Endocrinology

Question 1

Rx that can cause hyperprolactinemia?

Answer 1

antipsychotics, methyldopa, metoclopramide, opioids, TCAs, verapamil

Question 2

Thryoid and prolactin connection?

Answer 2

Hypothyroidism leads to hyperprolactinemia due to extremely high TRH levels which stimluate prolactin secretion

Question 3

Most common cause of Hypercalcemia?

Answer 3

primary hyperparathyroidism

(typically from cancer/malignancy)

Others include: vitamin D intoxication, sarcoid, thiazide diuretics, hyperthyroidism, metastases to bone, multiple myeloma

C – Calcium supplementation

H – Hydrochlorothiazide

I – Iatrogenic, immobilization

M – Multiple myeloma, milk-alkali syndrome, medication (e.g Lithium)

P – Parathyroid hyperplasia or adenoma

A – Alcohol

N – Neoplasm (e.g breast cancer, lung cancer)

Z – Zollinger Ellison syndrome

E – Excessive vitamin D

E – Excessive vitamin A

S – Sarcoidosis

Question 4

Signs and symptoms of hypercalcemia?

Answer 4

Stones, bones, abdominal moans, psychogenic groans

lethargic and slow (Short QT interval)

Question 5

Causes of hyperparathyroidism

Answer 5

solitary adenoma (80%)

hyperplasia of all 4 glands (20%)

parathyroid malignancy (1%)

Question 6

Diagnostic tests in hyperparathyroidism?

Answer 6

See high calcium, PTH, low phosphaote, high chloride, EKG with short QT (AlkPhos may be elevated from effect of PTH on bone)

Question 7

How does the PTH Calcium VitD axis work?