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Compiled PPS board reviewer > Endo > Flashcards

Endo Flashcards

1
Q

Endocrine disorders manifest by

A

Excess hormone
Deficient hormone
Abnormal Response to end organ
Gland enlargement

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2
Q 
What are stimulated by the FF
GHRH
CRH
GNRH
TRH

In the hypothala

A

GH
ACTH
FSH,LH
TSH

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3
Q

Dopamine inhibits

A

Prolactin

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4
Q

Hypothalamic deficiency leads to decrease in most pituitary hormones expect

A

Prolactin

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5
Q

Diagnosis of diabetes

A
  1. Fasting glucose >126mg/dL
  2. Random glucose >200
  3. Abnormal ogtt >200 at 2 hours
  4. Hba1c >6.5
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6
Q

When ___% islet cells are destroyed the remaining ones are unable to sustain euglycemia

A

80-90%

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7
Q

Renal threshold for glucose absorption

A

160-190mg/dl

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8
Q

Polydypsia occurs because

A

Glucose causes osmotic diuresis

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9
Q

DKA considered if

A
  1. Arterial pH <7.3
  2. Serum bicarbonate <15 meq/L
  3. Ketones are elevated in serum or urine
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10
Q

Very short acting insulin

A

Lispo
Aspart
glulisine

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11
Q

Short acting insulin

A

Regular

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12
Q

Intermediate acting

A

Neutral protamine hagedorn

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13
Q

Long acting insulin

A

Glargine

Detemir

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14
Q

Hba1c targets

A

<6 years old
7.5-8.5

6-13 years old
<8

13-18 years old
<7.5

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15
Q

Severe hypoglycemia
Massive hepatomegaly
Growth retardation
Lactic acidosis

A

Glucose 6 phosphatase deficiency

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16
Q

During hypoglycemic episode

Blood sample obtained for

A 
Glucose
Insulin
GH
Cortisol
FFAs
Beta hydroxybutyrate
acetoacetate
Lactate
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17
Q

Hypoglycemia without ketonuria means

A

Hyperinsulinism

Or defect in fatty acid oxidation

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18
Q

Normal values upper to lower segment ratio

A

Infant 1.7:1
1 year old 1.4:1
10 year old 1:1

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19
Q 
Retinitis pigmentosa
Hypogonadism
Developmental delay
Autosomal dominant
Obesity
Polydactyly
Growth delay
A

Bardet Biedl syndrome

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20
Q 
Retinitis pigmentosa
Hypogonadism
Developmental delay
Autosomal dominant
Growth delay
Spastic paraplegia
A

Laurence Moon syndrome

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21
Q 
Short stature
Developmental delay
Short 4th and 5th digits
Resistance to parathyroid hormone
High Phos
Low Ca
A

Pseudohypoparathyroidism

Albright hereditary osteodystrophy phenotype

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22
Q 
Autosomal recessive
Prominent forehead
Hypoplastic nasal bridge
Delayed dentition
Sparse hair
Blue sclerae
Delayed bone maturation
Osteoporosis
Progressive adiposity
Hypercholesterolemia
Low blood glucose
Elevated GH
Low IGF-1
A

Laron syndrome

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23
Q

FSH

A

In females stimulation of estrogen production and formation and support of corpus luteum

In males stimulation of devt of seminiferous tubules

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24
Q

LH

A

In males stimulation of testosterone from leydig cells

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25
Q

Delayed puberty if

A

13 yrs in females
14 in males
No sign of puberty

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26
Q

activity ofGnRHhormone failure
Anosmia or hyposmia
Delayed puberty
Hypogonadotropic hypogonadism

A

Kallman syndrome

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27
Q

Congenital absence of uterus

A

Mayer-Rokitansky-Kuster-Hauser syndrome

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28
Q

Precocious puberty

A

8 years in girls

9 years in boys

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29
Q

autosomal dominantgenetic disorder
characterized by the development of benignhamartomatouspolypsin thegastrointestinal tractand hyperpigmentedmaculeson thelipsandoral mucosa(melanosis)
Precocious puberty

A

Peutz–Jeghers syndrome

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30
Q

suspected when two or more of the following features are present:
Fibrous dysplasia
Café au lait macules following lines of Blaschko
Hyperfunctioningendocrine disease
(Precious puberty, hyperthyroidism, testicular abnormalities, growth hormone excess, Cushing’s syndrome)

