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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 T3/T4 made
Hashimotos thyroiditis
Lumen of follicles - thryglobulin + I2 with MIT and DIT - proteolysis and secrete into blood back through follicular cell
Stim
BRICK L - brain - RBC - intestine - cornea - kidney - liver
2. GOAT goes IP3
Tonic DA from hypothalamus inhibits - prolactin causes DA synthesis and increases own inhibition - TRH stimulates prolactin
GnRH - Oxytocin - ADH (V1) - TRH
Inhibits glucagon release
Cushing's
3. Which are the acidophiles
Prolactin and GH
HVA
Inc serum IGF-1 - failure to suppress serum GH following oral glucose tolerance test
No - proinsulin to insulin + C peptide
4. 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
TSH - elevated in hypo - low in hyper
Small cell lung cancer and bronchial carcinoids
Raises free testosterone and they gey hirsutism
5. In which DM is there an HLA association and What is it
Less likely
Moderatly enlarged nontender thyroid
DM1 = dec - DM2 = variable
DM1 - HLA- DR3 and DR4
6. What are the 3 problems in SIADH
TSH - elevated in hypo - low in hyper
Inc absorption of dietary Ca and phosphate - inc bone resorption of Ca and phosphate
Kidney - 1 -25 OH2 vit d
Excessive water retenion - hyponatremia - urine osm > serum osm
7. What are the clinical findings of cushing's
MSH - a by product of inc ACTH production from POMC
DKA - inc insulin requirements from inc stress (infxn) - excess fat breakdown and inc ketogenesis from FFA made into ketone bodies
HTN - weight gain - moon facies - truncal obesity - buffalo hump - hyperglycemia - skin thinning and striae - osteoporosis - amenorrhea - immune suppression
Islets of langerhans are collections of alpha - beta and delta
8. 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
Epi - norepi - and DA - epidosic HTN - urinary VMA and elevated catecholamines
Neuroendocrine cells of GI tract
Prolactin and GH
9. Medullary carcinoma forms From what cells and What do they produce - histo and association
Medullary thyroid carcinoma - calcitonin
Amenorrhea - galactorrhea - low libido - infertility from dec GnRH - - bitemporal heminanopia from imgingement of optic chiasm
Parafollicular C cells - calcitonin histo = sheets of cells in amyloid stroma - associated with MEN 2A/2B
Adquate fluid intake - central intranasal desmopressin - for nephrogenic use thiazide (for hypernatremia) - amiloride (for hypokalemia) and indomethacin to dec GFR
10. What is the breakdown product of NE
VMA
Inc PTH - dec Ca - dec PO4 cause inc in active form and then it feedback inhibits its own production
Toxic multinodular goiter
Chvostek's sign
11. cholecalciferol
ANP - NO and EDRF
Inhib
Vitamin d
Phenylalaline - tyrosine - L- dopa - dopa - NE - epi
12. What are the hormones released from the neurohypophysis and where are they made
All 3 - spares medulla
ADH - oxytocin - made in the hypothalamus and shipped to posterior pituitary
Episodic hyperadrenergic symptoms - pressure - pain (headache) - perspiration - palpitations (tachycardia) - pallor
Diffuse thickening of the BM
13. What kind of ligands bind intrinsice tyrosine kinase
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
T3/T4 - cytosol
FLT - hCG
Growth factors - IGF-1 - FGF - and PDGF all MAP kinase pathway
14. What is the depleted intracellular K due to in DKA
GH - prolactin also IL-2
Alpha antagonists - esp phenoxybenzamine - nonselective - irreversible - surgery to remove tumor
Rugal thickening and acid hypersecretion causing recurrent ulcers - associated with MEN type 1
Transcellular shif from dec insulin
15. In which DM is polyuria - polydipsia - thirst and weight loss more common
DM1
Beta - hydroxybutyrate > acetoacetate
Bromocriptine
Caused by aldosterone secreting tumor - resulting in HTN - hypokalemia - metaboolic alkalosis low plasma renin - B/L or unilateral
16. What causes skin hyperpigmentation in primary adrenal insuff
Antibodies against TSH receptors - II
Moderatly enlarged nontender thyroid
MSH - a by product of inc ACTH production from POMC
Inactive form
17. In which DM is there a stronger genetic association
