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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 1 P of MEN 2B
Pheochromocytoma
Carrier protiens in posterior pituitary that carry hormones in circulation - derived from neuroectoderm
Zona reticularis - ACTH hypothalamic CRH - sex hormones - androgens
21 hydroxylase - masculinization - hypotension - hyperkalemia - inc plasma renin - volume depletion
2. What does vitamin D deficiency cause in kids and adults
Kids = rickets - adults = osteomalacia
Direct stimulation of osteoblasts - which indirectly stimulates osteoclastic cells via RANK L (down regulates OPG that usually blocks RANK L from binding RANK)
Neurofibramtosis - MEN types 2A and 2B
Neuroendocrine cells of GI tract
3. What happens in the dexamethasone suppresion test in a health individual
Dec cortisol after lose dose
DM1
Free hormone is active T3 bind more than T4
Rapid/deep breathing (Kussmal's resps) N/V - abdominal pain - psychosis/delirium - dehydration - FRUITY breath odor -
4. Most common tumor of adrenal medulla in adults - cells - and embyronic origin
Inc cortisol after low dose - dec cortisol after high dose
Riedel's - fixed hard and painless goiter
Cushing's
Chromaffin cells from NC
5. The adrenal medulla derives From What embryonic tissue
ADH - oxytocin - made in the hypothalamus and shipped to posterior pituitary
Neural crest
BRICK L - brain - RBC - intestine - cornea - kidney - liver
Urine specific grav < 1.006 - serum osm > 290
6. How many cortical divisions are involved in primary adrenal insuff
FLAT PiG - FSH - LH - ACTH - TSH - Prolactin - GH
Renal osteodystrophy
Vitamin d
All 3 - spares medulla
7. Do you see C peptide in exogenous insulin intake
Osteitis fibrosa cystica
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
No - proinsulin to insulin + C peptide
Accidental surgical excision - autoimmune destruction and DiGeorge syndrome
8. pituitary adenoma is what kind of oma?
Prolactinoma
1 = juveline - IDDM - 2 = adult - NIDDM
Cushing's
Islets of langerhans are collections of alpha - beta and delta
9. What does insulin do in alpha cells
T3/T4 - cytosol
Inhibits glucagon release
Dec in DM1 - variable in DM2 with possible amyloid
TSH receptor leading to inc release of T3 and T4 - hot nodules are rarely malignant
10. In what organs/systems do you see the effects of small vessel disease
Diarrhea - aminoglycosides - diuretics - and EtOH
Retinopathy (hemorrhage - exudates - microanuerysms - vessel proliferation) - glaucoma - nephropathy (noduclar sclerosis - progressive proteinuria - CRF) - arteriosclerosis leading to HTN - kimmelstiel wilson nodules
HTN
Neurofibramtosis - MEN types 2A and 2B
11. Do pts with neuroblastoma develop HTN
Due to dec gut absorption of Ca - inc PO4 due to chronic renal disease (no vit D) hypOcalcemia - hyperphophatemia - inc alk phos - inc PTH
VMA
Def in aldosterone and cortisol leading to hypotension (hyponatremic volume contraction) hyperkalemia - acidosis - and skin hyperpigmentation
Less likely
12. Which are the acidophiles
Inc serum IGF-1 - failure to suppress serum GH following oral glucose tolerance test
HTN
Prolactin and GH
Inactive form
13. Recurrent diarrhea - cutaneous flushing - asthatic wheezing - right side valvular disease
Carcinoid syndrome
Rapid/deep breathing (Kussmal's resps) N/V - abdominal pain - psychosis/delirium - dehydration - FRUITY breath odor -
Rugal thickening and acid hypersecretion causing recurrent ulcers - associated with MEN type 1
Hypocalcemia and tetany
14. GOAT goes IP3
Islets of langerhans are collections of alpha - beta and delta
GnRH - Oxytocin - ADH (V1) - TRH
During stress - childbirth
Waterhouse friderichsen - n meningitidis septicemia
15. What is the breakdown product of dopamine
All 3 - spares medulla
HVA
HTN - weight gain - moon facies - truncal obesity - buffalo hump - hyperglycemia - skin thinning and striae - osteoporosis - amenorrhea - immune suppression
