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ENDO-RENAL > Pituitary Hormones, Adenoma, CS > Flashcards

Pituitary Hormones, Adenoma, CS Flashcards

1
Q

Which of the following is referred to as the master gland?

A. Hypothalamus
B. Pineal gland
C. Anterior pituitary gland
D. Posterior pituitary gland
E. Two of the options
F. None of the options
A

C. Anterior pituitary gland

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2
Q

Which of the following anterior pituitary cells is produced first?

A. Corticotrope
B. Somatotrope
C. Lactotrope
D. Thyrotrope
E. Gonadotrope
A

A. Corticotrope = 6 weeks

Somatotrope = 8 weeks

Lacto/Thyro/Gonado = 12 weeks

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3
Q

Which of the following anterior pituitary cells targets the liver and bone?

A. Corticotrope
B. Somatotrope
C. Lactotrope
D. Thyrotrope
E. Gonadotrope
A

B. Somatotrope = Liver and bone

Cortico = adrenal
Lacto = breast
Thyro = thyroid
Gonado = ovary, testis
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4
Q

Growth hormones induces all of the following EXCEPT:

A. Protein synthesis
B. Nitrogen retention
C. Glucose tolerance impairment
D. Lipogenesis

A

D. Lipogenesis

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5
Q

This is an autosomal dominant syndrome characterized by primarily a genetic predisposition to parathyroid, pancreatic islet, and pituitary adenomas, Half of the affected patients with this disease develop prolactinomas.

A. McCune-Albright Syndrome
B. Carney complex
C. Familial acromegaly
D. Multiple endocrine neoplasia 1

A

D. Multiple endocrine neoplasia 1

Carney = spotty skin pigmentation
McCune-Albright = polyostotic fibrous dysplasia
Acromegaly = gigantism
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6
Q

All are following features of chronic cortisol excess EXCEPT:

A. Thin skin
B. Peripheral obesity
C. Plethoric moon facies
D. DM
E. Osteoporosis
A

B. Peripheral obesity

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7
Q

All are following are hematopoietic features of chronic cortisol excess EXCEPT:

A. Leukocytosis
B. Lymphocytosis
C. Lymphopenia
D. Eosinopenia

A

B. Lymphocytosis

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8
Q

All of the following describes ACTH-secreting pituitary hormone EXCEPT

A. Most common are microadenomas
B. Slow onset
C. F > M
D. Hypokalemia is present in <10% of patients
E. Two of the options
F. None of the options
A

F. None of the options

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9
Q

Which of the following confirms pituitary Cushing’s syndrome?

A. Increased ratio (>2) of inferior petrosal:peripheral vein ACTH
B. Increased peak petrosal:peripheral ACTH ratio >3
C. Decreased ratio (<2) of inferior petrosal:peripheral vein ACTH
D. Decreased peak petrosal:peripheral ACTH ratio <3

A

A. Increased ratio (>2) of inferior petrosal:peripheral vein ACTH

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10
Q

This is the only parenteral drug indicated for severe Cushing’s syndrome.

A. Aminoglutethimide
B. Etomidate
C. Mifepristone
D. Metyrapone
E. Ketoconazole
A

B. Etomidate

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11
Q

The only drug safe for pregnant women with Cushing’s syndrome

A. Aminoglutethimide
B. Etomidate
C. Mifepristone
D. Metyrapone
E. Ketoconazole
A

D. Metyrapone

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12
Q

Drug indicated for inoperable adrenocortical cancer (ACC)

A. Trilostane
B. Mitotane
C. Mifepristone
D. Metyrapone
E. Aberaterone
A

B. Mitotane

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13
Q

This drug blocks peripheral cortisol action which doesn’t target pituitary tumor. Also used to treat hyperglycemia in Cushing’s syndrome.

A. Aminoglutethimide
B. Etomidate
C. Mifepristone
D. Metyrapone
E. Ketoconazole
A

C. Mifepristone

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14
Q

All of the following are cardiovascular signs and symptoms of Cushing’s syndrome EXCEPT:

A. Diastolic hypertension
B. Systolic hypertension
C. Hypokalemia
D. Edema
E. Atherosclerosis
A

B. Systolic hypertension

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15
Q

DHEA is produced in which kidney region?

