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CPD III > Endocrine Quiz #4 > Flashcards

Endocrine Quiz #4 Flashcards

1
Q

Where does hypothalamus secrete hormones and what systems do these hormones control?

A
  • to ant pituitary

- control thyroid, adrenals, gonads, growth

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2
Q

What is the difference between primary and secondary endocrine disorders?

A

primary: originating in peripheral endocrine gland.
secondary: from over or under stimulation by pituitary/HTH

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3
Q

What questions do you want to be sure to ask in HPI?

A

HA, heat or cold intolerance, response to exercise, changes in menses, erectile function, skin, vision, weight.

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4
Q

Empty Sella

A

anterior pit lobe disorder

enlarged sella turcica is not entirely filled

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5
Q

primary vs secondary empty sella

A

primary: congenital defect in diaphragm allows CSF pressure to enlarge sella
sec: mass enlarges sells

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6
Q

imaging for empty sella

A

xray

MRI of brain

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7
Q

cause of hypofunction of ant pituitary

A

pituitary tumors, sarcoidosis, thrombosis, traumatic brain injury, ischemic stroke, etc.

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8
Q

sx of hypo ant pit

A
  • GH def in children: growth retardation, lack of maturation
  • Los of GN (LH and FSH) decreases sexual function
  • depends on hormones that are deminished or absent.
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9
Q

lab workup and imaging for hypofunction of ant pit

A 
cortisol
TSH
Gonadotropins
GH
CT or MRI
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10
Q

What does low cortisol and high ACTH indicate?

A

adrenal insufficiency

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11
Q

Pituitary apoplexy

A

sudden hem of pituitary adenoma causing edema and hypofunction

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12
Q

sx of pituitary apoplexy

A

sudden onset severe HA
stiff neck
visual field defects

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13
Q

complications of pit apoplexy

A

coma or death

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14
Q

DX of pit apoplexy

A

MRI

lumbar puncture to see if blood in CSF

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15
Q

Pituitary infarction (Sheehan syndrome)

A

pituitary necrosis as a result of postpartum hemorrhage and hypovolemic shock

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16
Q

sx of sheehan syndrome

A

severe: lethargy, anorexia, weight loss, inability to lactate
less severe: failure to lactate, menses do not resume, loss of sexual hair

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17
Q

pituitary dwarfism

A

decreased GH from pit or HTH disease

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18
Q

causes of pit dwarfism

A

idiopathic, emotional deprivation, hereditary

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19
Q

PE and lab for pit dwarfism

A

PE: growth charts
Lab: IGF-1 and GH levels may be low

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20
Q

what hormones are over-produced in hyperfunction of ant pit

A

adenomas over secrete hormones: PRL, GH, ACTH

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21
Q

sx of hyperprolactinemia in women

A

premenopausal: lactation after pregnancy, amenorrhea, menstrual abnormalities
post men: HA, vision impairment,

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22
Q

sx of hyperprolactinemia in men

A

decreased libido, erectile dysfunction, infertility, gynecomastia

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23
Q

Acromegaly vs gigantism

A

acromegaly: start out looking normal and then have changes in adulthood
gigantism: starts as kids

24
Q

sx of acromegaly

A

enlargement of jaw, hands, feet, coarse facial features, CVD, sleep apnea, DM2, vision loss, carpal tunnel

25
Q

Workup for acromegaly

A

PE: organomegaly, enlarged tongue
Lab: serum IGF-1 elevated
glucose test

26
Q

Central Diabetes Insipidus (neurogenic)

A

deficiency of ADH leads to large amounts of very dilute urein and excessive thirst

27
Q

causes of central diabetes insipidus

A

hypothalamus or post pit disease, autoimmune, familial

28
Q

sx of central diabetes insipidus

A

abrupt onset polyuria, poludipsia, nocturia

dry skin, dry mucus membranes, tachycardia

29
Q

**What tests can you run for central diabetes insipidus? How do you run it?

A

water restriction test: measure urine volume and osmolality every hr and plasma sodium every 2 hrs.
In DI: urine is more dilute than plasma

30
Q

SIADH

A

increased secretion of ADH without stimulus

hyper function of posterior pituitary caused by stroke, head trauma, drugs, pneumonia, HIV

31
Q

sx SIADH

A

lethargy, HA, difficulty concentrating, gait disturbances, vomiting, coma, seizures

32
Q

insidious progressive weakness, fatigue, anorexia, N/V, diarrhea or constipation, abdominal pain, cold intolerance, dizziness, fainting, low resistance to infection, salt craving, joint pain, gait disturbance?

