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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. Where are carcinoid tumors often found - What do they secrete and where do they go
Islets of langerhans are collections of alpha - beta and delta
Proptosis - EOM swelling - pretibial mxyedema - diffuse goiter
Dec aldosterone causing hyponatremia which can lead to seizures
Small (metastatic) bowel tumors - 5HT goes to liver for first pass -
2. What is the general chronic manifestation of DM
PseudohypoPTH - albright's hereditary osteodystrophy
DR5 - antimicrosomal - antithyroglobulin
10% malignant - 10% bilateral - 10% extra - adrenal - 10% calcify - 10% kids - 10% familial
Nonenzymatic glycosylation
3. self - limiting hypothyroidism following a flu - like illness - dz - hist - and findings
Hyperglycemia - inc H+ - dec bicarb leading to anion gap acidosis - inc blood ketone levels - leukocytosis - hyperkalemia - but depleted intracellular K
Waterhouse friderichsen - n meningitidis septicemia
Subactute thyroiditis - granulomatous inflammation - elev ESR - jaw pain - ealy inflammation - tender thyroid
Type 1
4. What drugs cause shrinkage of prolactinoma
Kidney - 1 -25 OH2 vit d
Inc absorption of dietary Ca and phosphate - inc bone resorption of Ca and phosphate
Zollinger Ellison
Bromocriptine or cabergoline
5. cholecalciferol
Vitamin d
Urine specific grav < 1.006 - serum osm > 290
DM1 - HLA- DR3 and DR4
Medullary thyroid carcinoma with calcitonin and oral/intestinal ganglioneuromatosis (associated with marfanoid habitus)
6. What is the effect of prolactin on GnRH
17alpha - HTN - hypokalemia - in males - dec DHT - externally phenotypic females - in females nl genitals but no secondary sex characteristis
Metanephrine
Less likely
Inhib
7. In which DM is there an islet cell leukocytic infiltrate and what kind of infiltrate does the other have
MSH - a by product of inc ACTH production from POMC
Anwhere along the sympathetic chaing - HVA - N- myc
Antibodies against TSH receptors - II
DM1 - DM2 has islet amyloid deposit
8. How does MEN type 1 usually present
Kidney stones and stomach ulcers
GH - prolactin also IL-2
Dec free serum Ca inc PTH secretion - dec free serum Mg dec PTH secretion
RBC brain
9. How is thyroid hormone regulated
TRH from the hypothalamus stimulates TSH release from ant pit which stimulates follicular cells - neg feedback to ant bit dec sens to TRH
Retinopathy (hemorrhage - exudates - microanuerysms - vessel proliferation) - glaucoma - nephropathy (noduclar sclerosis - progressive proteinuria - CRF) - arteriosclerosis leading to HTN - kimmelstiel wilson nodules
Type 1
Stim
10. nonenzymatic glycosylation leads to what 3 catageories of defects
HTN - weight gain - moon facies - truncal obesity - buffalo hump - hyperglycemia - skin thinning and striae - osteoporosis - amenorrhea - immune suppression
Small vessel disease - large vessel disease and osmotic drainage
Free hormone is active T3 bind more than T4
Mucormycosis - Rhizopus infxn - cerebral edema - cardia arrhythmias - HF
11. How do you diagnose GH abnl?
Inc serum IGF-1 - failure to suppress serum GH following oral glucose tolerance test
Trousseau's sign
Inactive form
Undifferentiated/anaplastic
12. In which DM is there a stronger genetic association
DM1
Osteitis fibrosa cystica
DM2
DM1 = dec - DM2 = variable
13. tapping of the facial nerve leads to contraction of facial muscles
14. What is the serum insulin level of DM1 vs DM2
Def in aldosterone and cortisol leading to hypotension (hyponatremic volume contraction) hyperkalemia - acidosis - and skin hyperpigmentation
DKA - inc insulin requirements from inc stress (infxn) - excess fat breakdown and inc ketogenesis from FFA made into ketone bodies
DM1 = dec - DM2 = variable
Tonic DA from hypothalamus inhibits - prolactin causes DA synthesis and increases own inhibition - TRH stimulates prolactin
15. In what hormones are the alpha subunit the same
Dehydration and acidosis leading to coma and death
Most antipsychotics and all OCPs - estrogen in pregs
PseudohypoPTH - albright's hereditary osteodystrophy
FLT - hCG
16. Where are the beta cells located in the islets
FLAT
Proptosis - EOM swelling - pretibial mxyedema - diffuse goiter
Inside
Cretinism - whereever there is endemic goiter - sporadic version due to defect in T4 formation or thyroid development
17. pituitary adenoma is what kind of oma?
