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Endocrinology
Overall by section
| Question | Answer |
|---|---|
| From what amino acid is Thyroid hormone made from? | Tyrosine |
| Which amino acid is a precursor of Tyrosine? | Phenylalanine |
| Which segment of the loop of Henle, actively reabsorbs sodium? | Thick segment |
| Which segment of the loop of Henle in the nephron, passively reabsorbs sodium? | Thin segment |
| What is used by the thick ascending loop of Henle, to actively reabsorb sodium? | Na+/K+/2Cl cotransporter |
| What substance remain impermeable in both the thin and thick ascending loop of Henle? | Water |
| Which organ produces IGF-1? | Liver |
| What is a result of elevated GH levels? | Increased IGF-1 |
| How does IGF-1 work? | Binds to its receptors causing increased tyrosine kinase receptor activity |
| What type of receptors are used by IGF-1? | Tyrosine kinase receptor |
| To which receptors, V1 or V2, does ADH bind? | V2 receptors |
| What is the result of ADH bind to V2 receptors in the kidney? | Activation of adenylyl cyclase and sets-off cAMP-mediated signaling cascades, ultimately causing increased water reabsorption |
| How is IGF -1 related to serum glucose homeostasis? | 1. Enhances insulin sensitivity 2. Increases cellular glucose uptake 3. Decreases hepatic gluconeogenesis |
| How does ESRD lead to increased risk for bone fracture? | Leads to reduced filtration of phosphate, which contributes to hypocalcemia, secondary hyperPTH, and ultimately bone disease |
| What is the most common cause of Congenital Adrenal Hyperplasia (CAH)? | 21-hydroxylase deficiency |
| How is a female patient with 21-(OH) deficiency clinically presented? | Virilized genitals, HYPOTENSION, hyperkalemia, and hyponatremia |
| Are levels of 17-hydroxyprogesterone elevated or decreased in 21-hydroxylase deficiency? | Elevated 17-(OH) |
| What are the clinical features of 17-(OH) deficiency? | Impaired production of sex hormones and excess production of mineralocorticoids |
| Which CAH pathology is characterized by low levels of sex hormones and increased mineralocorticoids? | 17α-hydroxylase deficiency |
| Which CAH pathology is featured by decreased glucocorticoid and sex steroid synthesis? | 17α-hydroxylase deficiency |
| Which adrenal gland zone is expected to undergo hypertrophy in patients with 17α-hydroxylase deficiency? | Zona fasciculata |
| Which thyroid condition is characterized by a painful goiter and sings of hypothyroidism? | Subacute granulomatous thyroiditis |
| What are the histological findings of Subacute granulomatous thyroiditis? | Granulomatous inflammation with multinucleated giant cells |
| What does administering 5% dextrose to a healthy individual is equivalent to? | Administering pure water because the dextrose is quickly metabolized |
| A low ADH secretion leads to: | 1. Decreased water reabsorption 2. Decrease urea reabsorption from the collecting duct |
| What are common mass-effects due to prolactinomas in women? | 1. Prolactin-induced milk production 2. Hypoestrogenism secondary to prolactin suppressing of GnRH |
| What are risks of women with hypoestrogenism? | Increased risk of oligo/amenorrhea, anovulation, decreased bone density and osteoporosis, and vaginal atrophy |
| Which endocrine tumor often precedes a setting on hypoestrogenism? | Prolactinomas |
| Which is the signaling pathway family of IGF-1? | Tyrosine kinase |
| What are the main electrolyte and physical features of 21β-hydroxylase deficiency? | Virilization, hypotension, hyponatremia, and hyperkalemia |
| 21β-hydroxylase deficiency most often lead to what levels of androgens and mineralocorticoids? | High androgens and low cortisol and mineralocorticoids |
| How are Thyroglossal duct cyst most often presented? | Childhod as an anterior midline neck mass that moves with swallowing or tongue protrusion |
| Child with midline neck mass that moves as patient swallow saliva. Dx? | Thyroglossal duct cyst |
| What is leptin? | Appetite regulatory hormone synthesized by the adipose tissue in response to high-energy states (fed) |
| Does leptin concentration increased or decreased with weight loss? | Decreases |
| What is an important consequence of elevated GH, other than acromegaly? | Impaired glucose tolerance and DM |
