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Endocrine notas
| Question | Answer |
|---|---|
| It helps to down regulate gastric secretion after a MEAL? | Intestinal Influences |
| Stimulation of acid secretion within the stomach three phases? | Cephalic, gastric and intestinal |
| Mediated primarily by cholinergic and vagal mechanism and is triggered by the thought, sight, smell and taste of food? | Cephalic phase |
| Mediated by the presence of GASTRIN (which stimulates histamine secretion and indirectly acid secretion) and triggered by the chemical stimulus of food and distention of the stomach? | Gastric phase |
| Initiated when protein containing food enters the duodenum it plays a role in stimulating gastric acid secretion? | Intestinal phase |
| Organs that release peptide YY which binds to receptor on the endocrine, histamine containing cells described as enterochromaffin like (ECL)? | Ileum and colon |
| Increase plasma HCO3 and decrease in plasma Cl- secondary to the surge of acid within the gastric lumen? | Postpandrial alkaline tide |
| Pituitary adenoma Cell type that causes Hypogonadism, infertility ( men), causes galactorrhea, amenorrhea (women)? | Lactotroph (prolactin) |
| Pituitary adenoma cell type causes Cushing disease? | Corticotroph (ACTH) |
| Pituitary adenoma cell type that causes acromegaly in adults and Gigantism in children? | Somatotroph (growth hormone) |
| Pituitary adenoma cell type that causes Thyrotoxicosis? | Thyrotroph (TSH) |
| Pituitary adenoma cell type that causes Nonfunctioning (hypopituitarism) and mass effect? | Gonadotroph (LH, FSH) |
| Large tumors can cause HEADACHES due to mass effect and compression of the optic chiasm by SUPRASELLAR extension of the tumor can cause? | Bitemporal hemianopsia |
| Suppresses GnRH production from Hypothalamus which leads to amenorrhea in women and hypogonadism (impotence, decreased libido, infertility in men)? | Prolactin (lactotroph) |
| Features of acromegaly? | Enlarged facial, brow protrusion, prognathism, skin tags, cardiomyopathy/enlarged organs, large hands, arthritis, large feet, carpal tunnel Sx and peripheral neuropathy. |
| Features of Cushing syndrome? | Moon face, muscle wasting, striae, Buffalo hump, supraclavicular fat pads, central obesity |
| Large pituitary mass causes bitemporal visual field deficit, high prolactin, what is the changes in LH, GnRH and testosterone? | ⬇️ GnRG, ⬇️ LH ⬇️ Testosterone |
| ⬇️ low Testosterone results in loss of negative feedback on GnRH release, causes ⬆️ GnRH ⬆️LH | Primary Hypogonadism |
| Prolactinoma mass effect symptoms | Headache, visual field defects, suppression of other pituitary hormones |
| Complication of prolactinoma (hyperprolactinemia) in children/adolescents? | Delayed puberty, growth impairment |
| Manifest as vasomotor symptoms (flashes) vaginal dryness and atrophy and dyspareunia? | Estrogen deficiency |
| Maintain bone mass in premenopausal women, can lead to Osteoporosis and increased risk for fragility fractures (fractures due to minimal trauma, such as a fall from standing height) | Estrogen |
| It can lead to enlargement of the thyroid gland and compressive symptom like dysphagia (swallowing difficulty) | Chronic TSH stimulation |
| Complication of hyperparathyroidism | Osteoporosis and kidney stones |
| The cc of Syndrome of Inappropriate Antidiuretic Hormone Secretion SIADH? | Central nervous system disruption (stroke, infection, trauma, neurosurgery). *Malignancies(small cell lung carcinoma). *Drugs (desmopressin, Chlorpromide and carbamazepine). *Pulmonary disorders (pneumonia, tb and ventilator use). |
| Produced in hypothalamus and secreted from Posterior pituitary in response to changes in plasma Osmolality and intravascular volume? | ADH |
| Tumor of Neuroendocrine origin, released ADH independent feedback inhibition (paraneoplastic effect)? | Small cell lung carcinoma |
| SIADH leads to? | Hyponatremia (can cause headache, weakness, altered mental status and seizures), ⬇️plasma osmolality (Euvolemic hypinatremia), ⬆️ Urine osmolality (normal. <100) |
