CIS-Dr.Singh

Question 1

• Relative adrenal insufficiency (adrenal crisis)

Answer 1

• Inability of HPA axis to keep up with demand
• Insufficient mineralcorticoids (Salt Wasting)

Question 2

• What are the two ways to prove primary acute adrenal insuffiency?

Answer 2

• ACTH
  
  • Should be elevated in primary adrenal insufficiency
• ACTH stimulation test
  
  • Should have no respinse with elevated cortisol *

Question 3

• Primary chronic adrenocortical insufficiency

Answer 3

• Long duration of malaise, fatigue
• Anorexia and weight loss
• Joint pain
• Hyperpigmentation of skin (increased ACTH)

Question 4

• What type of hyperparathyroidism is shown below?

Answer 4

• Primary

Question 5

• What type of hyperparathyroidism is shown?

Answer 5

• Secondary

Question 6

• Insulitis occurs d/t failure of _ in T lymphocytes
• What are the four Ts to look out for in T1DM

Answer 6

• self tolerance
• Toilet
• Thirsty
• Tired
• Thinner

Question 7

• What happens in diabetic ketoacidosis

Answer 7

• Free fatty acids from adipose tissue used be liver to generate ketoacids
• Leads to:
  
  • Acidosis
  • Labored breathing
  • Nause/Vomiting
  • Fruity/Nail Polish Remover breath

Question 8

• What is Pemberton’s sign?

Answer 8

• Facial flushing and venous dilation when arms are raised

Question 9

• What is located posterior to the thyroid and can be compressed with goiter?

Answer 9

• Immediately posterior-trachea
• More posterior-esophagus

Question 10

• What are some signs and symptoms of hyperthyroidism

Answer 10

Question 11

• What are some signs and symptoms of hypothyroidism

Answer 11

Question 12

• Why do goiters develop? (3 ways)

Answer 12

• Nutrition
  
  • I- deficiency
  • Goitrogens
• Genetics
  
  • Familial predisposition
• Environment
  
  • Alcohol
  • Smoking
  • Obesity/Insulin Resistance

Question 13

• Why do nontoxic (euthyroid) goiters develop?

Answer 13

• Adaptive response to impaired thyroid hormone synthesis (gland must grow to keep up with normal physiological function)

Question 14

• Why is it important to treat euthyroid?
• How do you treat?

Answer 14

• Obstructive symptoms
  
  • Dysphagia
  • Dyspnea
• Risk of malignancy
• Treatment
  
  • Surgery (preferred)
  • Radioactive Iodine therapy

Question 15

_ is indicative of elevated intracranial pressure

Answer 15

• Papilledema

Question 16

• A pituitary tumor can cause what visual defect?
• What hormonal defects can result? (The ones she talked about)

Answer 16

• Bitemporal hemianopsia
• Elevated ACTH-Cushing’s Disease
• Elevated GH-Acromegaly in adults, gigantism in children

Question 17

• What two things should be tested/measured when testing for acromegaly?

Answer 17

• Serum levels of IGF (should be elevated d/t increase in GH secretion from the anterior pituitary-more stable secretion than GH, why we use this as a measurement)
• Oral Glucose Tolerance Test
  
  • Normal person- administering oral glucose will suppress GH
  • Acromegaly-administration of oral glucose will not suppress GH

Question 18

• What are some not-so obvious features of acromegaly?

Answer 18

• Prominent Jaw
• Larger Hands
• Accelerated Osteoarthritis