Fa Endo

Front 1

woman presents with diffuse goiter and hyperthyroidism:what are the expected values of TSH and thyroid hormone?

Back 1

low TSH, high thyroid

Front 2

48- year old woman presents with progressive lethary and extreme sensitivity to cold:diagnosis please?

Back 2

hypothyroid

Front 3

patient with elevated serum cortisol levels undergoes a dexamethasone suppresion test. 1 mg of dexamethasone does not decrease cortisol levels, but 8 mg does: diagnosis

Back 3

pituitary tumor (ACThoma)

Front 4

50 yo man complains of diarrhea- his face is plethoric and a heart murmur is detected: diagnosis?

Back 4

carcinoid syndrome

Front 5

woman of short stature presents with shortened 4th and 5th metacarpals- what endocrine disoder?

Back 5

albright's hereditary osteodystrophy, or pseudohypoparathyroidism

Front 6

diabetic patient presents with hypoglycemia but low levels of C-peptide- diagnosis?

Back 6

surreptitious insulin injections

Front 7

patient's MRI shows filling of sella turcica with cerebrospinal fluid: most likely clinical presentation

Back 7

normal- residual pituitary tissue is functional and can compensate: empty sella turcica syndrom

Front 8

patient complains of double vision, gynocomastia, and headaches: most likely diagnosis

Back 8

prolactinoma-

Front 9

patient presents with hypotension and bronzed skin: diagnosis

Back 9

1 adrenocortical deficiency (addison's )

Front 10

primary regulatory control and secretory product of : zona glomerulosa

Back 10

Renin- angiontensin system ---aldosterone

Front 11

primary regulatory control and secretory product of: zona fasciculata

Back 11

ACTH, hypothalamic CRH ---- Cortisol, sex hormones

Front 12

primary regulatory control and secretory product of: zona reticularis

Back 12

ACTH, hypothalamic CRH ---- sex hormones

Front 13

primary regulatory control and secretory product of: adrenal medulla

Back 13

preganglionic sympathetic fibers----- catacholamines

Front 14

most common tumor of the adrenal medulla of adults

Back 14

pheochomocytoma

Front 15

most comm tumor of the adrenal medulla in children:

Back 15

neuroblastoma- does not cause episodic HTN like pheochromocytoma

Front 16

adrenal drainage (veins) of right adrenal gland vs left

Back 16

left adrenal gland goes to left renal vein to IVC, while right goes straight to IVC (same as left and right gonadal veins)

Front 17

alpha subunit is common to ____, ___, ____, and _____ hormones:

Back 17

FSH, LH, TSH, bHCG

Front 18

Flat pig nemonic-

Back 18

just a reminder here

Front 19

in the islet of langerhans- the alpha cells secrete ______ and are located ______

Back 19

glucagon , peripherally

Front 20

in the islet of langerhans- the beta cells secrete ______ and are located ______

Back 20

insulin, centrally

Front 21

in the islet of langerhans- the delta cells secrete ______ and are located ______

Back 21

somatostatin, interspersed

Front 22

prolactin _____ DA release from the hypothalamus and _____ GnRH release

Back 22

increases, decreases

Front 23

the hormone that blocks anterior pituitary release of prolactin is _______, while _____ increases secretion of prolactin at the pituitary

Back 23

DA, TRH

Front 24

bromocriptine is a DA _______ and will _______ release of prolactin from the anterior pituitary

Back 24

agonist, inhibit

Front 25

amenorrhea is commonly seen in prolactinomas because prolactin inhibits _____

Back 25

GNrH

Front 26

TRH stimulates both _____ and ______

Back 26

TSH , prolactin

Front 27

somatostatin inhibits both ____ and _____

Back 27

GH, TSH

Front 28

decrease sex hormones, decrease cortisol, increase mineralocorticoids. HTN, hypokalemia- phenotypically female but no maturation

Back 28

17 alpha hydroxylase deficiency : can't get out of column 1 - make aldosterone

Front 29

decrease cortisol, increased ACTH, decrease mineralocorticoids, increased sex hormones- masculinization, femal pseudohermaphrotitism, hypotension, hyperkalemia, increase plasma renin, volume depletion. Salt wasting can lead to hypovolemic shock in newborn.