Inhibits glucagon release
16. In graves dz - what pathological antibody is produced - and what kind of hypersens rxn is it?
ANP - NO and EDRF
Antibodies against TSH receptors - II
Inhib
Milk production in females and spermatogenesis in males (by inhibiting GnRH synthesis and release
17. What are the anabolic effects of insulin
BRICK L - brain - RBC - intestine - cornea - kidney - liver
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
Episodic hyperadrenergic symptoms - pressure - pain (headache) - perspiration - palpitations (tachycardia) - pallor
Kidney - 1 -25 OH2 vit d
18. What enzyme is responsible for oxidation and organification of iodide as well as coupling of MIT and DIT
Peroxidase
FSH - LH - ACTH - TSH - CRH - hCG - ADH (V2) - MSH - PTH - + calcitonin - GHRH and glucagon
Inc plasma amino acids - nitrogen loss in urine
Central - pituitary tumor - truama - surgery - histiocytosis X and nephrogenic - hereditary - 2ndary to hypoglycemia - lithium - demeclocycline (ADH antagonist)
19. How do T3/T4 travel in blood and what happens to this substance in liver disease and pregnancy
Mesoderm
Def in aldosterone and cortisol leading to hypotension (hyponatremic volume contraction) hyperkalemia - acidosis - and skin hyperpigmentation
TGB - dec in hepatic failure - inc in pregnancy via estrogen
Adenoma - hypercalcemia - hypercalciuria - hypophosohatemia - inc PTH - inc alk phos - inc cAMP in urine - often asymptomatic present as weakness and contipation - groans
20. What are the common causes of dec Mg
Most antipsychotics and all OCPs - estrogen in pregs
Diarrhea - aminoglycosides - diuretics - and EtOH
DM1 = dec - DM2 = variable
Inhib
21. What is the most external latery of the adrenal cortex - What is its primary control and What does it secrete
Zona glomerulosa - renin - angiontensin - aldosterone
Raises free testosterone and they gey hirsutism
Pheochromocytoma
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
22. How is PTH regulated
Dec free serum Ca inc PTH secretion - dec free serum Mg dec PTH secretion
DM1 = dec - DM2 = variable
Trousseau's sign
Inc cortisol after low dose and high dose
23. What is the fxn of prolactin
Cushing's
Urine osm doesn't inc - and desmopressin admin distinguishes
Retinopathy (hemorrhage - exudates - microanuerysms - vessel proliferation) - glaucoma - nephropathy (noduclar sclerosis - progressive proteinuria - CRF) - arteriosclerosis leading to HTN - kimmelstiel wilson nodules
Milk production in females and spermatogenesis in males (by inhibiting GnRH synthesis and release
24. How do you diagnose GH abnl?
Neuroblastoma
Chromaffin cells from NC
Autoimmune - TB - metastasis
Inc serum IGF-1 - failure to suppress serum GH following oral glucose tolerance test
25. What kind of ligands bind intrinsice tyrosine kinase
Growth factors - IGF-1 - FGF - and PDGF all MAP kinase pathway
Cold intolerance - weight gain - dec appetite - lethargy/fatigue - constipation - dec reflexes - myxedema (facial/periorbital) - dry cool skin - coarse brittle hair - bradycardia - dyspnea on exertion
GH - prolactin also IL-2
RBC brain
26. When diagnosing diabetes insipidus - what happens to the urine osm in the water deprivation test and How do you distinguish between central and nephrogenic
27. What is the general chronic manifestation of DM
Somatostatin analog
DKA - inc insulin requirements from inc stress (infxn) - excess fat breakdown and inc ketogenesis from FFA made into ketone bodies
Waterhouse friderichsen - n meningitidis septicemia
Nonenzymatic glycosylation
28. How does PTH stimulate Ca relase from bone
Riedel's - fixed hard and painless goiter
ANP - NO and EDRF
17alpha - HTN - hypokalemia - in males - dec DHT - externally phenotypic females - in females nl genitals but no secondary sex characteristis
Direct stimulation of osteoblasts - which indirectly stimulates osteoclastic cells via RANK L (down regulates OPG that usually blocks RANK L from binding RANK)
29. How does cortisol travel in the blood
Bidirectional - beta cells - liver kidney - small intestine
Pancreas - pituitary and PTH
Hashimotos thyroiditis
Bound to corticosteroid binding globulin - CGB
30. What are the 4 fxns of PTH
Follicular carcinoma of thyroid
Milk production in females and spermatogenesis in males (by inhibiting GnRH synthesis and release
10% malignant - 10% bilateral - 10% extra - adrenal - 10% calcify - 10% kids - 10% familial
Inc bone resorption of Ca and PO4 - inc kidney reabsorption of Ca in DIC - dec kidney reabsorption of PO4 - inc calcitriol production by stimulated 1alpha - hydroxylase
31. Where do you see the GLUT 1 transporter
RBC brain
Def in aldosterone and cortisol leading to hypotension (hyponatremic volume contraction) hyperkalemia - acidosis - and skin hyperpigmentation
Carrier protiens in posterior pituitary that carry hormones in circulation - derived from neuroectoderm
Bound to corticosteroid binding globulin - CGB
32. inc lipolysis leads to...
