Endocrine

Question 1

Where is the pituitary gland (ant.,post.) located?

Answer 1

It is within the sella turcica within the sphenoid bone in the middle cranial fossa and covered by dural fold.

Question 2

How is the Anterior pituitary controlled?

Answer 2

It receives hormonal control from the hypothalamus by hypothalamo-pituitary portal system

Question 3

Does the posterior pituitary gland secrete hormones?

Answer 3

No, the hormones are synthesized by hypothalamus then transported by hypothalamo-pituitary tract and stored in the posterior pituitary.

Question 4

What are the hormones secreted by the anterior pituitary?

Answer 4

GH
prolactin
TSH
ACTH & MSH
LH & FSH

Question 5

What are the hormones that are stored in the posterior pituitary?

Answer 5

Oxytocin
ADH

Question 6

What is the acromegaly? Clinical picture? Investigations?

Answer 6

⬆️GH secretion after the union of epiphysis may be due to pituitary adenoma

Clinical picture:
-Big skull and lips
-Separated teeth
-Spade hands
-Enlarged feel
-Vertebrae kyphosis

Investigations: CT brain and MRI

Question 7

Pituitary adenoma might be seen as part of ……. Syndrome

Answer 7

MEN syndrome type 1

Question 8

What is the levels of TSH, T3 & T4 in 1ry and 2ry hyperthyroidism?

Answer 8

1ry:
TSH ⬇️
T3,T4 ⬆️

2ry:
TSH⬆️
T3, T4⬆️

Question 9

What is the levels of TSH, T3 & T4 in 1ry and 2ry hypothyroidism?

Answer 9

1ry:
TSH ⬆️
T3,T4 ⬇️

2ry:
TSH⬇️
T3,T4⬇️

Question 10

What is the TSH, T3 & T4 levels in sub clinical hypo?

Answer 10

TSH⬆️
T3,T4 normal (or low normal)

Question 11

What is the TSH, T3 & T4 levels in isolated T3 toxicosis?

Answer 11

TSH⬇️
Only T3⬆️

Question 12

What is the TSH, T3 & T4 levels in sick euthyroid in ICU patient?

Answer 12

TSH, T3 & T4 low or low normal

Question 13

Hypercholesterolemia and low voltage ECG is associated with which thyroid disorder?

Answer 13

Hypothyroidism

Question 14

……. is the most dangerous inter operative effect with hypothyroidism

Answer 14

Decrease cardiac contractility

Question 15

The first hormones decrease in fever is ….

Answer 15

TRH and TSH

Question 16

What is the effect of PTH on GIT, Bone, Kidney?

Answer 16

GIT: ⬆️Ca and PH absorption
Bone: ⬆️Bone resorption
Kidney: ⬆️Ca reabsorption (from DCT and CT) ⬇️PH reabsorption (from PCT)

Result: ⬆️Ca in blood, ⬇️PH in blood

Question 17

What is the effect of calcitonin on GIT, Bone, Kidney?

Answer 17

GIT: no effect
Bone: ⬆️Bone mineralization
Kidney: ⬇️Ca reabsorption

Result: ⬇️Ca in blood, ⬇️PH in blood

Question 18

What is the effect of vitamin D on GIT, Bone, Kidney?

Answer 18

GIT: ⬆️Ca and PH absorption
Bone: ⬆️Bone mineralization
Kidney: ⬆️Reabsorption

Result: ⬆️Ca in blood, ⬆️PH in blood

Question 19

The PTH half-life is…..

Answer 19

10 minutes

Question 20

What are the laboratory findings of 1ry hyperparathyroidism?

Answer 20

PTH: High
Ca: high
PH: low
The cause is mainly adenoma but the kidney is normal.

Question 21

What are the laboratory findings of 2ry hyperparathyroidism?

Answer 21

PTH: high
Ca: low or normal
PH: high or normal

Causes might be hyperplasia in chronic renal patient

Question 22

What are the laboratory findings of 3ry hyperparathyroidism?

Answer 22

PTH: high
Ca: high
PH: low

Causes might be hyperplasia in a patient post renal transplant

Question 23

What are the adrenal cortex zones and their secretions?

