ENDOCRINE > PATHOPHYS > Flashcards

PATHOPHYS Flashcards

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1
Q

What effects will prolactin excess have in a female?

A 
AMENORRHEA
OLIGOMENORRHEA
GALACTORRHEA
INFERTILITY
OSTEOPENIA
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2
Q

what effects will prolactin excess have in a male?

A

HYPOGONADISM
DECREASED LIBIDO
GALACTORRHEA (RARE)
PITUITARY DEFICIENCIES

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3
Q

how would you treat hyperprolactinemia?

A

bromocriptine (dopamine antagonist)

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4
Q

what is the name of the enzyme that cleaves pro-insulin to insulin?

A

carboxypeptidase E

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5
Q

why won’t you see an increase in glucagon after a nomral meal?

A

pancreas sends glucagon to Liver and liver increases blood glucose (so you never really see the glucagon concentration)

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6
Q

Glucagon and catecholamines need prior action of __________ to function optimally in the liver.

A

cortisol

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7
Q

what are 2 hormones that cause cells to have a decreased sensitivity to insulin?

A

Growth hormone

Cortisol

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8
Q

what enzyme has increased expression in conditions associated w/ water retention including CHF, pregnancy, & SIADH

A

AQP2

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9
Q

what is enuresis?

A

inability to control urination

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10
Q

what is the classic triad of symptoms in pheochromocytomea?

A
  1. headache
  2. sweating
  3. palpitations
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11
Q

what are the 3 main causes of endocrine htn?

A
  1. hyperaldosteronism
  2. pheochromocytoma
  3. cushing’s syndrome
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12
Q

how do you tell the difference b/w primary hyperaldosteronism and secondary hyperaldosteronism?

A
  • primary hyperaldosteronism has high aldosterone/renin ratio b/c of negative feedback
  • secondary hyperaldosteronism has normal Aldosterone/renin ratio
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13
Q

what is the primary endogenous inhibitor of NF-kB and platelet aggregation?

A

Nitric oxide, deficiency allows inflammation to proceed unchecked.

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14
Q

which ROS is a potent activator of protein kinase C?

A

superoxide

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15
Q

what are the 2 classes of drugs that have shown to reduce the hyperfiltration, proteinuria, and progressive loss of GFR?

A

ACEis, ARBs

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16
Q

why do diabetics become anemic with kidney damage?

A

the kidneys stop making EPO

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17
Q

Retinopathy affects over __________% of diabetic pts and is the leading cause of blindness in US.

A

80%

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18
Q

Retinopathy can lead to one or both of these typical clinical presentations?

A

macular edema &/or Neo-vascularization

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19
Q

what are the earliest changes seen in diabetic eyes?

A

increase in basement membrane thickening & reduction in the number of pericytes

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20
Q

what is the leading cause of vision loss in diabetic pts?

A

macular edema (if you have swelling from leakage of proteins and blood near the macula?

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21
Q

what makes hemorrhage very likely in the retina of diabetic pts?

A

diabetic pts have angiogenesis with newer very leaky blood vessels.

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22
Q

what happens when diabetic pts bleed and the blood grows out into the vitreous?

A

the pt can’t see

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23
Q

describe the fudamental pathophysiology of a neuropathic ulcer?

A

pressure–>ischemia–>inflammation

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24
Q

what is the obvious treatment for a pt with a neuropathic ulcer?

