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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. Which kind of cells don't need insulin to take up glucose
Less likely
BRICK L - brain - RBC - intestine - cornea - kidney - liver
17alpha - HTN - hypokalemia - in males - dec DHT - externally phenotypic females - in females nl genitals but no secondary sex characteristis
Accidental surgical excision - autoimmune destruction and DiGeorge syndrome
2. What are the 4 causes of SIADH
Neurofibramtosis - MEN types 2A and 2B
Chvostek's sign
Diarrhea - aminoglycosides - diuretics - and EtOH
Ectopic ADH in small cell lung cancer - CNS disorder/head trauma - pulmonary diseae - drugs like cyclophosphamide
3. What is the pathway of catecholamine production
17alpha - HTN - hypokalemia - in males - dec DHT - externally phenotypic females - in females nl genitals but no secondary sex characteristis
Pot - bellied - pale - puffy faced witih protruding umbilicus and protuberant tongue
Beta - hydroxybutyrate > acetoacetate
Phenylalaline - tyrosine - L- dopa - dopa - NE - epi
4. In which type of DM is ketoacidosis more common
10% malignant - 10% bilateral - 10% extra - adrenal - 10% calcify - 10% kids - 10% familial
Excellent prognosis - risk with childhood radiation - papillary carcinoma
2A and 2B
DM1
5. Which steroid receptors are nuclear and where are the others located
Vitamin d
T3/T4 - cytosol
DKA - inc insulin requirements from inc stress (infxn) - excess fat breakdown and inc ketogenesis from FFA made into ketone bodies
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
6. Which substances bind receptor associated tyrosine kinase via the JAK/STAT pathway
Prolactin or GH
Neuroblastoma
GH - prolactin also IL-2
RBC brain
7. What are the labs for free T4 - total T4 and T3 uptake for hypo/hyperthyroidism
Chief cells of parathyroid
Hypo is low - hyper is high on all
Prolactinoma
Inactive form
8. What does fetal hypothyroidism cause - where do you see this birth defect endemically - and What causes the sporadic form
BRICK L - brain - RBC - intestine - cornea - kidney - liver
Direct stimulation of osteoblasts - which indirectly stimulates osteoclastic cells via RANK L (down regulates OPG that usually blocks RANK L from binding RANK)
Hypo is low - hyper is high on all
Cretinism - whereever there is endemic goiter - sporadic version due to defect in T4 formation or thyroid development
9. What is octreotide
Heat intolerance - weight loss - inc appetite - hyperactivity - diarrhea - inc reflexes - pretibial myxedema (graves) warm - moist skin - fine hair - chest pain - palpitations - arrhythmias
Kids = rickets - adults = osteomalacia
Ingested from plants
Somatostatin analog
10. Which are the basophiles
Inc absorption of dietary Ca and phosphate - inc bone resorption of Ca and phosphate
FLAT
Small cell lung cancer and bronchial carcinoids
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
11. What happens in the dexamethasone suppression test in someone with a cortisol producing tumor
Diffuse thickening of the BM
Raises free testosterone and they gey hirsutism
Inc cortisol after low and high dose
Osteitis fibrosa cystica
12. What are the 3 problems in SIADH
DKA - inc insulin requirements from inc stress (infxn) - excess fat breakdown and inc ketogenesis from FFA made into ketone bodies
Excessive water retenion - hyponatremia - urine osm > serum osm
Less likely
Trousseau's sign
13. The adrenal cortex derives From What embryonic tissue
PTH = inc ca reabsorption and dec PO4 reabsorption in DIC - active vit D = inc absorption of both in gut
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
Mesoderm
17alpha - HTN - hypokalemia - in males - dec DHT - externally phenotypic females - in females nl genitals but no secondary sex characteristis
14. 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
TGB - dec in hepatic failure - inc in pregnancy via estrogen
Phenylalaline - tyrosine - L- dopa - dopa - NE - epi
Demeclocycline or H2O restriction
15. Recurrent diarrhea - cutaneous flushing - asthatic wheezing - right side valvular disease
1 = viral/immune destruction beta cells - 2 = insulin resistance
Pheochromocytoma
Carcinoid syndrome
Neuroblastoma
16. What is the TX for DKA
Fluids - insulin - and K - glucose if necessary to prevent hypoglycemia
Inc plasma amino acids - nitrogen loss in urine
MSH - a by product of inc ACTH production from POMC
1 = juveline - IDDM - 2 = adult - NIDDM
17. nonenzymatic glycosylation leads to what 3 catageories of defects
Excessive water retenion - hyponatremia - urine osm > serum osm
