1.2 Endocrinology

Question 1

drugs that raise prolactin level

Answer 1

• antipsychotic medications
• tricyclic antidepressants
• methlydopa
• verapamil
• opioids
• metoclopramide

Question 2

drugs that can cause gynecomastia

Answer 2

• spironolactone
• opiates
• oral ketoconazol
• estrogen

Question 3

what are the 3 main causes of hyper parathyroidism

Answer 3

1. solitary adenoma
2. hyperplasia of all 4 glands
3. parathyroid malignancy

Question 4

how do you treat hypercalcemia from sarcoidosis or any other granulomatoues disease?

Answer 4

prednisone

Question 5

what are the indications for removal of the parathyroid glands?

Answer 5

1. bone disease
2. renal involvement (Even stones)
3. age <50
4. calcium consistently >1 pt above normal

Question 6

EKG in calcium disorders

Answer 6

hypercalcemia: short QT
hypocalcemia: prolonged QT

Question 7

Cushing Syndrome vs Cushing Disease

Answer 7

Syndrome = hypercortisolism

Disease = pituitary overproduction of ACTH

Question 8

🚩 “I feel weak and tired and I notice hair growth and strange marks on my stomach”

Answer 8

hypercortisolism!

Question 9

evaluation of adrenal incidentaloma?

Answer 9

1. metanephrines of blood urine to excluse pheochromocytoma
2. renin and aldosterone levels to exclude hyperaldosteronism
3. 1 mg overnight dexamethasone suppression test

Question 10

what drug should the patient recieve before being operated for pheochromocytoma?

Answer 10

phenoxybenzamine (alpha blocker)

Question 11

causes of primary hyperaldosteronism?

Answer 11

1. solitary adenoma (80%)
2. bilateral hyperplasia
3. malignancy

Question 12

🚩 high BP + hypokalemia

Answer 12

primary hyperaldosteronism

Question 13

🚩 aldosterone/renin 20:1

aldosterone >15

Answer 13

hyperaldosteronism

Question 14

🚩 hypoglycemia + high insulin level

Answer 14

insulinoma

Question 15

MEN 1

Answer 15

parathyroid

anterior pituitary

pancreatic islets

Question 16

MEN 2A

Answer 16

parathyroid

medullary thyroid

pheochromocytoma

Question 17

MEN 2B

Answer 17

mucosal neuroma

mudellary thyroid

pheochromocytoma

marfanoid

Question 18

tests that should be sent to a patient with suspected virilization, hirsutism and irregular emnstrual periods

Answer 18

prolactin

DHEA, testosterone

FSH/LH

17-hydroxyprogesterone

Question 19

diagnostic criteria for PCOS

Answer 19

1. clinical hirsutism OR high testosterone/DHEA
2. irregular menstruation
3. 10 cysts on pelvic sonogram wiht enlarged ovary (>10cm)

only 2/3 needed to diagnose

Question 20

in what patients is metformin contraindicated

Answer 20

renal dysfunction

accumulates and causes metabolic acidosis

Question 21

what diseases cause nephrogenic DI

Answer 21

• chronic pyelonephritis
• amyloidosis
• myeloma
• sickle cell disease
• hypercalcemia
• hypokalemia

Question 22

what effect does dopamine have on growth hormone?

Answer 22

INHIBITS!

Question 23

Pegvisomant

Answer 23

GH receptor antagonist

inhibitis IGF release from liver

acromegaly

Question 24

hypercalcemia 💡

Answer 24

cancer

primary hyperparathyroidism

Question 25

what effect does calcium have on gastrin?

Answer 25

STIMULATES

Question 26

Cinacalcet

Answer 26

**inhibits release of PTH** primary hyperparathyroidism

Question 27

what effect does albumin have on calcium?

Answer 27

every point decrease in albumin, the calcium level decreases by 0.8

Question 28

pasireotide

Answer 28

**somatostatin** **analog** hypercortisolism post surgery

Question 29

mitotane

Answer 29

**inhibitorof steroidogenesis** **cytotoxic to adrenal tissue** adrenal metastic mass non-operable in hypercortisolism

Question 30

cosyntrhopin

Answer 30

**synthetic ACTH** used in: Cosynthropin Stimulation Test (hypoadrenalism)

Question 31

in what patients are thiazolidinediones contraindicated

Answer 31

CHF fluid overload