A

get the pt off of their feet entirely until the lesion completely heals

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25
how do you treat autonomic neuropathy in diabetic pts?
PREVENTION!
26
which 2 cancers are the ones that most commonly cause hypercalcemia of malignancy?
breast & squamous cell carcinoma
27
what will the PTH levels be like in hypercalcemia of malignancy?
PTH will be suppressed
28
what is the treatment for acute hypocalcemic crisis?
- always correct magnesium if low! | - calcium gluconate
29
what is the treatment for long-term management of hypocalcemia?
- oral calcium salts - vitamin D - HCTZ
30
what is the genetic defect in MEN1 syndrome?
Chromosome 11 MENIN (product of TSG MEN1)
31
What is the genetic defect in MEN2A?
Chromosome 10 MEN2A-->RET gene affected (cys codon)
32
what is the genetic defect in MEN2B? | Know this question!
chromosome 10 MEN2B-->RET gene affected (met codon-consequence of single AA)
33
what are the 3 P's of MEN1?
1. Parathyroid (primary HPT) 2. Pancreas (insulinoma) 3. Pituitary (prolactinoma/cushings)
34
what are the 3 clinical findings in MEN2A?
1. Medullary Thyroid carcinoma 2. Pheochromocytoma 3. Parathyroid 2AM-MEg-PP
35
what are the 4 clinical findings in MEN2B?
1. medullary thyroid carcinoma 2. mucosal neuromas 3. marfinoid habitus 4. pheochromocytoma 2B-MMMP
36
of the 3 layers of the adrenal gland, which one is the largest and what does it secrete?
zona fasciculata: secretes cortisol and androgens
37
both the zona fasciulata & zona reticularis both secrete what 2 classes of hormones?
Cortisol and androgen
38
which of the 3 layers of the adrenal gland lacks 17-alpha-hydroxylase and so can't make cortisol?
zona glomerulosa (makes aldosterone instead)
39
what is the rate limiting step in adrenal steroidogenesis?
conversion of cholesterol to pregnenolone by cholesterol desmolase -ACTH is the stimulus for cholesterol desmolase
40
what does estrogen do to osteoclasts?
estrogen inhibits osteoclasts (also decreases IL-6)
41
what effect does calcitonin have on osteoclasts?
inhibits osteoclast function
42
what effect does cortisol have on osteoblasts?
causes osteoblast apoptosis
43
what does GH/IGF-1 do to osteoblasts?
increases osteoblast function
44
what does thyroid hormone do to osteoclasts?
stimulates osteoclasts
45
what does Vitamin A do to osteoclasts?
stimulates osteoclasts
46
Bone morphogenic proteins are members of what cytokine superfamily?
TGF-beta
47
describe endochondral bone formation
bone forms on a cartilage scaffold | cartilage becomes calcified and replaced by bone matrix and a vascular bed at the growing ends of the bone
48
what is the type of collagen in bone?
type 1
49
what is the type of collagen in cartilage?
type 2
50
what is used as a marker for clinical bone turnover measurement?
bone collagen crosslinks
51
the bone collagen crosslinks that are commonly used for clinical bone turnover measurement are derived from one?
hydroxylysine (pyridinoline crosslinks)
52
an Inbalance b/w formation & resorption can lead to bone disorders such as? (5)
``` ostoeporosis Osteopetrosis Paget's disease osteosclerosis hyperparathyroidism ```
53
what are some things you can do to prevent osteoporosis?
early buildup of bone mass in prepuberty and early adulthood - diet, calcium, vit. D, sunlight - exercise builds and maintains better bone mass
54
what is the name of the form of calcium stored in bone?
hydroxyapatite, a hydroxyl calcium phosphate
55
what blood component is the main source of cholesterol for synthesis of all steroid hormones?
LDL
56
what organs express mineralocorticoid receptors?
``` kidneys brain lungs heart vascular tissues ```
57
what happens to cortisol production with the long term treatment of dexamethasone?
cortisol production decreases | -you also get functional atrophy of the hypothalamic-pituitary-adrenal axis
58
what are some physiological causes of stress?
``` starvation infection trauma debilitating disease psychological stress anxiety depression ```
59
what are some major long term complications of severe stress on the hypothalamic-pituitary-adrenal axis?
``` heart disease immunosuppression digestive problems sleep disorders anxiety depression ```
60
what are the only 3 tests you need to diagnose a pt with cushing's disease?
1. 24 hr urine free cortisol 2. measurement of plasma cortisol & ACTH 3. high-dose dex suppression test
61
what is the most common type of pancreatic neuro-endocrine tumor to produce an endocrine syndrome?
insulinoma
62
what are the symptoms of hypoglycemia? (7)
1. shakiness 2. sweatiness 3. nervousness 4. hunger 5. weakness 6. visual disturbances 7. palpitations
ENDOCRINE
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