Endocrine

Question 1

Grave’s disease

Answer 1

hyperthryoidism (diffuse toxic goiter)

Question 2

most common cause for hyperthryoidism?

Answer 2

Grave’s dz

other causes are Plummer’s/multinodular toxic goiter

Question 3

what is the mechanism for Grave’s dz?

Answer 3

autoimmune dz (thyroid-stimulating IgG) binds TSH receptors that triggers excess synthesis of thyroid hormone

Question 4

Hashimoto’s thyroiditis

Answer 4

HYPERthyroidism

Question 5

what is multinodular toxic goiter?

Answer 5

hyperfunctioning areas that produce high T4 and T3 levels, thereby decreasing TSH levels

Question 6

S/S of hyperthyroidism?

Answer 6

• sweating
• heat intolerance
• weight loss despite decreased appetite
• nervousness, insomnia, irritability
• diarrhea
• palpitations

Question 7

what are 3 classic signs of Graves dz?

Answer 7

exophthalamos
pretibial myxedema
thyroid bruit

Question 8

explain the levels of TSH and T4/T3 hormone in HYPERthyroidism.

Answer 8

low TSH but high T4/T3 hormone levels

Question 9

which is more biologically active, T4 or T3?

Answer 9

T3

bc T4 has to be de-iodinated to T3 outside of the thyroid

Question 10

pharmacologic management of HYPERthyroidism?

Answer 10

1) Methimazole and propylthiouracil (PTU) inhibit thyroid hormone synthesis; PTU inhibits conversion of T4 to T3
2) beta-blockers to manage symptoms such as palpitations, tremors, anxiety, tachy, sweating
3) radioactive iodine ablation therapy

Question 11

most common cause of HYPOthyroidism?

Answer 11

Hashimoto’s thyroiditis

Question 12

S/S of HYPOthyroidism?

Answer 12

• fatigue, weakness, lethargy
• cold intolerance
• constipation
• muscle weakness, arthralgias
• nonpitting edema

Question 13

goiters are associated with what?

Answer 13

Hashimoto’s thyroiditis (HYPOthyoridism)

Question 14

what are the TSH and T4 levels in HYPOthyroidism?

Answer 14

high TSH but low T4 levels

Question 15

increased antimicrosomal antibodies are suggestive of what?

Answer 15

Hashimoto’s thyroiditis

Question 16

treatment of choice for HYPOthyroidism?

Answer 16

Levothyroxine (T4)

Question 17

Cushing’s SYNDROME? vs. DISEASE?

Answer 17

SYNDROME- excessive levels of cortisone

DISEASE- (usually from pituitary adenoma)

Question 18

clinical features of Cushing’s syndrome?

Answer 18

central obesity 
hirsutism 
moon facies
buffalo hump
purple striae on abdomen
lanugo hair
acne
easy bruising

Question 19

what are the cortisol and ACTH levels in Cushing’s disease?

Answer 19

high cortisol/ high ACTH levels

Question 20

Conn’s syndrome

Answer 20

HYPERaldosteronism (aldosterone producing adenoma)

Question 21

Addison’s disease

Answer 21

HYPOaldosteronism (primary adrenal insufficiency)