SUBJECTS
|
BROWSE
|
CAREER CENTER
|
POPULAR
|
JOIN
|
LOGIN
Business Skills
|
Soft Skills
|
Basic Literacy
|
Certifications
About
|
Help
|
Privacy
|
Terms
|
Email
Search
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. In which DM is there a stronger genetic association
Transcellular shif from dec insulin
DM2
5- HIAA
DM1
2. What occurs to beta cells in DM1 vs DM2
Dec in DM1 - variable in DM2 with possible amyloid
DM1 = dec - DM2 = variable
Carrier protiens in posterior pituitary that carry hormones in circulation - derived from neuroectoderm
Dec cortisol after lose dose
3. What is the depleted intracellular K due to in DKA
GnRH - Oxytocin - ADH (V1) - TRH
Central - pituitary tumor - truama - surgery - histiocytosis X and nephrogenic - hereditary - 2ndary to hypoglycemia - lithium - demeclocycline (ADH antagonist)
Inc cortisol after low dose - dec cortisol after high dose
Transcellular shif from dec insulin
4. 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
Rapid/deep breathing (Kussmal's resps) N/V - abdominal pain - psychosis/delirium - dehydration - FRUITY breath odor -
RBC brain
T3/T4 - cytosol
5. What are the labs for free T4 - total T4 and T3 uptake for hypo/hyperthyroidism
All 3 - spares medulla
Hypo is low - hyper is high on all
Stress - exercise and hypoglycemia
Cold intolerance - weight gain - dec appetite - lethargy/fatigue - constipation - dec reflexes - myxedema (facial/periorbital) - dry cool skin - coarse brittle hair - bradycardia - dyspnea on exertion
6. What happens in the dexamethasone suppression test in somoeone with an ectopic ACTH producing tumor
Lumen of follicles - thryglobulin + I2 with MIT and DIT - proteolysis and secrete into blood back through follicular cell
Inc cortisol after low dose and high dose
Neuroendocrine cells of GI tract
FLAT
7. What does insulin do in alpha cells
Pheochromocytoma and PTH
Chvostek's sign
Inhibits glucagon release
1 = viral/immune destruction beta cells - 2 = insulin resistance
8. What are the 2 P's of MEN 2A
Pheochromocytoma and PTH
Antibodies against TSH receptors - II
Neurofibramtosis - MEN types 2A and 2B
Mesoderm
9. The adrenal cortex derives From What embryonic tissue
Ingested from plants
Mesoderm
TRH from the hypothalamus stimulates TSH release from ant pit which stimulates follicular cells - neg feedback to ant bit dec sens to TRH
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
10. What thyroid condition is associated with lymphoma
Inc plasma FFAs - ketogenesis - ketonuria - ketonemia
Hashimotos
Heat intolerance - weight loss - inc appetite - hyperactivity - diarrhea - inc reflexes - pretibial myxedema (graves) warm - moist skin - fine hair - chest pain - palpitations - arrhythmias
Fluids - insulin - and K - glucose if necessary to prevent hypoglycemia
11. Where are carcinoid tumors often found - What do they secrete and where do they go
Adquate fluid intake - central intranasal desmopressin - for nephrogenic use thiazide (for hypernatremia) - amiloride (for hypokalemia) and indomethacin to dec GFR
Small (metastatic) bowel tumors - 5HT goes to liver for first pass -
Dec aldosterone causing hyponatremia which can lead to seizures
Growth factors - IGF-1 - FGF - and PDGF all MAP kinase pathway
12. What is the 1 P of MEN 2B
Prolactin and GH
Prolactin or GH
DM1 = dec - DM2 = variable
Pheochromocytoma
13. What is secondary hyperPTH due to and What are the expected serum values
Medullary thyroid carcinoma - calcitonin
Polydipsia - polyuria - polyphagia - weight loss - DKA (type1) - hyperosmolor coma (type2) unopposed secretion of GH and epi (exacerbating hyperglycemia
Stim
Due to dec gut absorption of Ca - inc PO4 due to chronic renal disease (no vit D) hypOcalcemia - hyperphophatemia - inc alk phos - inc PTH
14. Which steroid receptors are nuclear and where are the others located
T3/T4 - cytosol
Z- E - insulinomas - VIPomas - glucagonomas are rare
Neurofibramtosis - MEN types 2A and 2B
ADH - oxytocin - made in the hypothalamus and shipped to posterior pituitary
15. 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
17alpha - HTN - hypokalemia - in males - dec DHT - externally phenotypic females - in females nl genitals but no secondary sex characteristis
Cretinism - whereever there is endemic goiter - sporadic version due to defect in T4 formation or thyroid development
Pot - bellied - pale - puffy faced witih protruding umbilicus and protuberant tongue
Subactute thyroiditis - granulomatous inflammation - elev ESR - jaw pain - ealy inflammation - tender thyroid
16. What is the TX for carcinoid syndrome
DM2
Prolactinoma
Octreotide
Fluids - insulin - and K - glucose if necessary to prevent hypoglycemia
17. What kind of cells are in the adrenal medulla and What do they secrete
Renal osteodystrophy
Chromaffin cells - catecholamines
Amenorrhea - galactorrhea - low libido - infertility from dec GnRH - - bitemporal heminanopia from imgingement of optic chiasm
No - proinsulin to insulin + C peptide
18. What drugs cause shrinkage of prolactinoma
Proptosis - EOM swelling - pretibial mxyedema - diffuse goiter
Bromocriptine or cabergoline
DM1
Parafollicular cells of thyroid (C cells) - dec bone resorption of Ca
19. In what instances in an inc in GH normal
Inhibits glucagon release
Stress - exercise and hypoglycemia
Lower free testosterone and gynecomastia
Bidirectional - beta cells - liver kidney - small intestine
20. What are two examples of ectopic ACTH producing tumors
During stress - childbirth
Inside
Diabetes insipidus - lack of ADH - or lack of response to ADH in kidney
Small cell lung cancer and bronchial carcinoids
21. What is the fxn of prolactin
Milk production in females and spermatogenesis in males (by inhibiting GnRH synthesis and release
No - proinsulin to insulin + C peptide
Hypocalcemia and tetany
Diabetes insipidus - lack of ADH - or lack of response to ADH in kidney
22. inc lipolysis leads to...
