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Endocrinology

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resexuwe's version from 2017-07-26 07:07

ENDOCRINOLOGY

Question Answer
What is a Somatotrope?GH
What is a Gonadotrope?LH, FSH
What is a Thyrotrope?TSH
What is a Corticotrope?ACTH
What is a Lactotrope?PRL
What receptors do protein hormones use?Cell membrane receptors
What receptors do steroid hormones use?Nuclear membrane recpetors
What are the steroid hormones?“PET CAD” (1) Progesterone, (2) E2, (3) Testosterone, (4) Cortisol Aldo, and (5) Vitamin D. Note → Thyroid hormone act like a 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” (1) Brain, (2) RBC, (3) Intestine, (4) Cardiac, Cornea (5) Kidney, (6) Liver, and (7) Exercising muscles
What does GnRH do?Stimulate LH, FSH
What does GRH do?Stimulate GH
What does CRH do?Stimulate ACTH
What does TRH do?Stimulate TSH
What does PRH do?Stimulate PRL
What does DA do?Inhibit PRL
What does Somatostatin (SS) do?Inhibit 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 dose TSH do?T3, T4 release from thyroid
What does LH do?Testosterone release from testis, E2 and Progesterone release from Ovary
What does FSH do?Sperm or egg growth
What does PRL 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 – 20min, (3) Insulin – 30min, (4) ADH – 30min, (5) Cortisol – (2-4hr), and (6) GH (24hr)
What 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 Domeclocycline
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 sodium (Na)
What is the difference b/w DI and SIADH?1) DI has dilute urine, 2) SIADH has concentrated urine
What is Pyschogenic Polydipsia?Pathologic water drinking → Low plasma osmolarity
What does Aldosterone do?Reabsorbs Sodium (Na), Secretes Hydrogen & Potassium (H+/K+)
What is Neuroblastoma?Adrenal Medulla tumor in kids, dancing eyes/feet, secretes catecholamines
What is a Pheochromocytoma?Adrenal Medulla tumor in adults, 5 P's
What does the Zona Glomerulosa make?Aldosterone “Salt”
What is the primary regulatory control for the Zona Glomerulosa?Renin-Angiotensin System (RAAS)
What does the Zona Fasiculata make?Cortisol “Sugar”
What is the primary regulatory control for the Zona Fasiculata?ACTH & CRH
What does the Zona Reticularis make?Androgens “Sex” hormone – (Testosterone)
What is the primary regulatory control for the Zona Reticularis?ACTH from (Ant-pituitary) & CRH
What do chromaffin cells produce?Catecholamines (NE, EPI, DA)
What is the primary regulatory control for the chromaffin cells?Preganglionic sympathetic fibers
What is Conn's Syndrome?High Aldosterone (tumor), Captopril test makes it worst
What does ANP do?Inhibit Aldosterone, Dilates Renal Artery (Afferent arterioles)
What does Calcitonin do?Inhibit Osteoclasts → Low serum Ca2+
What is MEN I?“Wermer's” → Pancrease, Pituitary, and Parathyroid adenoma (high Gasrin) “PPP”
What is MEN IIA?“Sipple's” → Pheochromocytoma, Medullary Thyroid Cancer (Calcitonin marker), and PTH
What is MEN IIB?Pheochoromocytoma, Medullary Thyroid Cancer (Calcitonin marker), Oral/GI nuromas, and Marfanoid features
What does CCK do?(1) Gallbladder contraction, (2) bile release
What does Cortisol do?Gluconeogenesis by Proteolysis → thin skin
What is Addison's disease?Autoimmune destruction of adrenal cortex → Hyper-pigmentation & Increase ACTH
What is Waterhouse Friderichsen?Adrenal hemorrhage
What is Cushing's syndrome?High Cortisol (Pituitary Tumor or Adrenal Tumor or Small cell lung CA)
What is Cushing's disease?High ACTH (pituitary tumor)
What is Nelson's syndrome?Hyperpigmentation after adrenalectomy
If the low-dose dexamethasone test suppression, what does that tell you?(1) Normal, (2) Obese, or (3) Depressed
If the low-dose dexamethosene test does NOT suppress, what does that tell you?“Cushing's” → do high does test
If the high-dose dexamethosone 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?(1) Gluconeogenesis, (2) Glycogenolysis
What does Erythropoietin do?Makes RBCs
What does Gastrin do?Stimulates parietal cells → IF, and H+
What does GH do?(1) Growh, (2) sends somatomedin to growth plate, (3) gluconeogenesis by proteolysis
What is a Pygmie?No Somatomedin receptors
