24- Endocrine

Question 1

98% of acromegaly cases is due to hypersecretion of GH by this condition

Answer 1

Pituitary adenoma

Question 2

Sign in cushing syndrome where skin may easily pull off when adhesive tape is removed due to thinning

Answer 2

Liddle sign

Question 3

Rapid screening for Cushing syndrome (3 steps)

Answer 3

1. 1mg dexamethasone at 11pm, 8am plasma cortisol
   Below 3ug/dL- rules out Cushing syndrome
2. 24h urinary free cortisol- 3x upper limit
3. Serum ACTH- if source is adrenal (low), pituitary tumor (high), ectopic tumor (very high)

Question 4

Diffuse hyperpigmentation mostly seen in sun exposed areas and sites of trauma or pressure

Palmar crease, hair, nails, mucous membrane darkening; Eruptive onset of multiple new nevi

Decreased axillary and pubic hair
Systemic: weight loss N/V, diarrhea, fatigue

Answer 4

Addisons disease

Question 5

Concave contour of the nail plate with distal onycholysis

Seen in hyperthyroidism

Answer 5

Plummer nails

Question 6

Faulty dentition
Dry and scaly skin
Diffuse scantiness of hair
Brittle nails

⬇️ Ca, Mg
⬆️ P

Answer 6

Hypoparathyroidism

Question 7

Serum Ca/P product is > 65mg/dL

Large subcutaneous nodules or white linearly arranged papules centered around joints

Answer 7

Hyperparathyroidism

Question 8

Acanthosis nigricans type that is associated with malignancy

Answer 8

Type 1

Question 9

Most cases of type 1 acanthosis nigricans is associated with

Answer 9

GIT adenocarcinoma (60% stomach)
Lung
Breast

Question 10

If only palms are involved (acanthosis palmaris), the most common cancer associated is

Answer 10

Lung

Question 11

Most common variety of acanthosis nigricans

Answer 11

Type 3- associated with insulin states and syndromes

Question 12

Treatment for Type 1 acanthosis nigricans

Answer 12

Remove causal tumor

Question 13

Treatment for type 3 acanthosis nigricans

Answer 13

Weight loss

Treat endocrinopathy