Back 29

21-hydroxylase deficiency- most common form (no aldo or cortison)

Front 30

decrease cortisol, aldosterone, corticosterone, increase sex hormones resulting in masculinization, hypertension

Back 30

11beta-hydroxylase deficiency

Front 31

testosterone to DHT enzyme

Back 31

5alpha-reductase

Front 32

testosterone to estradiol enzyme

Back 32

aromatase

Front 33

the _____ cells of the parathyroid secrete PTH

Back 33

chief

Front 34

decrease in _______ results in an increase in PTH

Back 34

free serum Ca++

Front 35

increases bone resporption of calcium and phosphate

Back 35

PTH

Front 36

increases kidney reabsorbtion of calcium in distal convoluted tubule

Back 36

PTH

Front 37

decreases kidney reabsorption of phosphate: hormone:

Back 37

PTH

Front 38

PTH increases 1,25 OH2 vit D production by stimulating ______ in the kidney

Back 38

1alpha hydroxylase

Front 39

PTH _____ serum Ca+, ____ serum phosphate, _____ urine phosphate

Back 39

increases, decreases, increases (PTH = phosphate trashing hormone_)

Front 40

T/F - PTH stimulates both osteoclasts and osteoblasts

Back 40

TRUE- directly stimulates osteoblasts, indirectly stims osteoclasts

Front 41

_____ directly increases intestinal calcium resorption: hormone

Back 41

1,25 OH2 vitamin D------ (PTH stimulates vit D production- so it does this indirectly)

Front 42

vitamin D__ is generated from sun-exposed skin, vitamin D__ is from plasnts.-- both are converted to ___ in the liver and ___ in the kidney

Back 42

D3, D2, 25 OH, 1,25 OH2

Front 43

vitamin D deficiency results in ____ in children and _____ in adults

Back 43

ricketts, osteomalacia

Front 44

Vit D increases absorption of both dietary ____ and ____.

Back 44

ca, phosphate

Front 45

triggers of increase 1,25 OH2 vitamin D:

Back 45

increase PTH, decrease Ca, phosphate ----> vit D negative feedback on itself

Front 46

following imbalances suggest what disorder: Ca up , Phosphate down , ALK phosphate up , PTH up

Back 46

hyperparathyroidism

Front 47

following imbalances suggest what disorder: Ca nl/up , Phosphate nl , ALK phosphate way up , PTH nl

Back 47

paget's disease of the bone

Front 48

following imbalances suggest what disorder: Ca up , Phosphate up , ALK phosphate nl/up , PTH down

Back 48

vit D intoxication

Front 49

following imbalances suggest what disorder: Ca down , Phosphate down , ALK phosphate up , PTH up

Back 49

vit D deficiency (osteomalacia)

Front 50

bone disorder following imbalances:
Ca nl , Phosphate nl , ALK phosphate nl , PTH nl

Back 50

bad question - but profile in osteoporosis

Front 51

following imbalances suggest what disorder: Ca nl , Phosphate nl , ALK phosphate nl , PTH up

Back 51

renal insufficiency

Front 52

calcitonin is made in the ______ cells of the thyroid

Back 52

parafollicular (C cells)

Front 53

calcitonin ____ bone resorption of calcium

Back 53

decreased (opposes actions of PTH)

Front 54

____ serum Ca causes release of calcitonin

Back 54

increased

Front 55

Most T3 is formed in the ______

Back 55

blood

Front 56

the 4 functions of T3 are (4Bs): ____, ____, ____, _____.

Back 56

brain maturation, bone growth, beta-adrenergic effects, increase BMR (increase Na/K/ATPase activity = O2 consumption, RR, increase in body temp)

Front 57

TSH stimulates _____ cells in the thyroids

Back 57

follicular cells

Front 58

hepatic failure would result in a ____ in TBG, while pregnancy would result in a ____ in TBG

Back 58

decrease, increase (estrogen increases TBG)

Front 59

functions of cortisol include: 5

Back 59

1)anti-inflammatory, 2)increase gluconeogenesis, lipolysis, proteolysis, 3) decrease immune function, 4) maintain BP, 5) decrease bone formation

Front 60

Insulin and IGF signal through ______ receptors

Back 60

tyrosine kinase

Front 61

brain and RBC take up glucose independent of insuline via _______ receptors

Back 61

glut-1

Front 62

dexamethasone supression test results: decrease cortisol after low dose

Back 62

healthy axis

Front 63

dexamethasone supression test results: high cortisol after low dose, decrease after high dose

Back 63

ACTH tumor (Cushing's disease)

