AG2-Endocrine

Question 1

What are the 6 hormones secreted by the anterior pituitary gland?

Answer 1

growth hormone (GH), prolactin, ACTH, TSH, FSH, LH

Question 2

What are the 2 hormones secreted by the posterior pituitary gland?

Answer 2

ADH and oxytocin

Question 3

What is acromegaly?

Answer 3

uncommon condition characterized by an overproduction of GH

Question 4

What is hypopituitarism?

Answer 4

rare disorder that involves a decrease in production of one or more of the pituitary hormones (GH, LH, FSH are most common)

Question 5

What is selective hypopituitarism?

Answer 5

The deficiency of only one pituitary hormone

Question 6

What is pan hypopituitarism?

Answer 6

total failure of the pituitary gland and deficiency of all pituitary hormones.

Question 7

What are early manifestations associated with a space-occupying lesion?

Answer 7

HA, visual changes, loss of sense of smell, N/V, sz

Question 8

What is SIADH?

Answer 8

the release of ADH despite normal or low plasma osmolarity

Question 9

What is the most common cause of SIADH?

Answer 9

small cell lung cancer

Question 10

Drugs associated with SIADH?

Answer 10

Carbamazepine, Chlorpropamide, General anesthesia agents, Opioids, Oxytocin, Thiazide diuretics, SSRIs, TCAs, chemotherapy drugs

Question 11

CNS disorders associated with SIADH?

Answer 11

head injury, stroke, brain tumors, infection (encephalitis, meningitis), cerebral atrophy, Guillain Barre syndrome, SLE

Question 12

Misc conditions associated with SIADH?

Answer 12

hypothyroidism, lung infection, COPD, positive pressure mechanical ventilation, HIV, adrenal insufficiency

Question 13

What causes hyponatremia in SIADH?

Answer 13

excess of water rather than deficiency of Na

Question 14

Global symptoms of SIADH?

Answer 14

Fluid retention, serum hypoosmolality, dilutional hyponatremia, concentrated urine in the presence of normal or increased intravascular volume, low urine output, increased body weight.

Question 15

Early sx of SIADH with mild hyponatremia?

Answer 15

thirst, dyspnea on exertion, fatigue, muscle cramping, irritability, HA

Question 16

Severe sx of SIADH w/ serum sodium <120mEq/L.

Answer 16

Vomiting, abdominal cramps, msl twitching

Question 17

Life threatening symptoms of SIADH from cerebral edema?

Answer 17

lethargy, confusion, sz, coma

Question 18

What is diabetes insipidus (DI)?

Answer 18

deficiency in production or secretion of ADH or a decreased renal response to ADH.

Question 19

Central or neurogenic DI causes?

Answer 19

brain tumor, head injury, brain surgery, CNS infections

Question 20

Nephrogenic DI caues?

Answer 20

LITHIUM, renal damage, hereditary renal disease

Question 21

Primary DI causes?

Answer 21

structural lesion in thirst center, psychologic disorder

Question 22

Patho of DI?

Answer 22

Decreased ADH→ Decreased water reabsorption in the renal tubules → Decreased intravascular fluid volume → Excessive urine output and hypernatremia

Question 23

Primary characteristics of DI?

Answer 23

polyuria, low specific gravity (<1.005), urine osmolality of < 100mOsm/kg

Question 24

General manifestations of DI?

Answer 24

hypernatremia, excessive thirst, fatigue, gen weakness, dilute urine

Question 25

What is hypophysectomy?

Answer 25

Surgical removal of the pituitary gland

Question 26

Areas to monitor with SIADH?

Answer 26

I&Os, VS, ht and lung sounds, daily weights, signs of hyponatremia (sz, HA, vomiting, decreased neuro function)

Question 27

Tx of severe hyponatremia? (Na< 120)

Answer 27

• IV hypertonic solution given slowly
• Fluid restrictions
• Conivaptan IV
• Tolvaptan PO

Question 28

Tx of chronic SIADH?

Answer 28

• fluid restriction
• ice chips or sugarless chewing gum to decrease thirst
• daily weights
• Na and K supplements (diuretic use)