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66 Cards in this Set
- Front
- Back
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Discuss thyroid development:
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Thyroid diverticulum arises from floor of primitive pharynx, descends into neck. Connected to tongue by thyroglossal duct, which normally disappears but may persist as pyramidal lobe of thyroid. Foramen cecum
is normal remnant of thyroglossal duct. Most common ectopic thyroid tissue site is the tongue. Thyroglossal duct cyst presents as an anterior midline neck mass that moves with swallowing (vs. persistent cervical sinus leading to branchial cleft cyst in lateral neck). |
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Discuss the fetal adrenal gland:
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Consists of an outer adult zone and inner active fetal zone. Adult zone is dormant during early fetal life but begins to secrete cortisol late in gestation.
Cortisol secretion is controlled by ACTH and CRH from fetal pituitary and placenta. Cortisol is responsible for fetal lung maturation and surfactant production. |
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Discuss the anatomy of the adrenal cortex and medulla:
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Discuss drainage of the adrenal gland:
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Generally discuss the pituitary, posterior and anterior, cell types and what they secrete, etc.--
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What are the pancreatic cell types? What do they make?
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Discuss the source of endogenous insulin and its function/receptor types:
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Discuss the functions of insulin:
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Discuss the regulation of insulin:
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Discuss insulin-dependent organs:
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Resting skeletal muscle and adipose tissue depend on insulin for increasing glucose uptake (GLUT-4). Brain and RBCs take up glucose independent of insulin levels (GLUT-1).
Brain depends on glucose for metabolism under normal circumstances and uses ketone bodies in starvation. RBCs always depend on glucose because they have no mitochondria for aerobic metabolism. |
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Source, function, and regulation of Glucagon:
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Briefly discuss Hypothalamic-pituitary hormone regulation:
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Discuss the source, function, and regulation of PRL:
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Diagram of PRL secretion/reg:
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Discuss the source, function, and regulation of GH:
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Pathway for Adrenal steroids:
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Discuss, compare, contrast the Congenital bilateral adrenal hyperplasias:
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Discuss the source, function, and regulation of cortisol:
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Discuss the source, function, and regulation of PTH:
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Diagrams of PO4 and Ca homeostasis:
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Discuss the source, function, and regulation of Vit D:
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Discuss the source, function, and regulation of calcitonin:
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Signaling pathways of endocrine hormones:
cAMP-- cGMP-- IP3-- Steroid receptor-- Intrinsic tyrosine kinase-- Receptor-associated tyrosine kinase-- |
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Discuss signaling pathways of steroid hormones:
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Discuss the source, function, and regulation of thyroid hormones:
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Diagram of thyroid cell and site of action of PTU/MMI:
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Cushing's syndrome--discuss:
causes: findings: |
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Effects of dexamethasone suppression tests on cortisol:
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Discuss 1˚ and 2˚ aldosteronism:
findings and treatment for each: |
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Discuss Addison's disease:
how do you know it's not 2˚ adrenal insufficiency? |
Chronic 1˚ adrenal insufficiency due to adrenal atrophy or destruction by disease (e.g., autoimmune, TB, metastasis).
Deficiency of aldosterone and cortisol, causing hypotension (hyponatremic volume contraction), hyperkalemia, acidosis, and skin hyperpigmentation (due to MSH , a by-product of increased ACTH production from POMC). Characterized by Adrenal Atrophy and Absence of hormone production; involves All 3 cortical divisions (spares medulla). Distinguish from 2˚ adrenal insufficiency (decreased pituitary ACTH production), which has no skin hyperpigmentation and no hyperkalemia. |
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What is Waterhouse-Friderichsen syndrome?
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Acute 1˚ adrenal insufficiency due to adrenal hemorrhage associated with Neisseria meningitidis septicemia, DIC, and endotoxic shock.
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Discuss pheo:
findings-- associations-- treatment-- pathway of secreted substances-- |
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Discuss neuroblastoma:
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The most common tumor of the adrenal medulla in children. Can occur anywhere along the sympathetic chain.
