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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 hypoPTH
Kids = rickets - adults = osteomalacia
Zona fasciculata - ACTH - hypothalamic CRH - cortisol/sex hormones
Inc cortisol after low dose and high dose
Hypocalcemia and tetany
2. What HLA association is with hashimotos and what kind of autoantibodies
DR5 - antimicrosomal - antithyroglobulin
Mesoderm
GH - large tognue - deep furrows - deep voice - large hands/feet - coarse fascial features - impaired glucose tolerance
Pot - bellied - pale - puffy faced witih protruding umbilicus and protuberant tongue
3. Which kind of cells don't need insulin to take up glucose
No - proinsulin to insulin + C peptide
VMA
Medullary thyroid carcinoma - calcitonin
BRICK L - brain - RBC - intestine - cornea - kidney - liver
4. Describe the signs and symptoms of DKA
5. What enzyme is responsible for oxidation and organification of iodide as well as coupling of MIT and DIT
Transcellular shif from dec insulin
Diarrhea - aminoglycosides - diuretics - and EtOH
Peroxidase
Follicles of thyroid - most T3 formed in the blood
6. What class of drugs are dopamine antagonists
Most antipsychotics and all OCPs - estrogen in pregs
Free hormone is active T3 bind more than T4
FLAT
Inc cortisol after low and high dose
7. How does the left adrenal gland drain
During stress - childbirth
Surgery to remove tumor - sprinolactone - (K sparing diuretic)
Left adrenal - left adrenal vein - left renal vein - IVC
DM1 - DM2 has islet amyloid deposit
8. What drugs cause shrinkage of prolactinoma
10% malignant - 10% bilateral - 10% extra - adrenal - 10% calcify - 10% kids - 10% familial
Stim
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
Bromocriptine or cabergoline
9. 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
Transcellular shif from dec insulin
Inside
17alpha - HTN - hypokalemia - in males - dec DHT - externally phenotypic females - in females nl genitals but no secondary sex characteristis
Dec glucose uptake - inc protein catabolism - inc lipolysis
10. autosomal dominant kidney unresponsive to PTH leading to hypocalcemia - shortened 4th/5th digits and short stature
11. What is the breakdown product of NE
VMA
Type 1
Hyperglycemia - glucosuria - osmotic diureses - lyte depletion
Ectopic ADH in small cell lung cancer - CNS disorder/head trauma - pulmonary diseae - drugs like cyclophosphamide
12. tapping of the facial nerve leads to contraction of facial muscles
13. GOAT goes IP3
GnRH - Oxytocin - ADH (V1) - TRH
Hurthle cells - lymphocytic infiltrate with germinal centers
DM2
Inc PTH - dec Ca - dec PO4 cause inc in active form and then it feedback inhibits its own production
14. What does insulin do in alpha cells
Inhibits glucagon release
Inhib
Inc in ACTH because low levels of cortisol
Hurthle cells - lymphocytic infiltrate with germinal centers
15. What are the 3 P's of MEN type 1 (Werners)
Transcellular shif from dec insulin
Inc plasma FFAs - ketogenesis - ketonuria - ketonemia
Bound to corticosteroid binding globulin - CGB
Pancreas - pituitary and PTH
16. What is the most common tumor of the adrenal medulla in children
Peripheral tissue
Neuroblastoma
T3/T4 - cytosol
Central - pituitary tumor - truama - surgery - histiocytosis X and nephrogenic - hereditary - 2ndary to hypoglycemia - lithium - demeclocycline (ADH antagonist)
17. What causes secdonary hyperaldosteronism and what plasma marker is different from primary
Cushing's
Tonic DA from hypothalamus inhibits - prolactin causes DA synthesis and increases own inhibition - TRH stimulates prolactin
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
Thyroid hormones T3/T4
18. What MEN syndromes are associated with the ret gene
Inc serum IGF-1 - failure to suppress serum GH following oral glucose tolerance test
Bound to corticosteroid binding globulin - CGB
2A and 2B