17alpha - HTN - hypokalemia - in males - dec DHT - externally phenotypic females - in females nl genitals but no secondary sex characteristis
PTH = inc ca reabsorption and dec PO4 reabsorption in DIC - active vit D = inc absorption of both in gut
DM2
Dehydration and acidosis leading to coma and death
18. What causes secdonary hyperaldosteronism and what plasma marker is different from primary
Inhib
Most antipsychotics and all OCPs - estrogen in pregs
ANP - NO and EDRF
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
19. occlusion of brachial artery with BP cuff leads to carpal spasm
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20. What are the clinical findings in cretinism
Kids = rickets - adults = osteomalacia
Pot - bellied - pale - puffy faced witih protruding umbilicus and protuberant tongue
Hashimotos
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
21. What does adrenal insufficiency cause
Inc in serum Ca causes calcitonin secretion
Peroxidase
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
Def in aldosterone and cortisol leading to hypotension (hyponatremic volume contraction) hyperkalemia - acidosis - and skin hyperpigmentation
22. How many cortical divisions are involved in primary adrenal insuff
Stress induced catecholamine surge leading to death by arrhythmia - graves
All 3 - spares medulla
Dec cortisol after lose dose
5- HIAA
23. What is the pathway of catecholamine production
5- HIAA
Inside
DM2
Phenylalaline - tyrosine - L- dopa - dopa - NE - epi
24. What is the rule of 10s in pheochromocytoma
Ectopic ADH in small cell lung cancer - CNS disorder/head trauma - pulmonary diseae - drugs like cyclophosphamide
10% malignant - 10% bilateral - 10% extra - adrenal - 10% calcify - 10% kids - 10% familial
Proptosis - EOM swelling - pretibial mxyedema - diffuse goiter
TRH from the hypothalamus stimulates TSH release from ant pit which stimulates follicular cells - neg feedback to ant bit dec sens to TRH
25. What is the effect of somatostatin on GH and TSH
10% malignant - 10% bilateral - 10% extra - adrenal - 10% calcify - 10% kids - 10% familial
Insulin responsive - adipose and skeletal muscle
Stress - exercise and hypoglycemia
Inhib
26. What are the urine and serum findings in diabetes insipidus
Urine specific grav < 1.006 - serum osm > 290
Phenylalaline - tyrosine - L- dopa - dopa - NE - epi
Pancreas - pituitary and PTH
DM2
27. What is octreotide
Fluids - insulin - and K - glucose if necessary to prevent hypoglycemia
ANP - NO and EDRF
Somatostatin analog
Octreotide
28. What are the endocrine cells of the pancrea
Islets of langerhans are collections of alpha - beta and delta
11beta - HTN because - 11 deoxycorticosterone is a mineralcorticoid and secreted in excess - masculinization because too much DHEA shuttling
TSH receptor leading to inc release of T3 and T4 - hot nodules are rarely malignant
Due to dec gut absorption of Ca - inc PO4 due to chronic renal disease (no vit D) hypOcalcemia - hyperphophatemia - inc alk phos - inc PTH
29. What is the effect of CRH on ACTH
Ectopic ADH in small cell lung cancer - CNS disorder/head trauma - pulmonary diseae - drugs like cyclophosphamide
Chief cells of parathyroid
Hypocalcemia and tetany
Stim
30. When is the onset of DM1 vs DM2 causing what kind of DM
1 = juveline - IDDM - 2 = adult - NIDDM
Bromocriptine
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
FLAT
31. What is the number one cause of cushing and What is the ACTH value
Direct stimulation of osteoblasts - which indirectly stimulates osteoclastic cells via RANK L (down regulates OPG that usually blocks RANK L from binding RANK)
Hyperglycemia - glucosuria - osmotic diureses - lyte depletion
Proptosis - EOM swelling - pretibial mxyedema - diffuse goiter
Iatrogenic - decreased
32. What is the tx for hyperaldosteronism
Stress - exercise and hypoglycemia
DM1
Diabetes insipidus - lack of ADH - or lack of response to ADH in kidney
Surgery to remove tumor - sprinolactone - (K sparing diuretic)
33. When does graves typically present
Hyperglycemia - inc H+ - dec bicarb leading to anion gap acidosis - inc blood ketone levels - leukocytosis - hyperkalemia - but depleted intracellular K
