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Endo Flashcards

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1
Q

What does the hypothalamus send?

A

Releasing hormone signals (TRH, GnRH, GHRH, CRH, & somatostatin)

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2
Q

What is the negative feedback system?

A

Low levels stimulate production; high levels cease production.

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3
Q

What is the goal of parathyroid hormone (PTH)?

A

Raise serum calcium.

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4
Q

What does the posterior pituitary release?

A

Antidiuretic hormone (ADH) promotes water retention at the kidneys.

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5
Q

What is the function of oxytocin?

A

Uterine contractions & breast milk ejection.

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6
Q

What does the anterior pituitary produce?

A

Follicle-stimulating hormone (FSH) for ovaries, eggs & estrogen development.

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7
Q

What does thyroid-stimulating hormone (TSH) do?

A

Stimulates the thyroid gland to produce T3 & T4.

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8
Q

What is the role of growth hormone (GH)?

A

Somatic growth of the body.

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9
Q

What does prolactin promote?

A

Lactation & breast development.

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10
Q

What does adrenocorticotropic hormone (ACTH) stimulate?

A

Adrenal glands to produce cortisol & aldosterone.

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11
Q

What is the function of luteinizing hormone (LH)?

A

Ovulation, progesterone & testosterone production.

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12
Q

What does melanocyte-stimulating hormone (MSH) do?

A

Stimulates melanin production in response to UV light.

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13
Q

What is the relationship between calcium and phosphorus?

A

Inverse relationship.

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14
Q

What is hypoparathyroidism associated with?

A

Hypocalcemia.

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15
Q

What are the must-know exam findings for calcium?

A

Decreases calcium release and clearance.

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16
Q

What is hyperparathyroidism associated with?

A

Hypercalcemia.

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17
Q

What are the etiologies of primary hyperparathyroidism?

A

Pituitary tumors.

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18
Q

What are the causes of secondary hyperparathyroidism?

A

Chronic kidney disease (CKD), low vitamin D, neck radiation.

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19
Q

What are the signs/symptoms of hyperparathyroidism?

A

Abdominal pain, nausea, vomiting, fatigue, confusion, muscle weakness, bone pain.

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20
Q

What risks are associated with elevated calcium levels?

A

May indicate underlying malignancy.

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21
Q

What is the treatment for hyperparathyroidism?

A

Parathyroidectomy (will need to take calcium supplements).

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22
Q

What does Trousseau’s sign indicate?

A

Tetany.

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23
Q

What does Chvostek’s sign indicate?

A

Facial twitching when facial nerve is tapped.

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24
Q

What is the treatment for tetany?

A

Calcium supplements.