Stress induced catecholamine surge leading to death by arrhythmia - graves
Sun exposure in skin
Inc plasma FFAs - ketogenesis - ketonuria - ketonemia
Carrier protiens in posterior pituitary that carry hormones in circulation - derived from neuroectoderm
23. What is the tx for hyperaldosteronism
Surgery to remove tumor - sprinolactone - (K sparing diuretic)
FLAT
Hashimotos thyroiditis
Bound to corticosteroid binding globulin - CGB
24. In graves dz - what pathological antibody is produced - and what kind of hypersens rxn is it?
Antibodies against TSH receptors - II
Medullary thyroid carcinoma - calcitonin
Bidirectional - beta cells - liver kidney - small intestine
Dec in DM1 - variable in DM2 with possible amyloid
25. What is the histology with hashimotos thyroiditis
Subactute thyroiditis - granulomatous inflammation - elev ESR - jaw pain - ealy inflammation - tender thyroid
Pheochromocytoma
Hurthle cells - lymphocytic infiltrate with germinal centers
Inc serum IGF-1 - failure to suppress serum GH following oral glucose tolerance test
26. What is the effect of GHRH on GH
Dec aldosterone causing hyponatremia which can lead to seizures
Stim
Mesoderm
Parafollicular C cells - calcitonin histo = sheets of cells in amyloid stroma - associated with MEN 2A/2B
27. When does graves typically present
Prolactin or GH
Surgery to remove tumor - sprinolactone - (K sparing diuretic)
During stress - childbirth
Peroxidase
28. What is the tx for SIADH
PTH = inc ca reabsorption and dec PO4 reabsorption in DIC - active vit D = inc absorption of both in gut
Demeclocycline or H2O restriction
Cushing's
Hashimotos
29. What is the rule of 10s in pheochromocytoma
TGB - dec in hepatic failure - inc in pregnancy via estrogen
10% malignant - 10% bilateral - 10% extra - adrenal - 10% calcify - 10% kids - 10% familial
Cold intolerance - weight gain - dec appetite - lethargy/fatigue - constipation - dec reflexes - myxedema (facial/periorbital) - dry cool skin - coarse brittle hair - bradycardia - dyspnea on exertion
All 3 - spares medulla
30. What causes secdonary hyperaldosteronism and what plasma marker is different from primary
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
Metanephrine
Hurthle cells - lymphocytic infiltrate with germinal centers
Inc plasma amino acids - nitrogen loss in urine
31. How can hashimotos present that is not typical hypothyroidism
Diabetes insipidus - lack of ADH - or lack of response to ADH in kidney
Hyperthyroid early in course - thyrotoxicosis during follicular rupture
Small vessel disease - large vessel disease and osmotic drainage
1/3 metastasize - 1/3 present with 2nd malignancy - and 1/3 multiple
32. What is the next layer in from ZG - What is its primary control - What does it secrete
Zona fasciculata - ACTH - hypothalamic CRH - cortisol/sex hormones
Medullary thyroid carcinoma with calcitonin and oral/intestinal ganglioneuromatosis (associated with marfanoid habitus)
Dec cortisol after lose dose
Carrier protiens in posterior pituitary that carry hormones in circulation - derived from neuroectoderm
33. What is the effect of CRH on ACTH
Renal osteodystrophy
Inc in serum Ca causes calcitonin secretion
Stim
Hyperglycemia - inc H+ - dec bicarb leading to anion gap acidosis - inc blood ketone levels - leukocytosis - hyperkalemia - but depleted intracellular K
34. What is the common etiology of primary hyperPTH and What are the expected changes in serum and urine - How does it present
Adenoma - hypercalcemia - hypercalciuria - hypophosohatemia - inc PTH - inc alk phos - inc cAMP in urine - often asymptomatic present as weakness and contipation - groans
Milk production in females and spermatogenesis in males (by inhibiting GnRH synthesis and release
Waterhouse friderichsen - n meningitidis septicemia
Kids = rickets - adults = osteomalacia
35. All three effects of hyperinsulinemia lead to which two clinical features
