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Endocrinology
PASS program drill notes
| Question | Answer |
|---|---|
| What is a Somatotrope? | GH |
| What are a Gonadotropes? | LH, FSH |
| What is a Thyrotrope? | TSH |
| What is a Corticotrope? | ACTH |
| What is a Lactotrope? | Prolactin |
| What receptors do protein hormones use? | Cell membrane receptors |
| What are the steroid hormones? | "PET CAD" Progesterone E2 Testosterone Cortisol Aldosterone Vit D |
| Does Thyroid hormone act like a steroid or protein? | Steroid |
| What does Endocrine mean? | Secretion into blood |
| What does Exocrine mean? | Secretion into non-blood |
| What is Autocrine? | Works on itself |
| What is Paracrine? | Works on its neighbor |
| What is Merocrine? | Cell is maintained ==> exocytosis |
| What is Apocrine? | Apex of the cell is secreted |
| What is Holocrine? | The whole cell is secreted |
| What organs do not require insulin? | "BRICKLE" Brain RBC Intestine Cardiac, Cornea Kidney Exercising muscle |
| Is the mnemonic 'BRICKLE' indicative of organs that DO NOT require insulin or glucose? | Insulin |
| What does GnRH do? | Stimulates LH, FSH |
| What does GRH do? | Stimulates GH |
| What does CRH do? | Stimulates ACTH |
| What does TRH do? | Stimulates TSH |
| What does PRH do? | Stimulates Prolactin (PRL) |
| What does DA do? | Inhibits Prolactin (PRL) |
| What does SS do? | Inhibits GH |
| What does ADH do? | Conserves water, vasoconstricts |
| What does Oxytocin do? | Milk letdown, baby letdown |
| What does GH do? | IGF-1 release from liver |
| What does TSH do? | T3/T4 release from thyroid |
| What does LH do? | Testosterone release form testis, E2 and Progesterone release from ovary |
| What does FSH do? | Sperm or egg growth |
| What does Prolactin do? | Milk production |
| What does ACTH do? | Cortisol release from adrenal gland |
| What does MSH do? | Skin pigmentation |
| What are the stress hormones? | 1. Epinephrine --> immediate 2. Glucagon ---> 20 minutes 3. Insulin ---> 30 minutes 4. ADH ----> 30 minutes 5. Cortisol ----> 2-4 hour 6. GH --> 24 hours |
| Wht does ADH do? | Concentrates urine |
| What is Diabetes insipidus? | Too little ADH ==> urinate a lot |
| What is Central DI? | Brain not making ADH |
| What is Nephrogenic DI? | Blocks ADH receptor, can be caused by Lithium and Domecocycline |
| What does the Water Deprivation test tell you? | Water deprivation ==> DI Fails to concentrate urine |
| What does giving DDAVP tell you? | DDAVP ==> Central DI concentrates > 25% |
| What is SIADH? | Too much ADH ==> expand plasma volume => pee Na+ (sodium) |
| What is the difference b/w DI and SIADH? | DI has diluted urine, SIADH has concentrated urine |
| Is concentrated urine seen with DI or SIADH? | SIADH |
| What is Psychogenic Polydipsia? | Pathologic water drinking => low plasma osmolarity |
| What does Aldosterone do? | Reabsorbs Na+, secretes H+/K+ |
| Which hormone reabsorbs Na+ and secretes K+ and H+? | Aldosterone |
| Which hormone is often associated with a high systolic and high diastolic pressure? | Aldosterone |
| What is a Neuroblastoma? | Adrenal medulla tumor in kids, dancing eyes/feet, secretes catecholamines in urine |
| What is a Pheochromocytoma? | Adrenal medulla tumor in adults, 5 P's: Pressure (↑BP) Pain (headache) Perspiration Palpitations (tachycardia) Pallor |
| What does the Zona Glomerulosa make? | Aldosterone "salt" |
| What is the primary regulatory control of the Z. Glomerulosa? | Renin-Angiotensin |
| What does the Zona Fasciculata make? | Cortisol "sugar" |
| What is the primary regulatory control for the Z. Fasciculata? | ACTH, CRH |
| What does the Zona Reticularis make? | Androgens "sex" |
| What is the primary regulatory control for the Z. Reticularis? | ACTH, CRH |
