Endocrine Block

Front 1

Name the three classes of hormones.

Back 1

Peptides/proteins,
Amines (tyrosine derivatives)
Steroids (cholesterol derivatives)

Front 2

What is the amino acid cutoff between peptide and protein hormones?

Back 2

3-100 = peptides (TRH, IGF-1, insulin)
>100 = proteins (GH, prolactin)

Front 3

How are protein/peptide hormones stored and circulated?

Back 3

Stored in secretory vesicles. Most circulate free because they are water soluble. Small peptides may have carrier proteins.

Front 4

Which hormones are tyrosine derivatives?

Back 4

Thyroxine, norepinephrine, epinephrine (catecholamines)

Front 5

How are T4/T3 hormones stored and circulated?

Back 5

T4/T3 stored in follicles with thyroglobulin (TG), 99% circulated with thyroid binding globulin (TBG)

Front 6

How are catecholamines stored and circulated?

Back 6

E/NE (4:1) stored in secretory vesicles, circulate 50% free (water soluble) and 50% loosely with albumin

Front 7

How are steroids stored and circulated?

Back 7

Cholesterol ester precursors are stored in adrenal cortex, gonads, and placenta, >90% circulate bound (binding acts as storage depot)

Front 8

Where are steroid receptors found?

Back 8

Usually unbound in the cytoplasm and nucleus

Front 9

Where are T4/T3 receptors found?

Back 9

In the nucleus bound to DNA with co-repressors. Activation causes binding to hormone response elements.

Front 10

Where are peptide/protein hormone receptors found?

Back 10

On the cell surface, as G-protein coupled receptors, receptor kinases, receptor-linked kinases or ligand gated ion channels

Front 11

Adrenotoxic used in non-resectable cushing's disease

Back 11

Mitotane - cousin of DDT

Front 12

Synthetic cortisol used to test for Cushing's

Back 12

Dexamethasone

Front 13

Converts Cortisol to cortisone (inactivates)

Back 13

11β-hydroxysteroid dehydrogenase D2

Front 14

Converts cortisone to Cortisol (activates)

Back 14

11β-hydroxysteroid dehydrogenase D1

Front 15

Describe Paget's disease

Back 15

Overactive osteoclasts = enlarged skull, pelvis, blindness, hearing loss, hyperparathyroidism, CN palsies

Front 16

Cause of familial hypocalciuric hypercalcimia

Back 16

CaSR defect. Important because not resectable

Front 17

Sulfonylurea MOA and AEs

Back 17

Glyburide
binds to Katp pump, causes Ca influx and insulin release from Beta cells. May cause hypoglycemia and weight gain
Chlorpropamide causes SIADH and disulfiram like rx

Front 18

Short acting secretagogues MOA and AEs

Back 18

Repaglinide (different than SU), and netaglinide
bind to Katp pump, causes insulin release from Beta cells
Hypoglycemia and wt gain

Front 19

Vascular diabetes complication causes

Back 19

Polyol - sugar > sorbitol, absorbed by vascular cells makes them swell and damage - leaky vessels
AGE / ROS / PKC - sugar > metabolites like PKC, ROSs and AGEs, AGE receptors in kidney produce harmful cytokines - kidney failure. PKC - vasodilation

Front 20

ADH receptor types

Back 20

V1 - direct vasoconstriction. Agonists used in septic shock
V2 - renal DCT increases permeability, allows H20 to be reabsorbed

Front 21

PRLoma tx

Back 21

DA agonists:
bromocriptine
cabergoline

Front 22

What causes tan in Addison's?

Back 22

Excess ACTH converted to alpha MSH melanocyte stim horm. ONLY in primary Addison's. 2o = no ACTH

Front 23

Waterhouse-Friedrichson syndrome

Back 23

Adrenal insufficiency caused by an adrenal hemorrhage in meningococcal sepsis

Front 24

Pituitary apoplexy

Back 24

bleeding into an undx pit adenoma that causes 2o Addison's

Front 25

Cosyntropin

Back 25

synthetic ACTH. Used to dx Addison's. Administer, then measure cortisol 30 min later - should peak, unless long term Addison's and adrenal's are dormant.

Front 26

Metapyrone

Back 26

blocks cortisol synthesis. Used to dx 2o Addison's - should cause ACTH to rise.

Front 27

Dx primary aldosteronism

Back 27

salt-loading with fludrocortisone causes salt retention and normally supresses aldosterone production, but not in disease

Front 28

Tx of aldosteronism

Back 28

surgery in adenoma
Rx aldosterone receptor antagonist:
spironolactone - causes hyperkal and gynecomast
eplerenone - Hyperkalemia
amiloride - inhibits Na retention, hyperkalemia

Front 29

Distinguish salt-wasting CAH from simple-virilizing

Back 29

simple-virilizing has normal aldosterone, so no salt-wasting crises

Front 30

Hypogonadotrophic hypogonadism types

Back 30

Kallmann's (men and women),
Fertile Eunuch (LH deficiency)
FSH deficiency

Front 31

What hormone is hCG similar to?

Back 31

LH

Front 32

Hypergonadotrophic hypogonadism types

Back 32

Mumps orchitis
Sertoli-only syndrome
Klinefelter's
Idiopathic

Front 33

What is the difference between T3 and T4?

Back 33

T3 is active, more actively taken up.