B6-074 Endocrine Myopathies

Question 1

most common endocrine myopathy

Answer 1

steroid myopathy

Question 2

examination may show ataxic gait and poor cognition

Answer 2

hypoadrenalism

Question 3

papilledema and other signs of increased ICP may be present

Answer 3

hyperadrenalism

Question 4

long term insufficient function of the adrenal cortex leading to underproduction of corticosteroids

Answer 4

Addison disease

Question 5

no response to ACTH stimulation test

Answer 5

Addison disease

Question 6

adrenal failure or destruction or infiltration of the adrenal glands

Answer 6

primary adrenal insufficiency (Addison)

Question 7

[…] adrenal insufficiency is caused by lack of ACTH stimulation from the pituitary

Answer 7

secondary

Question 8

secondary adrenal insufficiency is relatively common due to

Answer 8

widespread use of exogenous corticosteroids

Question 9

rhabdomyolysis has been reported in

Answer 9

hypothyroidism

**elevated CK and myoglobinuria

Question 10

motor movements can have reduced velocity with delayed relaxation of muscle stretch reflexes

Answer 10

hypothyroidism

Question 11

median neuropathy at wrist
myoedema
muscle enlargement

Answer 11

hypothyroidism

Question 12

muscle weakness with atrophy of the pelvic girdle

Answer 12

hyperthyroidism

Question 13

slowly progressive weakness, myalgia, rhabdomyolysis

Answer 13

hypothyroidism

Question 14

slowly progressive proximal weakness, acute severe quadriparesis

Answer 14

hyperthyroidism

Question 15

restrictive opthalmoparesis, proptosis

Answer 15

thyroid opthalamopathy

Question 16

attacks of generalized weakness lasting hours

Answer 16

thyrotoxic periodic paralysis

Question 17

tetany
cataracts
increased ICP

Answer 17

hypoparathyroidsim

Question 18

creatine kinase is usually markedly elevated

Answer 18

hypothyroidism

Question 19

in hyperthyroidism, creatine kinase is usually

Answer 19

normal

Question 20

in hypothyroidism, an EMG can be used to differentiate

Answer 20

delayed muscle relaxation from myotonia

Question 21

nonspecific type II muscle fiber loss with lipid storage

Answer 21

steroid myopathy

Question 22

nonspecific type II muscle fiber atrophy with glycogen storage

Answer 22

hypothyroidism

Question 23

vacuolar dilation of the sarcoplasmic reticulum

Answer 23

thyrotoxic periodic paralysis

Question 24

rapidly evolving myopathy with deficient muscle fibers

Answer 24

corticosteroid therapy

Question 25

slowly progressive proximal weakness, fatigue, muscle cramps

Answer 25

hypothyroidism

Question 26

the EMG in hypothyroidism is often

Answer 26

normal **doesn't pick up myopathic processes

Question 27

EMG reports which type of muscle fibers?

Answer 27

I **this is why it can look normal, if damage in type II

Question 28

hypothyroidism primarily atrophies type [...] fibers

Answer 28

II

Question 29

what changes may you see to type I fibers in hypothyroidism?

Answer 29

cores **may also see expression of neonatal/embryonic fiber types

Question 30

removal of the thyroid is a risk factor for the development of

Answer 30

hypoparathyroidism due to damage or accidental removal

Question 31

tetany spasms fasiculations Chvosteks Trousseaus

Answer 31

hypoparathyroidism causing hypocalcemia

Question 32

how does hypercortisolism cause striae?

Answer 32

decreases fibroblast activity --> decreases collagen formation

Question 33

exertional rhabdomyolysis

Answer 33

hypothyroidism

Question 34

hypothyroidism can cause atrophy of type [...] muscle fibers

Answer 34

II

Question 35

Addison disease is characterized by decreased levels of [2]

Answer 35

cortisol aldosterone

Question 36

fatigue weight loss skin hyperpigementation hyponetremia kyperkalemia hypotension

Answer 36

Addisons

Question 37

caused most often by autoimmune destruction of the adrenal glands

Answer 37

Addison disease

Question 38

what test can differentiate primary, secondary, and tertiary adrenal insufficiency?

Answer 38

ACTH

Question 39

most characteristic physical exam finding in patients with Addison disease

Answer 39

hyperpigmentation **prohormone POMC is cleaved into ACTH and MSH, elevated MSH stimulates melanocytes and causes hyperpigmentation

Question 40

thyroid hormone stimulates [3]

Answer 40

glycogenolysis gluconeogenesis lipolysis

Question 41

decreased serum calcium is a feature of

Answer 41

hypoparathyroidism

Question 42

increased serum calcium is a feature of

Answer 42

hyperparathyroidism

Question 43

Addisons disease is usually treated with

Answer 43

hydrocortisone

Question 44

the predominant manifestation of acute adrenal failure is [...] and should be treated with [...]

Answer 44

shock IM hydrocortisone

Question 45

combining any statin with [...] greatly increases the chance of rhabdomyolysis

Answer 45

gemfibrozil

Question 46

primary screening tests for Cushings [2]

Answer 46

24-urine free cortisol (or salivary) dexamethasone suppression test

Question 47

anti-thyroid drugs

Answer 47

methimazole PTU