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55555 > Clinical endocrinology > Flashcards

Clinical endocrinology Flashcards

1
Q

Most commonly used neurosurgical method in patients with pituitary adenomas:

A

trans-nasal/trans-sphenoidal approach

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2
Q

Test for screening Cushing’s syndrome

A

low-dose (1mg) overnight dexamethasone test

low cortisol -> normal

high/normal cortisol -> Cushing’s syndrome

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3
Q

Patients with acromegaly have an increased risk for

A
  • hypertension, cardiovascular complications
  • pulmonary complications
  • diabetes type 2
  • colorectal tumor
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4
Q

Which of the following genes are tumor suppressor(s)?

A

VHL

cf. RET (proto-oncogene)

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5
Q

Clinical symptoms of primary hyperparathyroidism

A

kidney stones, osteoporosis, polyuria, polydipsia, hypertension

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6
Q

Main manifestations of multiple endocrine neoplasia type 1

A

hyperparathyroidism, pituitary adenoma, pancreatic neuroendocrine tumor

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7
Q

Desmopressin is used for the treatment of:

A

Diabetes insipidus

Desmopressin, sold under the trade name DDAVP among others, is a medication used to treat diabetes insipidus, bedwetting, hemophilia A, von Willebrand disease, and high blood urea levels.

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8
Q

Which of the following statement is true for acromegaly

a. diagnosis is not delayed because of the well-visible signs
b. can be effectively treated with dopamine antagonists
c. life expectancy is decreased by 10 years, if untreated
d. none of the above

A

c. life expectancy is decreased by 10 years, if untreated

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9
Q

Definition of pituitary macroadenoma

A

larger than 1cm in size

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10
Q

Plasma prolactin is the highest

A

morning

The natural levels of prolactin in the body change throughout the day. Levels gradually rise overnight and are at their highest in the morning. Doctors usually ask to take a blood sample 3 to 4 hours after a person has woken up.

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11
Q

Serum calcitonin is a marker of

A

medullary thyroid carcinoma

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12
Q

Diagnosis of prolactin-producing pituitary adenoma is based on

A

pituitary MRI and morning plasma prolactin

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13
Q

Preventive thyroidectomy is indicated

A

RET gene mutations carriers

“Preventive thyroidectomy in patients with hereditary medullary thyroid carcinoma found heterozygote for mutant RET proto-oncogene”

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14
Q

Which genetic method is used for mutation screening?

A

DNA sequencing

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15
Q

Diagnosis of acromegaly is based on:

A

plasma GH response to oral glucose tolerance test

In someone without acromegaly, a higher blood glucose level usually causes the body to stop producing GH. Therefore, a doctor will purposely raise your blood glucose level using an OGTT and watch how your GH level responds.

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16
Q

Symptoms of hyperprolactinemia in women:

A
  • amenorrhea
  • galactorrhea
  • infertility
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17
Q

Hypocalciuric hypercalcemia:

A

may be a consequence of calcium sensor receptor abnormality

Familial hypocalciuric hypercalcemia (FHH) is a rare autosomal dominant condition. It occurs as a result of mutations in the calcium-sensing receptor gene (CASR) causing decreased receptor activity.

18
Q

Meaning of primary amenorrhea

A

Woman of postpubertal age who had never menstrual bleeding

Amenorrhea can be classified as primary or secondary. In primary amenorrhea, menstrual periods have never begun (by age 16), whereas secondary amenorrhea is defined as the absence of menstrual periods for three consecutive cycles or a time period of more than six months in a woman who was previously menstruating.

19
Q

Possible cause of double vision in patients with pituitary macroadenoma

A

compression of optic chiasm

20
Q

Which statement is correct?

a. prolactinomas are less common than ACTH-producing pituitary tumors
b. TSH-producing adenomas are more common than GH-producing adenomas
c. both (a and b) are correct
d. none of the above correct

A

a. prolactinomas are less common than ACTH-producing pituitary tumors

GH>LH/FSH>TSH>ACTH>PRL

21
Q

Overdosage with vitamin D may result in:

A

high serum calcium, nephrocalcinosis

22
Q

Typical findings in secondary hyperparathyroidism

A

low serum calcium and high serum phosphate

23
Q

Retinal angiomatosis occurs in:

A

von Hippel-Lindau syndrome

24
Q

Dopamine agonist (ie. bromocriptine) is primary therapy in patients with

A

prolactin-producing pituitary adenoma

25
Q

Cause of acromegaly

A

pituitary adenoma in about 98% of cases

26
Q

How many percent of pheochromocytomas has a hereditary cause?

A

25-30%

27
Q

Which of the following gene(s) is oncogene?

a. RET
b. VHL
c. both
d. none of the two

A

d. none of the two
cf. RET (proto-oncogene), VHL (tumor suppressor gene)

28
Q

Most commonly used surgical approach for adrenal tumors:

A

laparoscopy

29
Q

Plasma cortisol is the highest

A

early morning

30
Q

Cause of hyperprolactinemia

A
  • primary hypothyroidism
  • craniopharyngioma

Increased levels of thyroid-releasing hormone increase secretion of prolactin as well as thyroid-stimulating hormone (TSH).

31
Q

Typical findings in patients with primary hyperparathyroidism

A

increased serum parathyroid hormone, increased serum calcium

32
Q

Hirsutism is uncommon in patients with

a. polycystic ovary syndrome
b. Cushing’s disease
c. hypopituitarism
d. congenital adrenal hyperplasia (21-hydroxylase deficiency)

A

c. hypopituitarism

33
Q

What is the cause of hypogonadism in patient with hyperprolactinemia?

A

prolactin inhibits LH and FSH secretion

34
Q

Which drug is dopamine antagonist?

a. bromocriptone
b. haloperidol
c. metoclopramide
d. a and b
e. b and c
f. all above

A

c. b and c

(haloperidol and metoclopramide)

cf. bromocriptone (dopamine agonist)

35
Q

Endocrine disorder causing increased perspiration:

A

acromegaly

hypertrophy of sweat glands

36
Q

Somatostatin-analogues are used for the treatment of

a. carcinoid
b. acromegaly
c. prolactin-producing pituitary adenoma
d. a and b
e. a, b, and c

A

d. a and b

(carcinoid and acromegaly)

37
Q

Pheochromocytoma is uncommon in patients with:

a. vonHippel Lindau syndrome
b. neurofibromatosis type 1
c. multiple endocrine neoplasia type 2
d. autoimmune polyendocrine syndrome type 1

A

d. autoimmune polyendocrine syndrome type 1
cf. APS 2 -> pheochromocytoma (O)

38
Q

Uncommon in multiple endocrine neoplasia type 2:

a. pituitary adenoma
b. pheochromocytoma
c. medullary thyroid carcinoma
d. primary hyperparathyroidism

A

a. pituitary adenoma

39
Q

Mitotane is used for the treatment of

A

adrenocortical carcinoma

40
Q

Incidentally discovered adrenocortical adenomas (incidentalomas)

A

are more common in older than in younger age

55555 (6 decks)

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