| Secondary hyperPTH is a major complication of: | CKD |
| What are the common serum levels of a patient with CKD? | Elevated PTH, low calcium, and hyperphosphatemia |
| What are the common clinical consequences in males of Hyperprolactinemia? | Gynecomastia, galactorrhea, decreased libido, and erectile dysfunction |
| An antipsychotic would increase or decrease prolactin secretion? | Increase prolactin |
| What is the common treatment of Central DI? | Arginine vasopressin (DDAVP), providing an ADH-like agent that concentrates urine |
| DDVAP MOA: | 1. Provides ADH-like agent 2. Release vWF from endothelial cells |
| What are the common features of Diabetic retinopathy? | Slow onset of blurry vision, floaters, dark spots, and loss of night vision |
| What is the underlying mechanism of visual disturbances in Diabetic retinopathy? | Macular edema because of microaneurysm formation and hemorrhage from fragile vessels |
| What is the cause for Cushing disease? | High cortisol level due to excess ACTH secretion from the anterior pituitary |
| How do sulfonylureas cause episodes of hypoglycemia? | Due to increased release of insulin from pancreatic B cells |
| What is an example of a common sulfonylurea that often cause hypoglycemic episodes? | Chlorpropamide |
| Another name for Primary Adrenal Insufficiency? | Addsion disease |
| Addison disease cause a decrease in: | Glucocorticoids, mineralocorticoids, and androgens |
| What is the relation in Addison disease between serum cortisol and ACTH production? | Low serum cortisol land increased production of ACTH by the anterior pituitary gland |
| What are endorphins? | Endogenous hormones produced by the pituitary gland that function to reduce pain and induce euphoria |
| What are is the term for endogenous hormones that are produced by the pituitary gland, reduce pain, and induce euphhoria? | Endorphins |
| Which CAH condition is associated with ambiguous genitalia in a female along with hypotension? | 21α-hydroxylase deficiency |
| What is the receptor type of endorphins in the PNS and CNS? | GPCR |
| What causes the ambiguous genitalia in 21α-hydroxylase deficiency females? | Increase level of androgens by the Z reticularis |
| Rare form of CAH that presents with hypertension, hypokalemia, and hypogonadism. Dx? | 17α-hydroxylase deficiency |
| Which product is synthesized in excess in 17α-hydroxylase deficiency? | Mineralocorticoids by the Z glomerulosa |
| Which type of acid-base disorder is associated with Primary Hyperaldosteronism? | Metabolic alkalosis |
| What are the 2 main causes of Primary hyperaldosteronism? | 1. Adrenal adenoma 2. Adrenal hyperplasia with hypersecretion of aldosterone from the Z. glorumelosa |
| What are signs and symptoms that would indicate a Disulfiram-like reaction? | Headache, blurry vision, vomiting, hypotension, and facial flushing after alcohol consumption |
| Which enzyme is inhibited by disulfiram-like reaction? | Aldehyde dehydrogenase |
| What substance is accumulated in the blood in a Disulfiram-like reaction? | Acetaldehyde |
| Which is a common sulfonylurea that cause a disulfiram-like reaction? | Tolbutamide |
| What are two common examples of Thiazolidinediones? | Pioglitazone and Rosiglitazone |
| MOA of Thiazolidinediones? | Activation of PPAR increase peripheral sensitivity to insulin, decreasing blood glucose level |
| Which class of DM drugs safe to use in patients of CKD? | Thiazolidinediones |
| Which CAH is characterized by impaired production of sex hormones and excess production of mineralocorticoids? | 17α-hydroxylase deficiency |
| What is the most common presentation of Follicular Thyroid carcinoma? | Nodule in the anterior neck and may cause local compression with hoarseness or dysphagia |
| What is the histology of Follicular Thyroid cancer? | Follicular clusters of epithelial cells that sometimes extend through the capsule. |
| What is the result of a Parathyroid adenoma? | Development of Primary hyperPTH, which resulting Osteitis Fibrosa Cystica due to activating osteoclast |
| Which bone-related cells are activation Osteitis Fibrosa Cystica? | Osteoclasts |
| What is the most common cause of malignant hypercalcemia? | Secretion of PTHrP |
| Which are the antibodies that cause Grave's disease? | Anti-TSH receptor antibodies |
