Endocrine

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Neda317
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Endocrine
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2015-07-20 18:50:57
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  1. Common causes of dec. Mg2+
    • diarrhea,
    • aminoglycosides,
    • diuretics,
    • alcohol abuse
  2. ↧ serum Mg2+ -->


    ↧↧ serum Mg2+ -->

    PTH?
    ↧ serum Mg2+ --> ↥ PTH secretion



    ↧↧ serum Mg2+ -->↧ PTH secretion
  3. Ghrelin increase secretion of
    • GH
    • ACTH
    • Cortisol
    • Prolactin
  4. opsoclonus-myoclonus syndrome
    (“dancing eyes-dancing feet”) in Neuroblastoma
  5. Neuroblastoma characteristic
    • Originates
    • from neural crest cells; Homer-Wright rosettes characteristic.
    • Occurs anywhere along the
    • sympathetic chain.
    • Most common presentation is abdominal distension and a firm, irregular
    • mass that can cross the midline.
    •  Can also
    • present with opsoclonus-myoclonus syndrome (“dancing eyes-dancing feet”).
  6. What is Necrosis~
    Non-programmed·cell death = noisy, inflammation, nucleus destroyed first
  7. What is Apoptosis?
    Programmed cell death = quiet, no inflammation, nucleus guides it => destroyed last
  8. What is Pyknosis?
    Nucleus turns into blobs "pick blobs"
  9. What is Karyohexis?
    Nucleus fragments
  10. What is Karyolysis?
    Nucleus dissolves
  11. What is a Somatotrope?
    GH
  12. What is a Gonadotrope?
    LH, FSH
  13. What is a Thyrotrope?
    TSH
  14. What is a Corticotrope?
    ACTH
  15. What is a Lactotrope?
    PRL
  16. What receptors do protein hormones use?
    Cell membrane receptors
  17. What receptors do steroid hormones use?
    Nuclear membrane receptors
  18. What are the steroid hormones?
    • "PET CAD"
    • Note: thyroid hormone acts like a steroid
    • Progesterone
    • E2
    • Testosterone
    • Cortisol
    • Aldo
    • Vit D
  19. What does Endocrine mean?
    Secretion into blood
  20. What does Exocrine mean?
    Secretion into non-blood
  21. What is Autocrine?
    Works on itself
  22. What is Paracrine?
    Works on it's neighbor
  23. What is Merocrine?
    Cell is maintained => exocytosis
  24. What is Apocrine? 
    Apex of the cell is secreted
  25. What is Holocrine? 
    The whole cell is secreted
  26. What organs do not require insulin?
    • "BRICKLE"
    • Brain
    • RBC
    • Intestine
    • Cardiac, Cornea
    • Kidney
    • Liver
    • Exercising muscle
  27. What does GnRH do? 
    Stimulates LH, FSH
  28. What does GRH do? 
    Stimulates GH
  29. What does CRH do? 
    Stimulates ACTH
  30. What does TRH do? 
    Stimulates TSH
  31. What does PRH do? 
    Stimulates PRL
  32. What does DA do? 
    Inhibits PRL
  33. What does SS do? 
    Inhibits GH
  34. What does ADH do? 
    Conserves water, vasoconstricts
  35. What does oxytocin do?
    Milk letdown, baby letdown
  36. What does GH do? 
    lGF - 1 release from liver
  37. What does TSH do?
     T,,T~ release from thyroid
  38. What does LH do? 
     Testosterone release from testis , E2 and Progesterone release from ovary
  39. What does FSH do?
    Sperm or egg growth
  40. What does PRL do? 
    Milk production
  41. What does ACTH do? 
    Cortisol release from adrenal gland
  42. What does MSH do? 
    Skin pigmentation
  43. What are the stress hormones?
    • Epi: immediate
    • Glucagon: 20min
    • Insulin: 30min
    • ADH: 30min
    • Cortisol: 2-4hr
    • GH: 24 hr
  44. What does ADH do? 
    Concentrates mine
  45. What is Diabetes Insipidus? 
    Too little ADH =>urinate a lot
  46. What is Central DI? 
    Brain not making ADH
  47. What is N ephrogenic DI?
    Blocks ADH receptor, can be caused by Li and Domecocycline
  48. What does the Water Deprivation test tell you?
