Quiz 1

Front 1

what makes PTH?

Back 1

chief cells in the Parathyroid gland

Front 2

Collagen found in bone

Back 2

collagen type 1

Front 3

Collagen found in cartilage

Back 3

Collagen type 2

Front 4

paraventricular nucleus

Back 4

oxytocin and vasopressin

Front 5

what produces oxytocin

Back 5

paraventricular nucleus

Front 6

what produces ADH

Back 6

supraoptic nucleus and the paraventricular nucleus

Front 7

supraoptic nucelus

Back 7

produces ADH

Front 8

what does the adenohypophysis drain into

Back 8

anterior pituitary drains into the portal hypophysial blood vessels

Front 9

leuprolide

Back 9

GnRH agonist

used to treat prostate cancer

Front 10

Goserelin

Back 10

GnRH agonist

used to treat prostate cancer

Front 11

Degarelix

Back 11

GnGH antagonist

used to treat prostate cancer

Front 12

Somatropin

Back 12

GnRH agonist

used to treat dwarfism

Front 13

Mecasermin

Back 13

recombinant IGF-1

used to treat pituitary dwarfism

a little dwarf in a meca-suit

Front 14

octreotide and lanreotide

Back 14

somatostatin agonist

used to treat gigantism or acromegaly

Front 15

pegvisomant

Back 15

growth hormone receptor antagonist

Front 16

Risperidone

Back 16

antipsychotic drug that inhibits doapmine release and can cause hyperprolactinemia

Front 17

which hormones are produced by the anterior pituitary

Back 17

GH, ACTH, TSH, FSHm LH, and prolactin

adrenocorticotropic hormone

Front 18

Somatotropin

Back 18

Growth Hormone

Front 19

Basophilic hormones

Back 19

B-FLAT

FSH, LH, ACTH, TSH

Front 20

what do alpha, beta, and delta pancreatic cells secrete

Back 20

alpha- glucagon

beta- insulin

delta- somatostatin (growth hormone release inhibiting hormone)

Front 21

Nelson syndrome

Back 21

rapid enlargement of a pituitary adenoma that occurs after the removal of both adrenal glands, which causes cushing's syndrome

seen in corticotroph cell adenoma

Front 22

Sheehan's Syndrome

Back 22

postpartum necrosis of anterior pituitary due to post-partum hemorrhage, DIC, sickle cell anemia, trauma or shock

Front 23

patient presents with cushing-like symptoms but decreased ACTH levels

Back 23

the cause is the adrenal gland.

high ACTH suggests there is a problem with the pituitary or an ectopic source (SCC) pumping out ACTH leading to disease. low ACTH levels tell us the adrenal gland is pumping out excess cortisol on its own.

Front 24

Familial AD supernumerary copies of the N-myc oncogene on chromosome 1

Back 24

Adrenal neuoblastoma

Front 25

describe the axis for the release of cortisol

Back 25

Hypothalamus secretes Corticotropin releasing hormone (CRH) --> anterior pituitary releases ACTH --> adrenal cortex releases cortisol

Front 26

compare primary to secondary adrenal insufficiency

Back 26

primary- low cortisol and aldosterone

secondary- decreased ACTH secretion but no loss of aldosterone

Front 27

Orphan Annie Eyes

Back 27

Papillary Carcinoma of the Thyroid

Front 28

Psammoma

Back 28

calcifications seen in:

1. papillary carcinoma of the thyroid

2. papillary carcinoma of the ovary

3. meningioma of the brain

Front 29

one parathyroid gland is enlarged

all glands are enlarged

Back 29

parathyoid adenoma

parathyroid hyperplasia

Front 30

endocrine disease often associated with chronic renal failure

Back 30

parathyroid hyperplasia

Front 31

patient presents with decreased libido, moderately obesity, gynocomastia or galactorrhea

Back 31

Prolactinoma?