Subactute thyroiditis - granulomatous inflammation - elev ESR - jaw pain - ealy inflammation - tender thyroid
19. What is the fxn of vitamin D
All 3 - spares medulla
17alpha - HTN - hypokalemia - in males - dec DHT - externally phenotypic females - in females nl genitals but no secondary sex characteristis
AD
Inc absorption of dietary Ca and phosphate - inc bone resorption of Ca and phosphate
20. What is the 1 P of MEN 2B
DM1 - DM2 has islet amyloid deposit
Pheochromocytoma
Metanephrine
Episodic hyperadrenergic symptoms - pressure - pain (headache) - perspiration - palpitations (tachycardia) - pallor
21. How is prolactin secretion regulated
Tonic DA from hypothalamus inhibits - prolactin causes DA synthesis and increases own inhibition - TRH stimulates prolactin
Anwhere along the sympathetic chaing - HVA - N- myc
Lumen of follicles - thryglobulin + I2 with MIT and DIT - proteolysis and secrete into blood back through follicular cell
Inhib
22. What thyroid condition is associated with lymphoma
Hashimotos
Prolactin and GH
Medullary thyroid carcinoma - calcitonin
TGB - dec in hepatic failure - inc in pregnancy via estrogen
23. in congenital bilateral adrenal hyperplasia - what enzyme def is most common and associate with dec cortisol - dec mineralcorticoids - inc sex hormones - enzyme and sx
21 hydroxylase - masculinization - hypotension - hyperkalemia - inc plasma renin - volume depletion
DM1
Small (metastatic) bowel tumors - 5HT goes to liver for first pass -
DKA - inc insulin requirements from inc stress (infxn) - excess fat breakdown and inc ketogenesis from FFA made into ketone bodies
24. What is the histology with hashimotos thyroiditis
Beta - hydroxybutyrate > acetoacetate
21 hydroxylase - masculinization - hypotension - hyperkalemia - inc plasma renin - volume depletion
Anwhere along the sympathetic chaing - HVA - N- myc
Hurthle cells - lymphocytic infiltrate with germinal centers
25. What are the 3 problems in SIADH
Excessive water retenion - hyponatremia - urine osm > serum osm
Carcinoid syndrome
GH - prolactin also IL-2
Bone growth - brain (CNS maturation) - inc Beta 1 receptors - BML - inc glycogenolysis - gluconeogenesis and lipolysis
26. What is the next layer in from ZG - What is its primary control - What does it secrete
Growth factors - IGF-1 - FGF - and PDGF all MAP kinase pathway
Zona fasciculata - ACTH - hypothalamic CRH - cortisol/sex hormones
Direct stimulation of osteoblasts - which indirectly stimulates osteoclastic cells via RANK L (down regulates OPG that usually blocks RANK L from binding RANK)
Undifferentiated/anaplastic
27. Do you see C peptide in exogenous insulin intake
DM2
No - proinsulin to insulin + C peptide
Inc plasma FFAs - ketogenesis - ketonuria - ketonemia
5- HIAA
28. How is PTH regulated
Anwhere along the sympathetic chaing - HVA - N- myc
Type 1
DM2
Dec free serum Ca inc PTH secretion - dec free serum Mg dec PTH secretion
29. What is the breakdown product of dopamine
Neural crest
HVA
Inhib
Inhibits glucagon release
30. What hormones are secreted from the adenohypophysis
FLAT PiG - FSH - LH - ACTH - TSH - Prolactin - GH
Blood pressure - dec bone formation - anti - inflammatory - dec immune fxn - inc gluconeogenesis - lipolysis - proteolysis
Kidney - 1 -25 OH2 vit d
Carrier protiens in posterior pituitary that carry hormones in circulation - derived from neuroectoderm
31. What are the consequences of thyrotoxicisos - and who is at risk
Stress induced catecholamine surge leading to death by arrhythmia - graves
Removal of pituitary adenoma and octreotide
Left adrenal - left adrenal vein - left renal vein - IVC
Most antipsychotics and all OCPs - estrogen in pregs
32. Which steroid receptors are nuclear and where are the others located
Trousseau's sign
Raises free testosterone and they gey hirsutism
T3/T4 - cytosol
Def in aldosterone and cortisol leading to hypotension (hyponatremic volume contraction) hyperkalemia - acidosis - and skin hyperpigmentation
