Behavioral Science

Question 1

excessive growth of hair in women in androgen-dependent areas, typically the upper lip, chin, neck, chest, lower abdomen, & perineum

Answer 1

hirsutism

Cosmetic disturbances are due to increase in number and thickness of coarse dark terminal hairs.

Question 2

What is the difference between hirsutism & virilization?

Answer 2

In virilization the magnitude of androgen excess is greatly increased. In virilization the woman has temporal hair recession: male-pattern baldness, deepened voice, increased muscle mass, clitoral enlargement, signs of defeminization

Question 3

Distinguishes thyrotoxicosis from anxiety

Answer 3

Cognitive impairment, tachycardia, fatigue accompanied with desire to be active, warm dry hands (rather than cool and clammy)

Question 4

Psychiatric treatment plan for endocrine disorders

Answer 4

Treat the underlying endocrine condition first and the psychiatric aspects typically resolve.

Question 5

Diagnostic for thyrotoxicosis

Answer 5

Elevated T4 with depressed TSH

Question 6

Treatment for thyrotoxicosis

Answer 6

Beta blocker to manage symptoms
Propylthiouracil
Methimazole
Radioactive iodine

Question 7

Risk of radioactive iodine treatment for hyperthyroidism

Answer 7

Lifelong hypothyroidism that presents within 1-2 years of tx

Question 8

Preferred antipsychotics for psychosis in hyperthyroidism

Answer 8

Quetiapine

Olanzapine

Question 9

Common presenting complaints with hypothyroidism

Answer 9

Progressive cognitive dysfunction with slow comprehension, impaired attention, recent memory, abstract thinking
Personality changes may also be present.
Frequently present with DEPRESSION

Question 10

Most sensitive diagnostic for autoimmune thyroiditis (Hashimoto)

Answer 10

Antithyroid peroxidase antibody with hypothyroidism or goiter

Question 11

What drug used long term has increased risk of causing hypothyroidism?

Answer 11

Lithium

Question 12

Low T4 and FTI with a normal or minimally elevated serum TSH in the absence of clinical hypothyroidism

Answer 12

Euthyroid sick syndrome

Mechanism appears to be to conserve body nitrogen during states of severe stress

Question 13

Significantly inhibit secretion of TSH

Answer 13

Glucocorticoids

Dopamine

Question 14

Causes of false positive results of dexamethasone suppression test

Answer 14

Obesity
Depression
Acute stress
Alcohol withdrawal
Drugs: estrogens, phenytoin

Question 15

Hypercortisolism with major mood disorder or alcohol withdrawal

Answer 15

Pseudo-Cushing’s syndrome

Question 16

Agents used to inhibit cortisol biosynthesis in treatment of Cushing’s

Answer 16

Aminoglutethimide
Metyrapone
Ketoconazole

Question 17

Why should antidepressants be avoided in hypercortisolism?

Answer 17

May precipitate manic episode

Question 18

Misdiagnosed conditions that were really adrenal insufficiency (Addison’s)

Answer 18

Depression
Hypochondriasis
Conversion disorder

Question 19

Diagnostic for primary adrenal insufficiency

Answer 19

Clearly elevated serum ACTH
Abnormal Cortrosyn test

Low 8 AM serum cortisol or 24 hour urinary free cortisol excretion

Question 20

Treatment of Addison’s disease

Answer 20

Glucocorticoid and mineralocorticoid replacement

Question 21

Patients at risk for HPA suppression

Answer 21

Treatment with supraphysiologic doses of glucocorticoids for more than 2 weeks

Question 22

Causes of hypoparathyroidism

Answer 22

Accidental damage in thyroidectomy or radical neck surgery for cancer
Magnesium deficiency (alcoholism)
Neck irradiation
Autoimmune disorder

Question 23

Drug of choice for diabetic neuropathy

Answer 23

Gabapentin

Question 24

Most common causes of fasting hypoglycemia

Answer 24

Insulin
Sulfonylureas
Alcohol
Salicylate
Propranolol

Question 25

Atypical neuroleptic that causes elevated serum prolactin

Answer 25

Risperidone

Question 26

Dopamine antagonist used to lower prolactin levels in pituitary adenoma

Answer 26

Bromocriptine

Adverse: nausea and orthostatic hypotension

Question 27

Somatostatin analog used to treat acromegaly to suppress secretion of GH

Answer 27

Octreotide

Question 28

Diagnostic for acromegaly

Answer 28

Failure of GH suppression after oral glucose load

Increased somatomedin-c