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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 the effect of CRH on ACTH
Parafollicular cells of thyroid (C cells) - dec bone resorption of Ca
Stim
Diffuse thickening of the BM
Prolactinoma
2. in which DM is glucose intolerance severe and Which is more mild to moderate
DM1 = severe - DM2 = mild to moderate
Dec in DM1 - variable in DM2 with possible amyloid
Amenorrhea - galactorrhea - low libido - infertility from dec GnRH - - bitemporal heminanopia from imgingement of optic chiasm
Hashimotos thyroiditis
3. What are the 4 causes of SIADH
BRICK L - brain - RBC - intestine - cornea - kidney - liver
Ectopic ADH in small cell lung cancer - CNS disorder/head trauma - pulmonary diseae - drugs like cyclophosphamide
PTH = inc ca reabsorption and dec PO4 reabsorption in DIC - active vit D = inc absorption of both in gut
Excessive water retenion - hyponatremia - urine osm > serum osm
4. What is the source of D2
Surgery to remove tumor - sprinolactone - (K sparing diuretic)
Ingested from plants
Thyroid hormones T3/T4
Phenylalaline - tyrosine - L- dopa - dopa - NE - epi
5. What are the findings of hypoPTH
10% malignant - 10% bilateral - 10% extra - adrenal - 10% calcify - 10% kids - 10% familial
Hypocalcemia and tetany
Chief cells of parathyroid
Zona fasciculata - ACTH - hypothalamic CRH - cortisol/sex hormones
6. 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
Inc plasma FFAs - ketogenesis - ketonuria - ketonemia
Prolactinoma
Z- E - insulinomas - VIPomas - glucagonomas are rare
7. What are the likely causes of hypoPTH
Accidental surgical excision - autoimmune destruction and DiGeorge syndrome
17alpha - HTN - hypokalemia - in males - dec DHT - externally phenotypic females - in females nl genitals but no secondary sex characteristis
GH - large tognue - deep furrows - deep voice - large hands/feet - coarse fascial features - impaired glucose tolerance
Bone growth - brain (CNS maturation) - inc Beta 1 receptors - BML - inc glycogenolysis - gluconeogenesis and lipolysis
8. Where is the defect in toxic multinodular goiter
TSH receptor leading to inc release of T3 and T4 - hot nodules are rarely malignant
Diarrhea - aminoglycosides - diuretics - and EtOH
Cold intolerance - weight gain - dec appetite - lethargy/fatigue - constipation - dec reflexes - myxedema (facial/periorbital) - dry cool skin - coarse brittle hair - bradycardia - dyspnea on exertion
Inhib
9. What happens in the dexamethasone suppresion test in a health individual
PseudohypoPTH - albright's hereditary osteodystrophy
Dec cortisol after lose dose
Episodic hyperadrenergic symptoms - pressure - pain (headache) - perspiration - palpitations (tachycardia) - pallor
BRICK L - brain - RBC - intestine - cornea - kidney - liver
10. What are the labs for free T4 - total T4 and T3 uptake for hypo/hyperthyroidism
Thyroid hormones T3/T4
DM1 - DM2 has islet amyloid deposit
Hurthle cells - lymphocytic infiltrate with germinal centers
Hypo is low - hyper is high on all
11. endocrine hormones that use cAMP - FLAT CHAMP - What are they?
FSH - LH - ACTH - TSH - CRH - hCG - ADH (V2) - MSH - PTH - + calcitonin - GHRH and glucagon
Z- E - insulinomas - VIPomas - glucagonomas are rare
Lumen of follicles - thryglobulin + I2 with MIT and DIT - proteolysis and secrete into blood back through follicular cell
Inc cortisol after low dose - dec cortisol after high dose
12. tapping of the facial nerve leads to contraction of facial muscles
13. Do pts with neuroblastoma develop HTN
Less likely
Rugal thickening and acid hypersecretion causing recurrent ulcers - associated with MEN type 1
Chvostek's sign
Hypocalcemia and tetany
14. What is the next layer in from the ZF - What is its primary control and What does it secrete
Zona reticularis - ACTH hypothalamic CRH - sex hormones - androgens
Stim
During stress - childbirth
Dec in DM1 - variable in DM2 with possible amyloid
15. Recurrent diarrhea - cutaneous flushing - asthatic wheezing - right side valvular disease
Demeclocycline or H2O restriction
Caused by aldosterone secreting tumor - resulting in HTN - hypokalemia - metaboolic alkalosis low plasma renin - B/L or unilateral
