Endo UWorld

Question 1

What is the most effective preventative intervention in all patients, especially those with DM?

Answer 1

smoking cessation

Question 2

Pt presents with HTN, low plasma renin, hypokalemia, and metabolic alkalosis. What is the diagnosis?

Answer 2

Primary hyperaldosteronism caused by:

• adrenal adenoma
• bilateral adrenal hyperplasia

Question 3

What are the hormone/lab findings in Klinefelter syndrome? What is the cause of these hormone findings?

Answer 3

• low testosterone
• elevated LH
• elevated FSH
• dysgenesis of seminiferous tubules causes decreased inhibin B
• abnormal leydig cell function leads to decreased testosterone
  
  • low levels=no feedback inhibition= high levels of FSH and LH (estrogen) from the hypothalamus

*common cause of hypogonadism seen in infertility workup

Question 4

what are the physical sx of a person with Klinefelter syndrome?

Answer 4

• 47,XXY
• primary hypogonadism
• long lower extremities
• small, firm testes
• azoospermia

Question 5

sx of excess vitamin D intake

Answer 5

• hypercalcemia
• mental status change
• muscle weakness
• constipation
• polyuria/polydipsia

Question 6

explain Vitamin D metabolism in a person with granulomatous disease (sarcoidosis, tuberculosis)

Answer 6

Normally, 25-hydroxyvitamin D is converted to 1,25-dihydroxyvitamin D (active form) by 1-alpha-hydroxylase in the kidneys, a process regulated by parathyroid hormone.

Activated macrophages in sarcoidosis and other granulomatous diseases express 1-alpha-hydroxylase​, leading to excess production of 1,25-dihydroxyvitamin D (active form)​ and hypercalcemia.

Question 7

When is glycogenolysis the primary source of glucose?

Answer 7

the first 12-18 hours of fasting

Question 8

explain how cataracts are formed

Answer 8

in teh polyol pathway ,aldose reductase converts glucose into sorbitol, which is slowly metabolized into fructose by sorbitol dehydrogenase. Chronic hyperglycemia overwhelms this pathway, causing intracellular sorbitol accumulation and increased osmotic/oxidative stress. This accelerates cataract development in patients with diabetes, and contributes to the pathogenesis of diabetic retinopathy, neuropathy, and nephropathy.

Question 9

Which blood cell will be elevated in a person taking steroids?

Answer 9

neutrophils