations (tachycardia) - pallor
Small (metastatic) bowel tumors - 5HT goes to liver for first pass -
50. What is the source of thyroid hormone
17alpha - HTN - hypokalemia - in males - dec DHT - externally phenotypic females - in females nl genitals but no secondary sex characteristis
Inhibits glucagon release
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
Follicles of thyroid - most T3 formed in the blood