Medullary thyroid carcinoma with calcitonin and oral/intestinal ganglioneuromatosis (associated with marfanoid habitus)
Inc plasma FFAs - ketogenesis - ketonuria - ketonemia
DR5 - antimicrosomal - antithyroglobulin
Stress - exercise and hypoglycemia
33. What is the tx for pheochromocytoma
Central - pituitary tumor - truama - surgery - histiocytosis X and nephrogenic - hereditary - 2ndary to hypoglycemia - lithium - demeclocycline (ADH antagonist)
Follicles of thyroid - most T3 formed in the blood
Medullary thyroid carcinoma with calcitonin and oral/intestinal ganglioneuromatosis (associated with marfanoid habitus)
Alpha antagonists - esp phenoxybenzamine - nonselective - irreversible - surgery to remove tumor
34. Neuroblastoma does not come with...
Inc bone resorption of Ca and PO4 - inc kidney reabsorption of Ca in DIC - dec kidney reabsorption of PO4 - inc calcitriol production by stimulated 1alpha - hydroxylase
Ketone bodies
HTN
Mesoderm
35. What are the clinical findings of cushing's
HTN - weight gain - moon facies - truncal obesity - buffalo hump - hyperglycemia - skin thinning and striae - osteoporosis - amenorrhea - immune suppression
Left adrenal - left adrenal vein - left renal vein - IVC
Somatostatin analog
Ketone bodies
36. What is important to remember when correcting hyponatremia
Correct is slowly
Adenoma - hypercalcemia - hypercalciuria - hypophosohatemia - inc PTH - inc alk phos - inc cAMP in urine - often asymptomatic present as weakness and contipation - groans
Lower free testosterone and gynecomastia
Inc plasma FFAs - ketogenesis - ketonuria - ketonemia
37. What are the likely causes of hypoPTH
1 -25 OH2 vitamin D (active form)
Accidental surgical excision - autoimmune destruction and DiGeorge syndrome
Zona fasiculata
Dec aldosterone causing hyponatremia which can lead to seizures
38. What regulates vit D
Kidney - 1 -25 OH2 vit d
Inc PTH - dec Ca - dec PO4 cause inc in active form and then it feedback inhibits its own production
Autoimmune - TB - metastasis
Inhib
39. What MEN syndromes are associated with the ret gene
Chromaffin cells from NC
T3/T4 - cytosol
10% malignant - 10% bilateral - 10% extra - adrenal - 10% calcify - 10% kids - 10% familial
2A and 2B
40. What hormones are secreted from the adenohypophysis
FLAT PiG - FSH - LH - ACTH - TSH - Prolactin - GH
Toxic multinodular goiter
Inc serum IGF-1 - failure to suppress serum GH following oral glucose tolerance test
Def in aldosterone and cortisol leading to hypotension (hyponatremic volume contraction) hyperkalemia - acidosis - and skin hyperpigmentation
41. focal patches of hyperfxning follicular cells working independently of TSH
Zona glomerulosa - renin - angiontensin - aldosterone
Phenylalaline - tyrosine - L- dopa - dopa - NE - epi
Toxic multinodular goiter
PTH = inc ca reabsorption and dec PO4 reabsorption in DIC - active vit D = inc absorption of both in gut
42. What is octreotide
MSH - a by product of inc ACTH production from POMC
Inc in ACTH because low levels of cortisol
Fluids - insulin - and K - glucose if necessary to prevent hypoglycemia
Somatostatin analog
43. Where is cortisol made?
1/3 metastasize - 1/3 present with 2nd malignancy - and 1/3 multiple
Carcinoid syndrome
Kidney stones and stomach ulcers
Zona fasiculata
44. What HLA association is with hashimotos and what kind of autoantibodies
DR5 - antimicrosomal - antithyroglobulin
Direct stimulation of osteoblasts - which indirectly stimulates osteoclastic cells via RANK L (down regulates OPG that usually blocks RANK L from binding RANK)
Less likely
Stim
45. Gastrin secreting tumor of pancreas or duodenum
Zollinger Ellison
Type 1
1 = juveline - IDDM - 2 = adult - NIDDM
Undifferentiated/anaplastic
46. uniform follicles in thyroid with good prognosis
Follicular carcinoma of thyroid
Cold intolerance - weight gain - dec appetite - lethargy/fatigue - constipation - dec reflexes - myxedema (facial/periorbital) - dry cool skin - coarse brittle hair - bradycardia - dyspnea on exertion
Alpha = glucagon - beta = insulin - delta = somatostatin
Zollinger Ellison
47. What happens to women with dec SHBG
Renal osteodystrophy
Adquate fluid intake - central intranasal desmopressin - for nephrogenic use thiazide (for hypernatremia) - amiloride (for hypokalemia) and indomethacin to dec GFR
Raises free testosterone and they gey hirsutism
21 hydroxylase - masculinization - hypotension - hyperkalemia - inc plasma renin - volume depletion
48. What is the most common tumor of the adrenal medulla in children
Islets of langerhans are collections of alpha - beta and delta
Neuroblastoma
Undifferentiated/anaplastic
Nonenzymatic glycosylation
49. What causes primary hyperaldosteronism (Conn's syndrome) and What are the lab findings
Follicles of thyroid - most T3 formed in the blood
Caused by aldosterone secreting tumor - resulting in HTN - hypokalemia - metaboolic alkalosis low plasma renin - B/L or unilateral
DM1
ADH - oxytocin - made in the hypothalamus and shipped to posterior pituitary
50. What is a good test for primary hypo/hyperthyroidism and What do you expect to see in both
ANP - NO and EDRF
Excessive water retenion - hyponatremia - urine osm > serum osm
Bromocriptine or cabergoline
TSH - elevated in hypo - low in hyper