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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 seen in the urine in carcinoid syndrome
Inc cortisol after low and high dose
Hypocalcemia and tetany
5- HIAA
Peripheral tissue
2. thyroid cancer in older patients with poor prognosis
ADH - oxytocin - made in the hypothalamus and shipped to posterior pituitary
Undifferentiated/anaplastic
Dec in DM1 - variable in DM2 with possible amyloid
Lumen of follicles - thryglobulin + I2 with MIT and DIT - proteolysis and secrete into blood back through follicular cell
3. What are the 3 P's of MEN type 1 (Werners)
Pancreas - pituitary and PTH
Inactive form
Right adrenal - right adrenal vein - IVC
MSH - a by product of inc ACTH production from POMC
4. What vitamin D conversion takes place in the kidney
1 -25 OH2 vitamin D (active form)
Inhibits glucagon release
Hurthle cells - lymphocytic infiltrate with germinal centers
Inc PTH - dec Ca - dec PO4 cause inc in active form and then it feedback inhibits its own production
5. What is the tx for hyperaldosteronism
Kids = rickets - adults = osteomalacia
Hashimotos thyroiditis
1/3 metastasize - 1/3 present with 2nd malignancy - and 1/3 multiple
Surgery to remove tumor - sprinolactone - (K sparing diuretic)
6. What is the general chronic manifestation of DM
Inactive form
Dec in pit ACTH production - no skin hyperpigmentation and no hyperkalemia
Nonenzymatic glycosylation
AD
7. Where is cortisol made?
Z- E - insulinomas - VIPomas - glucagonomas are rare
Zona fasiculata
Hyperglycemia - glucosuria - osmotic diureses - lyte depletion
MSH - a by product of inc ACTH production from POMC
8. In what instances in an inc in GH normal
Stress - exercise and hypoglycemia
1 = juveline - IDDM - 2 = adult - NIDDM
DM1
Raises free testosterone and they gey hirsutism
9. Which ketone bodies are more common in DKA
Diabetes insipidus - lack of ADH - or lack of response to ADH in kidney
Excellent prognosis - risk with childhood radiation - papillary carcinoma
Stress - exercise and hypoglycemia
Beta - hydroxybutyrate > acetoacetate
10. occlusion of brachial artery with BP cuff leads to carpal spasm
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11. What is the depleted intracellular K due to in DKA
Transcellular shif from dec insulin
Hypocalcemia and tetany
Pot - bellied - pale - puffy faced witih protruding umbilicus and protuberant tongue
Inhib
12. What kind of ligands bind intrinsice tyrosine kinase
Demeclocycline or H2O restriction
GnRH - Oxytocin - ADH (V1) - TRH
Growth factors - IGF-1 - FGF - and PDGF all MAP kinase pathway
FLT - hCG
13. What are the anabolic effects of insulin
Inc glucose transport - inc glycogen synthesis and storage - inc triglyceride synthesis and storage - inc Na retention in kidney - inc protein synthesis in muscle - inc cellular uptake of K and amino acids
Kidney stones and stomach ulcers
Dec free serum Ca inc PTH secretion - dec free serum Mg dec PTH secretion
Prolactin or GH
14. intense thirst - polyuria and inability to concentrate urine
Diabetes insipidus - lack of ADH - or lack of response to ADH in kidney
Inc cortisol after low dose - dec cortisol after high dose
Small vessel disease - large vessel disease and osmotic drainage
Hashimotos
15. In which type of DM is insulin always necessary
Peroxidase
Neuroblastoma
TGB - dec in hepatic failure - inc in pregnancy via estrogen
Type 1
16. Where are T3/T4 made
Excessive water retenion - hyponatremia - urine osm > serum osm
Prolactin and GH
1 = viral/immune destruction beta cells - 2 = insulin resistance
Lumen of follicles - thryglobulin + I2 with MIT and DIT - proteolysis and secrete into blood back through follicular cell
17. 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
1 = viral/immune destruction beta cells - 2 = insulin resistance
Neurofibramtosis - MEN types 2A and 2B
Proptosis - EOM swelling - pretibial mxyedema - diffuse goiter
18. What is the source of D2
Heat intolerance - weight loss - inc appetite - hyperactivity - diarrhea - inc reflexes - pretibial myxedema (graves) warm - moist skin - fine hair - chest pain - palpitations - arrhythmias
DM1 - HLA- DR3 and DR4
Ingested from plants
FLAT