Front 32

Patient presents with amenorrhea, galactorrhea, decreased libido, and infertility

tests, diagnosis, treatment

Back 32

test- check prolactin levels

Dx- prolactinoma

Rx- Cabergoline or Bromocriptine

"losing your libido and milk will make you less of a bro and more crabby"

Front 33

treatment for prolactinoma

Back 33

Cabergoline and bromocriptine

"losing your libido and mil will make you less of a bro and more crabby"

Front 34

what is the most common functional pituitary tumor

Back 34

prolactinoma

Front 35

insulin induced hypoglycemia test is abnormal

Back 35

gold standard in the diagnosis of Growth Hormone Deficiency (GHD)

when insulin is administered the GH should increase to counteract it, but here we have a GH deficiency

Front 36

abnormal glucose suppression of GH test

Back 36

GH excess (acromegaly or gigantism)

normally when glucose is given we want less less GH (it is the opposite of insulin), but here we have an excess of GH

Front 37

best treatment for GH excess

Back 37

pituitary surgery

if that doesn't work then Octreotide (somatostatin receptor ligand- GH release inhibitor)

Front 38

Octreotide

Back 38

(somatostatin receptor ligand- GH release inhibitor)

Front 39

patient is given ACTH and there is no rise in cortisol levels

Back 39

primary or secondary adrenal insufficiency

Front 40

most common cause of hypopituitarism?

Back 40

pituitary tumors

Front 41

most pituitary tumors are non-functioning or functioning

Back 41

functioning

Front 42

long-term vs short-term mortality from hypopituitarism

Back 42

LT- CVD

ST- Lack of cortisol

Front 43

when people stop taking their glucocorticoids, it is the most common cause of what?

Back 43

secondary adrenal insufficiency and hypoadrenal crisis

they need to take their drugs so they will have cortisol or they could die

Front 44

treatment for ACUTE primary hypoadrenalism

Back 44

cortisol, fluid, glucose

hydrocortisone

Florinef

Front 45

treatment for CHRONIC primary hypoadrenalism

Back 45

hydrocortisone

Florinef

Front 46

patient presents with easy bruising, facial plethora, proximal myopathy, redish violaceous striae

Back 46

Cushing's

Front 47

Cushing's disease and dexamethasone suppresses serum cortisol

Back 47

Pituitary disease- because the problem is in the pituitary, not the adrenal, which will respond to dexamethasone by decreasing cortisol production

Front 48

Cushing's disease and dexamethasone does NOT suppress serum cortisol

Back 48

adrenal disease- we do not suppress cortisol because the problem is in the adrenals which produce the cortisol

could also be ectopic ACTH/CRH

Front 49

pheochromocytoma and symptoms

Back 49

tumor of the adrenal medulla that produces catecholamines (epinephrine, norepinephrine, dopamine)

hyPertension, head Pain (headache), Palipitations, Perspiration, Pallor

Front 50

Neuroma phenotype of MEN 2

Back 50

pheochromocytoma

Front 51

effect on calcium levels in serum:

1. acidic environment

2. alkalemic environment

Back 51

1. increased ionized free calcium

2. decreased ionized free calcium

Front 52

GLUT 4

Back 52

adipose tissue and skeletal muscle

reduced in type 2 diabetes

Front 53

intranuclear inclusions

Back 53

characteristic of papillary carcinoma

Front 54

psammoma body

Back 54

papillary carcinoma of the thyroid

papillary carcinoma of the ovary

meningioma

Front 55

orphan annie eyes

Back 55

papillary carcinoma of the thyroid

ground glass appearance of nuclei

Front 56

ground glass appearance of nuclei

Back 56

papillary carcinoma of the thyroid

Front 57

high calcitonin secreteing tumr

Back 57

medullary thyroid carcinoma

Front 58

most common cause of cushing's

Back 58

exogenous- we need to rule it out

Front 59

Cushing disease vs syndrome

Back 59

disease means there is pituitary hypersecretion

syndrome means there is any other cause

Front 60

diabetic ketoacidosis is suggestive of what?