| What is the result of the anti-TSH receptor antibodies in Grave's disease? | Stimulate the Thyroid gland to produce excess TH |
| What are the associated tumors in MEN-1? | Pancreatic tumor (MC gastrinoma), pituitary tumors, and PTH adenomas or hyperplasia |
| What is the reason for recurrent kidney stones in MEN-1? | Hyperparathyroidism due to PTH adenoma/hyperplasia leads to hypercalcemia |
| What are the main pathological findings of Papillary Thyroid cancer? | Psammoma bodies, nuclear grooves, and "Orphan Annie-eye" nuclei |
| Which thyroid cancer subtype is associated with "Orphan-Annie eye" nuclei? | Papillary Thyroid cancer |
| Which hormones are under-secreted in state of hypopituitarism? | Adrenocorticotropin, TSH, FSH, LH, GH, and prolactin |
| What serum abnormally may be experienced in a DM-2 patient n sulfonylurea? | Hypocalcemia |
| Which "heart" medication can mask the symptoms of DM? | Beta blockers |
| What is the MC pituitary tumor associated with MEN-1? | Prolactinoma |
| What cause hyponatremia in setting of small cell lung cancer? | SIADH secretion |
| What type of saline is used to treat the hyponatremia due to SIADH? | Hypertonic 3% normal saline |
| What serum abnormality and lung pathology can be suspected in a patient with slow infusion of hypertonic 3% normal saline? | Hyponatremia due to SIADH caused by small cell Lung carcinoma |
| What is the common clinical presentation of Addison disease? | Weakness, abdominal pain, weight loss, vomiting & diarrhea, and hyperpigmentation |
| Why are levels of cortisol and aldosterone unchanged in Addsion disease? | Adrenal gland cannot synthesize the hormones |
| What is the most common type of supratentorial cancer in children? | Craniopharyngioma |
| What is the significant endocrine consequence of a Craniopharyngioma? | Hypopituitarism |
| Which organ is the most common site for a Somatostatinoma? | Pancreas |
| Which cells produce Somatostatin? | Pancreatic D cells |
| What hormone is produced by Pancreatic D cells? | Somatostatin |
| What pathology is suggested in cases of diagnosing Cushing syndrome and the high cortisol levels failed to be suppressed even with high dose dexamethasone? | ACTH-secreting tumor |
| What are the features of Primary polydipsia? | Excessive water intake in the setting of normally functioning kidneys |
| Which type of patients most often present cases of Primary Polydipsia? | Patients on psychoactive medication that present with hyponatremia, polyuria, and dilute urine |
| Which type of DI has concertation of urine with administrating of ADH? | Central DI |
| What are common cause of Central DI? | Head trauma, brain surgery, or pituitary tumors |
| What are two common GLP-1 analogues? | Exenatide and Liraglutide |
| MOA of GLP-1 analogues | Increase glucose-dependent insulin secretion and decrease glucagon secretion |
| Wath is the cause of Diabetic polyneuropathy? | Axonal damage as result of chronic hyperglycemia |
| What anticonvulsant is known to treat Diabetic polyneuropathy? | Gabapentin |
| What MOA of Gabapentin aids to treat DM polyneuropathy? | Inhibition of presynaptic voltage-gated calcium channels, prevent release of excitatory glutamate and thereby providing analgesia |
| Which channels are blocked by Gabapentin? | Presynaptic Voltage-gated Calcium channels |
| Inhibition of presynaptic voltage gated Ca2+ channels by Gabapentin leads to failed release of which neurotransmitter? | Glutamate |
| In primary polydipsia what would be the free water clearance? | Positive; thus, reflecting the kidney's excreting free water in the setting of excessive water intake |
| What is the type of hyponatremia seen in Primary Polydipsia? | Hyponatremia with low plasma (hypoosmolality) and low urine osmolarity |
| What is a common cause of Euvolemic hyponatremia? | SIADH |
| What are common drugs that cause SIADH? | Glyburide, thiazides, antidepressants, or antipsychotics |
| Patients with SIADH present with: | Reduced free water clearance, resulting in water retention |
| What type of thyroid cancer is associated with MEN2-A and MEN2-B? | Medullary thyroid cancer |
| Which gene mutation leads to Medullary Thyroid cancer? | RET gene mutations |
Created by:
rakomi
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