A

McCune–Albright syndrome

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31
Q

Treatment for central precocious puberty

A

GnRH analog
Leuprolide
Histrelin

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32
Q

Tx for boys with GnRH independent precocious puberty

A

Inhibit testosterone synthesis (Ketoconazole)
Antiandrogen (Spironolactone)
Aromatase inhibitor (testolactone, letrozole)

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33
Q

Tx for McCune Albright precocious puberty

A

Testolactone

Tamoxifen

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34
Q

Thyroid metabolism of fetus occurs

A

Third trimester

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35
Q

___ exerts metabolic effect and negative feedback on TSH release

A

Ft3

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36
Q

Ft4 is test of choice because

A

It eliminates effects of variation in protein binding

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37
Q

Most common cause of acquired hypothyroidism in usa

A

Hashimoto thyroiditis

Lymphocytic autoimmune thyroiditis

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38
Q

Most common cause of acquired hypothyroidism in developing countries

A

Iodine deficiency

Endemic cretinism

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39
Q

Diagnosis for hashimoto thyroiditis

A

Serum antithyroid peroxidase

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40
Q

Side effect of methimazole

A

Granulocytopenia

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41
Q

___ can precipitate hypoCa by lowering ionized calcium without changing total serum Ca

A

Alkalosis

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42
Q

Most common cause of female ambiguous genitals

A

Congenital virilizing adrenal hyperplasia

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43
Q

Test to diagnose CAH with 21 hydroxylase deficiency

A

High levels 17 hydroxyprogesterone and androstenedione

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44
Q

Adrenal gland outer cortex for

A

Synthesis of steroids

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45
Q

Adrenal gland inner medulla

A

Synthesizes catecholamines

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46
Q

End product in adrenal cortex
A. Outer glomerulosa
B. Middle fasciculata
C. Inner reticularis

A

A. Aldosterone
B. Cortisol
C. Sex steroids

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47
Q

Feature of congenital adrenal mineralcorticoid deficiency

A

HypoNa

HyperK

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48
Q

autoimmune destruction of the adrenal cortex
hyperpigmentation, salt craving, postural hypotension, fasting hypoglycemia, anorexia, weakness, and episodes of shock during severe illness
hyponatremia, hyperkalemia, and elevated plasma renin activity
ACTH subnormal

A

Addison disease

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49
Q

Low dose dexamethasone suppression test
Normal result?
Abnormal result?

A

Normal - Decrease in cortisol

Cushing’s disease - no change in cortisol

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50
Q

High dose dexamethasone suppression test

Cushing’s disease result

A

Cortisol low in high dose

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51
Q

bone age?
growth rate?
adult height?

Androgen excess

A

Advanced
Increased
Diminished

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52
Q

bone age?
growth rate?
adult height?

Androgen deficiency

A

Normal or delayed
Normal or decreased
Increased slightly or normal

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53
Q

bone age?
growth rate?
adult height?

Thyroxine excess

A

Advanced
Increased
Normal or diminished

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54
Q

bone age?
growth rate?
adult height?

Thyroxine deficiency

A

Retarded
Decreased
Diminished

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55
Q

bone age?
growth rate?
adult height?

Growth hormone excess

A

Normal or advanced
Increased
Excessive

56
Q

bone age?
growth rate?
adult height?

Growth hormone deficiency

A

Retarded
Decreased
Diminished

57
Q

bone age?
growth rate?
adult height?

Cortisol excess

A

Retarded
Decreased
Diminished

58
Q

bone age?
growth rate?
adult height?

Cortisol deficiency

A

Normal
Normal
Normal

59
Q

provocative test for GH

A

insulin
arginine
clonidine
glucagon

60
Q 
diabetes insipidus
diabetes mellitus
optic atrophy
deafness
vasopressin deficiency
A

wolfram syndrome

61
Q

triphasic response after brain surgery

A

initial transient DI 12-48hours
then SIADH up to 10 days
then permanent DI

62
Q

drugs that inhibit vasopressin

A 
ethanol
phenytoin
opiate antagonists
halothane
alpha adrenergic
63
Q

acquired nephrogenic DI can occur with

A 
lithium
demeclocycline
foscarnet
clozapine
amphotericin
methicilln
rifampin
64
Q

drugs that mimic vasopressin

A 
vincristine
vinblastine
carbamazepine
tricycle antidepressants
oxcarbazepine
65
Q