Back 60

characteristic of type 1 diabetes

Front 61

Howship's lacunae

Back 61

formed by osteoclasts as they break down bone

Front 62

what is unique to cortical bone

Back 62

Volkman's canals

Front 63

Alendronate

Back 63

Bisphosphonate- used to treat osteoporosis

reduces hip fractures

Front 64

Risedronate

Back 64

Bisphosphonate- used to treat osteoporosis

reduces vertebral fractures

Front 65

Reclast

Back 65

Bisphosphonate- used to treat osteoporosis

3 year risk reduction of vertebral fractures

Front 66

managing the intake of what is the primary strategy for achieving glycemic control

Back 66

carbohydrates

Front 67

give three examples of carbohydrates

Back 67

grains, fruit/juice, milk/yogurt

Front 68

GAB

Back 68

marker for type 1 diabetes- beta cell death

Front 69

what are the three ketone bodies

Back 69

aceto-acetate

acetone

B-hydroxybutyrate

Front 70

which ketone body does not go to the brain or heart

Back 70

acetone

Front 71

treatment of decompensated diabetes

Back 71

must replace insulin

Front 72

primary factor in diagnosis of metabolic syndrome

Back 72

waist circumference

Front 73

Wolff-Chaikoff Effect

Back 73

high levels of iodine in the blood cause decreased synthesis of thyroid hormone

Front 74

D1 vs D2 vs D3

Back 74

D1: reverseT3 --> T4 --> T3 (plasma T3 production)

Increases hyperthyroidism

D2: T4 --> rT3 (local T3 production)
Decreases hyperthyroidism

D3: T3 --> T4 (T3 degradation)
Increases hyperthyroidism

Front 75

Thyroidoxicosis

Back 75

hyperthyroidism

Front 76

what is a secondary cause of hyperthyroidism

Back 76

TSH-secreting pituitary adenoma

Front 77

most useful screening test for hyperthyroidism

Back 77

TSH

Front 78

most common cause of hyperthyroidism

Back 78

Grave's disease

Front 79

Diffuse Toxic hyperplasia

Back 79

Grave's Disease

autoantibody stimulates TSH receptors and leads to release of thyroid hormone

Front 80

patient is mentally retarded, has short stature, coarse facial features, and a protruding tongue

Back 80

cretinism

Front 81

MEN 2A and 2B

Back 81

pheochromocytoma

Front 82

patient presents with an enlarged thyroid shortly after a viral infection

Back 82

Subacute granulomatous (de Quervain) thyroidits

Front 83

antithyroid microsomal antibody test

Back 83

Hashimoto thyroiditis

Front 84

what can get into the airway and mimic anaplastic carcinoma

Back 84

Riedel thyroiditis

Front 85

what frequently metastasizes to the lateral lymph nodes of the neck

Back 85

papillary carcinoma

Front 86

during surgery one parathyroid gland is found to be larger than the rest, what is the diagnosis

Back 86

Parathyroid adenoma

Front 87

which thyroiditis is very hard- "hard as wood"

Back 87

Riedel fibrosing thyroiditis

Front 88

55 year old man presents with deepening of the voice and large tongue

Back 88

myxedema

Front 89

what is the most often used thyroid hormone and what is it?

Back 89

Levothyroxine

pure synthetic T4, so it has a slower onset and longer duration.

Front 90

methimazole

Back 90

antithyroid drug

inhibits thyroid peroxidase- blocks thyroid hormone synthesis

Front 91

Sodium iodide 131-I is used as a cure for what?

Back 91

hyperthyroidism

Grave's disease

Front 92

alendronate

Back 92

bisphosphonate

used to treat osteoporosis by inhibiting osteoclast activity, decreasing bone resorption

SE- osteonecrosis of the jaw and atypical femur fractures

Front 93

Risedronate

Back 93

intermittent bisphosphonate

Front 94

Zoledronic acid

Back 94

intermittent bisphosphonate

Front 95

Denosumab

Back 95

anti- RANK antibody- stops osteoclast activation

used to treat osteoporosis

Front 96

Teriparatide

Back 96

PTH hormone

activates osteoclasts to resorb bone, which causes it to grow back fuller

only drug that causes bone anabolism

Front 97

if TSH is high on a serum sensitive TSH assay suspect what?