| Leg immobilized with cast several weeks, removal of casting materials finds 2 cm decrease in diameter during the time of immobilization. Pathologic process similar to? | Adrenal glands during prolonged glucocorticoid therapy |
| The skeletal muscle fibers decreased in size leading to? | Disuse atrophy |
| Tissue loss due to cellular DEATH or Reduced cell size. | Atrophy |
| Due to lack of use, loss of hormonal or neurologic stimulation, impaired circulation, mechanical compression, aging or nutritional insufficiency? | Pathologic atrophy |
| Characterized by decreased protein synthesis and loss of myofibrils? | Muscular atrophy |
| Seen in adrenal cortex during prolonged glucocorticoid use due to suppression of ACTH release, it can lead to acute adrenal insufficiency if exogenous glucocorticoid therapy is abruptly discontinued? | Pathologic atrophy |
| Endometrial tissue during ESTROGEN replacement therapy can cause? | Hyperplasia |
| Esophageal mucosa upon repeated acid exposure, chronic gastroesophageal reflux, may cause? | Metaplasia |
| Heart muscle during long standing hypertension is prone to develop? | Hypertrophy |
| HELICOBACTER pylori testing is negative, partial gastrectomy for peptic ulcer, gastric mucosa reveals parietal cell hyperplasia and the proliferation of parietal cell is due to ? | Gastrin |
| Diabetes mellitus coalescing erythematous plaques with crusting and scaling at the border and central areas of brownish induration the biopsy reveal superficial necrolysis? | Elevated ⬆️Glucagon |
| Features of Glucagonoma clinical presentation? | Necrolytic migratory erythema, erythematous papular/plaques on face, perineum & extremities. Lesions enlarge & coalesce, leaving a central indurated area with peripheral blistering & scaling. DM/hyperglycemia, GI (diarrhea, anorexia, abdominal pain). |
| Acts on the liver to promote AMINO ACIDS oxidation and GlucoNeogenesis from amino acids? | Glucagon |
| Gastrinoma are associated with hypersecretion of gastric acid and resultant GI ulceration? | Elevated GASTRIN |
| Occur in gastrinomas in unusual areas such as JEJUNUM also presents with diarrhea and abdominal pain? | Peptic ulcer |
| Presents with abdominal pain, gallbladder stones, constipation, hyperglycemia, and steatorrhea? | Somatostatinoma |
| Typically presents with intractable diarrhea, hypokalemia, and achlorhydria, hypotension due to dehydration is due to? | Elevated vasoactive intestinal polypeptide (VIPoma) |
| Insulin levels tend to be normal but can be elevated secondary to hyperglycemia and glucagon induced stimulation of? | Pancreatic beta cells |
| Resemble necrolytic migratory erythematous skin lesions predominantly vesicular and pustular. Causes hypogonadism, impaired taste and smell, night blindness and impaired wound healing. | Zinc deficiency |
| Neural crest fails to migrate into the derivative of the 3rd (affects INFERIOR parathyroid and thymus) and 4th (affects SUPERIOR parathyroid) pharyngeal/branchial pouches. | DiGeorge Sx. |
| Parathyroid and thymic hypoplasia results in? | Hypocalcemia and T cell deficiency |
| In DiGeorge Sx it leads to increased neuromuscular excitability, it manifest tetany, carpopedal spasm | |
| In DiGeorge Sx it leads to increased neuromuscular excitability, it manifest tetany, carpopedal spasm or seizures? | Hypocalcemia (<8.4 mg/dL) |
| It’s absence leads to T cell dysfunction and results in recurrent viral, fungal and protozoan infections. | Thymic hypoplasia |
| Is a fibro muscular tissue between Uro genital triangle and Anal triangle.. | Perineal body laceration |
| It’s a vertical incision from posterior vaginal opening to perineal body? | Midline episiotomy |
| It transects tissue but NOT external anal sphincter or rectal mucosa. | Vaginal Sub Mucosal |
| Injecting intravaginally medial to ischial spine, through sacro spinous ligament | Pudendal Nerve Block anesthesia to most perineum |
| Regulated by inhibitory effects of hypothalamic dopaminergic pathways? | Prolactin (PRL) production |
| Is stimulated by thyrotropin releasing hormone (TRH) | Prolactin secretion |
| Prolactin increase production of TRH by hypothalamus can lead to Hyper PRL | Primary HypoThyroidism patients |