Homovanillic acid (HVA), a breakdown product of dopamine, elevated in urine. Less likely to develop hypertension. Overexpression of N-myc oncogene associated with rapid tumor progression. |
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Hypothyroidism vs. hyperthyroidism:
sx-- lab findings-- |
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Discuss hashimoto's thyroiditis:
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Discuss cretinism:
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Discuss subacute, riedel's and other causes of hypothyroidism:
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Discuss Toxic multinodular goiter, Graves' disease, and Thyroid storm:
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Discuss thyroid cancer:
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Discuss 1˚, 2˚, and 3˚ Hyperparathyroidism:
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Discuss hypoparathyroidism and pseudohypoparathyroidism:
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Chart of PTH and Calcium pathologies:
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Discuss pituitary adenoma:
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Most commonly prolactinoma.
Findings: amenorrhea, galactorrhea, low libido, infertility (decreased GnRH). Can impinge on optic chiasm --> bitemporal hemianopia. Treatment: dopamine agonists (bromocriptine or cabergoline) cause shrinkage of prolactinomas. |
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What is acromegaly?
Findings, diagnosis, and treatment: |
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What is Diabetes insipidus?
Findings, diagnosis, and treatment: |
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Discuss SIADH:
findings-- how does it happen-- causes include-- treatment-- |
Syndrome of inappropriate antidiuretic hormone secretion:
• Excessive water retention • Hyponatremia with continued urinary Na+ excretion • Urine osmolarity > serum osmolarity Body responds with decreased aldosterone (hyponatremia) to maintain near-normal volume status. Very low serum sodium levels can lead to seizures (correct slowly). Causes include: • Ectopic ADH (small cell lung cancer) • CNS disorders/head trauma • Pulmonary disease • Drugs (e.g., cyclophosphamide) Treatment: fluid restriction, IV saline, conivaptan, tolvaptan, clemeclocycline. |
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Discuss Hypopituitarism:
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Undersecretion of pituitary hormones due to:
• Nonsecreting pituitary adenoma, craniopharyngioma • Sheehan's syndrome (ischemic infarct of pituitary following postpartum bleeding; usually presents with failure to lactate) • Empty sella syndrome (atrophy or compression of pituitary, often idiopathic, common in obese women) • Brain injury, hemorrhage • Radiation Treatment: substitution therapy (corticosteroids, thyroxine, sex steroids, human growth hormone). |
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Discuss the acute manifestations of DM:
flow chart of outcomes: |
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Discuss the chronic manifestations of DM:
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Tests for DM?
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Fasting serum glucose
oral glucose tolerance test HbA1c (reflects average blood glucose over prior 3 mos) |
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Type 1 vs. type 2 diabetes mellitus:
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DKA: what is it?
sx-- labs-- complications-- treatment-- |
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Discuss carcinoid syndrome:
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Zollinger-Ellison syndrome:
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Gastrin-secreting tumor of pancreas or duodenum.
Stomach shows rugal thickening with acid hypersecretion. Causes recurrent ulcers. May be associated with MEN type 1. |
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Discuss MEN1, MEN2A, and MEN2B:
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Shape diagrams of MEN subtypes:
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Basic strategies for DM1 and DM2:
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Treatment strategy for type 1 DM: low-sugar diet, insulin replacement.
Treatment strategy for type 2 DM: dietary modification and exercise for weight loss; oral hypoglycemics and insulin replacement. |
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Diabetes drugs:
list classes-- action-- clinical use-- toxicities-- |
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Mechanism, clinical use, and toxicity of PTU & MMI, Levothyroxine, and triiodothyronine:
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List 4 Hypothalamic/pituitary drugs and their clinical use:
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Mechanism, clinical use, and toxicity of demeclocycline:
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List 5 glucocorticoids. Mechanism, clinical use, and toxicity of glucocorticoids:
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