Back 97

suspect hypothyroidism

Front 98

if TSH is low on a serum sensitive TSH assay suspect what?

Back 98

suspect hyperthyroidism

Front 99

antithyroid peroxidase antibodies present

Back 99

Hashimoto's thyroiditis

Front 100

high TSH, low free T3 and free T4

Back 100

hypothyroidism

Front 101

I-123

Back 101

used to test for hyperthyroidism

not for radioablation

Front 102

cold intolerance

constipation

facial puffiness

hair loss

dry skin

Back 102

Hypothyroidism

Front 103

when hypothyroidism is severe what can occur

Back 103

Myxedema

Front 104

Hashimoto's is hyper or hypothyroidism

Back 104

Hypothyroidism or more correctly it is thyroiditis

Front 105

Hypothyroidism (4 examples)

Back 105

-Hashimoto's (iodine sufficient; antibodies)

-Congenital hypthyroidism (cretinism)

-Subacute thyroiditis (de Quervain)- usually following the flu

-Riedel Thyroiditis (thyroid replaced by fibrous tissue)

Front 106

what is the main factor that predict s the progression of subclinical hypothyroidism to overt hypothyroidism

Back 106

the presence of antithyroid antibodies

Front 107

how do we treat subclinical hypothyroidism

Back 107

thyroxine (T4)

Front 108

low TSH, high free T3 and free T4

Back 108

hyperthyroidism

Front 109

hyperthyroidism with high radioiodine uptake

Back 109

goiter

toxic nodule or multinodular goiter

Front 110

iodine-131

Back 110

radio ablation

Front 111

pemberton sign

Back 111

you life your hands above your head and the goiter cuts off flow out your head- face turns red

Front 112

Goiter:

Is it hyperfunctioning?

Is it hypofunctioning?

Back 112

• Toxic multinodular goiter

• Hashimotos hypothyroidism

Front 113

what is the major incretin hormone

Back 113

Glucagon-like protein 1 (GLP)

it increases calcium levels in beta cells- stimulating insulin release

Front 114

compare GLUT 1-4

Back 114

o GLUT 1- all tissues (basal glucose uptake)
o GLUT 2- liver, pancreatic Beta cells, and GI epithelium
o GLUT 3- all tissues (basal glucose uptake)
o GLUT 4- muscle and fat cells

Front 115

C peptide

Back 115

o Proinsulin contains a C-peptide, but mature insulin does not.

o C peptide allows us to measure how much insulin in their blood came from an injection and how much is naturally produced.

Front 116

insulin upregulates which GLUT transporter

Back 116

GLUT 4

on skeletal muscle and adipocytes

Front 117

insulin enters beta cells via which GLUT

Back 117

GLUT 2

Front 118

what infection may trigger type 1 diabetes

Back 118

Coxsackie B4 virus

Front 119

patient presents with fruity smelling breath

Back 119

diabetic ketoacidosis

Front 120

amyloid deposits in the pancreatic islets

Back 120

type 2 diabetes

Front 121

patient presents with high insulin, low glucose, and high C peptide

Back 121

Insulinoma

Front 122

treatment-resistant peptic ulcers

Back 122

Insulinomas

Front 123

achlorhydria

Back 123

low stomach acid

Front 124

what is the drug of choice for type 2 diabetes and how does it work?

Back 124

Metformin

decreases gluconeogenesis and fatty acid oxidation in the liver

Front 125

patient presents with dermatitis, oral lesions, and abnormal amino acid levels

Back 125

Glucagonoma- tumor of the alpha cells of the pancreas

Front 126

what is the leading cause of blindness in adults

Back 126

diabetes

Front 127

patient presents with tremor, tachycardia, anxiety, sweating, flushing, abnormal mentation, headache, hypothermia, comvulsions

Back 127

Hypoglycemia

Front 128

what drugs block the post prandial rise in glucagon

Back 128

GLP-1 agents (Exenatide)

DPP-4 inhibitors

Front 129

what drug blocks glucose uptake in the intestines

Back 129

Acarbose