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25
What is prolactinemia?
Elevated serum prolactin levels.
26
What are the signs/symptoms of prolactinemia?
Slow onset, seen with amenorrhea or galactorrhea.
27
What risks are associated with prolactinemia?
Underlying sign of pituitary tumor; may cause headaches & vision changes.
28
What is a test tip regarding antipsychotics?
Atypical antipsychotics are notorious for causing galactorrhea.
29
What is the initial lab work for thyroid disorders?
Thyroid Stimulating Hormone (TSH) ## Footnote Initial screening tool for the thyroid.
30
What are normal TSH levels?
0.5 - 5 MU/L
31
What is hypothyroidism indicated by?
TSH > 5.0
32
What are common causes of hypothyroidism?
Long-term use of Lithium & Amiodarone
33
What is hyperthyroidism indicated by?
TSH < 0.5
34
What results from low production of thyroid hormones?
Hypothyroidism
35
What results from hyperfunction and overproduction of thyroid hormones?
Hyperthyroidism
36
What does low T3 & free T4 levels provide to the anterior pituitary gland?
Positive feedback
37
What does high T3 & T4 levels provide to the anterior pituitary gland?
Negative feedback
38
What is the most common cause of hypothyroidism?
Hashimoto's thyroiditis
39
What is the most common cause of hyperthyroidism?
Graves' disease (80%)
40
What are the signs/symptoms of hypothyroidism?
Weight gain, constipation, cold intolerance, fatigue, alopecia ## Footnote Goiter may also be present.
41
What are the signs/symptoms of hyperthyroidism?
Weight loss, lid lag, tremors, palpitations ## Footnote Goiter may also be present.
42
What are the lab diagnostics for hypothyroidism?
High TSH, low free T4 & high TPO's (antibodies)
43
What is a treatment option for hypothyroidism?
Synthroid (Levothyroxine) ## Footnote Start low & go slow for dosing.
44
What is a treatment option for hyperthyroidism in pregnant patients?
PTU (1st trimester) & Methimazole (2nd trimester) ## Footnote Caution in elderly & patients with cardiac history.
45
What are the long-term risks of hyperthyroidism treatment?
Osteoporosis
46
What is the recommended follow-up for TSH levels after treatment?
Recheck TSH levels every 6 weeks until normal (0.5-5 MU/L) ## Footnote Once TSH regulated, recheck every 6-12 months.
47
What is myxedema coma?
An endocrine emergency characterized by slow-thinking, hypotension, and hypothermia.
48
What is thyroid storm (thyrotoxicosis)?
A life-threatening condition with elevations in BP, HR, and temperature.
49
What are subclinical findings in thyroid disorders?
Abnormal TSH findings with normal T3/T4 levels.
50
What is subclinical hypothyroidism?
TSH > 5 & T3/free T4 normal.
51
What is subclinical hyperthyroidism?
TSH < 0.5 & T3/free T4 normal.
52
What is the treatment for subclinical thyroid disorders?
None; recheck levels in 6 months.
53
What is lupus?
An autoimmune disease that triggers the immune system to mistakenly attack healthy tissues, producing widespread inflammation.
54
What is the hallmark presentation of lupus?
Malar rash or 'butterfly rash' that spares the naso-labial folds and can present on the bridge of the nose.
55
What are the stereotypical symptoms for lupus diagnosis?
1. Malar rash (not necessary) 2. Discoid rash (to memorize for the exam) 3. Arthritis in >2 joints 4. Photosensitivity 5. Nasal/oral ulcerations 6. Serositis 7. Renal disorders 8. Neuro disorders 9. Immune disorders (PLTs <100K) 10. Cardio-pulmonary disorders 11. Positive ANA test (not solely diagnostic).
56
What are adverse events associated with lupus?
Lupus nephritis (ble edema with hematuria) - check renal panel; Sjogren's syndrome (extreme dry eyes - eye drops for lubrication).
57
What is Addison's disease?
Primary adrenal insufficiency due to autoimmune destruction of the adrenal cortex.
58
What are the signs and symptoms of Addison's disease?
Hyperpigmentation (appears tan), weight loss, nausea, vomiting, abdominal pain, myalgia, hypotension.
59
What are the diagnostics for Addison's disease?
High ACTH and low serum cortisol.
60
What is Cushing's disease?
Overproduction of cortisol.
61
What are the signs and symptoms of Cushing's disease?
'Moon face' (puffy, round face), irregular menses, hypertension, triangular obesity, purple striae, fatigue, muscle weakness, and easy bruising.
62
What are the diagnostics for Cushing's disease?
Normal ACTH and elevated midnight cortisol test.
63
What does aldosterone regulate?
Sodium retention and potassium excretion via kidneys.
64
What are the lab findings for Addison's disease?
Hyperkalemia and hyponatremia.
65
What are the lab findings for Cushing's disease?
Hypokalemia and hypernatremia.
66
What is an Addisonian crisis?
A medical emergency requiring treatment with emergency steroids.
67
What are the treatment options for Cushing's disease?
Surgical removal of tumor and radiation therapy.
68
What is the pancreas?
The pancreas is an exocrine gland with endocrine functions.
69
What are pancreatic islets?
Clusters of cells in the pancreas that produce hormones.
70
What do beta cells produce?
Beta cells produce insulin, which helps reduce blood glucose.
71
What do alpha cells produce?
Alpha cells produce glucagon, which helps increase blood glucose.
72
What do delta cells produce?
Delta cells produce somatostatin, which inhibits insulin and glucagon secretion.
73
What is the negative feedback system for?
It is for glucose regulation.
74
What is Type One Diabetes?
An autoimmune destruction of pancreatic beta cells (insulin-producing cells).
75
What is juvenile-onset diabetes?
Type One Diabetes that occurs in individuals under 30 years old.
76
What is a consequence of Type One Diabetes?
Insulin dependence due to destruction of beta cells.
77
What is a higher risk associated with Type One Diabetes?
Higher risk of urinary tract infections (UTIs).
78
What happens when there is no glucose to use?
The body resorts to fat backup methods.
79
What are ketones?
Byproducts from the breakdown of fats, leading to elevated acid levels.
80
What causes morning hyperglycemia?
Both Somogyi effect and Dawn phenomenon cause morning hyperglycemia for different reasons.
81
What is the Somogyi effect?
Rebound hypoglycemia that occurs after a drop in glucose levels.
82
What is the Dawn phenomenon?
Glucose steadily rises all night due to elevated growth hormone (GH) levels.
83
What happens during the Dawn phenomenon?
There is a drop in glucose during the night before it rises in the morning.
84
What should patients do to manage the Somogyi effect?
Cut back on PM insulin dose, eat a PM snack, and avoid exercise before bed.
85
What is acanthosis nigricans?
Dark, velvety patches of skin with poorly defined borders, often appearing around skin fold areas.
86
What is the etiology of acanthosis nigricans?
Commonly associated with diabetes and insulin resistance, as well as hormone disorders and medication use.
87
What labs should be checked for acanthosis nigricans?
Check HbA1c levels.
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