Pituitary Hormones, Adenoma, CS Flashcards
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
C. Anterior pituitary gland
Which of the following anterior pituitary cells is produced first?
A. Corticotrope B. Somatotrope C. Lactotrope D. Thyrotrope E. Gonadotrope
A. Corticotrope = 6 weeks
Somatotrope = 8 weeks
Lacto/Thyro/Gonado = 12 weeks
Which of the following anterior pituitary cells targets the liver and bone?
A. Corticotrope B. Somatotrope C. Lactotrope D. Thyrotrope E. Gonadotrope
B. Somatotrope = Liver and bone
Cortico = adrenal Lacto = breast Thyro = thyroid Gonado = ovary, testis
Growth hormones induces all of the following EXCEPT:
A. Protein synthesis
B. Nitrogen retention
C. Glucose tolerance impairment
D. Lipogenesis
D. Lipogenesis
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
D. Multiple endocrine neoplasia 1
Carney = spotty skin pigmentation McCune-Albright = polyostotic fibrous dysplasia Acromegaly = gigantism
All are following features of chronic cortisol excess EXCEPT:
A. Thin skin B. Peripheral obesity C. Plethoric moon facies D. DM E. Osteoporosis
B. Peripheral obesity
All are following are hematopoietic features of chronic cortisol excess EXCEPT:
A. Leukocytosis
B. Lymphocytosis
C. Lymphopenia
D. Eosinopenia
B. Lymphocytosis
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
F. None of the options
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. Increased ratio (>2) of inferior petrosal:peripheral vein ACTH
This is the only parenteral drug indicated for severe Cushing’s syndrome.
A. Aminoglutethimide B. Etomidate C. Mifepristone D. Metyrapone E. Ketoconazole
B. Etomidate
The only drug safe for pregnant women with Cushing’s syndrome
A. Aminoglutethimide B. Etomidate C. Mifepristone D. Metyrapone E. Ketoconazole
D. Metyrapone
Drug indicated for inoperable adrenocortical cancer (ACC)
A. Trilostane B. Mitotane C. Mifepristone D. Metyrapone E. Aberaterone
B. Mitotane
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
C. Mifepristone
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
B. Systolic hypertension
DHEA is produced in which kidney region?
A. Zona glomerulosa
B. Zona fasciculata
C. Zona reticularis
D. Adrenal medulla
C. Zona reticularis
Which of the following is the pivotal regulator of adrenal cortisol synthesis?
A. Cholesterol
B. ACTH
C. CRH
D. 11-beta-hydroxylase
B. ACTH
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
B. ACTH stimulation
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
D. Cholesterol desmolase
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
C. Macronodular adrenal disease
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
C. CVDs
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. Low dose DEX test (Plasma cortisol <50 nmol/L)
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
C. Identify as ACTH-independent Cushing’s, order unenhanced CT
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
B. Adrenal Cushing’s
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
E. Two of the options
