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38 Cards in this Set

  • Front
  • Back
What are etiologies of Cushing’s syndrome? Is ACTH always elevated?
increased cortisol due to: 1. Cushing’s disease (primary pituitary adenoma) increased ACTH 2. Primary adrenal (hyperplasia/neoplasia) decreased ACTH 3. Ectopic ACTH production (ie- small cell lung ca) increased ACTH 4. Iatrogenic, decreased ACTH
Describe the clinical picture of Cushings.
HTN, wt gain, moon facies, truncal obesity, buffalo hump, hyperglycemia (insulin resistance), skin change (thinning, striae), osteoporosis, immune suppression
T/F Conn’s syndrome is secondary hyperaldosteronism.
False. Conn’s syndrome is primary hyperaldosteronism, caused by an aldosterone-secreting tumor. Results in HTN, hypokalemia, metabolic alkalosis, low plasma renin.
Which hyperaldosteronism is associated with high plasma renin?
Secondary hyperaldosteronism. It is due to renal artery stenosis, chronic renal failure, CHF, cirrhosis, or nephrotic syndrome. Kidney perception of low intravascular volume results in an overactive renin-angiotensin sysem.
What is the tx for hyperaldosteronism?
Spironolactone, a diuretic that works by acting as a aldosterone antagonist.
What characterizes addison’s disease? (which hormones are elevated or deficient)? Is it associated with HTN or hypotension?
Primary deficiency of aldosterone and cortisol due to adrenal atrophy, causing hypotension and skin hyperpigmentation. Adrenal atrophy, absence of hormone production, involves all 3 cortical divisions.
T/F In primary insufficiency decreased pituitary ACTH production is characterized by skin hyperpigmentation.
False: increased ACTH causes MSH activity & hyperpigmentation
T/F Neuroblastoma is the most common tumor of adrenal medulla in adults.
False. Pheochromocytoma is the most common tumor of adrenal medulla in adults. It is derived from chromaffin cells (arise from neural crest). It is associated with neurofibromatosis MEN types II and III.
Where does neuroblastoma occur?
Neuroblastoma is the most common tumor of adrenal medulla in children. It can occur anywhere along the sympathetic chain.
Pheochromocytoma: secrete combination of two molecules
epinephrine and norepinephrine
Pheochromocytoma: epidemiology (rule of 10's)
10% malignant, 10% bilateral, 10% extra-adrenal, 10% calcify, 10% kids, 10% familial
Pheochromocytoma: symptoms - 5 P's
(elevated blood) Pressure, Pain (headache), Perspiration, Palpitations, Pallor/diaphoresis --> relapsing and remittant
Pheochromocytoma: elevations in two lab values
urinary VMA and serum catecholamines
Pheochromocytoma: association with two other endocrine diseases
Pheochromocytoma: treatment
Multiple Endocrine Neoplasia type I (Wermer's syndrome) - 3 P's
Pancreas, Pituitary, and Parathyroid tumors
Multiple Endocrine Neoplasia type II (Sipple's syndrome)
medullary carcinoma of thyroid, pheochromocytoma, parathyroid tumor, or adenoma
Multiple Endocrine Neoplasia type III
medullary carcinoma of thyroid, pheochromocytoma, oral/intestinal ganglioneuromatosis
Hypothyroidism or hyperthyroidism myxedema is prominent in which one
Hypothyroidism or hyperthyroidism chest pain, palpitations, arrhythmias
TSH is (increased/decreased) in primary hyperthyroidism? In primary hypothyroidism?
hyper - decreased, hypo - increased
Graves' disease involves autoantibodies with what mechanism of action?
stimulation of TSH receptors
three symptoms of Graves'
ophthalmopathy, pretibial myxedema, diffuse goiter
Graves' is a type __ hypersensitivity
type II
Hashimoto's thyroiditis: thyroid is (enlarged/not enlarged) and (tender/nontender)
enlarged, nontender
Hashimoto's thyroiditis: autoimmune antibodies directed against ---
Hashimoto's thyroiditis: histology shows (type of cell) infiltrate
lymphocytes (with germinal centers)
Subacute thyroiditis (de Quervain's): self-limited (hyper/hypo)thyroidism following ---
hypothyroidism following flu-like illness
Subacute thyroiditis (de Quervain's): symptoms include
jaw pain, tender thyroid gland, early hyperthyroidism
Thyroid cancer: most common, good prognosis, "ground glass" nuclei, psammoma bodies
papillary carcinoma
Thyroid cancer: poor prognosis, uniform follicles
follicular carcinoma
Thyroid cancer: calcitonin producing (C cells), sheets of cells
medullary carcinoma (MEN II and III)
Thyroid cancer: older patients, horrible prognosis
Cretinism: caused by a lack of dietary --- or defect in --- formation
iodine (endemic), T4 (sporadic)
Cretinism: symptoms include
pot-belly, paleness, puffy face, protuberant tongue, protruding umbilicus
Acromegaly: caused by excess --- in adults
growth hormone
Acromegaly: symptoms include
large furrowed tongue, deep voice, large hands and feet, coarse facial features
Acromegaly: in children, leads to ---