33. In graves dz - what pathological antibody is produced - and what kind of hypersens rxn is it?
Antibodies against TSH receptors - II
Direct stimulation of osteoblasts - which indirectly stimulates osteoclastic cells via RANK L (down regulates OPG that usually blocks RANK L from binding RANK)
PTH = inc ca reabsorption and dec PO4 reabsorption in DIC - active vit D = inc absorption of both in gut
Medullary thyroid carcinoma - calcitonin
34. cystic bone spaces filled with brown fibrous tissue causing pain
Stim
No - proinsulin to insulin + C peptide
Less likely
Osteitis fibrosa cystica
35. What does inc GH in children result In What is the characteristic bone growth
Neurofibramtosis - MEN types 2A and 2B
Fluids - insulin - and K - glucose if necessary to prevent hypoglycemia
Inactive form
Gigantism - linear bone growth
36. thyroid replaced by fibroid tissue - dz and findings
37. Where are the beta cells located in the islets
ATP from glucose metabolism closing K channels and depolarizing cells - required for adipose and skeletal muscle uptake of glucose
Inside
Zollinger Ellison
No - proinsulin to insulin + C peptide
38. What is the general chronic manifestation of DM
Small vessel disease - large vessel disease and osmotic drainage
Nonenzymatic glycosylation
Neural crest
Iatrogenic - decreased
39. What is the effect of prolactin on GnRH
Inhib
Neuroblastoma
Peripheral tissue
Chromaffin cells - catecholamines
40. Medullary carcinoma forms From what cells and What do they produce - histo and association
Urine osm doesn't inc - and desmopressin admin distinguishes
Amenorrhea - galactorrhea - low libido - infertility from dec GnRH - - bitemporal heminanopia from imgingement of optic chiasm
FLAT
Parafollicular C cells - calcitonin histo = sheets of cells in amyloid stroma - associated with MEN 2A/2B
41. What regulates vit D
Inc PTH - dec Ca - dec PO4 cause inc in active form and then it feedback inhibits its own production
RBC brain
Right adrenal - right adrenal vein - IVC
DM1 = dec - DM2 = variable
42. What 3 things does insuline def and glucagon excess lead to...
Follicular carcinoma of thyroid
DM2
Small (metastatic) bowel tumors - 5HT goes to liver for first pass -
Dec glucose uptake - inc protein catabolism - inc lipolysis
43. What are two examples of ectopic ACTH producing tumors
Islets of langerhans are collections of alpha - beta and delta
Small cell lung cancer and bronchial carcinoids
Adenoma - hypercalcemia - hypercalciuria - hypophosohatemia - inc PTH - inc alk phos - inc cAMP in urine - often asymptomatic present as weakness and contipation - groans
Right adrenal - right adrenal vein - IVC
44. Where is cortisol made?
Dec free serum Ca inc PTH secretion - dec free serum Mg dec PTH secretion
Bone growth - brain (CNS maturation) - inc Beta 1 receptors - BML - inc glycogenolysis - gluconeogenesis and lipolysis
Zona fasiculata
DM1 - HLA- DR3 and DR4
45. self - limiting hypothyroidism following a flu - like illness - dz - hist - and findings
17alpha - HTN - hypokalemia - in males - dec DHT - externally phenotypic females - in females nl genitals but no secondary sex characteristis
BRICK L - brain - RBC - intestine - cornea - kidney - liver
DM1 = dec - DM2 = variable
Subactute thyroiditis - granulomatous inflammation - elev ESR - jaw pain - ealy inflammation - tender thyroid
46. What happens in the dexamethasone suppression test in somoeone with an ectopic ACTH producing tumor
Inc cortisol after low dose and high dose
5- HIAA
Right adrenal - right adrenal vein - IVC
Urine specific grav < 1.006 - serum osm > 290
47. What does fetal hypothyroidism cause - where do you see this birth defect endemically - and What causes the sporadic form
Dec glucose uptake - inc protein catabolism - inc lipolysis
ATP from glucose metabolism closing K channels and depolarizing cells - required for adipose and skeletal muscle uptake of glucose
Cretinism - whereever there is endemic goiter - sporadic version due to defect in T4 formation or thyroid development
Insulin responsive - adipose and skeletal muscle
48. What are the findings of prolactinoma
Medullary thyroid carcinoma with calcitonin and oral/intestinal ganglioneuromatosis (associated with marfanoid habitus)
Due to dec gut absorption of Ca - inc PO4 due to chronic renal disease (no vit D) hypOcalcemia - hyperphophatemia - inc alk phos - inc PTH
BRICK L - brain - RBC - intestine - cornea - kidney - liver
Amenorrhea - galactorrhea - low libido - infertility from dec GnRH - - bitemporal heminanopia from imgingement of optic chiasm
49. Which ketone bodies are more common in DKA
Cretinism - whereever there is endemic goiter - sporadic version due to defect in T4 formation or thyroid development
Toxic multinodular goiter
Beta - hydroxybutyrate > acetoacetate
Kidney - 1 -25 OH2 vit d
50. occlusion of brachial artery with BP cuff leads to carpal spasm