Endocrine: Hormones + Dx and Ant. Pit + GH

Question 1

Stimulation tests are used when what is suspected

Answer 1

hypofunction; a stimulating hormone is given and the re: of the target gland is measured

Question 2

Suppression tests are used when what is suspected

Answer 2

hyperfunction (not turning off when it is told to = not re: to negative feedback)

Question 3

Primary dysfunction; problem located?

Answer 3

in the gland

Question 4

Secondary dysfunction

Answer 4

problem with the pituitary

Question 5

Tertiary dysfunction

Answer 5

problem w/ the hypothalamus

Question 6

The only inhibitory hormone

Answer 6

Somatostatin. Inhibits release of GH and TSH; can be used in tx of acromegaly

Question 7

Prolactin secretion inhibited by

Answer 7

dopamine from hypothalamus

Question 8

Adrenal axis

Answer 8

CRH > ACTH > adrenal gland (cortisol + androgens)

Question 9

Thyroid axis

Answer 9

TRH > TSH > thyroid gland (T4, T3)

Question 10

Gonadal axis

Answer 10

GnRH > LH, FSH (FSH sperm; LH testosterone) >testes/ ovaries

Question 11

Somatotropic axis

Answer 11

GHRH > GH

Question 12

MC cause of pituitary dz in adults

Answer 12

pituitary adenomas

Question 13

MC cause of pituitary dysfunction in children

Answer 13

hypothalamic tumors

Question 14

Imaging of choice for pituitary of hypothalamus

Answer 14

MRI

Question 15

MC cause of hyperpituitarism

Answer 15

anterior pituitary adenoma

Question 16

What kind of adenoma in Cushing’s

Answer 16

ACTH-secreting adenoma

Question 17

What tumors will present w/ hypogonadism

Answer 17

LH/FSH-secreting tumors

Question 18

MC type of hyperfunctioning pituitary adenoma

Answer 18

Prolactin-secreting adenoma

Question 19

Tx of most adenomas = RADn or surgery EXCEPT

Answer 19

prolactin-secreting adenomas. Tx: dopamine agonist: bromocriptine

Question 20

Increase TSH, Decrease T4

Answer 20

Primary hypothyroidism

Question 21

Decrease TSH, Decrease T4

Answer 21

Secondary hypothyroidism

Question 22

Increase ACTH

Answer 22

Primary adrenal failure

Question 23

Decrease ACTH

Answer 23

Secondary adrenal failure

Question 24

Hypothyroid tx and how to monitor

Answer 24

Synthroid; monitor with free T4

Question 25

ACTH deficiency tx

Answer 25

cortisol

Question 26

LH and FSH deficiency tx:

Answer 26

gonadotropin replacement

Question 27

tx for dwarfism

Answer 27

GH

Question 28

Macroadenoma tx

Answer 28

transsphenoidal surgical resection except prolactin secreting tumor --> tx w/ dopamine agonist (bromocriptine)

Question 29

Many effects of GH (esp linear bone growth) are mediated by

Answer 29

insulin-like growth factor (IGF-1 is the most important and most readily measured)

Question 30

Positive finding in glucose challenge test

Answer 30

if GH does not decrease (usually GH would be suppressed in a normal patient after administration of glucose)

Question 31

What test to stimulate GH secretion

Answer 31

insulin induced hypoglycemia: should induce increase in GH. Failure to do so = measure of growth hormone deficiency

Question 32

What is pegvisomant?

Answer 32

human GH analog used for tx of refractive acromegaly