Questions

Question 1

Company develops irreversible antagonist of neuropeptide Y. What side effects?

a. nothing, NPY only stimulates appetite
b. constipation b/c increased water reabsorption
c. diarrhea b/c increased small intestine motility
d. steatorrhea [fat in stool]
e. C and D
f. B and D

Answer 1

answer = E

Question 2

Of prolactin, growth hormone, IGF-1, somatostatin – which act on JAK/STAT coupled receptors?

Answer 2

• prolactin
• GH
• IGF-1

not somatostatin

Question 3

What does acute abdominal pain represent in terms of timing in menstrual cycle?

Answer 3

ovulation

Question 4

What levels of LH/FSH/estrogen in menopause?

Answer 4

• at menopause loss of functioning follicles in ovaries

- get high LH/FSH but low estrogen

Question 5

Effect of test protein meal on acid output in patient with zollinger-ellison?

Answer 5

• normally protein meal causes increased gastrin secretion which causes increased acid
• since the gastrin she is getting is already super high from an ectopic source, G cells are super inhibited so the protein will have no effect on acid secretion

Question 6

What happens to gastric mucosa in zollinger-ellison?

Answer 6

• hypertrophy of gastric mucosa since high gastrin stimulates growth of ECL etc

Question 7

what is gastrin and acid level in patient taking proton pump inhibitor or H2 blocker?

Answer 7

• high gastrin [no neg feedback]

- low acid

Question 8

What is normal affect of secretin on gastrin?

Answer 8

secretin normally inhibits gastrin secretion by G cells

Question 9

3 signs of VIPoma? why?

Answer 9

• watery diarrhea
• hypokalemia
• achlorrhydia

Question 10

What is action of VIP?

Answer 10

• stimulates fluid and electrolyte secretion by intestine/pancreas/liver
• inhibits acid secretion [by inhibiting G cells release of gastrin]
• smooth muscle relaxation [peristalsis, sphincters]

Question 11

3 things that inhibit G cells release of gastrin

Answer 11

• secretin
• VIP
• low pH in stomach

Question 12

What is dumping syndrome?

Answer 12

• dizziness, sweating, palpitations after eating
• ingested food moves quickly into duodenum and is hypertonic so draws large volume fluid and electrolytes into gut
• causes drop in BP

Question 13

Why would lack of stomach cause iron-deficiency?

Answer 13

• ferrous [2+] iron is more soluble and absorbable in intestine than ferrric [3+]
• 3+ is the kind found in food
• 3+ gets converted to 2+ in acidic stomach so get more iron that is able to be absorbed
• if no stomach this doesn’t happen

Question 14

Why would lack of stomach cause metabolic acidosis?

Answer 14

• in intestinal phase of digestion: HCO3 secreted into lumen and get equivalent H+ secreted into blood stream
• normally this is balanced out in stomach where H+ in lumen and HCO3 to blood stream
• if no H+ production you have none of the HCO3 entering blood stream so get metabolic acidosis

Question 15

What 4 things injected intraveneously could cause increase in bile secretion? how to determine between them?

Answer 15

• CCK [also causes gall bladder contraction]
• gastrin because of homology to CCK [also causes acid secretion and gall bladder contraction]
• secretin [also cause pancreatic secretion]
• bile salts [just increase bile flow]

Question 16

What causes gall bladder contraction?

Answer 16

CCK

Question 17

Is fructose absorption Na dependent or independent?

Answer 17

independent

Question 18

What causes release of PTH?

Answer 18

low ionized [free] Ca

Question 19

What are effects of PTH?

Answer 19

• increased Ca and PO4 from bone resorption
• in kidney: more reabsorption Ca, excretion PO4, hydroxylation 25OH-D to active form
• in intestine: vid D causes increased Ca absorption

Question 20

What happens to serum PO4, PTH, and 1,25 OH D [active D] in hyperparathyroidism?

Answer 20

• low PO4
• high PTH
• high 1, 25 OH D

Question 21

What happens to serum PO4, PTH, and 1,25 OH D [active D] when you ingest too much vit D?

Answer 21

• high PO4
• low PTH
• high 1, 25 OH D

Question 22

What are actions of Vit D

Answer 22

• increases absorption PO4 and Ca from intestines

Question 23

What happens to serum PO4, PTH, and 1,25 OH D [active D] when you have bone destruction?

Answer 23

• high PO4
• low PTH
• unchanged vit D

Question 24

What happens to serum PO4, PTH, and 1,25 OH D [active D] from PTH-rp [parathyroid related protein]?

Answer 24

• low PO4
• low PTH
• high vit D

PTH-rp is homologous to PTH so will bind PTH receptor and have same functions at PTH but cause low PTH due to neg feedback. PTH-rp also can increase cancer growth/survival

Question 25

What is dexamethasone suppression test?

Answer 25

- for pt with high ACTH - give dex, if ACTH coming from pituitary adenoma, it will bind ACTH and lower cortisol even in cushings - if ectopic ACTH, dex will have no effect on ACTH and thus not lower cortisol