endocrine

Question 1

Precocious puberty definition

Answer 1

girls <8, boy < 9

Question 2

assessment of precocious puberty

Answer 2

-bone age (advanced vs normal) if advanced check LH if high its central if low confirm with a gnrh stimulation test if still low peripheral

Question 3

nonclassical congenital adrenal hyperplasia

Answer 3

21 hydroxylase deficiency but with maintained glucocorticoid and mineralcorticoid so patients just have the high androgens

Question 4

hypercalcemia with low pth

Answer 4

malignancy, vit d toxicity,granulamatous diseases thiazides,milk alkali syndrom, thyrotoxicosis,vit A toxicity, immobilization

Question 5

how do we evaluate thyroid nodule?

Answer 5

TSH and US, if the TSH is low, get a radioactive scan if its cold consider FNA if hot treat hyperthyroid

Question 6

symptoms of carcinoid syndrom

Answer 6

skin: flushing, telengiactasia, cyanosis
GI: diarrhea, abd pain
CVS: valvular legions
pulmonary: bronchospasm
niacin deficiency (diarrhea dermatitis,dementia)

Question 7

management of carcinoid syndrom

Answer 7

octreotide for symptomatic or prior to surgery, and surgery for liver mets

Question 8

evaluation of carcinoid syndrom?

Answer 8

-elevated urine 5HIAA
-CT/MRI localizing tumor
-octreoscan detects METs
-echo

Question 9

what are carcinoids?

Answer 9

small tumors that secrete histamine, seritonine and vasoactive peptide they are slow growing occur in the intestines and lung and metastasize to liver

Question 10

high thyroid binding globulin

Answer 10

-estrogens(pregnancy,OCP
acute hepatitis

Question 11

low thyroid globulin

Answer 11

-androgenic hormones
-increased cortisol (medication)
-hypoproteinemia
-chronic liver disease

Question 12

humeral hypercalcemia of malignancy

Answer 12

paraneoplastic syndrome caused by the release of parathyroid related peptide which causes hypophosphatemia and hypercalcemia

Question 13

triad of pheochromocytoma

Answer 13

episodic headache,sweating,tachycardia

Question 14

features of pheochromocytoma(10%)

Answer 14

10%malignant
10%bilateral
10%extraadrenal

Question 15

management of pheochromocytoma:

Answer 15

preop alpha blocker (7-14 days prior to surgery) prior to beta blocker, surgery

Question 16

enzyme for phenylketonuria

Answer 16

phenylalanine hydroxylase
inability to metabolize phenylalanine to tyrosine

Question 17

clinical features of phenylketonuria

Answer 17

microceph, developmental delay, seizures, severe intellectual disability,

eczema, hypopigmentation,musty odor

Question 18

phenylketonuria treatment

Answer 18

phenylalanine restricted diet, diatary supplement (tyrosine)
if you delay treatment the neurological injury is irreversable, thats why we do newborn screen!

Question 19

how does hypomagnesemia cause hypocalcemia?

Answer 19

-induces resistance to PTH
-decrease PTH secretion