case 2 Flashcards
(37 cards)
What is the most common cause of Cushing’s disease?
a. pituitary corticotrope microadenoma
b. occult carcinoid tumors
c. iatrogenic
d. adrenal adenoma
A
The following are ACTH-independent causes of Cushing’s syndrome, except:
a. adrenocortical adenoma
b. adrenal adenoma
c. adrenocortical carcinoma
d. small-cell carcinoma of the lung
e. both A and B
D
Which of the following is not seen in Carney’s complex?
a. cardiac myxomas
b. hyperlentiginosis
c. polyostotic fibrous dysplasia
d. Sertoli cell tumors
e. primary pigment nodular adrenal disease
C
McCune-Albright Syndrome:
polyostotic fibrous dysplasia
unilateral cafe-au-lair spots
precocious puberty
Which of the following causes ACTH-independent CS?
a. primary pigmented nodular adrenal disease
b. bronchial carcinoid tumors
c. bronchial carcinoid tumors
d. pheochromocytoma
A
It is the investigation of choice for ACTH-dependent tumors.
a. unenhanced CT
b. MRI
c. dexamethasone overnight test
d. both A and B
e. both B and C
B
A 25y/o female is diagnosed with Cushing’s disease, which is a suggested treatment for persistent hypercortisolism after trassphenoidal surgery, except?
a. pasireotide
b. mifepristone
c. pituitary irradiation
d. both A and B
e. none of the options
E
It is the most important diagnostic tool in endocrinology
a. mass spectroscopy
b. enzymatic methods
c. bioassays
d. immunoasays
D
Primary gonadal problem exhibits which of the following?
a. decrease in testosterone, increase in LH
b. decrease in testosterone, decrease in LH
c. increase in testosterone, decrease in LH
d. increase in testosterone, increase in LH
A
decrease in testosterone, decrease in LH - hypothalamic pituitary disorder
Which of the following is not an adverse effect of ketoconazole?
a. hepatoxicity
b. lethargy
c. impotence
d. GI upset
e. gynecomastia
B
adverse effects of ketoconazole hepatoxicity impotence GI upset gynecomastia edema
It blocks the peripheral cortisol action
a. mifeprestone
b. metyrapone
c. mitotane
d. etomidate
A
It blocks the peripheral cortisol action
a. mifeprestone
b. metyrapone
c. mitotane
d. trilostane
A
It is the only adrenal-inhibiting medication for pregnant patients with Cushing’s syndrome
a. mifeprestone
b. metyrapone
c. mitotane
d. trilostane
B
It inhibits early steps of steroidogenesis
a. abiraterone
b. aminoglutethimide
c. etomidate
d. ketoconazole
D
Which of the following adrenocortical antagonists exhibit adverse effects of lethargy and skin rash?
a. abiraterone
b. aminoglutethimide
c. etomidate
d. ketoconazole
B
Which of the following is the only parenteral medication for Cushing’s syndrome?
a. abiraterone
b. aminoglutethimide
c. etomidate
d. ketoconazole
C
Which of the following does not target pituitary tumor so ACTH and cortisol remain elevated?
a. mifeprestone
b. metyrapone
c. mitotane
d. trilostane
A
The following clinical impacts are seen when the pituitary is affected, except:
a. hypogonadism
b. hypothyroidism
c. growth failure and adult hyposomatotropism
d. hypoadrenalism
e. obesity
E
Which of the following clinical features is not seen when the optic chiasm is impacted?
a. loss of red perception
b. bitemporal hemianopia
c. superior or bitemporal field defect
d. scotoma
e. ophthalmoplegia with or without ptosis or diplopia
E Optic chiasm is impaired: loss of red perception bitemporal hemianopia superior or bitemporal field defect scotoma blindness
Cavernous sinus is impaired:
ophthalmoplegia with or without ptosis or diplopia
facial numbness
It is a result of postchiasmal compression.
a. monocular temporal field loss
b. bitemporal hemianopia
c. homonimous hemianopia
d. diplopia
C
Monocular temporal field
loss → prechiasmal
compression
Height of pituitary gland during puberty and pregnancy
a. 6mm
b. 8mm
c. 10-12mm
d. 6cm
e. 8cm
f. 10-12cm
C
Which of the following tests is used in acromegaly?
a. ACTH assay
b. dexamethasone
c. 24-h urinary free cortisol
d. serum PRL
e. serum IGF-1
E
Both prolactin and growth hormone are products of the following adenoma cell origin, except:
a. lactotrope
b. acidophil stem cell
c. mammosomatotrope
d. mixed growth hormone and prolactin cell
A
Which of the following side effects of transsphenoidal surgery is most likely to occur?
a. cranial nerve damage
b. carotid artery damage
c. transient diabetes insipidus
d. permanent diabetes insipidus
C
Pharmacologic treatment for prolactinomas include:
a. dopamine agonists
b. somatostatin analogues
c. GH receptor antagonist
d. both A and B
e. both B and C
A
acromegaly → somatostatin
analogues, GH receptor antagonist
TSH-secreting tumors → somatostatin
analogues, dopamine agonists
ACTH-secreting tumors →
somatostatin analogues, adrenal-directed therapy
Nonfunctioning tumors →
surgery/irradiation
