Term
| why don't males get galactorrhea w/ a prolactin-secreting pituitary adenoma? |
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Definition
| because their breast tissue has a terminal duct, but no lobular unit |
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Term
| most common cause of death in acromegaly? |
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Definition
| Cardiac failure (growth of visceral organ leads to dysfunction) |
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Term
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Definition
Increased serum IGF-1 levels +/- failure for glucose to suppress GH secretion
NOTE: treat w/ somatostatin -> depresses GH release (also decreases TSH release; somatostatin is a hypothalamic negative regulator of GH & TSH) |
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Term
| Poor lactation, loss of pubic hair, and fatigue in a lady who just gave birth |
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Definition
| Sheehan syndrome (pituitary infarction from bleeding during delivery; pituitary gland doubles in size w/out increasing vasculature during pregnancy) |
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Term
| arachnoid & CSF herniates into sella & destroys the pituitary |
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Definition
"empty sella syndrome": congenital defect in the dural diaphragm covering the sella or from increased intracranial pressure (pseudotumor cerebri)
Although the pituitary is compressed & may be absent from imaging, it usually retains normal function! (source: adams & victor neurology) |
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Term
| 3 common drugs that can cause SIADH |
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Definition
1) Cyclophosphamide
2) Chlorpropamide (1st gen OSU)
3) Carbamazepine
Other than drugs, lung pathology (small cell cancer, infection, COPD, etc), & CNS trauma can cause SIADH |
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Term
What sympathetic receptor does T3/T4 increase?
What sympathetic receptor does cortisol increase? |
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Definition
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Term
Bone homeostasis in hyperthyroidism?
Cholesterol?
Glucose? |
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Definition
1) increased bone resorption & HYPERCALCEMIA (risk for osteoporosis)
2) Hypocholesterolemia (hyper in hypothyroid)
3) Hyperglycemia (b.c. increased gluconeogenesis & glycogenolysis) |
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Term
For each endocrine hormone, name what part of the hypothalamus-pituitary axis it negatively feeds back on:
1) T3/T4
2) GH & IGF1
3) Prolactin
4) Cortisol
5) Testosterone & inhibin |
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Definition
1) T3/T4: only pituitary
2) GH increases somatostatin release from the hypothalamus; IGF1 (aka "somatomedin" both increases somatostatin & directly inhibits GH release by pituitary; GHRH also negatively feeds back on itself in the hypothalamus
3) Increases DA release from hypothal
4) Inhibits Hypothal & pituitary
5) Testosterone inhibits LH & GnRH release; Inhibit inhibits FSH release
NOTE: testosterone also increases inhibin release from sertoli cells |
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Term
| Arrhythmia, hyperthermia, & vomiting w/ hypovolemic shock in a woman w/ graves giving birth |
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Definition
Thyroid storm: massive release of catecholamines
This is usually brought on in a person that has graves and is under acute stress (e.g. childbirth)
Tx w. PTU, propranolol, & steroids |
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Term
| child born with short stature, skeletal abnormalities, coarse facial features, macroglossia, and umbilical hernia |
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Definition
Hypothyroidism (cretinism); also severely mentally retarded
NOTE: thyroid hormone needed for normal brain & skeletal development |
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Term
| Child born with hypothyroidism & hearing loss. Lab studies show defect in a specific ion transporter |
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Definition
Pendrid syndrome (a type of dyshormogenic goiter)
Most common cause of dyshormogenic goiter is loss of thyroid peroxidase. |
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Term
| why do you get a deeper voice w/ hypothyroidism? |
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Definition
| b.c. glycosaminoglycans build up in larynx (& other tissues) |
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Term
| Oligomenorrhea in hypothyroid, hyperthyroid, or both? |
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Definition
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Term
| Drug causing hypothyroidism |
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Definition
| lithium (also amiodarone, PTU/methimazole (duh), phenylbutazone, sulfonamides, etc) |
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Term
| antimicrosomal antibodies |
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Definition
| hashimotos thyroiditis (also see anti thyroglobulin) |
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Term
1) painless enlargement of thyroid. Biopsy shows chronic inflammation & Hurthle cells?