| Which zona of the Adrenal cortex is not regulated/controlled by ACTH and CRH? | Zona Glomerulosa |
| What do Chromaffin cells produce? | Catecholamines |
| What is the primary regulatory control for the chromaffin cells? | Preganglionic sympathetic fibers |
| What is Conn's syndrome? | High aldosterone (tumor), Captopril tests makes it worse |
| What does ANP do? | Inhibits Aldosterone, dilates renal artery (afferent arteriole) |
| What does Calcitonin do? | Inhibits osteoclasts ==> low serum Calcium |
| What is MEN I? | "Wermer's": Pancreas, Pituitary, Parathyroid adenoma (high gastrin) "PPP" |
| What is MEN II? | "Sipple's": Pheochromocytoma, Medullary thyroid cancer, PTH |
| What is MEN 2B? | MEN III Pheochromocytoma, Medullary thyroid cancer, Oral/GI neuromas |
| What does CCK do? | Gallbladder contraction, bile release |
| What does Cortisol do? | Gluconeogenesis by proteolysis => thin skin |
| What is Addison's disease? | Autoimmune destruction of adrenal cortex => hyperpigmentation, ↑ACTH |
| What is Waterhouse Friedrichsen? | Adrenal hemorrhage |
| What is Cushing's syndrome? | High cortisol (pituitary tumor or adrenal tumor or small cell lung cancer |
| What is Cushing's disease? | High ACTH (pituitary tumor) |
| What is Nelson's syndrome? | Hyperpigmentation after adrenalectomy |
| If the low-dose dexamethasone test does suppress, what does taht tell you? | Normal, obese, or depressed |
| If the low-dose dexamethasone test does NOT suppress, what does that tell you? | Cushing's ==> do high dose test |
| If the high-dose dexamethasone test suppresses, what does that tell you? | Pituitary tumor ==> ACTH (call brain surgeon) |
| If the high-dose dexamethasone test does NOT suppress, what does that tell you? | 1. Adrenal adenoma => Cortisol (call general surgeon) 2. Small cell lung cancer => ACTH (call thoracic surgeon) |
| What are the survival hormones? | 1. Cortisol => permissive under stress 2. TSH => permissive under normal |
| What does Epinephrine do? | Gluconeogenesis, glycogenolysis |
| What does Erythropoietin do? | Makes RBCs |
| What does Gastrin do? | Stimulates parietal cells => IF, H+ |
| What does Growth hormone do? | Growth, sends somatomedin to growth plates, gluconeogenesis by proteolysis |
| How does GH induce gluconeogenesis? | Breakdown of proteins |
| What is a Pygmie? | No somatomedin receptors |
| What is Achondroplasia = Laron Dwarf? | Abnormal FGF receptors in extremities |
| What is a Midget? | ↓Somatomedin receptor sensitivity |
| What is Acromegaly? | Adult bones stretch "my hat doesn't fit", coarse facies, large, furrowed tongue, deep husky voice, jaw protrusion, ↑IGF-1 because of GH tumor |
| Which hormone, other than GH, is increased in Acromegaly? | IGF-1 |
| What is Gigantism? | Childhood acromegaly |
| What does GIP do? | Enhances insulin action => post-prandial hypoglycemia |
| What does Glucagon do? | Gluconeogenesis, glycogenolysis, lipolysis, ketogenesis |
| What does Insulin do? | Pushes glucose INTO cells |
| What is type I DM? | Anti-islet cell antibody, GAD Ab, Coxsackie B, low insulin, DKA, polyuria, polydipsia, polyphagia |
| What is type II DM? | Insulin receptor insensitivity, high insulin, HONK coma, acanthosis |
| Which type of DM, II or I, presents with acanthosis? | Type I DM |
| How does DKA present? | Kussmaul respirations, fruity breath (acetone), altered mental status |
| What is the Dawn phenomenon? | Morning hypoglycemia 2° to GH |
| What is the Somogyi Effect? | Morning hyperglycemia 2° to evening hypoglycemia |
| What is Factitious Hypoglycemia? | Insulin injection (↑insulin, ↓C-peptide) |
| What is an Insulinoma? | Tumor (↑insulin, ↑C-peptide) |
