Clinical endocrinology Flashcards
Most commonly used neurosurgical method in patients with pituitary adenomas:
trans-nasal/trans-sphenoidal approach
Test for screening Cushing’s syndrome
low-dose (1mg) overnight dexamethasone test
low cortisol -> normal
high/normal cortisol -> Cushing’s syndrome
Patients with acromegaly have an increased risk for
- hypertension, cardiovascular complications
- pulmonary complications
- diabetes type 2
- colorectal tumor
Which of the following genes are tumor suppressor(s)?
VHL
cf. RET (proto-oncogene)
Clinical symptoms of primary hyperparathyroidism
kidney stones, osteoporosis, polyuria, polydipsia, hypertension
Main manifestations of multiple endocrine neoplasia type 1
hyperparathyroidism, pituitary adenoma, pancreatic neuroendocrine tumor
Desmopressin is used for the treatment of:
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.
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
c. life expectancy is decreased by 10 years, if untreated
Definition of pituitary macroadenoma
larger than 1cm in size
Plasma prolactin is the highest
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.
Serum calcitonin is a marker of
medullary thyroid carcinoma
Diagnosis of prolactin-producing pituitary adenoma is based on
pituitary MRI and morning plasma prolactin
Preventive thyroidectomy is indicated
RET gene mutations carriers
“Preventive thyroidectomy in patients with hereditary medullary thyroid carcinoma found heterozygote for mutant RET proto-oncogene”
Which genetic method is used for mutation screening?
DNA sequencing
Diagnosis of acromegaly is based on:
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.
Symptoms of hyperprolactinemia in women:
- amenorrhea
- galactorrhea
- infertility
Hypocalciuric hypercalcemia:
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.
Meaning of primary amenorrhea
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.
Possible cause of double vision in patients with pituitary macroadenoma
compression of optic chiasm
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. prolactinomas are less common than ACTH-producing pituitary tumors
GH>LH/FSH>TSH>ACTH>PRL
Overdosage with vitamin D may result in:
high serum calcium, nephrocalcinosis
Typical findings in secondary hyperparathyroidism
low serum calcium and high serum phosphate
Retinal angiomatosis occurs in:
von Hippel-Lindau syndrome
Dopamine agonist (ie. bromocriptine) is primary therapy in patients with
prolactin-producing pituitary adenoma
Cause of acromegaly
pituitary adenoma in about 98% of cases
How many percent of pheochromocytomas has a hereditary cause?
25-30%
Which of the following gene(s) is oncogene?
a. RET
b. VHL
c. both
d. none of the two
d. none of the two
cf. RET (proto-oncogene), VHL (tumor suppressor gene)
Most commonly used surgical approach for adrenal tumors:
laparoscopy
Plasma cortisol is the highest
early morning
Cause of hyperprolactinemia
- primary hypothyroidism
- craniopharyngioma
Increased levels of thyroid-releasing hormone increase secretion of prolactin as well as thyroid-stimulating hormone (TSH).
Typical findings in patients with primary hyperparathyroidism
increased serum parathyroid hormone, increased serum calcium
Hirsutism is uncommon in patients with
a. polycystic ovary syndrome
b. Cushing’s disease
c. hypopituitarism
d. congenital adrenal hyperplasia (21-hydroxylase deficiency)
c. hypopituitarism
What is the cause of hypogonadism in patient with hyperprolactinemia?
prolactin inhibits LH and FSH secretion
Which drug is dopamine antagonist?
a. bromocriptone
b. haloperidol
c. metoclopramide
d. a and b
e. b and c
f. all above
c. b and c
(haloperidol and metoclopramide)
cf. bromocriptone (dopamine agonist)
Endocrine disorder causing increased perspiration:
acromegaly
hypertrophy of sweat glands
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
d. a and b
(carcinoid and acromegaly)
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
d. autoimmune polyendocrine syndrome type 1
cf. APS 2 -> pheochromocytoma (O)
Uncommon in multiple endocrine neoplasia type 2:
a. pituitary adenoma
b. pheochromocytoma
c. medullary thyroid carcinoma
d. primary hyperparathyroidism
a. pituitary adenoma
Mitotane is used for the treatment of
adrenocortical carcinoma
Incidentally discovered adrenocortical adenomas (incidentalomas)
are more common in older than in younger age