    • water deprivation => DI
    • concentrates 25%
  49. What is SIADH? 
    Too much ADH => expand plasma vol => pee Na
  50. What is the difference b/w DI and SIADH? 
    •  DI has dilute urine,
    • SIADH has concentrated urine
  51. What is Psychogenic Polydipsia? 
    Pathologic water drinking => low plasma osmolarity
  52. What does Aldosterone do? R e absorbs N a , secretes H • / K+
    Reabsorbs Na, secretes H+/K+
  53. What is a Neuroblastoma?
    Adrenal medulla tumor in kids, dancing eyes/feet, secretes catecholamines
  54. What is a Pheochromocytoma? 
    Adrenal medulla tumor in adults, 5 P's
  55. What does the Zona Glomemlosa make? 
    Aldosterone "salt"
  56. What does the Zona Fasiculata make?
    Cortisol "sugar"
  57. What does the Zona Reticularis make? 
    Androgens "sex"
  58. What is Conn's syndrome? 
    High Aldo (tumor), Captopril test makes it worse
  59. What does ANP do? 
    Inhibits Aldo, dilates renal artery (afferent arteriole)
  60. What does Calcitonin do? 
    Inhibits osteoclasts => low serum Ca2+
  61. What is MEN I? 
    "Wermer's": Pancreas, Pituitary, Parathyroid adenoma (high gastrin) "PPP"
  62. What is MEN II?
    "Sipple's": Pheo, Medullary thyroid cancer, PTH
  63. What is MEN III? 
    "MEN IIB": Pheo, Medullary thyroid cancer, Oral/GI neuromas
  64. What docs CCK do? 
    Gallbladder contraction, bile release
  65. What does Cortisol do?
    Gluconeogenesis by proteolysis => thin skin
  66. What is Addison's disease?
    • Autoimmune destruction of adrenal cortex=>
    • hyper-pigmentation, INC ACTH
  67. What is Waterhouse Friderichsen?
    Adrenal hemorrage
  68. What is Cushing's syndrome?
    High cortisol (pituitary tumor or adrenal tumor or small cell lung CA)
  69. What is Cushing's disease?
    High ACTH (pituitary tumor)
  70. What is Nelson's syndrome?
    Hyperpigmentation after adrenalectomy
  71. If the low-dose dexamethasone test suppresses, what does that tell you?
    Normal, obese, or depressed
  72. If the low- dose dexamethasone test does not suppress, what does that tell you?
    Cushing's => do high dose test
  73. If the high-dose dexamethasone test suppresses, what does that tell you?
    Pituitary tumor => ACTH (call brain surgeon)
  74. If the high-dose dexamethasone test does not suppress, what does that tell you?
    • • Adrenal adenoma => Cortisol (call general surgeon)
    • • Small cell lung cancer=> ACTH (call thoracic surgeon)
  75. What are the survival hormones?
    • Cortisol: permissive under stress
    • TSH: permissive under normal
  76. What does Epinephrine do?
    Gluconeogenesis, glycogenolysis
  77. What does Erythropoietin do?
    Makes RBCs
  78. What does Gastrin do?
    Stimulates parietal cells => IF, H+
  79. What does Growth hormone do?
    Growth, sends somatomedin to growth plates, gluconeogenesis by proteolysis
  80. What is a Pygmie?
    No somatomedin receptors
  81. What is Achondroplasia = Laron Dwarf?
    Abnormal FGF receptors in extremities
  82. What is a Midget?
    DEC⇩ Somatomedin receptor sensitivity
  83. What is Acromegaly?
    Adult bones stretch "my hat doesn't fit", coarse facial features, large furrowed tongue, deep husky voice, jaw protrusion,↑IGF-1 b/c of GH tumor
  84. What is Gigantism?
    childhood acromegaly
  85. What does GIP do?
    Enhances insulin action→postprandial hypoglycemia
  86. What does Glucagon do?
    Gluconeogenesis, glycogenolysis, lipolysis, ketogenesis
  87. What does Insulin do?
    Pushes glucose into cells
  88. What is Type I DM?
    Anti-islet cell Ab, GAD Ab, Coxsackie B, low insulin,DKA, polyuria, polydipsia, polyphagia
  89. What is Type II DM?
    Insulin receptor insensitivity, high insulin, HONK coma, acanthosis nigricans
  90. How does DKA present?
    Kussmaul respirations, fruity breath (acetone), altered mental status
