2: Endocrine Complaint: Thyroid, Parathyroid, Adrenals

Question 1

Thyroid H production pathway

Answer 1

Hypothalamus makes TRH -> pituitary makes TSH -> thyroid makes T4 and T3

Question 2

Which thyroid H is made in the periphery?

Answer 2

T3

Question 3

What typically causes goiter?

Answer 3

Increased TSH, which stimulates thyroid growth

Question 4

Parathyroid function

Answer 4

Maintain calcium balance by increasing Ca in the blood

Question 5

Three ways PTH works

Answer 5

1. Increases bone resorption
2. Increases intestinal Ca absorption
3. Decreases Ca excretion in kidney

Question 6

Differential consideration for primary hyperparathyroidism

Answer 6

Hypercalcemia of malignancy, but is usually symptomatic at discovery

Question 7

Trousseau’s sign

Answer 7

Carpal spasms caused by inflation of a sphygmomanometer (present in hypoparathyroidism)

Question 8

Chvostek’s sign

Answer 8

Facial muscle contraction when tapping the facial nerve -> painful twitching (present in hypoparathyroidism)

Question 9

Four categories of products of the adrenal glands

Answer 9

Mineralocorticoids, glucocorticoids, catecholamines, adrenal androgens

Question 10

Mineralocorticoids function

Answer 10

Regulate Na and K in kidney, which affects BP

Question 11

Glucocorticoid function

Answer 11

glucose metabolism, inflammatory and immune responses, maintenance of BP and cardiac output

Question 12

Glucocorticoid and mineralocorticoid production pathway

Answer 12

Hypothalamus makes CRH -> pituitary makes ACTH -> adrenal glands make cortisol

Question 13

What pathway mainly regulates mineralocorticoid production

Answer 13

renin-angiotensin-aldosterone pathway

Question 14

How are adrenal masses usually found?

Answer 14

Typically incidental

Question 15

Majority of benign adrenal masses are what?

Answer 15

Endocrine inactive

Question 16

Management of an adrenal mass that is less or greater than 1cm in size

Answer 16

Less than 1cm: monitor

Greater than 1cm: requires diagnostic eval for malignancy, endocrine activity

Question 17

Dxing metabolic syndrome: need 3+ of the following 5 things

Answer 17

1. Central obesity
2. High triglycerides
3. High LDL
4. BP > 130/85
5. Fasting glucose > 100 mg/dL

Question 18

Four dx criteria for DM II

Answer 18

1. A1c > 6.5%
2. Fasting glucose > 126
3. 2hr glucose > 200
4. Random glucose > 200 with Sx hyperglycemia

Question 19

8 conditions that youre studying that have to do with hyper or hypo endocrine

Answer 19

1. Hypothyroid
2. Hyperthyroid
3. Hypoparathyroidism
4. Primary hyperparathyroidism
5. Hypoadrenalism
6. Hypercortisolism (Cushing’s)
7. Aldosteronism
8. Pheocytochromia

Question 20

Most common endocrine malignancy

Answer 20

Thyroid cancer

Question 21

Most common cause of hyperparathyroidism

Answer 21

Autonomously functioning adenoma s

Question 22

Most common cause of primary and secondary hypoadrenalism

Answer 22

1: Addisons

2. : exogenous glucocorticoids