Front 64

dexamethasone supression test results: high cortisol after low and high dose

Back 64

ectopic ACTH (small cell carcinoma) or cortisol producing tumor

Front 65

HTN, weight gain, moon facies, truncal obesity, buffalo hump, hyperglycemia, skin changes, osteoporosis, amernorrhea and immune suppression

Back 65

cushing's syndrom

Front 66

pituitary tumor leading to increased ACTH is call ______ disease

Back 66

cushings

Front 67

primary adrenal (hyperplasia/neoplasia) results in _____ ACTH and ______ syndrome

Back 67

decreased , cushings

Front 68

ectopic _____ production as seen in small cell lung cancer, can lead to cushing's syndrome

Back 68

ACTH

Front 69

primary ________, or Conn's syndrome, is caused by a _________ secreting tumor.

Back 69

hyperaldosteronism, aldosterone

Front 70

hypertension, hypokalemia, metabolic alkalosis, and LOW plasma renin

Back 70

Conn's (hyperaldo)

Front 71

secondary hyperaldosteronism is caused by ?

Back 71

renal artery stenosis, chronic renal failure, CHF, cirrhosis, or nephrotic syndrome.

Front 72

secondary hyperaldosteronism is differentiated from primary base on what lab value?

Back 72

plasma renin- low in primary (Conn's) and high in secondary

Front 73

hypotension, and skin hyperpigmentation

Back 73

addison's disease

Front 74

deficiency of ____ and ____ due to adrenal atrophy causes addison's disease

Back 74

aldosrterone and corticol

Front 75

Adrenal atrophy, Absence of hormone production, involves all 3 layers of cortex:

Back 75

addison's disease

Front 76

adrenal hemorrhage syndrome associated with meningoccocal septocemia

Back 76

waterhouse-friderichsen syndrome- acute adrenocortical insufficiency

Front 77

pheochromocytoma derived from _____ cells of __________ origin

Back 77

chromaffin cells of neural crest origin

Front 78

Pheochromocytomas are associated with _______ and MEN types ____ and ____

Back 78

neurofibromatosis, men types II, III

Front 79

most common adrenal medulla tumor in adults

Back 79

pheochomocytoma

Front 80

most common adrenal medulla tumor in children - associated with the ____ oncogene

Back 80

neuroblastoma, n-myc

Front 81

pheochromocytomas present with ____ in the urine, while neuroblastomas present with _____ in the urine

Back 81

VMA, HVA

Front 82

postpartum- fatigue, anorexia, poor lactation, and loss of pubic and axillary hair-

Back 82

sheehan's

Front 83

pheochromocytomas are treated with __ antagonists, especially _____, a nonselective irreversible blocker

Back 83

alpha, phenoxybenzamine

Front 84

rule of 10's- 10% malignant, bilateral, extra-adrenal, calcify, kids, familial applies to what disease?

Back 84

pheochomocytoma

Front 85

pancreas (Z-E syndrome, insulinomas, VIPomas), parathyroid, and pituitary tumors (prolactinoma)- presents with kidney stones and stomach ulcers-

Back 85

MEN type I

Front 86

medullary carcinoma of the thyroid, pheochromocytoma, parathyroid tumor

Back 86

MEN type II

Front 87

medullary carcinoma of the thyroid, pheochromocytoma, oral and intestinal ganglioneuromatosis (mucousal neuromas)

Back 87

MEN type III

Front 88

all MEN syndroms have ______ inheritance, and type II, III are associated with the ____ gene

Back 88

AD, ret

Front 89

rule regarding MEN syndromes and Ps-

Back 89

inverse- MEN 1 has 3 P's (pit, panc, parathyroid), MEN II (pheo, parathyroid), MEN III (pheochromo)

Front 90

cold intolerance, hypoactivity, weight gain, fatigue, lethargy, decreased appetite, constipations, weakness, decreased reflexes, myxadema, dry, cool skin, and coarse brittle hair

Back 90

hypothyroid

Front 91

heat intolerance, hyperacticity, weight loss, chest pain/palpations, arrythmias, diarrhea, increased reflexes, warm, moist skin, and fine hair

Back 91

hyperthyroidism

Front 92

stimulating TSH receptor antibodies.

