Endo 3

Question 1

Effect of hyperthyroidism on CVS

Answer 1

↑ number and sensitivity of β-adrenergic receptors
↑expression of cardiac sarcolemmal ATPase
↓expression of phospholamban

Question 2

↓ reflexes (slow/ delayed relaxing) is due to

Answer 2

impaired reuptake of Ca by sarcoplasmic reticulum

Question 3

Effect of hypothyroidism on Na

Answer 3

Hypothyroidism ↑ ADH secretion ► hyponatremia

Question 4

Effect of hyperthyroidism on height of children

Answer 4

short stature

Question 5

In DM serum sodium is _____

Answer 5

low → Dilutional hypopnatremia due to glucose driven pull on water into extracellular space

Question 6

Hypotension in adrenal crisis is refractory to vasopressor due to

Answer 6

permissive effect of glucocorticoid

Question 7

Affect of primary adrenal insufficiency on Cl-

Answer 7

PAI → ↓H+ excretion → low plasma HCO3 → compensatory Cl- retention to maintain electrical neutrality of ECF

Question 8

Effect of cortisol on Epi and norepi

Answer 8

cortisol → ↑epi ↓ norepi

Question 9

In PAI, patient with diabetes have ____ insulin requirement due to _____

Answer 9

↓

↓appetite, weight loss and ↑ insulin sensitivity (glucocorticoid ↓ insulin sensitivity)

Question 10

Neuroblastoma

markers:

mutation

histology

Answer 10

bombesin, NSE+

c-myc amplification

Homer wright rosettes

Question 11

Laron syndrome:

Answer 11

defect in GH receptor

Question 12

Acromegaly has increased risk of

Answer 12

colorectal polyp and cancer

Question 13

Acromegaly treatment

Answer 13

octreotide (somatostatin analog),
pegvisomant (GH receptor antagonist), or
dopamine agonists (eg, cabergoline).

Question 14

dyshormonogenetic goiter (commonly due to mutations in _____).

Answer 14

thyroid peroxidase

Question 15

Jod-Basedow phenomenon

Answer 15

Iodine-induced hyperthyroidism

Question 16

Thyroid storm treatment

Answer 16

Treat with the 4 P’s: 
β-blockers (eg, Propranolol), 
Propylthiouracil, 
corticosteroids (eg, Prednisolone), 
Potassium iodide (Lugol iodine). Iodide load T4 synthesis Wolff-Chaikoff effect.

Question 17

Euthyroid sick syndrome

Answer 17

Abnormal thyroid tests seen in patient with severe systemic illness
↓T3, ↑rT3, Normal or ↓TSH, T4

Question 18

Papillary carcinoma mutations

Answer 18

↑risk with RET/PTC rearrangements and BRAF mutations

Question 19

Follicular carcinoma mutations

Answer 19

Associated with RAS mutation and PAX8-PPAR-γ translocations.

Question 20

Pseudohypoparathyroidism type 1A

Answer 20

autosomal dominant, maternally transmitted mutations (imprinted GNAS gene). GNAS1-inactivating mutation (coupled to PTH receptor) that encodes the Gs protein α subunit →inactivation of adenylate cyclase when PTH binds to its receptor →end-organ resistance (kidney and bone) to PTH.

Question 21

Familial hypocalciuric hypercalcemia

Answer 21

Defective G-coupled Ca2+-sensing receptors in multiple tissues (eg, parathyroids, kidneys).

Question 22

PAI: patient with diabetes have ____ insulin requirements.

Why?

Answer 22

↓

↓appetite, weightloss, ↑ insulin sensitivity (glucocorticoids ↓ insulin sensitivity)