DM1 = severe - DM2 = mild to moderate
Urine osm doesn't inc - and desmopressin admin distinguishes
Hypo is low - hyper is high on all
Prolactinoma
18. Do pts with neuroblastoma develop HTN
Less likely
Alpha = glucagon - beta = insulin - delta = somatostatin
Cushing's
Demeclocycline or H2O restriction
19. Where can neuroblastomas occur - What do you see elevated in the urine and what oncogene is associated
Beta - hydroxybutyrate > acetoacetate
Inactive form
Pheochromocytoma
Anwhere along the sympathetic chaing - HVA - N- myc
20. What other conditions are associated with MEN 2B
Hyperglycemia - glucosuria - osmotic diureses - lyte depletion
Pheochromocytoma and PTH
Medullary thyroid carcinoma with calcitonin and oral/intestinal ganglioneuromatosis (associated with marfanoid habitus)
Trousseau's sign
21. What is a good test for primary hypo/hyperthyroidism and What do you expect to see in both
DM1 = severe - DM2 = mild to moderate
Free hormone is active T3 bind more than T4
TSH - elevated in hypo - low in hyper
Dec free serum Ca inc PTH secretion - dec free serum Mg dec PTH secretion
22. What does insulin do in alpha cells
Inhibits glucagon release
Fluids - insulin - and K - glucose if necessary to prevent hypoglycemia
Accidental surgical excision - autoimmune destruction and DiGeorge syndrome
T3/T4 - cytosol
23. What other diseases or syndromes are associated with pheochromocytoma
Peroxidase
Neurofibramtosis - MEN types 2A and 2B
Follicular carcinoma of thyroid
HTN - weight gain - moon facies - truncal obesity - buffalo hump - hyperglycemia - skin thinning and striae - osteoporosis - amenorrhea - immune suppression
24. What 3 things does insuline def and glucagon excess lead to...
DR5 - antimicrosomal - antithyroglobulin
Rapid/deep breathing (Kussmal's resps) N/V - abdominal pain - psychosis/delirium - dehydration - FRUITY breath odor -
Z- E - insulinomas - VIPomas - glucagonomas are rare
Dec glucose uptake - inc protein catabolism - inc lipolysis
25. What does the stomach show in Zollinger Ellison
RBC brain
Chromaffin cells - catecholamines
Rugal thickening and acid hypersecretion causing recurrent ulcers - associated with MEN type 1
Stim
26. What vasodilators use the cGMP pathway
FLT - hCG
Lumen of follicles - thryglobulin + I2 with MIT and DIT - proteolysis and secrete into blood back through follicular cell
HTN - weight gain - moon facies - truncal obesity - buffalo hump - hyperglycemia - skin thinning and striae - osteoporosis - amenorrhea - immune suppression
ANP - NO and EDRF
27. What hormones are secreted from the adenohypophysis
Lower free testosterone and gynecomastia
FLAT PiG - FSH - LH - ACTH - TSH - Prolactin - GH
Accidental surgical excision - autoimmune destruction and DiGeorge syndrome
Antibodies against TSH receptors - II
28. What happens in the dexamethasone suppression test in somoeone with an ectopic ACTH producing tumor
Chromaffin cells from NC
DM2
Undifferentiated/anaplastic
Inc cortisol after low dose and high dose
29. What are two examples of ectopic ACTH producing tumors
Small cell lung cancer and bronchial carcinoids
Transcellular shif from dec insulin
Zona glomerulosa - renin - angiontensin - aldosterone
Carcinoid syndrome
30. What are the urine and serum findings in diabetes insipidus
Toxic multinodular goiter
Dec cortisol after lose dose
Prolactinoma
Urine specific grav < 1.006 - serum osm > 290
31. When is the onset of DM1 vs DM2 causing what kind of DM
Inc serum IGF-1 - failure to suppress serum GH following oral glucose tolerance test
Adquate fluid intake - central intranasal desmopressin - for nephrogenic use thiazide (for hypernatremia) - amiloride (for hypokalemia) and indomethacin to dec GFR
1 = juveline - IDDM - 2 = adult - NIDDM
Trousseau's sign
32. How is prolactin secretion regulated
Tonic DA from hypothalamus inhibits - prolactin causes DA synthesis and increases own inhibition - TRH stimulates prolactin
Carcinoid syndrome
Removal of pituitary adenoma and octreotide
Hyperglycemia - inc H+ - dec bicarb leading to anion gap acidosis - inc blood ketone levels - leukocytosis - hyperkalemia - but depleted intracellular K
33. What is the source of calcitonin and What does it do
Caused by aldosterone secreting tumor - resulting in HTN - hypokalemia - metaboolic alkalosis low plasma renin - B/L or unilateral
Parafollicular cells of thyroid (C cells) - dec bone resorption of Ca
1 = viral/immune destruction beta cells - 2 = insulin resistance
