endocrine

Question 1

which type of pituitary tumor is the most common, micro or macro

Answer 1

microadenomas are more common

Question 2

what is the most common type off functional adenoma

Answer 2

prolactin 50-60%
growth hormone 15-20%
ACTH 10-15%
gonadotrophin 10-15%

Question 3

what hormones are secreted by the anterior pit

Answer 3

TSH, GH, ACTH, prolactin, FSH, LH

PAO posterior ADH/oxytocin

Question 4

what hormones are secreted by the posterior pit

Answer 4

ADH and oxytocin

PAO posterior ADH/oxytocin

Question 5

what is the measurement for microadenoma

Answer 5

<1 cm \

Question 6

what is the measurement for macroadenome

Answer 6

> 1 cm

Question 7

are prolactin levels correlated with the size of the adenoma?

Answer 7

YES. 1cm = 100ng\ml; 2 cm = 200ng/ml

Question 8

how does hyperprolactinemia present in men and women

Answer 8

men: decreased libido, erectile dysfunction, RARE for men to get gynecosmastia or galactorrhea but can happen.
women: galactorrhea, amenorrhea. osteoporosis and osteopenia. infertility and gynecomastia

Question 9

what medication can treat hyperprolactinemia

Answer 9

bromocroptine or cabergoline

Question 10

what is acromegaly

Answer 10

excessive growth hormone secretion That causes insidious, chronic debilitating disease associated with overgrowth of the bony and soft tissues. diagnosis made by determining the levels of IGF-1.

Question 11

what is the cause of acromegaly

Answer 11

75% of cases are caused by macroadenomas.

Question 12

what is the medical treatment for acromegaly and what are the SE

Answer 12

octreotide or lanreotide.
these are somatostatin analogs
cholestasis and cholecystitis

Question 13

what is the second line agent for the treatment of acromegaly

Answer 13

pegvisomant

Question 14

what is the most common cause of panhypopituitarism

Answer 14

pituitary adenomas through pressure, trauma and necrosis

Question 15

what is the order of hormone loss typically seen

Answer 15

LH/FSH
growth hormone deficiency
thyrotropin
adrenocorticotropin

Question 16

what is the most common presentation of loss of LH and FSH

Answer 16

loss of axillary and pubic hair

leads to genital atrophy in women

Question 17

what is the common demographic for empty sella

Answer 17

multiparous, obese women with headaches

30% have headaches

Question 18

what is the treatment for empty sella

Answer 18

reassurance

Question 19

what does a deficiency in ADH cause

Answer 19

diabetes insipidus

Question 20

what does excess ADH cause

Answer 20

SIADH

Question 21

what is central diabetes insipidus

Answer 21

this is caused by the loss of most or all ADH secretion from the neurohypophyseal system. results in excessive dilute urine and increased thirst associated with hypernatremia.

Question 22

what are the causes of mental diabetes insipidus

Answer 22

neoplastic or infiltrative lesions, pituitary or hypothalamic surgery, radiotherapy, severe head injuries, anoxia, hypertension\, meningitis

Question 23

what is nephrogenic DI

Answer 23

renal resistance to the action of vasopressin.

Question 24

what are the causes of nephrogenic DI

Answer 24

hypercalcemia, hypokalemia, sickle cell disease, amyloidosis, myeloma, pyelonephritis, sarcoidosis, sjrogens disease.

Question 25

what drugs can cause neprhogenic DI

Answer 25

lithium, demeclocycline colchicine

Question 26

what are the diagnostic criteria for diabetes insipidus

Answer 26

excessive thirst, polydipsia, polyuria. hypernatremia, with high serum osmolarity, and coexisting low urine osmolarity, and a urine specific gravity of < 1.010

Question 27

how do we diagnose DI

Answer 27

water deprivation test; in someone with DI the urine output is the same and the osmolarity doesn't change.

Question 28

what is the normal response to water deprivation test

Answer 28

increased urine osmolarity, decreased urine output,

Question 29

what happens to ADH in someone with nephrogenic

Answer 29

increased

Question 30

what happens to the ADH in someone with central DI

Answer 30

decreased

Question 31

what drugs can stimulate the secretion of ADH

Answer 31

carbamazepine, chlorpropamide, clofibrate

Question 32

what drugs can treat nephrogenic DI

Answer 32

hydrochlorothiazide or ameloride to increase the retention of fluids.

Question 33

what are the common carinomas cause of SIADH

Answer 33

small cell lung cancer and pancreatic carcinoma

Question 34

what infections can cause SIADH

Answer 34

TB, pneumonia and lung abscess

Question 35

what drugs can cause SIADH

Answer 35

carbamazepine, vinblastine, vincristine, clofibrate, cyclophopsphamide, chlorpropamide

Question 36

what are some of the treatments for SIADH

Answer 36

hypertonic saline, fluid restriction, demeclocycline

Question 37

what is the most sensitive test for thyroid function

Answer 37

TSH levels. if they are normal then the person is euthyroid.

Question 38

what is thyroid binding globulin and how does it effect labs

Answer 38

this is the protein in serum that binds thyroid hormone. If there is an increase TBG, then the t4 levels will be off because it be bound...

Question 39

what can cause increases in TBG

Answer 39

pregnancy and oral contraceptives.

Question 40

what antibody is causal for Graves

Answer 40

TSI thyoid stimulating immunoglobulin

Question 41

what is the causal antibody in hashimotos

Answer 41

antimicrosomal and antithyroglobulin

Question 42

what is the most common cause of hyperthyroid

Answer 42

graves disease

Question 43

what are some other causes of hyperthyroidism

Answer 43

hyper functioning adenoma, toxic multi nodular goiter, simple goiter

Question 44

what drugs can cause thyrotoxicosis

Answer 44

lithium, amiodorone, alpha interferon

Question 45

what is the thyroid presentation of graves

Answer 45

painless, diffuse enlargement

Question 46

what is the thyroid presentation of subacute thyroiditis

Answer 46

painful and diffuse enlargment

Question 47

what is the thyroid presentation of Plummer thyroiditis

Answer 47

painless nodules

Question 48

what is the thyroid presentation of factitious

Answer 48

no thyroid enlargement or the thyroid not palpated

Question 49

what is the presentation of graves disease

Answer 49

goiter, exopthalmus, dermatopathy, nervousness, a fib, emotional lability, frequent bowel movements, sweating and heat intolerance, weight loss, oliogomenorrhea, osteoporosis

Question 50

what are some common triggers for graves

Answer 50

stress, pregnancy, infection. | another autoimmune disease

Question 51

what causes exacerbation of graves

Answer 51

smoking

Question 52

what are the treatments for graves

Answer 52

propanolol for adrenergic hyperfunctioning. methimazole or propylthioluracil

Question 53

what thyroid treatment can be used in pregnancy

Answer 53

propylthiouyracil, but only in the first trimester

Question 54

how does thyroid storm present

Answer 54

extreme irritability, delirium, coma, tachycardia, restlessness, vomiting, jaundice, diarrhea, hypertension, dehydration and fever

Question 55

what is the treatment for thyroid storm

Answer 55

propylthiopuracil adrenergic agonists dexamethasone to support adrenal function

Question 56

what are the symptoms of hypothyroidism

Answer 56

constipation, lethargy, cold intolerance, stiffness and cramping of the muscles, carpel tunnel, menorrhagia, intellectual slowing, weight gain, dry hair and skin.

Question 57

How does myxedema present

Answer 57

expressionless face, puffy eyes, large tongue, pale, cool skin that feels doughy.

Question 58

how long does it take for TSH top normalized after dosage changes of T4

Answer 58

6 weeks.