VMA
Small vessel disease - large vessel disease and osmotic drainage
Carcinoid syndrome
18. What is the fxn of prolactin
Milk production in females and spermatogenesis in males (by inhibiting GnRH synthesis and release
Mucormycosis - Rhizopus infxn - cerebral edema - cardia arrhythmias - HF
Stress - exercise and hypoglycemia
Pot - bellied - pale - puffy faced witih protruding umbilicus and protuberant tongue
19. What other diseases or syndromes are associated with pheochromocytoma
Pot - bellied - pale - puffy faced witih protruding umbilicus and protuberant tongue
Bidirectional - beta cells - liver kidney - small intestine
Neurofibramtosis - MEN types 2A and 2B
During stress - childbirth
20. What diseases can cause primary adrenal insufficiency
Pheochromocytoma and PTH
Excellent prognosis - risk with childhood radiation - papillary carcinoma
Subactute thyroiditis - granulomatous inflammation - elev ESR - jaw pain - ealy inflammation - tender thyroid
Autoimmune - TB - metastasis
21. How can hashimotos present that is not typical hypothyroidism
HTN
Chromaffin cells from NC
Hyperthyroid early in course - thyrotoxicosis during follicular rupture
Diarrhea - aminoglycosides - diuretics - and EtOH
22. What is the effect of somatostatin on GH and TSH
Moderatly enlarged nontender thyroid
Hypo is low - hyper is high on all
Dec aldosterone causing hyponatremia which can lead to seizures
Inhib
23. What is secondary hyperPTH due to and What are the expected serum values
1 -25 OH2 vitamin D (active form)
DM2
Bound to corticosteroid binding globulin - CGB
Due to dec gut absorption of Ca - inc PO4 due to chronic renal disease (no vit D) hypOcalcemia - hyperphophatemia - inc alk phos - inc PTH
24. In what hormones are the alpha subunit the same
HTN - weight gain - moon facies - truncal obesity - buffalo hump - hyperglycemia - skin thinning and striae - osteoporosis - amenorrhea - immune suppression
Pheochromocytoma and PTH
FLT - hCG
DR5 - antimicrosomal - antithyroglobulin
25. Do pts with neuroblastoma develop HTN
Octreotide
Urine osm doesn't inc - and desmopressin admin distinguishes
Less likely
DR5 - antimicrosomal - antithyroglobulin
26. How is PTH regulated
Dec free serum Ca inc PTH secretion - dec free serum Mg dec PTH secretion
Subactute thyroiditis - granulomatous inflammation - elev ESR - jaw pain - ealy inflammation - tender thyroid
10% malignant - 10% bilateral - 10% extra - adrenal - 10% calcify - 10% kids - 10% familial
Bound to corticosteroid binding globulin - CGB
27. All three effects of hyperinsulinemia lead to which two clinical features
Waterhouse friderichsen - n meningitidis septicemia
Dehydration and acidosis leading to coma and death
Thyroid hormones T3/T4
Hyperglycemia - glucosuria - osmotic diureses - lyte depletion
28. What happens to women with dec SHBG
Raises free testosterone and they gey hirsutism
Chief cells of parathyroid
Peripheral tissue
Inhib
29. What enzyme is responsible for oxidation and organification of iodide as well as coupling of MIT and DIT
Tonic DA from hypothalamus inhibits - prolactin causes DA synthesis and increases own inhibition - TRH stimulates prolactin
Ketone bodies
Renal osteodystrophy
Peroxidase
30. What do the three endocrine cells of the pancreas secrete
Alpha = glucagon - beta = insulin - delta = somatostatin
Removal of pituitary adenoma and octreotide
Urine specific grav < 1.006 - serum osm > 290
Prolactinoma
31. How is calcitonin regulated
Stim
Hurthle cells - lymphocytic infiltrate with germinal centers
Inc in serum Ca causes calcitonin secretion
Rugal thickening and acid hypersecretion causing recurrent ulcers - associated with MEN type 1
32. What are the 5 fxns of thyroid hormone
Inhib
10% malignant - 10% bilateral - 10% extra - adrenal - 10% calcify - 10% kids - 10% familial
Bone growth - brain (CNS maturation) - inc Beta 1 receptors - BML - inc glycogenolysis - gluconeogenesis and lipolysis
Insulin responsive - adipose and skeletal muscle
33. in which DM is glucose intolerance severe and Which is more mild to moderate
Correct is slowly
Follicular carcinoma of thyroid
DM1 = severe - DM2 = mild to moderate
Small vessel disease - large vessel disease and osmotic drainage
34. What is the most common tumor of the adrenal medulla in adults
Pheochromocytoma
Lumen of follicles - thryglobulin + I2 with MIT and DIT - proteolysis and secrete into blood back through follicular cell
Inhib
Mesoderm
35. What are the two types of diabetes insipidus and What causes them
PseudohypoPTH - albright's hereditary osteodystrophy