Back 92

Graves- type II hypersensitivity

Front 93

ophthalmopathy, pretibial myxadema, diffuse goiter, presents during stress

Back 93

Graves- type II hypersensitivity

Front 94

thyroid replaced by fibrous tissue

Back 94

riedel's thyroiditis

Front 95

underlying graves with stress-induces catacholamine surge leading to death by _________: diagnosis

Back 95

arrythmia- thyroid storm

Front 96

slow course, moderatley enlarged nontender thyroid- wuth lymphocytic infiltrate in the germinal centers: hurthle cells on histology: hypothyroid

Back 96

hoshimoto's thyroiditis

Front 97

antimicrosomal and antithyroglobulin abs

Back 97

hoshimoto's thyroiditis

Front 98

self-limited hypothyroid often post-flu-like illness (may be hyperthyroid early in course)

Back 98

subacute thyroiditis (de quervain's)

Front 99

hypothyoid with elevated ESR, jaw pain, early inflammation, very tender thyroid gland- histology show granulomatous inflammation

Back 99

subacute thyroiditis (de quervain's)

Front 100

goider post iodine deprivation and iodine restoration-

Back 100

toxic multinodular goiter - releases T3 and T4

Front 101

most common thyroid cancer-

Back 101

papillary- good prognosis

Front 102

thyroid cancer with "ground-glass" nuclei (orphan annie)

Back 102

papillary

Front 103

thyroid cancer from parafollicular "c-cells" that produce calcitonin and sheets of cells in amyloid stroma

Back 103

medullary

Front 104

thyroud cancer associated with MEN types II, III

Back 104

medullary

Front 105

lymphoma in thyroid gland is associated with what disease?

Back 105

hashimoto's thyroiditis

Front 106

endemic cretinism is caused by _________ while sporadic is caused by a defect in ________.

Back 106

lack of iodine, defect in T4 or developmental failure of thyroid

Front 107

pot-bellies, pale, puffy faced child with protruding umbilicus and protuberant tongue

Back 107

cretinism- common in china

Front 108

large tongue with deep furrows, deep voice, large hands and feet, coarse facial features, impared glucose intolerance

Back 108

acromegaly (GH)

Front 109

what is used to treat acromegally?

Back 109

octreotide- (somatostatin that inhibits release of GH, glucagon, insulin, and gastrin)

Front 110

cystic bone spaces filled with brown fibrous tissue ?

Back 110

osteitis fibrosa cystica(part of hyperparathyroidism)

Front 111

what are the stone, bones, and groans of primary parathyroidism?

Back 111

stones = hypercalciuria bones= osteitis fibrosa cystica gorans= weakness an/or constipation

Front 112

secondary hyperparathyroidism is commonly cuased by a decrease in _________, most often due to _________

Back 112

serum calcium, chronic renal failure

Front 113

difference between 1 and 2 hyperparathyroidism as far as blood labs-

Back 113

primary (usually adenoma) = hypercalcemia, hypo phosphatemia, secondary (renal disease) =hypocalcemia, hyper phosphatemia,

Front 114

bone lesion due to seconadry hyperPTH due to renal disease is called _______

Back 114

renal osteodystrophy

Front 115

chvostek's sign- =?

Back 115

tap facial nerve, contraction of muscles indicates hypocalcemia (tetany) as in hypoparathyroidism

Front 116

trousseau's sign =?

Back 116

occlusion of braichial artery with BP cuff- carpal spasm- as in hypocalcemia in hypoPTH

Front 117

AD disorder with kidney unresponsive to ______. Results in hypocalcemia, shortened 4th/5th digits, short stature..

Back 117

PTH, psuedohypoparathyroidism

Front 118

treatment for prolactinoma

Back 118

bromocriptine (DA agonsist)

Front 119

what are chronic manifestations of Diabetes and nonenzymatic glycosylation on small vessels?

Back 119

diffuse thickening of the basement membrane leads to retinopathy, glaucoma, nephropathy (nodular sclerosis,progressive proteinuria, chronic renal failure, arteriosclerosis leading to HTN, kimmelstiel-wilson nodules)

Front 120

what are chronic manifestations of Diabetes and nonenzymatic glycosylation on large vessels?