What is Achondroplasia → Laron Dwarf?Abnormal FGF receptors in extremities
What is a Midget?Decrease Somatomedin receptor sensitivity
What is Acromegaly?(1) Adult bones stretch “my hat doesn't fit”, (2) Coarse facial features, (3) large furrowed tongue, (4) deep husky voice, (5) Jaw protrusion, and (6) Increase IGF-1 b/c of GH tumor
What is Gigantism?Childhood acromegaly
What does gastric-inhibitory polypetide (GIP) do?Enhances Insulin action → post-prandial hypoglycemia
What does Glucagon do?(1) Gluconeogenesis, (2) Glycogenolysis, (3) Lipolysis, and (4) Ketogenesis
What does Insulin do?Pushes glucose into cells
What is Type I DM?Anti-islet cell antibody (Ab), GAD (Ab), Coxsckie B, low insulin, DKA, polyuria, polydipsia, and polyphagia
What is Type II DM?Insulin receptor insensitivity, high insulin, HONK coma, and acanthosis
How does DKA present?(1) Kussmahl respiration, (2) fruity breath (acetone), and (3) altered mental
What is the Dawn Phenomenon?Morning hyperglycemia secondary to GH
What is the Somogyi effect?Morning hyperglycemia seconday to evening hypoglycemia
What is Factitious Hypoglycemia?Insulin injection (Increase Insulin, & Decrease C-peptide)
What is an Insulinoma?Tumor (Increase Insulin & Increase C-peptide)
What is Erythrasma?1) Rash in skin folds, 2) Coral-red Wood's lamp
What is Syndrome X = Metabolic Syndrome?“Pre-DM” → HTN, dyslipidemia, hyperinsulinemia, acanthosis nigricans
What are foot ulce 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, and (5) Anasarca (generalized massive edema)
What does Motilin do?Stimulates segmentation (primary peristalis, and (MMC) migratory myoelectric complexes)
What does Oxytocin do?Milk ejection & Baby ejection
What does PRL do?Milk production
What does PTH do?Chews up bone, (phosphate trashing hormone)
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 NE and EPI?(1) NE is a Neurotransmitter, (2), EPI is a hormone
What is primary Hyper-Parathyroidism?Parathyroid adenoma
What is sendory Hyper-Parathyroidism?Reneal Failure
What is Familial Hypo-calci-uria Hypercalcemia?Decreases (Ca2+) excretion
What if both serum (Ca2+) and (PO4-) decreases?Vitamin D deficiency
What if serum (Ca2+) and (PO4-) change in opposite directions?PTH problem, (1) High (Ca2+) → Hyper-PTH, and (2) Low (Ca2+) → Hypo-PTH
What is the MCC of primary Hypo-parathyroidism?Thyroidectomy
What is Pseudohypoparathyroidism?Bad kidney PTH receptor, and Decrease urinary cAMP
What is Hungry Bone Syndrome?Remove PTH → Bone sucks in (Ca2+)
What is Pseudo-hypo-para-thyroidism?G-protein defect, NO (Ca2+) problem
What does secretion do?Secretion of Bicarb (HCO3-), Inhibit Gastrin, and tighten pyloric sphincter
What does Somatostatin do?Inhibits Secretin, motilin, and CCK
What do T3 and T4 do?Growth, differentiation
What disease has Exopathalmos?Grave's hyper-para-thyroidism
What disease has Endopthalmos?Horner's
What are the Hyper-thyroid diseases?(1) Grave's → Exopthalmos, Pretibial myxedema, and TSHr Ab, (2) DeQuervain's → Viral infection and painful jaw contractions, (3) Silent Thyroiditis → Post-partum, (4) Plummer's Vincen → Benign adenoma, and Old person, (5) Jod-Basedow → Transient hyperthyroidisim due to increase I
What are the Hypo-thyroid diseases?(1) Hashimoto's → Anti-microsomal Ab, and Thyroid peroxidase Ab (TPO Ab), (2) Reidal's Struma → Woody neck, (3) Cretin → Freaky features, hypothryoid Mom & Baby, (4) Euthyroid sick syndrome → Low T3 syndrome, (5) Wolff-Chaikoff → Transient hypothyroidism
What is Plummer's syndrome?Hyper-thyroid adenoma
What is Plummer-Vinson syndrome?Esophageal Webs
What does Testosterone do?Makes internal 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, and CCK
How does VIPoma present?Watery diarrhea (secretory diarrhea)
How does Ssoma (Somatostatinoma) present?Constipation
What are the hormones with “Di-Sulfide” bonds?“PIGI” = (1) Prolactin, (2) Insulin, (3) GH, (4) Inhibin
What hormones have the same “alpha” subunits?(1) LH & FSH, (2) TSH, (3) b-HCG
What hormones produce “acidophils”?“GAP” → (1) GH, (2) PRL
What hormones produces “Basophils”?“B-FLAT” → (1) FSH, (2) LH, (3) ACTH, (4) TSH
memorize