A

Addisons Disease (primary adrenal insufficiency)

33
Q

etiology of Addisons disease

A

70% idiopathic (autoimmune) atrophy of adrenal gland

34
Q

What is the gold standard test for Addisons disease?

A

ACTH stimulation test: IV cortisol administered and measured at baseline, 30 min, 60 min

  • if elevated, primary adrenal insufficiency
  • not elevated, secondary to pituitary insufficiency
35
Q

profound weakness, peripheral vascular collapse, renal failure/azotemia, pain in legs, back, abdomen

A

Adrenal Crisis (emergency)

36
Q

What is the difference between primary and secondary adrenal insufficiency with low cortisol?

A

secondary has no hyperpigmentation

37
Q

what is the mechanism of the problem with secondary adrenal deficiency with low cortisol?

A

secondary to low ACTH stimulation which is a result of destructive pituitary or pituitary lesion
*issue with pituitary (not adrenal).

38
Q

permanently high ACTH levels due to defects in cortisol hydroxylation with accumulation of precursors of cortisol.

A

Congenital adrenal hyperplasia (CAH)

39
Q

sx of congenital adrenal hyperplasia

A

F: masculinization of fetus in utero, ambiguous genitalia

males: infant hercules syndrome
* adrenal crisis in early two weeks of age from salt loss

40
Q

workup for congenital adrenal hyperplasia

A

very high serum 17 hydroxyprogesterone

increased testosterone

41
Q

excess ACth production leads to hyper pigmentation (80% due to tumors of pituitary gland)

A

Cushing’s Disease

42
Q

due to longterm use of corticosteroids or cortisol secreting tumors

A

Cushings syndrome

43
Q

sx of cushing disease/syndrome

A 
moon face
buffalo hump
truncal obesity
skinny limbs
easy bruising
purple striae 
poor wound healing
44
Q

adrenal adenoma/hyperplasia leads to increased aldosterone

A

primary hyperaldosteronism (conn syndrome)

45
Q

sx of primary hyperaldosteronism

A

hypervolemia, muscle weakness, parasthesias, transient paralysis, personality disturbances

46
Q

tumor of sympathetic ganglia or adrenal medulla with excess catecholemines.

A

pheochromocytoma

47
Q

sx of pheochromocytoma

A 
sudden increases in BP with severe HA
diaphoresis
flushing
cold clammy skin
angina
palpitations
tremor
N/V
epigastric pain
visual disorders
dyspnea
parasthesias
panic attack
48
Q

what are actions of parathyroid hormone?

A

increased bone, tubular, and intestinal resorptions of Ca.

Decreased tubular resorption (increased excretion) of PO4 and activation of Vit D.

49
Q

What is normal serum Ca level?

A

8.5-10.5 (40% bound to serum protein)

50
Q

hypo secretion of PTH leading to hypocalcemia.

A

hypoparathyroidism

51
Q

sx of hypoparathyroidism

A 
asymptomatic
tetany
numbness
tingling
carpo-pedal spasm
laryngeal stridor
seizure
psychiatric findings (depression, confusion, psychosis)
52
Q

lab findings for hypoparathyroid

A

low ca (les than 8.5mg)
low PTH
high PO4
hypomagnesemia

53
Q

what causes pseudohypoparathyroidism?

A

end organ insensitivity to PTH

lab: hypercalcemia

54
Q

excess PTH secretion
high Ca
low PO4
bone resorption

A

hyperparathyroid

55
Q

causes of hyperparathyroid

A

adenoma
PTH producing carcinoma
hypercalcemia

56
Q

sx of hyperparathyroid

A 
kidney stones
constipation
anorexia
N/V with abdominal pain
muscular weakness
renal impairment

CPD III (7 decks)

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