relationship between sodium and glucose

A

for every 100mg/dl increase in GLUCOSE (above 100mg/dl),

SODIUM decreases 1.6 meq/L

66
Q

bone age
sexual development
HYPOPITUITARISM GH DEFICIENCY

A

Delayed

Delayed

67
Q

bone age
sexual development
CONSTITUTIONAL DELAY

A

Delayed

Delayed

68
Q

bone age
sexual development
FAMILIAL SHORT STATURE

A

normal

normal

69
Q

bone age
sexual development
DEPRIVATIONAL DWARFISM

A

Usually delayed; growth arrest lines present

May be delayed

70
Q

bone age
sexual development
TURNER SYNDROME

A

delayed

Female prepubertal

71
Q

bone age
sexual development
HYPOTHYROIDISM

A

delayed

Usually delayed, may be precocious if hypothyroidism is severe

72
Q

bone age
sexual development
CHRONIC DISEASE

A

delayed

Delayed

73
Q

CALCIUM
PHOSPHATE
PARATHYROID HORMONE
25(OH)D

Primary hypoparathyroidism

A

↓
↑
↓
N

74
Q

CALCIUM
PHOSPHATE
PARATHYROID HORMONE
25(OH)D

Pseudohypoparathyroidism

A

↓
↑
↑
N

75
Q

CALCIUM
PHOSPHATE
PARATHYROID HORMONE
25(OH)D

Vitamin D de ciency

A

Nl(↓)
↓
↑
↓

76
Q

CALCIUM
PHOSPHATE
PARATHYROID HORMONE
25(OH)D

Familial hypophosphatemic rickets

A

Nl
↓
Nl (sl↑)
Nl

77
Q

CALCIUM
PHOSPHATE
PARATHYROID HORMONE
25(OH)D

Hyperparathyroidism

A

↑
↓
↑
Nl

78
Q

CALCIUM
PHOSPHATE
PARATHYROID HORMONE
25(OH)D

Immobilization

A

↑
↑
↓
Nl

79
Q

TOTAL T4
FREE T4
SERUM TSH
SERUM TBG

Primary hypothyroidism

A

↓
↓
↑
N

80
Q

TOTAL T4
FREE T4
SERUM TSH
SERUM TBG

Hypothalamic (TRH) tertiary hypothyroidism

A

↓
↓
↓
N

81
Q

TOTAL T4
FREE T4
SERUM TSH
SERUM TBG

Pituitary (TSH) secondary hypothyroidism

A

↓
↓
↓
N

82
Q

TOTAL T4
FREE T4
SERUM TSH
SERUM TBG

TBG de ciency

A

↓
N
N
↓

83
Q

TOTAL T4
FREE T4
SERUM TSH
SERUM TBG

TBG excess

A

↑
N
N
↑

84
Q

tx mccune albright syndrome

A

letrozole

tamoxifen

85
Q

thyroxine synthesis occurs at __ wks aog

A

4

86
Q

iodine trapping occurs at __ wks aog

A

8-10

87
Q

most common cause of congenital hypothyroidisim

A

thyroid dysgenesis

88
Q

autosomal recessive
deafness
goiter
impaired iodide organification

A

pendred syndrome

89
Q

muscular pseudohypertrophy in congenital hypothyroidism

A

kocher debre semelaigne syndrome

90
Q

thyroxine tablets should not be mixed to __ because these bind t4 and inhibit absorption

A

soy
calcium
concentrated iron

91
Q

most common cause of acquired hypothyroidisim

A

chronic lymphocytic thyroiditis

92
Q

drugs that cause hypothyroidism

A 
amiodarone
methimazole
propylthiouracil
lithium
interferon alpha
thalidome
valproate
93
Q

pathogens in acute suppurative thyroiditis

A

anaerobe
strep viridans
staph
pneumococcus

94
Q

how are cassava and cruciferous veggies like cabbage, kale goitrogens?

A

compete with iodine for uptake in thyroid

95
Q

reduction in thyroid hormone levels caused by ingestion of a large amount of iodine

A

Wolff–Chaikoff effect

96
Q

retraction of eyelid in graves

A

dalrymple sign

97
Q 
neonate with:
advanced bone age
iugr
infant is restless,irritable
exophthalmic eyes
weight loss
severe hypertension
cardiac decompression 
hepatomegaly
frontal bossing
craniosynostosis
triangular facies
A

congenital hyperthyroidism

98
Q

most common type of thyroid carcinoma in kids

A

papillary

99
Q

most common site of mets for thyroid carcinoma

A

lungs

100
Q

marker for tumor recurrence in thyroid carcinoma

A

serum thyroglobulin

101
Q

thyroid nodules producing hyperthyroidism

A

plummer disease

102
Q

hypocalcemia is common ___ hrs in newborns

A

12 to 72 hours

103
Q

autoimmune hypoparathyroidism associated with

A

addison disease

chronic mucocutaneous candidiasis

104
Q 
medullary stenosis of long bones
short stature
delayed fontanel closure
delayed bone age
abnormal PTH
episodic hypocalcemia
A

