Endocrine Flashcards
What hormones are produced in the anterior pituitary gland?
- LH
- FSH
- Prolactin
- Growth Hormone
- adrenocorticotropic hormone
- TSH
What class of antihyperglycemic medication can cause acute pancreatitis?
Glucagon-like peptide-1 receptor agonists such as exenatide and liraglutide
A 68-year-old man with a history of type 2 diabetes presents to the ED with altered mental status after the fall an hour ago. His spouse found him minimally responsive with incoherent speech and agitation. His medication list includes regular insulin and glyburide. His spouse reports no head strike. On exam, he is noted to be confused with a Glasgow Coma Scale score of 11. Point-of-care glucose level is 45 mg/dL. Which of the following therapies is indicated?
A) Glucose tablets
B) Intravenous dextrose
C) Orange juice
D) Thiamine
Intravenous dextrose
Treatment of acute hypoglycemia involves the provision of glucose. If the patient cannot eat or drink, intravenous dextrose should be administered. Alternatively, glucagon administered intramuscularly, intranasally, or subcutaneously can resolve hypoglycemic symptoms.
A 35-year-old woman presents to her primary care physician for her annual physical exam. CBC, CMP, lipid panel, and TSH are drawn. Lab results reveal a serum calcium of 11 mg/dL that was confirmed by repeat CMP. What is the best next step in evaluating this patient?
A) 24-hour urinary calcium
B) Ionized calcium
C) Serum 25-hydroxyvitamin D
D) Serum parathyroid hormone
Serum parathyroid hormone
If an elevated serum calcium concentration is found on routine testing, confirmation by repeat lab draw is the first step. If an elevated level is found on repeat lab draw, the next step in evaluation is a serum parathyroid hormone. Elevated serum calcium and elevated serum parathyroid hormone are diagnostic for primary hyperparathyroidism.
What is the most common cause of primary hyperparathyroidism?
A) Parathyroid carcinoma
B) Parathyroid adenoma
C) Parathyroid hyperplasia
D) Chronic kidney disease
Parathyroid adenoma
The most common cause of primary hyperparathyroidism is a benign parathyroid adenoma, which results in excessive production of parathyroid hormone (PTH)
Which electrolyte abnormality is most commonly seen in hyperparathyroidism?
A) Hyperkalemia
B) Hypernatremia
C) Hypercalcemia
D) Hypocalcemia
Hypercalcemia
Hyperparathyroidism leads to increased calcium levels in the blood due to excessive PTH, which raises serum calcium by increasing calcium resorption from bone, the kidneys, and the intestines
Which of the following symptoms is most commonly associated with hyperparathyroidism?
A) Fatigue
B) Tinnitus
C) Palpitations
D) Dysphagia
Fatigue
Hyperparathyroidism often presents with vague symptoms like fatigue, weakness, and cognitive dysfunction, due to the effects of hypercalcemia
A 55-year-old woman presents with fatigue, bone pain, and recent episodes of kidney stones. Her lab results show elevated serum calcium and low phosphate levels. Parathyroid hormone (PTH) levels are elevated. What is the most likely diagnosis?
A) Primary hyperparathyroidism
B) Secondary hyperparathyroidism
C) Hypoparathyroidism
D) Vitamin D deficiency
Primary hyperparathyroidism
The combination of elevated PTH, hypercalcemia, and low phosphate is characteristic of primary hyperparathyroidism, often caused by a parathyroid adenoma
A 60-year-old man with chronic kidney disease presents with muscle weakness and diffuse bone pain. His labs reveal hypocalcemia, hyperphosphatemia, and elevated parathyroid hormone (PTH) levels. What is the most likely diagnosis?
A) Primary hyperparathyroidism
B) Secondary hyperparathyroidism
C) Tertiary hyperparathyroidism
D) Hypercalcemia of malignancy
Secondary hyperparathyroidism
Secondary hyperparathyroidism occurs in the setting of chronic kidney disease, where hypocalcemia and hyperphosphatemia stimulate increased PTH production.
A 48-year-old woman presents with a history of recurrent kidney stones and generalized fatigue. Her labs reveal an elevated calcium level and elevated PTH. She is diagnosed with primary hyperparathyroidism. What is the most definitive treatment for this condition?
A) Cinacalcet
B) Thiazide diuretics
C) Parathyroidectomy
D) Oral phosphate supplements
Parathyroidectomy
Parathyroidectomy, the surgical removal of the overactive parathyroid gland(s), is the definitive treatment for primary hyperparathyroidism.
A 50-year-old man presents with complaints of abdominal pain, constipation, and depression. Lab results reveal elevated calcium and parathyroid hormone levels. Imaging shows a solitary parathyroid adenoma. What is the classic mnemonic used to describe the clinical features of hyperparathyroidism?
A) “Fat, fair, and forty”
B) “Stones, bones, abdominal groans, and psychiatric overtones”
C) “Wet, wobbly, and wacky”
D) “Tremor, tachycardia, and intolerance to heat”
“Stones, bones, abdominal groans, and psychiatric overtones”
This mnemonic refers to the common symptoms of hyperparathyroidism, including kidney stones, bone pain, abdominal symptoms, and psychiatric disturbances.
A 32-year-old woman who is 9 weeks pregnant presents to the clinic to discuss her routine annual exam labs. Over the last few months, she has noticed a decrease in her energy level and has experienced intermittent episodes of her “heart racing.” Her vitals are as follows: weight 146 pounds, body mass index 24.6 kg/m2, O2 99% on room air, heart rate 90 bpm, and blood pressure 120/86 mm Hg. Her labs are all within normal limits with the exception of TSH at 0.12 µU/mL, total T4 at 15 µg/dL, and total T3 at 218 ng/dL. Which of the following therapies is most appropriate for this patient?
A) Levothyroxine
B) Methimazole
C) Propranolol
D) Propylthiouracil
Propylthiouracil
The initial treatment for hyperthyroidism is an antithyroid-modulating drug, such as methimazole or propylthiouracil. For patients who are pregnant, especially in their first trimester like the patient in the vignette, propylthiouracil is the preferred treatment.
What finding on a radioactive iodine scan would be most consistent with the diagnosis of Graves disease?
Diffuse uptake of iodine
What nerves may be injured as a complication during a total thyroidectomy?
- Recurrent laryngeal nerve
- Superior laryngeal nerve
- Vagus nerve