19. What are the findings of hypoPTH
Hypocalcemia and tetany
Lower free testosterone and gynecomastia
Inc glucose transport - inc glycogen synthesis and storage - inc triglyceride synthesis and storage - inc Na retention in kidney - inc protein synthesis in muscle - inc cellular uptake of K and amino acids
Neuroendocrine cells of GI tract
20. How is PTH regulated
Dec free serum Ca inc PTH secretion - dec free serum Mg dec PTH secretion
ATP from glucose metabolism closing K channels and depolarizing cells - required for adipose and skeletal muscle uptake of glucose
Free hormone is active T3 bind more than T4
Peroxidase
21. What are the urine and serum findings in diabetes insipidus
Mesoderm
Urine specific grav < 1.006 - serum osm > 290
No - proinsulin to insulin + C peptide
Inside
22. hyperthyroidism signs/symptoms
Heat intolerance - weight loss - inc appetite - hyperactivity - diarrhea - inc reflexes - pretibial myxedema (graves) warm - moist skin - fine hair - chest pain - palpitations - arrhythmias
Medullary thyroid carcinoma with calcitonin and oral/intestinal ganglioneuromatosis (associated with marfanoid habitus)
Dehydration and acidosis leading to coma and death
DM1 = dec - DM2 = variable
23. What drugs cause shrinkage of prolactinoma
Bromocriptine or cabergoline
Somatostatin analog
Bromocriptine
Carcinoid syndrome
24. Describe the signs and symptoms of DKA
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25. What carcinoma is common in MEN 2A and What does it secrete
Small (metastatic) bowel tumors - 5HT goes to liver for first pass -
Adenoma - hypercalcemia - hypercalciuria - hypophosohatemia - inc PTH - inc alk phos - inc cAMP in urine - often asymptomatic present as weakness and contipation - groans
Medullary thyroid carcinoma - calcitonin
Fluids - insulin - and K - glucose if necessary to prevent hypoglycemia
26. In which DM is there a stronger genetic association
Moderatly enlarged nontender thyroid
Free hormone is active T3 bind more than T4
DM2
Inhib
27. What is the next layer in from the ZF - What is its primary control and What does it secrete
Lumen of follicles - thryglobulin + I2 with MIT and DIT - proteolysis and secrete into blood back through follicular cell
Zona reticularis - ACTH hypothalamic CRH - sex hormones - androgens
Autoimmune - TB - metastasis
Proptosis - EOM swelling - pretibial mxyedema - diffuse goiter
28. How is calcitonin regulated
Raises free testosterone and they gey hirsutism
Inc in serum Ca causes calcitonin secretion
DM2
FLAT
29. In which DM is there an HLA association and What is it
Somatostatin analog
DM1 - HLA- DR3 and DR4
Anwhere along the sympathetic chaing - HVA - N- myc
Renal osteodystrophy
30. What is the serum insulin level of DM1 vs DM2
DM1 = dec - DM2 = variable
Adenoma - hypercalcemia - hypercalciuria - hypophosohatemia - inc PTH - inc alk phos - inc cAMP in urine - often asymptomatic present as weakness and contipation - groans
Dec in pit ACTH production - no skin hyperpigmentation and no hyperkalemia
Antibodies against TSH receptors - II
31. Where are carcinoid tumors often found - What do they secrete and where do they go
Small (metastatic) bowel tumors - 5HT goes to liver for first pass -
Subactute thyroiditis - granulomatous inflammation - elev ESR - jaw pain - ealy inflammation - tender thyroid
Def in aldosterone and cortisol leading to hypotension (hyponatremic volume contraction) hyperkalemia - acidosis - and skin hyperpigmentation
Hypo is low - hyper is high on all
32. What HLA association is with hashimotos and what kind of autoantibodies
ANP - NO and EDRF
Pheochromocytoma
1/3 metastasize - 1/3 present with 2nd malignancy - and 1/3 multiple
DR5 - antimicrosomal - antithyroglobulin
33. inc cortisol creates what syndrome
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34. What MEN syndromes are associated with the ret gene
Parafollicular cells of thyroid (C cells) - dec bone resorption of Ca
Pheochromocytoma
Inc cortisol after low dose - dec cortisol after high dose
2A and 2B
35. What are the 4 causes of SIADH
Carcinoid syndrome
Ectopic ADH in small cell lung cancer - CNS disorder/head trauma - pulmonary diseae - drugs like cyclophosphamide
Inhib
