Endocrinology

Question 1

Primary endocrine disorders involve what organ(s)?

Answer 1

target endocrine organs e.g. gonads, adrenal cortex, thyroid, mammary gland, liver, kidney

Question 2

Secondary endocrine disorders involve what organ(s)?

Answer 2

anterior pituitary/adenohypophysis

Question 3

Tertiary endocrine disorders involve what organ(s)?

Answer 3

hypothalamus

Question 4

List actions of cortisol

Answer 4

• gluconeogenesis
• increase blood sugar
• suppress immune system
• reduce inflammation
• reduce bone formation
• raise blood pressure

Question 5

T3 and T4 function to ____________

Answer 5

determine basal rate of metabolic reactions

Question 6

Prolactin functions to ___________. It is known as the _________ out of the trophs.

Answer 6

inhibit secretion of FSH, TSH, GH, ACTH

Balancer

Question 7

Aspirin is contraindicated in hyperthyroidism because _________

Answer 7

aspirin competes with T3 and T4 on liver hepatocytes, leading to higher T3/T4 levels in the blood

Question 8

The most common etiology of hypothyroidism is _______The most common auto-immune etiology of hypothyroidism is ___________

Answer 8

aging

Hashimoto’s disease

Question 9

The most common hyperthyroid disorder is _______.The most common etiologies are ______.

Answer 9

Grave’s disease

Toxic adenoma, toxic goiter, thyroiditis.

Question 10

Describe the pathogenesis of Grave’s disease

Answer 10

auto-immune reaction results in production of self-antibodies (IgG), over-stimulating TSH receptors of the thyroid gland

Question 11

What are hallmark features of Grave’s disease?

Answer 11

exopthalmos, heat intolerance, nervousness, insomnia, fine and silky hair alopecia, alternating diarrhea, tremors, irregular menstruations or AMENORRHEA,

Question 12

Describe the pathogenesis of Hashimoto’s disease.

Answer 12

Immune system produces immunoglobulins against thyroid follicles, eventually damaging core substate thyro-globulin

Question 13

What are clinical presentations of hypothyroidsim?

Answer 13

cold intolerance, facial myxedema, fatigue, weight gain, brittle and dry hair alopecia, decreased BMR, irregular/HEAVY menstruation

Question 14

Cushing Syndrome is an endocrine condition characterized by excessive production of ___________

Answer 14

cortisol

Question 15

The most common cause of Cushing’s syndrome is _________

Answer 15

long term steroid medications to suppress inflammation

Question 16

Cushing’s disease is a type of Cushing’s syndrome where _______

Answer 16

anterior pituitary adenoma secretes excessive ACTH which stimulates adrenal gland to produce more cortisol, aldosterone, sex hormone precursors

Question 17

In Cushing’s disease, ACTH levels are ____ and cortisol levels are _____

Answer 17

elevated

elevated

Question 18

What are clinical hallmarks of Cushing’s syndrome?

Answer 18

buffalo hump, central obesity, thin lower limbs, hirsutism, aterial hypertension, diabetes mellitus, osteoporosis, altered mental status (depression, anxiety, psychosis) due to excesses cortisol

Question 19

Cretinism is an outdated medical term for _________. It is generally reversible in the following time frame ________.

Answer 19

• congenital hypothyroidism

- within 1-2 months after birth

Question 20

The hallmark of congenital hypothyroidism is ______

Answer 20

profound mental retardation

Question 21

Gigantism is an excess _____ production initiated __________. Acromegaly is an excess GH production with the beginning of _________, after _________of the long bones are already closed.

Answer 21

• GH production
• before puberty
• adulthood
• epiphyseal plates

Question 22

Addison’s Disease is ________ insufficiency. The causes of Addison’s disease are ___________

Answer 22

• adrenal

- largely unknown, possibly infection, neoplasia, auto-immune

Question 23

Describe typical menses in hypothyroidism.Describe typical menses in hyperthyroidism.

Answer 23

• heavy, painful menses

- oligomenorrhea, amenorrhea

Question 24

What is the potential impact of pituitary adenoma on vision?

Answer 24

enlarged pituitary can impact the optic chiasm, eventually leading to blindness

Question 25

ACTH and MSH share the same _______. Thus, endocrine disorders where ACTH levels are elevated such as _______ will also show signs of darkened skin pigmentation.

Answer 25

precursor molecule (proopiomelanocortin / POMC)Cushing’s disease, primary Addison’s disease

Question 26

Primary Addison’s disease is a deficiency in ______ release from the __________, thus leading to compensation and over production of ________. Signs and symptoms include __________ as a result of primary ________ deficiency.

Answer 26

• glucocorticoid
• adrenal cortex
• ACTH (MSH)
• fatigue, muscle weakness, hypotension, craving salt, brown/bronze discolorations
• cortisol

Question 27

Primary Addison’s disease is also known as __________

Answer 27

brown diabetes

Question 28

Secondary or tertiary Addison’s disease present with all the signs of primary Addison’s except ___________ because ____________

Answer 28

• brown/bronze discolorations

- hypothalamus is not secreting CRH or anterior pituitary not secreting ACTH so MSH is not secreted either

Question 29

Addisonian crisis indicates __________. It can be caused by __________

Answer 29

• severe adrenal insufficiency

- bacterial meningitis, abruptly ceasing long term steroid medication

Question 30

Describe the pathology of primary diabetes mellitus. Describe the pathology of secondary diabetes mellitus.

Answer 30

• auto-immune injury of beta pancreatic islet cells

- resistance of insulin receptors on cellular membranes

Question 31

Obesity and diabetes mellitus type 2 are linked together because _________, affecting blood vessels and pancreatic secretion of insulin. The more cholesterol is available in the human body, the more ______ hormones will be produced, which, in turn, ________ secretion and action of insulin and ________resistance of insulin receptors.

Answer 31

• excessive adipose tissues predispose to accumulation of toxins and proinflammatory mediators
• adrenal
• down regulates
• increases

Question 32

The clinical hallmark of diabetes mellitus is _______ because ______________

Answer 32

wasting body syndrome

it relies on catabolism of proteins and fat than cellular accommodation of glucose

Question 33

DM should be suspected when on two random occasions, fasting blood glucose test shows glucose concentration in blood above _________.What is a normal range of fasting blood glucose?

Answer 33

125-126 mg/dL

70-99 mg/dL

Question 34

OGTT stands for _______. Diagnosis of DM will be established if OGTT in ___ hours shows blood glucose level at _______

Answer 34

Oral Glucose Tolerance Test
2
200 mg/dL or higher

Question 35

The best test for long term control of DM management is _____. Normal values are not to exceed ___

Answer 35

glycosylated hemoglobin test (HbA1c)

6%

Question 36

Central Diabetes insipidus is _______ while nephrogenic diabetes insipidus is _________. Either case results in dysfunction of _______ leading to presentation of __________

Answer 36

• deficient production of ADH by hypothalamus
• resistance of kidney to ADH
• water reabsorption in distal convoluted tubules and collecting ducts
• urine that is diluted (low specific gravity) and abundant

Question 37

Signs and symptoms that suggest Diabetes mellitus are _______

Answer 37

polyuria, polydipsia, polyphagia

Question 38

Thyroid storm is a rare but severe and potentially life-threatening complication of ___________. It is characterized by ________

Answer 38

• hyperthyroidism

- a high fever (often above 40°C/104°F), fast and often irregular heart beat, vomiting, diarrhea and agitation

Question 39

The negative feedback regulation is ________ in any secondary endocrine disorder.

Answer 39

interrupted