| What is Erythrasma? | Rash in skin folds, coral-red Wood's lamps |
| What is Syndrome X = Metabolic syndrome? | Pre-DM" => HTN, dyslipidemia, hyperinsulinemia, acanthosis nigricans |
| What are foot ulcer risk factors? | 1. DM/Glycemic control 2. Male smoker 3. Bony abnormalities 4. Previous ulcers |
| What conditions cause weight gain? | 1. Obesity 2. Hypothyroidism 3. Depression 4. Cushing's 5. Anasarca |
| What does Motilin do? | Stimulates segmentation (1° peristalsis, MMC) |
| What does Oxytocin do? | Milk ejection, baby ejection |
| What does PRL do? | Milk production |
| What does PTH do? | Chews up bone |
| What does Vit D do? | Builds bone |
| What do parathyroid chief cells secrete? | PTH |
| What do stomach chief cells secrete? | Pepsin |
| What is the difference between Norepinephrine and Epinephrine? | NE ====> Neurotransmitter Epi ======> Hormone |
| What is 1° hyperparathyroidism? | Parathyroid adenoma |
| What is 2° hyperparathyroidism? | Renal failure |
| What is the main defect in Familial Hypercalciuria Hypercalcemia? | ↓Ca excretion |
| What is the cause if both, serum Ca2+ and PO4 decrease? | Vitamin D deficiency |
| What if serum Ca and PO4 change in opposite directions? | PTH problem: 1. High Ca2+ =====> hyperPTH 2. Low Ca2+ ======> hypoPTH |
| What is the MCC of 1° hypoparathyroidism? | Thyroidectomy |
| What is Pseudohypoparathyroidism? | Bad kidney PTH receptor, ↓urinary cAMP |
| What is Pseudopseudohypoparathyroidism? | G-protein defect, no Ca2+ problem |
| What is Hungry Bone syndrome? | Remove PTH --> bone sucks-in (eat up) calcium |
| What does Secretin do? | 1. Secretion of bicarb 2. Inhibit gastrin 3. Tighten pyloric sphincter |
| What does Somatostatin do? | Inhibits secretin, motilin, CCK |
| What do T3 and T4 do? | Growth, differentiation |
| What disease has Exophthalmos? | Grave's |
| What disease has Enopthalmos? | Horner's |
| What are the Hyperthyroid diseases? | Grave's DeQuervain's Silent thyroiditis Plummer's Jod-Basedow |
| What are the main features of Grave's disease? | Exophthalmos, pretibial myxedema, TSHr Ab |
| What are the main features of De Quervain's? | Viral, painful jaw |
| What is the main feature of Silent Thyroiditis? | Post-partum |
| What are the main features of Plummer's? | Bening adenoma, old person |
| What are the main features of Jod-Basedow? | Transient hyperthyroidism due to ↑ Iodine |
| What are the hypothyroid diseases? | 1. Hashimoto's 2. Reidel's struma 3. Cretin 4. Euthyroid sick syndrome 5. Wolff-Chaikoff |
| What is the associated antibody of Hashimoto's? | Antimicrosomal Ab = TPO Ab |
| What is the main feature of Reidel's struma? | Woody neck |
| What are the main features of Cretin? | Freaky features, hypothyroid Mom and Baby |
| What are the main deficient of Euthyroid sick syndrome? | Low T3 syndrome |
| What is the main feature of Wolff-Chaikoff? | Transient hypothyroidism |
| What is Plummer's syndrome? | Hyperthyroid adenoma |
| What is Plummer-Vinson syndrome GI association? | Esophageal webs |
| What does Testosterone do? | Makes external male genitalia |
| What does Mullerian inhibiting Factor do? | Makes internal male genitalia |
| What do TPO and Thymosin do? | Help T cells mature |
| What does VIP do? | Inhibits secretin, motilin, CCK |
| How VIPoma present? | Watery diarrhea |
| How does SSoma present? | Constipation |
| What are the hormones with disulfide bonds? | "PIGI" 1. Prolactin 2. Inhibin 3. Growth Hormone 4. Insulin |
| Which hormones have the same α subunits? | 1. LH, FSH 2. TSH 3. ß-hCG |
| What hormones produce acidophils? | "GAP" GH Acidophils Prolactin |
| What hormones produce basophils? | "B FLAT" Basophils FSH LH ACTH TSH |
Created by:
rakomi
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