Back 120

large vessel artherosclerosis, CAD, peripheral vascular occclusive disease and gangrene, cerebrovacular disease

Front 121

what 2 manifestations of osmotic damage are seen in DM

Back 121

neuropathy ( monot, sensory, autonomic degeneration), and cataracts (sorbitol accumulation)

Front 122

HLA ___ and ___ are associated with type I DM, not type II

Back 122

DR3 DR4

Front 123

Diabetic ketoacidosis is usually triggered by _____

Back 123

increase in insulin requirement as in stress or infection

Front 124

where do ketone bodies come from during DKA

Back 124

excess fat breakdown (insulin resistance) and increased ketogenesis from the increase in free Fas, which are made into ketone bodies (beta-hydroxybutyrate> acetoacetate)

Front 125

signs and symptoms of DKA

Back 125

kussmaul respirations, N,V, abd. Pain, psychosis/delerium, dehydration. Fruity breath odor

Front 126

in DKA, the follwing labs are seen hyperglycemia, ___H+, ___ HCO3-, increase blood ketones, leukocytosis, ____kalemia, ____ intracellular K+ due to decreased insulin.

Back 126

increase, decrease, hyper, decrease

Front 127

mucormycosis, rhizupus infections, cerebral edema, cardiac arrhythmias, heart failure are all copmlications of:

Back 127

DKA

Front 128

Tx for DKA includes:

Back 128

fluids, insulin, K (intracellular stores), glucose if necessary to prevent hypoglycemia

Front 129

intense thirst and polyuria without ability to concentrate urine:

Back 129

Diabetes Insipidus (no ADH)

Front 130

test for diabetes insipidus:

Back 130

water deprivation test- urine osmolality doesn't increase (response to desmopressin distinguishes between primary (works) and secondary (as in kidney- doesn't work)

Front 131

in DI, urine S.G. ______, while serum OSM ________

Back 131

decreased (<1.006), increased >290 OSM

Front 132

central DI is treated with ________, while nephrogenic DI is treated with ________

Back 132

desmopressin (ADH analog), diarrhetics (hydroclorothiozide, indomethacin? , amiloride) both need adequate fluid intake

Front 133

SIADH results in 1______2______3______

Back 133

excessive water retention, hyponatremia, urine osmolarity> serum osmolarity

Front 134

SIADH treatment is with 1_______(easiest) or 2________

Back 134

water restriction, demeclocycline?

Front 135

top 4 causes of SIADH:

Back 135

1) ectopic- small cell lung cancer 2) CNS disorder/head trauma 3) pulmonary disease 4) drugs (cyclophosphamide)

Front 136

recurrent diarrhea, cutaneous flushing, asthmatic wheezing, and right-sided valvular disease: increase in 5-HIAA in urine

Back 136

carcinoid syndrome

Front 137

most common tumor of appendix

Back 137

carcinoid syndrome

Front 138

carcinoid tumors are derived from ______ cells, and secrete high levels of ______ (although not seen if goes through 1st pass metabolism)

Back 138

neuroendocrine, 5-HT

Front 139

treatment for carcinoid syndrome

Back 139

octreotide- (somatostatin that inhibits release of GH, glucagon, insulin, and gastrin)

Front 140

rule of 1/3's appies to what? 1/3 metastasize, 1/3 present with 2nd malignancy, 1/3 multiple

Back 140

carcinoid syndrome

Front 141

gastrin-secreting tumor of pancrease or duodenum- causes recurrent ulcers.

Back 141

Zollinger-ellison syndrome

Front 142

MEN type I assocaited with this disease of the pancrease or duodenum

Back 142

Zollinger-ellison syndrome

Front 143

MOA of sulfonylureas

Back 143

close the K+ channel in B-cell --> depolarizes cell--> triggering insulin release via influx of Ca++

Front 144

MOA of metformin

Back 144

unkown- possibly decrease gluconeogensis

Front 145

MOA of glitazones

Back 145

increase target cell response to insulin (skeletal muscle, adipose tissue)

Front 146

MOA of alpha-glucoside inhibitors

Back 146

inhibit intestinal bruch border alpha-glucosidases- delayed sugar hydrolysis and glucose absorption--> decreased postprandial hyperglycemia

Front 147

which diabetic drug class can result in disulfam-like effects

Back 147

sulfonylureas

Front 148

lactic acidosis is the most grave toxicity of this diabetes drug

Back 148

metformin

Front 149

these diabetic drugs can result in weight gain, edema, hepatotoxicity, and CV toxicity. Nasty

Back 149

glitazones

Front 150

tolbutamide and chlorpropamide are 1st generation ______

Back 150

sulfonylureas

Front 151

glyburide , glimepiride, anf glipizide are 2nd gen______

Back 151

sulfonylureas

Front 152

acarbose and miglitol belong to the ____ class of antidiabetic drugs

Back 152

alpha-glucosidase inhibitors