Removal of pituitary adenoma and octreotide
ANP - NO and EDRF
During stress - childbirth
34. Is there an association with obesity in DM1 or DM2
DM2
Dec free serum Ca inc PTH secretion - dec free serum Mg dec PTH secretion
Moderatly enlarged nontender thyroid
Accidental surgical excision - autoimmune destruction and DiGeorge syndrome
35. What other diseases or syndromes are associated with pheochromocytoma
Follicular carcinoma of thyroid
Insulin responsive - adipose and skeletal muscle
Phenylalaline - tyrosine - L- dopa - dopa - NE - epi
Neurofibramtosis - MEN types 2A and 2B
36. autosomal dominant kidney unresponsive to PTH leading to hypocalcemia - shortened 4th/5th digits and short stature
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37. Which are the basophiles
5- HIAA
Stress - exercise and hypoglycemia
FLAT
T3/T4 - cytosol
38. pheochromocytoma rule of 5 P's - What are they
Episodic hyperadrenergic symptoms - pressure - pain (headache) - perspiration - palpitations (tachycardia) - pallor
Pheochromocytoma
17alpha - HTN - hypokalemia - in males - dec DHT - externally phenotypic females - in females nl genitals but no secondary sex characteristis
Bromocriptine or cabergoline
39. What is 24 - 25 OH2 vit D
MSH - a by product of inc ACTH production from POMC
Inactive form
Inhib
Def in aldosterone and cortisol leading to hypotension (hyponatremic volume contraction) hyperkalemia - acidosis - and skin hyperpigmentation
40. endocrine hormones that use cAMP - FLAT CHAMP - What are they?
Anwhere along the sympathetic chaing - HVA - N- myc
FSH - LH - ACTH - TSH - CRH - hCG - ADH (V2) - MSH - PTH - + calcitonin - GHRH and glucagon
Dec glucose uptake - inc protein catabolism - inc lipolysis
FLT - hCG
41. What is the source of D2
DM1 - HLA- DR3 and DR4
T3/T4 - cytosol
Alpha antagonists - esp phenoxybenzamine - nonselective - irreversible - surgery to remove tumor
Ingested from plants
42. Which steroid receptors are nuclear and where are the others located
T3/T4 - cytosol
Hypo is low - hyper is high on all
Correct is slowly
Neural crest
43. What are the complications of DKA
25- OH vitamin D
Mucormycosis - Rhizopus infxn - cerebral edema - cardia arrhythmias - HF
Growth factors - IGF-1 - FGF - and PDGF all MAP kinase pathway
Antibodies against TSH receptors - II
44. How is PTH regulated
Dec free serum Ca inc PTH secretion - dec free serum Mg dec PTH secretion
Pheochromocytoma
During stress - childbirth
Parafollicular cells of thyroid (C cells) - dec bone resorption of Ca
45. How is thyroid hormone regulated
Medullary thyroid carcinoma - calcitonin
Waterhouse friderichsen - n meningitidis septicemia
Chief cells of parathyroid
TRH from the hypothalamus stimulates TSH release from ant pit which stimulates follicular cells - neg feedback to ant bit dec sens to TRH
46. 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
Correct is slowly
1 = juveline - IDDM - 2 = adult - NIDDM
Subactute thyroiditis - granulomatous inflammation - elev ESR - jaw pain - ealy inflammation - tender thyroid
47. What happens in the dexamethasone suppression test in someone with a cortisol producing tumor
Follicles of thyroid - most T3 formed in the blood
Inc cortisol after low and high dose
Osteitis fibrosa cystica
Raises free testosterone and they gey hirsutism
48. What are the consequences of thyrotoxicisos - and who is at risk
Stress induced catecholamine surge leading to death by arrhythmia - graves
Inc in serum Ca causes calcitonin secretion
FSH - LH - ACTH - TSH - CRH - hCG - ADH (V2) - MSH - PTH - + calcitonin - GHRH and glucagon
HVA
49. In what instances in an inc in GH normal
Stress - exercise and hypoglycemia
PseudohypoPTH - albright's hereditary osteodystrophy
Alpha antagonists - esp phenoxybenzamine - nonselective - irreversible - surgery to remove tumor
Inc plasma amino acids - nitrogen loss in urine
50. Where can neuroblastomas occur - What do you see elevated in the urine and what oncogene is associated
Hashimotos thyroiditis
Excessive water retenion - hyponatremia - urine osm > serum osm
Surgery to remove tumor - sprinolactone - (K sparing diuretic)
Anwhere along the sympathetic chaing - HVA - N- myc