Central - pituitary tumor - truama - surgery - histiocytosis X and nephrogenic - hereditary - 2ndary to hypoglycemia - lithium - demeclocycline (ADH antagonist)
Zona fasiculata
Autoimmune - TB - metastasis
36. hyperthyroidism signs/symptoms
Milk production in females and spermatogenesis in males (by inhibiting GnRH synthesis and release
Heat intolerance - weight loss - inc appetite - hyperactivity - diarrhea - inc reflexes - pretibial myxedema (graves) warm - moist skin - fine hair - chest pain - palpitations - arrhythmias
TGB - dec in hepatic failure - inc in pregnancy via estrogen
DR5 - antimicrosomal - antithyroglobulin
37. Carcoid tumors are derived From what cells
Parafollicular C cells - calcitonin histo = sheets of cells in amyloid stroma - associated with MEN 2A/2B
FSH - LH - ACTH - TSH - CRH - hCG - ADH (V2) - MSH - PTH - + calcitonin - GHRH and glucagon
Chromaffin cells - catecholamines
Neuroendocrine cells of GI tract
38. autosomal dominant kidney unresponsive to PTH leading to hypocalcemia - shortened 4th/5th digits and short stature
39. where do you see GLUT 4 transporter
Adenoma - hypercalcemia - hypercalciuria - hypophosohatemia - inc PTH - inc alk phos - inc cAMP in urine - often asymptomatic present as weakness and contipation - groans
Inhib
DM1
Insulin responsive - adipose and skeletal muscle
40. What is secondary adrenal insuff and how can you distinguish it from primary
Small (metastatic) bowel tumors - 5HT goes to liver for first pass -
Dec in pit ACTH production - no skin hyperpigmentation and no hyperkalemia
Epi - norepi - and DA - epidosic HTN - urinary VMA and elevated catecholamines
HTN - weight gain - moon facies - truncal obesity - buffalo hump - hyperglycemia - skin thinning and striae - osteoporosis - amenorrhea - immune suppression
41. What is the rule of 10s in pheochromocytoma
Follicles of thyroid - most T3 formed in the blood
17alpha - HTN - hypokalemia - in males - dec DHT - externally phenotypic females - in females nl genitals but no secondary sex characteristis
10% malignant - 10% bilateral - 10% extra - adrenal - 10% calcify - 10% kids - 10% familial
Inc plasma amino acids - nitrogen loss in urine
42. How does the body respond to SIADH and What does that cause
1/3 metastasize - 1/3 present with 2nd malignancy - and 1/3 multiple
FLT - hCG
Dec aldosterone causing hyponatremia which can lead to seizures
DM2
43. How many cortical divisions are involved in primary adrenal insuff
Bromocriptine or cabergoline
Dec in pit ACTH production - no skin hyperpigmentation and no hyperkalemia
Stim
All 3 - spares medulla
44. What do pituitary tumors usually secrete in MEN type 1
Left adrenal - left adrenal vein - left renal vein - IVC
Hyperglycemia - inc H+ - dec bicarb leading to anion gap acidosis - inc blood ketone levels - leukocytosis - hyperkalemia - but depleted intracellular K
GnRH - Oxytocin - ADH (V1) - TRH
Prolactin or GH
45. What does inc GH in children result In What is the characteristic bone growth
Milk production in females and spermatogenesis in males (by inhibiting GnRH synthesis and release
1 = viral/immune destruction beta cells - 2 = insulin resistance
Ketone bodies
Gigantism - linear bone growth
46. What are the clinical findings of graves
Proptosis - EOM swelling - pretibial mxyedema - diffuse goiter
Stim
Trousseau's sign
Surgery to remove tumor - sprinolactone - (K sparing diuretic)
47. What other conditions are associated with MEN 2B
Hypo is low - hyper is high on all
Medullary thyroid carcinoma with calcitonin and oral/intestinal ganglioneuromatosis (associated with marfanoid habitus)
Ketone bodies
Stim
48. What kind of ligands bind intrinsice tyrosine kinase
Growth factors - IGF-1 - FGF - and PDGF all MAP kinase pathway
Neuroendocrine cells of GI tract
Caused by aldosterone secreting tumor - resulting in HTN - hypokalemia - metaboolic alkalosis low plasma renin - B/L or unilateral
Phenylalaline - tyrosine - L- dopa - dopa - NE - epi
49. What is the fxn of vitamin D
BRICK L - brain - RBC - intestine - cornea - kidney - liver
Inc absorption of dietary Ca and phosphate - inc bone resorption of Ca and phosphate
Hashimotos thyroiditis
Adquate fluid intake - central intranasal desmopressin - for nephrogenic use thiazide (for hypernatremia) - amiloride (for hypokalemia) and indomethacin to dec GFR
50. What MEN syndromes are associated with the ret gene
2A and 2B
Bidirectional - beta cells - liver kidney - small intestine
Undifferentiated/anaplastic
Milk production in females and spermatogenesis in males (by inhibiting GnRH synthesis and release