| Most common active pituitary adenoma? | prolactinomas |
| These tumor can cause galactorrhea and amenorrhea in pre-menopausal women? | Prolactinomas |
| Presents with a large mass, visual changes and headaches may occur due to compression of Optic Chiasm | prolactinomas |
| Hormone responsible for stimulating the Endometrium so that it is suitable for implantation? | Progesterone |
| Withdrawal causes endometrial cells to undergo apoptosis, resulting in menstrual bleeding? | Progesterone |
| Stimulates THECA interna cells of ovarian follicle to produce Androgens. | LH |
| Aromatase within follicles granulosa cells converts androgens to? | Estradiol under FSH stimulation. |
| Serve as connective tissue support structure for follicle | THECA externa cells |
| Competitive inhibitors of estrogen binding to estrogen receptors | SERM- Selective Estrogen Receptor Modulators (Tamoxifen,Raloxifene) |
| Has an estrogenic effect on uterus and can cause endometrial hyperplasia & cancer. | Tamoxifen (SERM) |
| presents as irregular shaped, adherent breast mass, mc in upper OUTER quadrant? | Invasive Breast cancer |
| In breast cancer suspensory ligaments can cause skin retractions? | Malignant infiltration |
| Presents without breast masses or skin changes, is a mcc of bloody type nipple discharge? | Intraductal papilloma |
| P310. Complications of Prolactinomas? | Hyperprolactinemia, Mass effect symptoms |
| P310. Hormones that may increase prolactin levels are? | Thyrotropin releasing hormone (TRH), VIP, Oxytocin and Vasopressin. |
| P310. Suppresses GnRH production from hypothalamus which causes decreased libido, amenorrhea, and infertility? | Excess Prolactin |
| P310. Prolactin inhibiting GnRH secretions results in? | ⬇️ LH, ⬇️ FSH from anterior pituitary preventing ovulation |
| Helps maintain bone mass in premenopausal women, prolonged estrogen deficiency can lead to osteoporosis and an increased risk for fragility fractures (due to minimal trauma, such as a fall from standing height). | estrogen |
| Characterized by primary hyperparathyroidism (with hypercalcemia), pituitary tumors (including prolactinoma) and endocrine pancreatic tumors? | MEN 1 (multiple endocrine neoplasia 1) |
| Inhibit prolactin secretion and can be used in treatment of prolactinoma? | Bromocriptine (tx also for parkinson) |
| Compression of the optic chiasm by suprasellar extension of pituitary tumors causes? | Bitemporal hemianopsia |
| Due to sudden hemorrhage into the pituitary presents with acute severe headache, opthalmoplegia, and altered sensorium? | Pituitary apoplexy |
| Is the mc inflammatory condition of the pituitary and occurs late in pregnancy or early postpartum period, presents as acute with severe headaches and visual field defects? | Lymphocytic hypophysitis |
| Antipsychotic (risperidone, haloperidol, fluphenazine, chlorpromazine) and antidepressants action is? | Inhibit DOPAMINE D2 receptors (theres a loss of the normal tonic inhibition of prolactin release) causes hyperprolactinemia |
| What’s the adverse effect of LITHIUM used in manic and depressive, bipolar disorder? | Diabetes insipidus, Hypothyroidism, Tremor, Ebstein anomaly (teratogenic) |
| During pregnancy has been associated with Ebstein anomaly of the tricuspid valve? | lithium |
| Situated in lower anterior neck, in front of upper trachea and larynx | Thyroid gland |
| Is a low affinity, high capacity transport protein that is responsible for reabsorbing 90% of filtered glucose in the proximal tubule? | Sodium Glucose Cotransporter 2 (SGLT2) |
| Oral anti diabetic that decrease renal reabsorption of glucose, leading to increased urinary glucose loss and decreased blood glucose levels? | SGLT2 inhibitors (canagliflozin, Dapagliflozin) Sodium Glucose cotransporter 2 inhibitor |
| Inhibits hepatic GlucoNeogenesis and increase peripheral glucose utilization? | Metformin |
| Is caused by stimulation of orbital fibroblast by thyrotropin receptor antibodies, which leads to excess deposition of Extracellular glycosaminoglycans? | Graves ophthalmopathy |
Created by:
Lillianita
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