Answer 23

Zona granulosa: Aldosterone
Zona Fasciculata: Cortisol
Zona Reticularis: Sex hormones

Question 24

What are the zones of the adrenal gland and their secretions?

Answer 24

Zona granulosa: Aldosterone
Zona Fasciculata: Cortisol
Zona Reticularis: Sex Hormones

Question 25

What are the secretions of the adrenal medulla?

Answer 25

Catecholamines, adrenaline mainly and noradrenaline

Question 26

What controls the secretions of the adrenal gland?

Answer 26

Cortex: 1-Aldosterone is controlled by the renin angiotensin system. 2-Cortisol is controlled by ACTH 3-Sex hormones are controlled by ACTH Medulla: 1-Catecholamines are controlled by sympathetic system.

Question 27

What are the diseases of increased aldosterone, cortisol and Sex hormones?

Answer 27

-Increased Aldosterone: Hyperaldosteronism (1ry called conn’s disease) -Increased Cortisol: Cushing syndrome -Increased hormones: Adrenogenital syndrome

Question 28

What are the diseases of increased aldosterone, cortisol and sex hormones?

Answer 28

-Increased Aldosterone: Hyperaldosteronism (1ry called conn’s disease) -Increased Cortisol: Cushing syndrome -Increased hormones: Adrenogenital syndrome

Question 29

What is pheochromocytoma?

Answer 29

Increased catecholamines due to tumor of the chromaffin cells of adrenal medulla.

Question 30

What is Pheochromocytoma?

Answer 30

Increased catecholamine due to tumor of the chromaffin cells of the adrenal medulla.

Question 31

What is the Addisonian crisis?

Answer 31

It is adrenal insufficiency due to decreased secretion of cortisol and aldosterone and happens with sepsis, surgery, steroidal withdrawal and adrenal hemorrhage e.g: Waterhouse frederickson

Question 32

What are the symptoms of addisonian crisis?

Answer 32

Hypoglycemia Hypotension Pigmentation

Question 33

What are the addisonian crisis investigations?

Answer 33

ACTH Test Short syntactic test

Question 34

What are the cells of islets of langerhans?

Answer 34

-Beta cells-Insulin (70% of the gland secretion) -Alpha cells-Glucagon -Delta cells- Somatostatin -F Cells- Pancreatic polypeptides

Question 35

What is pro-insulin?

Answer 35

It is formed by the rough endoplasmic reticulum in pancreatic beta cells and it’s cleavage gives insulin and c-peptide which can be measured in insulinoma.

Question 36

The insulin half-life is …..

Answer 36

30 minutes

Question 37

What is the metabolic effect of insulin?

Answer 37

بيبني حاجتين ويدخل حاجتين -Glucose uptake and glycolysis -Decrese blood K+ level -Increase lipid and protein synthesis -Formation of glycogen in liver, muscle and adipose tissue

Question 38

How to diagnose DM?

Answer 38

Fasting glucose >7 2 hours post-prandial >11

Question 39

What are the glucose levels of normoglycemia?

Answer 39

Fasting glucose <6.1 2 hours post-prandial <7.8

Question 40

What are the hormones that increase, decrease or don’t even change in response to stress?

Answer 40

-Increase: GH, Prolactin, ADH, Cortisol, Aldosterone, Aldosterone -Decrease: Testosterone, Estrogen, Insulin -Don’t change: FSH, LH, TSH

Question 41

Regarding para neoplastic syndrome: What are the syndromes associated with small cell lung cancer?

Answer 41

Cushing syndrome (⬆️cortisol) SIADH (⬆️ADH)

Question 42

Regarding para neoplastic syndrome: What are the syndromes associated with squamous cell lung cancer?

Answer 42

Hypercalcemia (PTH related peptide)

Question 43

Regarding para neoplastic syndrome: What are the syndromes associated with Gastric cancer?

Answer 43

Acanthosis nigricans

Question 44

Regarding para neoplastic syndrome: What are the syndromes associated with Renal cell cancer + HCC?

Answer 44

Polycythemia