RHEUMATOLOGY

 

Question Answer
What is Rheumatoid Factor?IgM against Fc portion of IgG
What are Tophi?Gout Crystals + giant cells
What is Podagra?Big toe inflammation from gout
Avoiding places brightUveitis
What is CREST syndrome?Calcinosis, Raynaud's, Esophageal dys-motility, Sclerodactyly, Telangiectasis
What Ab is associated with CREST?Anti-centromere Ab
What diseases have Raynaud's syndrome?(1) Scleroderma, (2) Takayasu's , (3) RA, (4) SLE
What platelet count do most types of vasculitis have?Low Platelets
Which Vasculitis has a high platelet count?Kawasaki disease
Which Vasculitis has a normal Platelet count?Henoch-Schonlein Purpura
What is Osteoarthritis?Pain worse w/ activity, PIP/DIP joint
What is Rheumatoid Arthritis?Pain worse in morning, MCP/PIP joints
What is Still's disease?Juvenile RA
What is Pseudo-gout?Pyrophosphate crystals in knees/wrists
What is Gout?Urate crystals in big toe, Negative (-) birefringence
What is Myositis?1 muscle hurts
What is Poly-myositis?>1 muscles hurts
What is Dermatomyositis?Myositis + rash
What is Fibromyalgia?(1) Hurt all the time, (2) 11 trigger points
What is Polymyalgia Rheumatica?(1) Weak shoulders, (2) temporal arteritis
What is SLE = Lupus?Meet 4 criteria → “DOPAMIN RASH” → (1) Discoid rash, (2) Oral ulcers, (3) Photosensitivity, (4) Arthritis, (5) Malar rash, (6) Immunologic disorder → Anti-dsDNA Ab, Anti-smooth muscle Ab, and Anti-cardiolipin Ab, (7) Neurologic disorder → Seizure or Psychosis, (8) Renal Failure → die of this ANA, (9) Serositis → pleuritis/pericarditis (Libman-Sacks endocarditis)
What is Scleroderma?Tight skin, fibrosis
What is Takayasu's Arteritis?(1) Pulseless Asian women, (2) Aortic Inflammation
What is Polyarteritis Nodosa?(1) p-ANCA Ab, (2) Attacks gut/kidney, (3) Hepatitis B
What is Wegener's Granulomatosis?(1) c-ANCA Ab, (2) Attacks Ear, Nose, Throat, Lungs, Kidney
What is Goodpasture's?Anti-GBM Ab, attacks lung/kidney, RPGN
What is Reiter's syndrome?Males that can't see, pee, or climb a tree
What is Sjogren's syndrome?Females that have dry eyes/mouth, RA
What is Behcet's Syndome?Oral and genital ulcers, uveitis
What is Churg-Strauss?Asthma, eosinophils, multi-organ involvement
What is Felty's syndrome?RA, Leukopenia, Splenomegaly
What is Kawasaki's disease?“CRASH” → (1) Conjunctivitis, (2) Rash (palm/sole), (3) Aneurysm (coronary artery) → Min kids, (4) Strawberry toungue, (5) Hot (fever > 102F for at least 3 days + cervical lymphaadenopathy)
memorize