Trousseau's sign
Carcinoid syndrome
16. Which is the active form or thyroid
Free hormone is active T3 bind more than T4
Stim
Ingested from plants
VMA
17. What is the most common tumor of the adrenal medulla in children
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
Right adrenal - right adrenal vein - IVC
Riedel's - fixed hard and painless goiter
Neuroblastoma
18. Which substances bind receptor associated tyrosine kinase via the JAK/STAT pathway
Removal of pituitary adenoma and octreotide
Chromaffin cells - catecholamines
Dec aldosterone causing hyponatremia which can lead to seizures
GH - prolactin also IL-2
19. In which DM is there an HLA association and What is it
DM1 - HLA- DR3 and DR4
Polydipsia - polyuria - polyphagia - weight loss - DKA (type1) - hyperosmolor coma (type2) unopposed secretion of GH and epi (exacerbating hyperglycemia
Adquate fluid intake - central intranasal desmopressin - for nephrogenic use thiazide (for hypernatremia) - amiloride (for hypokalemia) and indomethacin to dec GFR
Follicular carcinoma of thyroid
20. Describe the signs and symptoms of DKA
21. What is a good test for primary hypo/hyperthyroidism and What do you expect to see in both
TSH - elevated in hypo - low in hyper
GH - prolactin also IL-2
21 hydroxylase - masculinization - hypotension - hyperkalemia - inc plasma renin - volume depletion
DM1 - DM2 has islet amyloid deposit
22. What is the breakdown product of epi
Somatostatin analog
No - proinsulin to insulin + C peptide
Inhib
Metanephrine
23. What is the 1 P of MEN 2B
21 hydroxylase - masculinization - hypotension - hyperkalemia - inc plasma renin - volume depletion
Metanephrine
Parafollicular cells of thyroid (C cells) - dec bone resorption of Ca
Pheochromocytoma
24. When does graves typically present
During stress - childbirth
Central - pituitary tumor - truama - surgery - histiocytosis X and nephrogenic - hereditary - 2ndary to hypoglycemia - lithium - demeclocycline (ADH antagonist)
1/3 metastasize - 1/3 present with 2nd malignancy - and 1/3 multiple
Metanephrine
25. What do the three endocrine cells of the pancreas secrete
Insulin responsive - adipose and skeletal muscle
Small (metastatic) bowel tumors - 5HT goes to liver for first pass -
Alpha = glucagon - beta = insulin - delta = somatostatin
Stim
26. What are the 3 problems in SIADH
Peripheral tissue
Excessive water retenion - hyponatremia - urine osm > serum osm
Zona reticularis - ACTH hypothalamic CRH - sex hormones - androgens
Stim
27. What is the tx for SIADH
Pancreas - pituitary and PTH
Demeclocycline or H2O restriction
Hypocalcemia and tetany
Inc cortisol after low dose - dec cortisol after high dose
28. hyperthyroidism signs/symptoms
Right adrenal - right adrenal vein - IVC
2A and 2B
Dec in pit ACTH production - no skin hyperpigmentation and no hyperkalemia
Heat intolerance - weight loss - inc appetite - hyperactivity - diarrhea - inc reflexes - pretibial myxedema (graves) warm - moist skin - fine hair - chest pain - palpitations - arrhythmias
29. What are the clinical findings of graves
Kidney - 1 -25 OH2 vit d
Carrier protiens in posterior pituitary that carry hormones in circulation - derived from neuroectoderm
Proptosis - EOM swelling - pretibial mxyedema - diffuse goiter
FLAT
30. What vasodilators use the cGMP pathway
Amenorrhea - galactorrhea - low libido - infertility from dec GnRH - - bitemporal heminanopia from imgingement of optic chiasm
Zona fasiculata
Tonic DA from hypothalamus inhibits - prolactin causes DA synthesis and increases own inhibition - TRH stimulates prolactin
ANP - NO and EDRF
31. What is the pathway of catecholamine production
GH - large tognue - deep furrows - deep voice - large hands/feet - coarse fascial features - impaired glucose tolerance
Phenylalaline - tyrosine - L- dopa - dopa - NE - epi
Zona fasiculata
Parafollicular C cells - calcitonin histo = sheets of cells in amyloid stroma - associated with MEN 2A/2B
32. What other conditions are associated with MEN 2B
Beta - hydroxybutyrate > acetoacetate
Inactive form
Moderatly enlarged nontender thyroid
Medullary thyroid carcinoma with calcitonin and oral/intestinal ganglioneuromatosis (associated with marfanoid habitus)