kenny-caffey syndrome

105
Q 
Oliguria
Azotemia
Stupor
Coma
HyperCa
A

Parathyroid crisis

106
Q

Ectopic source of vit D in granulomatous disease

A

Activated macrophages

107
Q

Prolonged immobilization can lead to

A

Hypercalcemia

108
Q

Short limbed dwarfism
Severe hyperCa
Undetectable PTH levels

A

Jansen type metaphyseal chondrodysplasia

109
Q

Rate limiting step in adrenal steroidogenesis

A

Importation of cholesterol across mitochondrial outer and inner membrane

110
Q

Schedule of ACTH pulses

A

every 30-120 min, are highest at about the time of waking, are low in late afternoon and evening, and reach their lowest point 1 or 2 hr after sleep begins

111
Q

Achalasia
Alacrima
Adrenal insufficiency

A

Allgrove syndrome

112
Q

Adrenocortical deficiency

Associated with demyelination of cns

A

Adrenoleukodystrophy

113
Q

Chronic mucocutaneous candidiasis as first manifestation
Hypoparathyroidism
Addison disease

Autosomal recessive

A

Type 1 autoimmune polyendocrinopathy
OR
autoimmune polyendocrinopathy–candidiasis–ectodermal dystrophy (APECED)

114
Q

Most common cause of corticotropin deficiency

A

Craniopharyngioma

Germinoma

115
Q

Most common cause of Addison disease

A

Autoimmune destruction of glands

116
Q

Prominent labs in adrenal insufficiency

A

HyperK
HypoNa
Hypoglycemia

117
Q

Test when CAH suspected

A

17 hydroxyprogesterone

Along with cortisol in acth stimulation test

118
Q

required for conversion of Δ5 steroids (pregnenolone, 17-hydroxypregnenolone, dehydroepiandrosterone [DHEA])

A

3β-hydroxysteroid dehydrogenase

119
Q

Acth dependent Cushing syndrome
Small adrenal gland
Multiple small pigmented black nodules with large cells with lipofuscin

A

Primary pigmented nodular adrenocortical disease

120
Q

autosomal dominant disorder also consisting of centrofacial lentigines and blue nevi; cardiac and cutaneous myxomas; pituitary, thyroid, and testicular tumors; and pigmented melanotic schwannomas

With Primary pigmented nodular adrenocortical disease

A

Carney complex

121
Q

Centrally acting serotonin antagonist that blocks acth release
Treatment

A

Cyproheptadine

122
Q 
Hypertension
HypoK
Autosomal dominant
Aldosterone and renin levels suppressed
Mineralcorticoid excess
A

Liddle syndrome

123
Q 
Short stature
Webbing of neck
Pectus carinatum
Cubitus valgus
Right sided CHD
Facies
A

Turner

124
Q

nephropathy with ambiguous genitalia and bilateral Wilms tumor
Progress to nephrotic syndrome and end stage renal failure

A

Denys drash syndrome

125
Q

Most common form of male DSD

A

Androgen insensitivity syndrome

126
Q

Wilms tumor
Aniridia
GU malformation
Retardation

A

WAGR syndrome

127
Q

Testes absent but male phenotype complete

A

Bilateral anorchia
Or
Vanishing testes syndrome

128
Q

Dose of insulin with long standing DM and no insulin reserve

A

Prepubertal 0.7 u/kg/day
Midpuberty 1.0 u/kg/day
End of puberty 1.2 u/kg/day

129
Q

Sodium should increase by _ for every _ of glucose

A

1.6mmol

100mg/dl

130
Q

In DKA when should glucose be added

A

When serum glucose 250mg/dL

131
Q

hormones that promote glycogenolysis

A

epinephrine

glucagon

132
Q

hormones that promote gluconeogenesis

A

glucagon

cortisol

133
Q

hormones that inhibit muscle uptake of glucose

A

epinephrine
growth hormone
cortisol

134
Q

hormone that mobilizes amino acid for gluconeogenesis

A

cortisol

135
Q

hormones for activating lipolysis

A

epinephrine
cortisol
growth hormone
glucagon

136
Q

hormone that inhibits insulin release and promotes growth factor and glucagon secretion

A

epinephrine

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