Week 10: Endocrine

Question 1

acromegaly

Answer 1

results from excess secretion of growth hormone (GH), a rare condition
of bone and soft tissue overgrowth.

Question 2

manifestations of acromegaly

Answer 2

enlargement of hands and feet, thickening and enlargement of
bony and soft tissue on face and head, sleep apnea, signs of diabetes mellitus,
cardiomegaly, and hypertension.

Question 3

Hypopituitarism

Answer 3

is rare, and involves a decrease in one or more of the pituitary
hormones

Question 4

Syndrome of inappropriate antidiuretic hormone (SIADH)

Answer 4

results from abnormal
production or sustained secretion of ADH and is characterized by fluid retention,
serum hypo-osmolality, dilutional hyponatremia, hypochloremia, concentrated urine
in presence of normal or increased intravascular volume, and normal renal function.

Question 5

Diabetes insipidus (DI)

Answer 5

associated with deficiency of production or secretion of

ADH or decreased renal response to ADH.

Question 6

Types of DI:

Answer 6

o Central DI (or neurogenic DI) occurs when an organic lesion of the
hypothalamus, infundibular stem, or posterior pituitary interferes with ADH
synthesis, transport, or release.
o Nephrogenic DI occurs when there is adequate ADH, but a decreased kidney
response to ADH. Lithium is a common cause of drug-induced nephrogenic DI.
o Primary (or psychogenic) DI is associated with excessive water intake, caused by
a structural lesion in the thirst centre or by psychological disorders.

Question 7

goitre

Answer 7

an enlarged thyroid gland. In a person with a goitre, the thyroid cells are
stimulated to grow, which may result in an overactive thyroid (hyperthyroidism) or an
underactive one (hypothyroidism).

Question 8

The primary sign of thyroid cancer is

Answer 8

the presence of painless, palpable nodule or

nodules in an enlarged thyroid gland.

Question 9

Hashimoto’s thyroiditis

Answer 9

a chronic autoimmune disease in which thyroid tissue is
replaced by lymphocytes and fibrous tissue. It is the most common cause of goitrous
hypothyroidism.

Question 10

Hyperthyroidism

Answer 10

thyroid gland hyperactivity with sustained increase in synthesis
and release of thyroid hormones.

Question 11

Thyrotoxicosis

Answer 11

refers to clinical syndrome of hypermetabolism resulting from excess
circulating levels of T4, T3, or both.

Question 12

Graves’ disease

Answer 12

an autoimmune disease marked by diffuse thyroid enlargement

and excessive thyroid hormone secretion.

Question 13

Thyrotoxic crisis,

Answer 13

an acute, rare condition in which all

hyperthyroid manifestations are heightened.

Question 14

manifestations of thyrotoxic crisis

Answer 14

severe tachycardia, heart failure, shock, hyperthermia,
restlessness, agitation, seizures, abdominal pain, nausea, vomiting, diarrhea, delirium,
and coma.

Question 15

Hypothyroidism

Answer 15

from insufficient circulating thyroid hormone as a result of

various abnormalities.

Question 16

Cretinism,

Answer 16

hypothyroidism that develops in infancy, is caused by thyroid hormone
deficiencies during fetal or early neonatal life.

Question 17

myxedema,

Answer 17

an

accumulation of hydrophilic mucopolysaccharides in dermis and other tissues.

Question 18

myxedema coma

Answer 18

precipitated by infection, drugs (especially opioids,
tranquilizers, and barbiturates), exposure to cold, and trauma. This condition is
characterized by subnormal temperature, hypotension, and hypoventilation. To
survive, vital functions are supported and IV thyroid hormone replacement
administered.

Question 19

Hyperparathyroidism

Answer 19

involves increased secretion of parathyroid hormone (PTH).

Question 20

Manifestations of hyperparathyroidism

Answer 20

include muscle weakness, loss of appetite, constipation, fatigue,
emotional disorders, and shortened attention span.

Question 21

Hypoparathyroidism

Answer 21

rare, and results from inadequate circulating PTH.

Question 22

Cushing’s syndrome

Answer 22

a spectrum of clinical abnormalities caused by excessive

corticosteroids, particularly glucocorticoids.

Question 23

cushings syndrome key signs

Answer 23

centripedal (truncal) or generalized obesity, “moon facies”
(fullness of face), purplish red striae below the skin surface, hirsutism and menstrual
disorders in women, hypertension, and unexplained hypokalemia.