33. Neuroblastoma does not come with...
Caused by aldosterone secreting tumor - resulting in HTN - hypokalemia - metaboolic alkalosis low plasma renin - B/L or unilateral
HTN
FLAT
ADH - oxytocin - made in the hypothalamus and shipped to posterior pituitary
34. What are the 3 P's of MEN type 1 (Werners)
Pancreas - pituitary and PTH
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
Antibodies against TSH receptors - II
35. occlusion of brachial artery with BP cuff leads to carpal spasm
36. How can hashimotos present that is not typical hypothyroidism
Hyperthyroid early in course - thyrotoxicosis during follicular rupture
Mesoderm
Episodic hyperadrenergic symptoms - pressure - pain (headache) - perspiration - palpitations (tachycardia) - pallor
Tonic DA from hypothalamus inhibits - prolactin causes DA synthesis and increases own inhibition - TRH stimulates prolactin
37. Cortisol fxn is BBIIG
Blood pressure - dec bone formation - anti - inflammatory - dec immune fxn - inc gluconeogenesis - lipolysis - proteolysis
Prolactinoma
Alpha antagonists - esp phenoxybenzamine - nonselective - irreversible - surgery to remove tumor
TGB - dec in hepatic failure - inc in pregnancy via estrogen
38. In what organs/systems do you see the effects of small vessel disease
HTN
Retinopathy (hemorrhage - exudates - microanuerysms - vessel proliferation) - glaucoma - nephropathy (noduclar sclerosis - progressive proteinuria - CRF) - arteriosclerosis leading to HTN - kimmelstiel wilson nodules
Medullary thyroid carcinoma - calcitonin
Inc cortisol after low dose and high dose
39. What is secondary hyperPTH due to and What are the expected serum values
Metanephrine
Adquate fluid intake - central intranasal desmopressin - for nephrogenic use thiazide (for hypernatremia) - amiloride (for hypokalemia) and indomethacin to dec GFR
Due to dec gut absorption of Ca - inc PO4 due to chronic renal disease (no vit D) hypOcalcemia - hyperphophatemia - inc alk phos - inc PTH
Amenorrhea - galactorrhea - low libido - infertility from dec GnRH - - bitemporal heminanopia from imgingement of optic chiasm
40. What are the consequences of thyrotoxicisos - and who is at risk
Kidney stones and stomach ulcers
Stress induced catecholamine surge leading to death by arrhythmia - graves
During stress - childbirth
Rapid/deep breathing (Kussmal's resps) N/V - abdominal pain - psychosis/delirium - dehydration - FRUITY breath odor -
41. What kind of cells are in the adrenal medulla and What do they secrete
Dec in pit ACTH production - no skin hyperpigmentation and no hyperkalemia
Waterhouse friderichsen - n meningitidis septicemia
Chromaffin cells - catecholamines
Retinopathy (hemorrhage - exudates - microanuerysms - vessel proliferation) - glaucoma - nephropathy (noduclar sclerosis - progressive proteinuria - CRF) - arteriosclerosis leading to HTN - kimmelstiel wilson nodules
42. What causes skin hyperpigmentation in primary adrenal insuff
Chvostek's sign
25- OH vitamin D
Transcellular shif from dec insulin
MSH - a by product of inc ACTH production from POMC
43. What is the TX for DKA
GH - large tognue - deep furrows - deep voice - large hands/feet - coarse fascial features - impaired glucose tolerance
Zona fasiculata
ATP from glucose metabolism closing K channels and depolarizing cells - required for adipose and skeletal muscle uptake of glucose
Fluids - insulin - and K - glucose if necessary to prevent hypoglycemia
44. Why do congential adrenal enzyme deficiences end up with hyperplasia and not hypoplasia
Dec cortisol after lose dose
Growth factors - IGF-1 - FGF - and PDGF all MAP kinase pathway
Inc in ACTH because low levels of cortisol
Stim
45. In graves dz - what pathological antibody is produced - and what kind of hypersens rxn is it?
Inc in serum Ca causes calcitonin secretion
Bromocriptine
Antibodies against TSH receptors - II
Small vessel disease - large vessel disease and osmotic drainage
46. What are the two types of diabetes insipidus and What causes them
Central - pituitary tumor - truama - surgery - histiocytosis X and nephrogenic - hereditary - 2ndary to hypoglycemia - lithium - demeclocycline (ADH antagonist)
Chvostek's sign
FLT - hCG
Adquate fluid intake - central intranasal desmopressin - for nephrogenic use thiazide (for hypernatremia) - amiloride (for hypokalemia) and indomethacin to dec GFR
47. How does right adrenal gland drain
Parafollicular C cells - calcitonin histo = sheets of cells in amyloid stroma - associated with MEN 2A/2B
Central - pituitary tumor - truama - surgery - histiocytosis X and nephrogenic - hereditary - 2ndary to hypoglycemia - lithium - demeclocycline (ADH antagonist)
Neuroendocrine cells of GI tract
Right adrenal - right adrenal vein - IVC
48. What does pheo tumors secrete - What can they cause and what serum and urinary makers are there
Stress - exercise and hypoglycemia
DM1 = severe - DM2 = mild to moderate
Type 1
Epi - norepi - and DA - epidosic HTN - urinary VMA and elevated catecholamines
49. What hormones are secreted from the adenohypophysis
FLAT PiG - FSH - LH - ACTH - TSH - Prolactin - GH
Mesoderm
Dec aldosterone causing hyponatremia which can lead to seizures
Parafollicular cells of thyroid (C cells) - dec bone resorption of Ca
50. What does the brain use for fuel in starvation
TSH - elevated in hypo - low in hyper
Inc serum IGF-1 - failure to suppress serum GH following oral glucose tolerance test
Ketone bodies
Prolactin or GH