Parafollicular cells of thyroid (C cells) - dec bone resorption of Ca
Raises free testosterone and they gey hirsutism
Dehydration and acidosis leading to coma and death
Kidney - 1 -25 OH2 vit d
36. What diseases can cause primary adrenal insufficiency
Insulin responsive - adipose and skeletal muscle
Zona fasiculata
5- HIAA
Autoimmune - TB - metastasis
37. in which DM is glucose intolerance severe and Which is more mild to moderate
DM1 = severe - DM2 = mild to moderate
Dec cortisol after lose dose
Renal osteodystrophy
GnRH - Oxytocin - ADH (V1) - TRH
38. What is octreotide
Neuroblastoma
Somatostatin analog
Bromocriptine or cabergoline
Tonic DA from hypothalamus inhibits - prolactin causes DA synthesis and increases own inhibition - TRH stimulates prolactin
39. What is the difference in PTH vs active vit d
21 hydroxylase - masculinization - hypotension - hyperkalemia - inc plasma renin - volume depletion
Inc cortisol after low dose and high dose
Zona fasiculata
PTH = inc ca reabsorption and dec PO4 reabsorption in DIC - active vit D = inc absorption of both in gut
40. What are the clinical findings with hashimotos
Growth factors - IGF-1 - FGF - and PDGF all MAP kinase pathway
1 = juveline - IDDM - 2 = adult - NIDDM
Moderatly enlarged nontender thyroid
Hypocalcemia and tetany
41. autosomal dominant kidney unresponsive to PTH leading to hypocalcemia - shortened 4th/5th digits and short stature
42. What happens in the dexamethasone suppression test in someone with a cortisol producing tumor
Zollinger Ellison
Gigantism - linear bone growth
Inc cortisol after low and high dose
Trousseau's sign
43. What is the effect of somatostatin on GH and TSH
Inc cortisol after low dose and high dose
Inhib
Fluids - insulin - and K - glucose if necessary to prevent hypoglycemia
Stress induced catecholamine surge leading to death by arrhythmia - graves
44. What carcinoma is common in MEN 2A and What does it secrete
Sun exposure in skin
Trousseau's sign
Neuroblastoma
Medullary thyroid carcinoma - calcitonin
45. What is the most common tumor of the adrenal medulla in children
Osteitis fibrosa cystica
Neuroblastoma
Urine osm doesn't inc - and desmopressin admin distinguishes
Toxic multinodular goiter
46. iodine containing hormones that control the body's metabolic rate
Thyroid hormones T3/T4
Nonenzymatic glycosylation
Inc cortisol after low dose and high dose
MSH - a by product of inc ACTH production from POMC
47. Where do you see GLUT 2 transporter
Bidirectional - beta cells - liver kidney - small intestine
T3/T4 - cytosol
AD
Diffuse thickening of the BM
48. In which DM is polyuria - polydipsia - thirst and weight loss more common
Due to dec gut absorption of Ca - inc PO4 due to chronic renal disease (no vit D) hypOcalcemia - hyperphophatemia - inc alk phos - inc PTH
DM1
Inc serum IGF-1 - failure to suppress serum GH following oral glucose tolerance test
HTN - weight gain - moon facies - truncal obesity - buffalo hump - hyperglycemia - skin thinning and striae - osteoporosis - amenorrhea - immune suppression
49. hyperthyroidism signs/symptoms
Osteitis fibrosa cystica
Alpha antagonists - esp phenoxybenzamine - nonselective - irreversible - surgery to remove tumor
Heat intolerance - weight loss - inc appetite - hyperactivity - diarrhea - inc reflexes - pretibial myxedema (graves) warm - moist skin - fine hair - chest pain - palpitations - arrhythmias
Pancreas - pituitary and PTH
50. What 3 things does insuline def and glucagon excess lead to...
Medullary thyroid carcinoma with calcitonin and oral/intestinal ganglioneuromatosis (associated with marfanoid habitus)
Zona fasciculata - ACTH - hypothalamic CRH - cortisol/sex hormones
Hyperglycemia - inc H+ - dec bicarb leading to anion gap acidosis - inc blood ketone levels - leukocytosis - hyperkalemia - but depleted intracellular K
Dec glucose uptake - inc protein catabolism - inc lipolysis