2) Goes untreated. years later starts enlarging rapidly? |
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Definition
1) Hashimotos (hurthle cell is an eosinophilic metaplasia of cells that line follicle)
2) Marginal B-cell lymphoma developed from chronic inflammation |
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Term
Firm thyroid w/ extension into local structures in a:
1) 40 year old & "hard as wood"
2) 80 year old |
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Definition
1) Reidel fibrosing thyroiditis (idiopathic fibrosis may also exist in retroperitoneum)
2) Anaplastic carcinoma of thyroid |
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Term
| Name 4 carcinomas that like to spread hematogenously |
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Definition
1) Renal cell carcinoma (into renal vein)
2) Hepatocellular carcinoma (hepatic vein)
3) Choriocarcinoma (blood loving to begin with)
4) Follicular thyroid carcinoma |
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Term
Name manifestation for each sign of hyperparathyroidism:
1) Stones
2) Bones
3) Groans
4) Psychogenic overtones |
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Definition
1) Nephrolithiasis (Ca-oxylate) & nephrocalcinosis (leading to renal insufficiency/polyuria)
2) osteitis fibrosa cystica (brown tumors)
3) Constipation, PUD, pancreatitis
4) Seizures, depression |
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Term
Say if you get elevated alk phos or not:
1) Primary hyperparathyroidism
2) Secondary hyperparathyroidism
3) Paget's disease of bone
4) Fracture
5) Osteomalacia/rickets
6) Osteoporosis
7) osteopetrosis |
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Definition
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Term
| where do beta & alpha cells lie in islet? |
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Definition
| beta cell in center, alpha @ periphery (& delta cells throughout) |
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Term
| HLA associated w/ diabetes 1? Hashimoto? |
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Definition
DM1 = DR3 & DR4
Hashi = DR5 |
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Term
Glucose threshold for diagnosis of T2DM for:
1) Random gluocose
2) Fasting glucose
3) 2hrs post glucose challenge |
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Definition
1) >200mg/dL
2) >126mg/dL (best test; needs 2 positive results to be diagnostic)
3) >200mg/dL |
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Term
| leading cause of death in diabetics? |
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Definition
cardiac disease (atherosclerosis is accelerated by the glycosylization)
NOTE: peripheral vascular disease is leading cause of non-traumatic amputation |
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Term
| name the 3 cells that are affected by osmotic damage by sorbitol in diabetes? |
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Definition
1) Pericytes of retina (diabetic retinopathy = microaneurisms (first), cotton-wool spots, hemorrhages)
2) Schwann cells -> peripheral neuropathy
3) lens -> cataracts |
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Term
name pancreatic tumor:
1) Achlorhydria, cholelithiasis (w/ steatorrhea)
2) Watery diarrhea (doesn't improve w/ fasting), hypokalemia, achlorhydria |
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Definition
1) Somatostatinoma
2) VIPoma
both somatostatin & VIP inhibit gastrin secretion. Somatostatin inhibits CCK release -> Cholestasis |
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Term
| 3 mechanism that cortisol uses to suppress the immune system? |
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Definition
1) Inhibit PLA2
2) Inhibit IL2
3) inhibit histamine release
It is also cytotoxic to lymphocytes |
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Term
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Definition
located @ IMA: area where 10% pheochromocytomas are extramedullary (along w/ sympathetic chain or bladder)
NOTE: the ones on the bladder can manifest as catecholamine release while urinating |
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Term
| name syndromes associated w/ pheochromocytoma (4) |
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Definition
1) MEN2a
2) MEN2b
3) NF1
4) Von Hippau Lindau (also cavernous hemangiomas of skin, mucosa organs; hamngioblastoma of CNS, retina) |
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