Vitamin d
36. What does fetal hypothyroidism cause - where do you see this birth defect endemically - and What causes the sporadic form
Bromocriptine or cabergoline
Renal osteodystrophy
Cretinism - whereever there is endemic goiter - sporadic version due to defect in T4 formation or thyroid development
Pheochromocytoma
37. What are the clinical findings with hashimotos
Growth factors - IGF-1 - FGF - and PDGF all MAP kinase pathway
Dehydration and acidosis leading to coma and death
Moderatly enlarged nontender thyroid
Stim
38. What is the difference in PTH vs active vit d
PTH = inc ca reabsorption and dec PO4 reabsorption in DIC - active vit D = inc absorption of both in gut
Insulin responsive - adipose and skeletal muscle
BRICK L - brain - RBC - intestine - cornea - kidney - liver
Transcellular shif from dec insulin
39. What is the most common cause of hypothyroidism
PTH = inc ca reabsorption and dec PO4 reabsorption in DIC - active vit D = inc absorption of both in gut
Carrier protiens in posterior pituitary that carry hormones in circulation - derived from neuroectoderm
Hashimotos thyroiditis
DKA - inc insulin requirements from inc stress (infxn) - excess fat breakdown and inc ketogenesis from FFA made into ketone bodies
40. What happens in the dexamethasone suppression test in somoeone with an ectopic ACTH producing tumor
Neural crest
Inc cortisol after low dose and high dose
TSH receptor leading to inc release of T3 and T4 - hot nodules are rarely malignant
Stim
41. In which type of DM is ketoacidosis more common
Inc cortisol after low dose and high dose
Inside
DM1
Right adrenal - right adrenal vein - IVC
42. What are the likely causes of hypoPTH
DKA - inc insulin requirements from inc stress (infxn) - excess fat breakdown and inc ketogenesis from FFA made into ketone bodies
Tonic DA from hypothalamus inhibits - prolactin causes DA synthesis and increases own inhibition - TRH stimulates prolactin
Polydipsia - polyuria - polyphagia - weight loss - DKA (type1) - hyperosmolor coma (type2) unopposed secretion of GH and epi (exacerbating hyperglycemia
Accidental surgical excision - autoimmune destruction and DiGeorge syndrome
43. where do you see GLUT 4 transporter
Medullary thyroid carcinoma with calcitonin and oral/intestinal ganglioneuromatosis (associated with marfanoid habitus)
Insulin responsive - adipose and skeletal muscle
Renal osteodystrophy
Stim
44. How does cortisol travel in the blood
BRICK L - brain - RBC - intestine - cornea - kidney - liver
Bound to corticosteroid binding globulin - CGB
Undifferentiated/anaplastic
Removal of pituitary adenoma and octreotide
45. What is the pathway of catecholamine production
Polydipsia - polyuria - polyphagia - weight loss - DKA (type1) - hyperosmolor coma (type2) unopposed secretion of GH and epi (exacerbating hyperglycemia
Phenylalaline - tyrosine - L- dopa - dopa - NE - epi
Hashimotos thyroiditis
Chvostek's sign
46. How can hashimotos present that is not typical hypothyroidism
Hyperthyroid early in course - thyrotoxicosis during follicular rupture
ATP from glucose metabolism closing K channels and depolarizing cells - required for adipose and skeletal muscle uptake of glucose
Hyperglycemia - glucosuria - osmotic diureses - lyte depletion
Pancreas - pituitary and PTH
47. What 3 things does insuline def and glucagon excess lead to...
ATP from glucose metabolism closing K channels and depolarizing cells - required for adipose and skeletal muscle uptake of glucose
Dec glucose uptake - inc protein catabolism - inc lipolysis
No - proinsulin to insulin + C peptide
Thyroid hormones T3/T4
48. What does the brain use for fuel in starvation
Peroxidase
Ketone bodies
DM1
Bromocriptine or cabergoline
49. What stimulus causes beta cells to make insulin
ATP from glucose metabolism closing K channels and depolarizing cells - required for adipose and skeletal muscle uptake of glucose
Accidental surgical excision - autoimmune destruction and DiGeorge syndrome
Anwhere along the sympathetic chaing - HVA - N- myc
Bromocriptine or cabergoline
50. What is the effect of GnRH on FSH and LH
Stim
Prolactinoma
Inhib
Dec in pit ACTH production - no skin hyperpigmentation and no hyperkalemia