Question 24

addisons disease

Answer 24

all three classes of adrenal corticosteroids

(glucocorticoids, mineralocorticoids, and androgens) are reduced.

Question 25

Addisonian crisis is triggered by

Answer 25

stress (e.g., infection, surgery, trauma, hemorrhage, or psychological distress); sudden withdrawal of corticosteroid hormone replacement therapy; adrenal surgery; or by sudden pituitary gland destruction.

Question 26

Hyperaldosteronism

Answer 26

characterized by excessive aldosterone secretion, commonly | caused by small, solitary adrenocortical adenoma (primary hyperaldosteronism [PA]).

Question 27

Pheochromocytoma

Answer 27

a rare condition characterized by an adrenal medulla tumour | that produces excessive catecholamines (epinephrine, norepinephrine).

Question 28

If undiagnosed and untreated, pheochromocytoma may lead to

Answer 28

hypertensive | encephalopathy, diabetes mellitus, cardiomyopathy, and death.

Question 29

Diabetes mellitus (DM)

Answer 29

a multisystem disease related to abnormal insulin | production, impaired insulin utilization, or both.

Question 30

Type 1 DM results from

Answer 30

progressive destruction of pancreatic β cells owing to an | autoimmune process in susceptible individuals.

Question 31

In type 2 DM,

Answer 31

the pancreas usually continues to produce some endogenous (self- made) insulin. However, the insulin that is produced is either insufficient for the needs of the body and/or is poorly used by the tissues.

Question 32

Gestational diabetes mellitus

Answer 32

develops during pregnancy and is detected atanywhere between 24 and 28 weeks of gestation, using a sequential screening method.

Question 33

A diagnosis of diabetes is based on one of four methods:

Answer 33

(1) glycated hemoglobin (A1C), (2) fasting blood glucose (FBG) level, (3) random plasma glucose (RPG) measurement, or (4) 2-hour plasma glucose (PG) level.

Question 34

Lipodystrophy

Answer 34

(hypertrophy or atrophy of subcutaneous tissue) may occur if the same injection sites are used frequently.

Question 35

Somogyi effect

Answer 35

characterized by wide differences in early-morning (low) and fasting (high) glucose levels. Usually occurring during the hours of sleep, the Somogyi effect produces a decline in blood glucose level in response to too much insulin.

Question 36

OHAs | work on the three defects of type 2 diabetes:

Answer 36

(1) insulin resistance, (2) decreased | insulin production, and (3) increased hepatic glucose production.

Question 37

The primary action of the sulphonylureas

Answer 37

increase β-cell insulin production from | the pancreas.

Question 38

meglitinides

Answer 38

increase insulin production from the pancreas. But because they are more rapidly absorbed and eliminated, they offer a reduced potential for hypoglycemia.

Question 39

α-glucosidase inhibitors, also known as starch blockers,

Answer 39

work by slowing down the | absorption of carbohydrate in the small intestine.

Question 40

Glycemic index (GI)

Answer 40

term used to describe the rise in blood glucose levels after a person has consumed carbohydrate-containing food. Foods with a high GI will cause a sharp rise in blood glucose, whereas those with a low GI steadily increase blood glucose over a longer period.

Question 41

Diabetic ketoacidosis (DKA)

Answer 41

an acute metabolic complication of DM occurring when fats are metabolized in the absence of insulin. It is caused by a profound deficiency of insulin and is characterized by hyperglycemia, ketosis, metabolic acidosis, and dehydration. It is most likely to occur in people with type 1 DM.

Question 42

Hyperosmolar hyperglycemic state (HHS)

Answer 42

a life-threatening syndrome that can occur in the patient with DM who is able to produce enough insulin to prevent DKA but not enough to prevent severe hyperglycemia, osmotic diuresis, and extracellular fluid depletion.

Question 43

Diabetic retinopathy

Answer 43

refers to the process of microvascular damage to the blood vessels in the retina as a result of chronic hyperglycemia, presence of nephropathy, and hypertension in patients with DM.

Question 44

Diabetic nephropathy

Answer 44

a microvascular complication associated with damage to | the small blood vessels that supply the glomeruli of the kidney.

Question 45

Diabetic neuropathy

Answer 45

nerve damage that occurs because of the metabolic derangements associated with DM. The two major categories of diabetic neuropathy affect the peripheral nervous system: sensory neuropathy (which affects the somatic division) and autonomic neuropathy (which affects the autonomic division).