Excellent prognosis - risk with childhood radiation - papillary carcinoma
34. What is secondary adrenal insuff and how can you distinguish it from primary
Zona glomerulosa - renin - angiontensin - aldosterone
TGB - dec in hepatic failure - inc in pregnancy via estrogen
Dec in pit ACTH production - no skin hyperpigmentation and no hyperkalemia
All 3 - spares medulla
35. pheochromocytoma rule of 5 P's - What are they
Diffuse thickening of the BM
Type 1
Episodic hyperadrenergic symptoms - pressure - pain (headache) - perspiration - palpitations (tachycardia) - pallor
Central - pituitary tumor - truama - surgery - histiocytosis X and nephrogenic - hereditary - 2ndary to hypoglycemia - lithium - demeclocycline (ADH antagonist)
36. When does graves typically present
HTN - weight gain - moon facies - truncal obesity - buffalo hump - hyperglycemia - skin thinning and striae - osteoporosis - amenorrhea - immune suppression
Neural crest
Heat intolerance - weight loss - inc appetite - hyperactivity - diarrhea - inc reflexes - pretibial myxedema (graves) warm - moist skin - fine hair - chest pain - palpitations - arrhythmias
During stress - childbirth
37. hypothyroidism - signs/symptoms
Cold intolerance - weight gain - dec appetite - lethargy/fatigue - constipation - dec reflexes - myxedema (facial/periorbital) - dry cool skin - coarse brittle hair - bradycardia - dyspnea on exertion
Insulin responsive - adipose and skeletal muscle
Alpha = glucagon - beta = insulin - delta = somatostatin
Renal osteodystrophy
38. Carcoid tumors are derived From what cells
DM1
Medullary thyroid carcinoma - calcitonin
Hypocalcemia and tetany
Neuroendocrine cells of GI tract
39. intense thirst - polyuria and inability to concentrate urine
Alpha = glucagon - beta = insulin - delta = somatostatin
Diabetes insipidus - lack of ADH - or lack of response to ADH in kidney
Epi - norepi - and DA - epidosic HTN - urinary VMA and elevated catecholamines
Stim
40. DM1 complication - most important - pathogenesis
Dec in DM1 - variable in DM2 with possible amyloid
Waterhouse friderichsen - n meningitidis septicemia
Stim
DKA - inc insulin requirements from inc stress (infxn) - excess fat breakdown and inc ketogenesis from FFA made into ketone bodies
41. Where is the source of PTH
Diarrhea - aminoglycosides - diuretics - and EtOH
Chief cells of parathyroid
Diffuse thickening of the BM
Inhib
42. How does cortisol travel in the blood
Def in aldosterone and cortisol leading to hypotension (hyponatremic volume contraction) hyperkalemia - acidosis - and skin hyperpigmentation
Sun exposure in skin
Growth factors - IGF-1 - FGF - and PDGF all MAP kinase pathway
Bound to corticosteroid binding globulin - CGB
43. What are the findings of hypoPTH
Bromocriptine
Osteitis fibrosa cystica
Hypocalcemia and tetany
DR5 - antimicrosomal - antithyroglobulin
44. Where are T3/T4 made
Stim
Toxic multinodular goiter
Stim
Lumen of follicles - thryglobulin + I2 with MIT and DIT - proteolysis and secrete into blood back through follicular cell
45. How does the left adrenal gland drain
Hyperthyroid early in course - thyrotoxicosis during follicular rupture
Left adrenal - left adrenal vein - left renal vein - IVC
Polydipsia - polyuria - polyphagia - weight loss - DKA (type1) - hyperosmolor coma (type2) unopposed secretion of GH and epi (exacerbating hyperglycemia
Hashimotos thyroiditis
46. What is the histology with hashimotos thyroiditis
Zollinger Ellison
Octreotide
Hurthle cells - lymphocytic infiltrate with germinal centers
No - proinsulin to insulin + C peptide
47. What are the consequences of thyrotoxicisos - and who is at risk
Stress induced catecholamine surge leading to death by arrhythmia - graves
Kidney - 1 -25 OH2 vit d
1/3 metastasize - 1/3 present with 2nd malignancy - and 1/3 multiple
Carrier protiens in posterior pituitary that carry hormones in circulation - derived from neuroectoderm
48. What happens to women with dec SHBG
Pheochromocytoma and PTH
Proptosis - EOM swelling - pretibial mxyedema - diffuse goiter
Raises free testosterone and they gey hirsutism
Beta - hydroxybutyrate > acetoacetate
49. What are the 4 fxns of PTH
Vitamin d
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
DR5 - antimicrosomal - antithyroglobulin
Chromaffin cells from NC
50. in which DM is glucose intolerance severe and Which is more mild to moderate
Urine specific grav < 1.006 - serum osm > 290
Inc cortisol after low dose - dec cortisol after high dose
Stim
DM1 = severe - DM2 = mild to moderate