A. Zona glomerulosa
B. Zona fasciculata
C. Zona reticularis
D. Adrenal medulla

A

C. Zona reticularis

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16
Q

Which of the following is the pivotal regulator of adrenal cortisol synthesis?

A. Cholesterol
B. ACTH
C. CRH
D. 11-beta-hydroxylase

A

B. ACTH

17
Q

Which of the following tests is useful in assessing glucocorticoid deficiency?

A. Dexamethasone suppression test
B. ACTH stimulation
C. Insulin tolerance test
D. Two of the options
E. All of the options
A

B. ACTH stimulation

18
Q

Which of the following is the rate limiting enzyme for adrenal steroidogenesis pathway?

A. 11-B-hydroxylase
B. 17,20-lyase
C. 17-a-hydroxylase 
D. Cholesterol desmolase
E. None of the options
A

D. Cholesterol desmolase

19
Q

All of the following are causes of ectopic ACTH syndrome EXCEPT:

A. Bronchial carcinoids
B. Pancreatic carcinoids
C. Macronodular adrenal disease
D. Pheochromocytoma
E. Small cell lung cancer
A

C. Macronodular adrenal disease

20
Q

The most common cause of death in Cushing’s syndrome

A. Acute Kidney Injury
B. Chronic Kidney failure
C. CVDs
D. Sepsis
E. Deep vein thrombosis
A

C. CVDs

21
Q

All of the following are results for screening/confirm CS diagnosis EXCEPT:

A. Low dose DEX test (Plasma cortisol <50 nmol/L)
B. 24-h UFC excretion increased above normal (3x)
C. Midnight plasma cortisol >130 nmol/L
D. Midnight salivary cortisol >5nmol/L
E. Two of the options
F. None of the options

A

A. Low dose DEX test (Plasma cortisol <50 nmol/L)

22
Q

Suppose the ACTH is suppressed to <5pg/ml, which of the following is the next step of management.

A. Identify as ACTH-dependent Cushing’s, order MRI pituitary
B. Identify as ACTH-independent Cushing’s, order MRI pituitary
C. Identify as ACTH-independent Cushing’s, order unenhanced CT
C. Identify as ACTH-independent Cushing’s, order enhanced CT
E. Identify as ACTH-independent Cushing’s, order MRI
F. Order MRI and CT

A

C. Identify as ACTH-independent Cushing’s, order unenhanced CT

23
Q

Which of the following has the least recovery rate?

A. Ectopic ACTH syndrome
B. Adrenal Cushing's 
C. Cushing's disease
D. Two of the options
E. None of the options
A

B. Adrenal Cushing’s

24
Q

All of the following are oral agents with established efficacy for CS EXCEPT:

A. Metyrapone
B. Ketoconazole
C. Mitotane
D. Etomidate
E. Two of the options
F. All of the options
A

E. Two of the options

25
Q

Which of the following is the most common adrenal tumor?

A. Adrenocortical adenoma
B. Adrenocortical carcinoma
C. Macronodular adrenal dysplasia
D. Micronodular adrenal metaplasia
E. None of the options
A

A. Adrenocortical adenoma

26
Q

Which of the following carcinoid tumors is most common ectopic ACTH producing?

A. Thyroid
B. Pancreas
C. Thymus
D. Lungs

A

D. Lungs

27
Q

All of the following are TRUE about thyroid hormones EXCEPT:

A. Bound to thyroxine-binding globulin
B. Most are bound to protein carriers
C. T4 is more stable than T3
D. T3 has longer half life than T4
E. None of the options
A

D. T3 has longer half life than T4

28
Q

Which of the following is the most common cause of hyperthyroidism?

A. Excessive iodine intake
B. Overactive thyroid nodules
C. Graves disease
D. Inflammation of the thyroid gland

A

C. Graves disease

29
Q

All are water soluble hormones EXCEPT:

A. Growth hormone
B. Prolactin
C. Cortisol
D. TSH

A

C. Cortisol

ENDO-RENAL (4 decks)

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