patho exam endocrine

Question 1

hormones produced by anterior pituitary

Answer 1

TSH, ACTH, GH

Question 2

hormones produced by posterior pituitary

Answer 2

vasopressin/ADH

Question 3

ACTH function

Answer 3

stimulates release of cortisol

Question 4

TSH

Answer 4

stimulates production/secretion of thyroid hormones

Question 5

patho acromegaly

Answer 5

hormonal disorder resulting from overproduction of GH – frequently misdiagnosed d/t slow onset – most common in middle age, can cause premature death

Question 6

dx acromegaly

Answer 6

serum GH > 10 ng/mL, CT, MRI

Question 7

causes acromegaly

Answer 7

benign tumors on pituitary gland (most common) or lungs

Question 8

s/s acromegaly

Answer 8

swelling of hands/feet, coarsening of facial features d/t bone growth, coarsening of hair/skin, barrel chest d/t thickened ribs, joint pain, cardiomegaly

Question 9

patho diabetes insipidus

Answer 9

decreased secretion of ADH causes polyuria & polydipsia

Question 10

dx diabetes insipidus

Answer 10

urine specific gravity < 1.005, osmolality < 200 mOsm/kg – hypernatremia – Miller-Moses water deprivation test

Question 11

s/s diabetes insipidus

Answer 11

dehydration, enlarged bladder, weight loss, muscle weakness, polyuria, polydipsia

Question 12

causes diabetes insipidus

Answer 12

idiopathic/autoimmune, damage from surgery, tumors, cancer, anorexia nervosa

Question 13

patho SIADH

Answer 13

inappropriate release of ADH

Question 14

dx SIADH

Answer 14

serum electrolytes, BUN, creatinine, glucose low; hyponatremia; serum osmolality < 280 mOsm/kg; urinary sodium elevated (>20 mmol/L)

Question 15

causes SIADH

Answer 15

cancer: lung, pancreas, lymphoma, leukemia; pulmonary disease: pneumonia, TB, COPD; CNS: head trauma, stroke, brain tumor; IDIOPATHIC MOST COMMON

Question 16

s/s SIADH

Answer 16

headache, muscle cramp, anorexia, nausea/vom, confusion, coma, convulsions – first sign usually decreased urine output w/increased specific gravity – serum hyponatremia & hypoosmolarity

Question 17

diet for hypoparathyroidism

Answer 17

high Ca: almonds, legumes, dark leafy greens, molasses, oats, sardines, prunes, apricots – low P, avoid oxalic acid (spinach, rhubarb), phytic acid (bran, whole grains) – avoid carbonated beverages, dairy, caffeine

Question 18

glucocorticoids

Answer 18

cortisol – help regulate blood sugar, increase burning of protein/fat, respond to stressors

Question 19

mineralcorticoids

Answer 19

aldosterone – regulate blood volume/pressure by acting on kidneys

Question 20

patho Cushing’s

Answer 20

hormonal disorder caused by prolonged exposure of tissues to high levels of cortisol – most common age 20-50

Question 21

dx Cushing’s

Answer 21

24-hr urinary free cortisol levels > 50-100 mcg, dexamathasone suppresion test, CT, MRI

Question 22

s/s Cushing’s

Answer 22

upper body obesity, round face, fat neck, thin limbs, thin skin, striae, bone fracture, fatigue, muscle weakness, high BP, hyperglycemia, irritability, anxiety, depression, hair loss

Question 23

patho Addison’s disease

Answer 23

hormone deficiency caused by damage to outer layer of adrenal gland – decreased production of cortisol & aldosterone

Question 24

primary Addison’s

Answer 24

adrenal gland damaged

Question 25

secondary Addison's

Answer 25

damage outside adrenal gland -- aldosterone may not be affected

Question 26

dx Addison's

Answer 26

ACTH/CRH stimulation tests, CT, MRI

Question 27

causes Addison's

Answer 27

autoimmune, infection (TB, HIV), hypovolemia, tumors, anticoagulant use

Question 28

s/s Addison's

Answer 28

increased HR, mouth lesions, hyperpigmentation, low BP, hyponatremia

Question 29

patho pheochromocytoma

Answer 29

tumor in core of adrenal gland -- most common age 40-60 -- often benign tumor, but causes adrenal gland to over-secrete catecholamines, raising BP & HR

Question 30

s/s pheo

Answer 30

headache, palpitations, rapid HR, diaphoresis, flushing, chest/ab pain, anxiety, irritability, increased appetite, loss of weight, HYPERTENSION

Question 31

normal function thyroid

Answer 31

uses iodine to produce hormones: thyroxine (T4) & triiodothyronine (T3)

Question 32

function T3

Answer 32

affects metabolism of cells

Question 33

patho Grave's disease (thyrotoxicosis)

Answer 33

autoimmune disease causing overproduction of thyroid hormones -- most common cause of hyperthyroidism

Question 34

s/s Grave's

Answer 34

exophthalmos, anxiety, restlessness, insomnia, weight loss

Question 35

exophthalmos

Answer 35

protrusion of eyeballs, may cause irritation & tearing

Question 36

dx all thyroid disorders

Answer 36

T3, T4, TSH levels

Question 37

mechanisms of thyroid hormone release

Answer 37

hypothalamus releases thyrotropin releasing hormone (TRH), which signals pituitary to release TSH, which signals thyroid to release T3/T4

Question 38

patho hypothyroidism

Answer 38

very common -- 3-5% of population -- more common in women, increases w/age

Question 39

causes hypothyroidism

Answer 39

Hashimoto's, lymphocytic (after hyperthyroidism), thyroid destruction from radiation/surgery), pituitary/hypothalamic disease, medication s/e, iodine deficiency

Question 40

Hashimoto's thyroiditis

Answer 40

most common cause of hypothyroidism in US -- genetic, autoimmune -- thyroid enlarged (goiter) w/decreased ability to produce hormones -- 10-15x more common in women

Question 41

dx Hashimoto's

Answer 41

low T3, high TSH & TRH

Question 42

s/s Hashimoto's/hypothyroid

Answer 42

fatigue, cold intolerance, constipation, dry flaky skin

Question 43

patho diabetes mellitus type 1

Answer 43

pancreatic atrophy & loss of beta cells -- does not produce insulin

Question 44

causes DM type 1

Answer 44

combo genetic & environmental factors

Question 45

s/s DM type 1

Answer 45

hyperglycemia, polydipsia, polyuria, polyphagia, weight loss, fatigue

Question 46

patho DM type 2

Answer 46

insulin resistance

Question 47

dx DM

Answer 47

serum glucose > 130; glucose tolerance test; glycated hemoglobin test (measures glucose utilization over 6-12 wks)

Question 48

complications DM

Answer 48

hypoglycemia, DKA (type 1), HHNKS (type 2)

Question 49

hyperosmolar hyperglycemic nonketotic syndrome (HHNKS)

Answer 49

complication of DM type 2 in which high blood sugars cause severe dehydration, increases in osmolarity (relative concentration of solute) and a high risk of complications, coma and death

Question 50

diabetic ketoacidosis (DKA)

Answer 50

body burns fatty acids in absence of insulin, which produces ketone bodies

Question 51

dx DKA

Answer 51

hyperglycemia, acidosis, ketones in blood/urine

Question 52

dx HHNKS

Answer 52

MRI, hyperglycemia