  91. What is the Dawn phenomenon?
    Morning hyperglycemia 2° to GH
  92. What is the Somogyi Effect?
    Morning hyperglycemia 2° to evening hypoglycemia
  93. What is Factitious Hypoglycemia?
    Insulin injection (↑INC insulin, ⇩DEC  C-peptide)
  94. What is an Insulinoma?
    Tumor (⇧INC insulin, ⇧INC C-peptide)
  95. What is Erythrasma?
    Rash in skin folds, coral-red Wood's lamp
  96. What is Syndrome X = Metabolic Syndrome?
    "Pre-DM"→ HTN, dyslipidemia, hyperinsulinemia, acanthosis nigricans
  97. What are foot ulcer risk factors?
    • • DM/ Glycemic control
    • • Male smoker
    • • Bony abnormalities
    • • Previous ulcers
  98. What conditions cause weight gain?
    • • Obesity
    • • Hypothyroidism
    • • Depression
    • • Cushing's
    • • Anasarca
  99. What does Motilin do?
    stimulates segmentation (1o peristalsis, MMC)
  100. What does Oxytocin do?
    Milk ejection, baby ejection
  101. What does PRL do?
    Milk production
  102. What does PTH do?
    Chews up bone
  103. What does Vit. D do?
    Builds bone
  104. What do parathyroid chief cells secrete?
    PTH
  105. What do stomach chief cells secrete?
    Pepsin
  106. What is the difference between Norepinephrine and Epinephrine?
    • NE: Nemotransmitter
    • Epi: Hormone
  107. What is 1° hyperparathyroidism?
    Parathyroid adenoma
  108. What is 2° hyperparathyroidism?
    Renal failure
  109. What is Familial Hypocalciuria Hypercalcemia?
    ↓DEC Ca excretion
  110. What if both serum Ca and PO4 decrease?
    Vit D deficiency
  111. What if serum Ca and PO4 change in opposite directions?
    • PTH problem
    • • High Ca → hyperPTH
    • • Low Ca → hypoPTH
  112. What is the most common cause of 1° hypoparathyroidism?
    Thyroidectomy
  113. What is Pseudohypoparathyroidism?
    Bad kidney PTH receptor,↓ DEC urinary cAMP
  114. What is Pseudopseudohypoparathyroidism?
    G-protein defect, no Ca2+ problem
  115. What is Hungry Bone syndrome?
    Remove PTH → bone sucks in Ca2+
  116. What does Secretin do?
    Secretion of bicarb, inhibit gastrin, tighten pyloric sphincter
  117. What does Somatostatin do?
    Inhibits secretin, motilin, CCK
  118. What do T3 and T4 do?
    Growth, differentiation
  119. What disease has Exophthalmos?
    Grave's
  120. What disease has Enophthalmos?
    Horner's
  121. What are the Hyperthyroid diseases and their descriptions ?
    • •Grave's-Exophthalmos, pretibial myxedema, TSHr Ab
    • • DeQuervain's- Viral, painful jaw
    • • Silent thyroiditis- Post-partum
    • • Plummer's-Benign adenoma, old person
    • • Jod-Basedow-Transient hyperthyroidism due to ↑I
  122. What are the Hypothyroid diseases and their descriptions?
    • • Hashimoto's- Antinucrosomal Ab = TPO Ab
    • • Reidel's struma- Woody neck
    • • Cretin- Freaky features, hypothyroid Mom and Baby
    • • Euthyroid sick syndrome- Low T3 syndrome
    • • Wolff-Chaikoff- Transient hypothyroidism.
  123. What is Plummer's syndrome?
    Hyperthyroid adenoma
  124. What is Plummer-Vinson syndrome?
    Esophageal webs
  125. What does Testosterone do?
    Makes external male genetalia
  126. What does Mullerian Inhibiting Factor do?
    Makes internal male getutalia
  127. What do TPO and Thymosin do?
    Help T cells mature
  128. What does VIP do?
    Inhibits secretin, motilin, CCK
  129. How does a VIPoma present?
    Watery diarrhea
  130. How does a SSoma present?
    Constipation
  131. What are the hormones with disulfide bonds?
    • "PIGI"
    • PRL
    • Insulin
    • GH
    • Inhibin
  132. Which hormones have the same a subunits?
    • • LH, FSH
    • •T SH
    • •β-HCG
  133. What hormones produce acidophils?
    • "GAP"
    • GH
    • PRL
  134. What hormones produce basophils?
    • "B FLAT"
    • FSH
    • LH
    • ACTH
    • TSH

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