Disease States

Question 1

/What is the most abundant hormone produced by the Adenohypophysis?

Answer 1

Growth Hormone

Question 2

When do we see rises in Growth Hormone (GH)?

Answer 2

Spike 3 hours after a meal
Peak during REM sleep

Question 3

What causes the release of polypeptide IGF-I?

Answer 3

Growth Hormone (GH) triggers the liver to synthesize it

Question 4

What has both anabolic and catabolic processes and what is the term for it?

Answer 4

Growth Hormone
Amphibolic

Question 5

What is the major effect of Growth Hormone?

Answer 5

Starts the synthesis of an IGF-I by the liver

Question 6

What is an excess of Growth Hormone (GH) in children?

Answer 6

Pituitary Gigantism

Question 7

What is an excess of Growth Hormone (GH) in adults?

Answer 7

Acromegaly

Question 8

How does a deficiency in Growth Hormone (GH) come about?

Answer 8

Congenital or acquired

Question 9

What is the cause of REVERSIBLE GH deficiency?

Answer 9

Environmental Stress

Question 10

What does a GH deficiency in adults lead to?

Answer 10

Premature Mortality
Abnormal Body Composition
Impaired Serum Lipids
Decreased Bone Density
Impaired quality of life

Question 11

What is considered the standard of care for GH?

Answer 11

GH replacement therapy

Question 12

What is the most common Hypothalamic-Pituitary disorder?

Answer 12

Hyperprolactinemia

Question 13

What interferes with puberty and fertility in patients?

Answer 13

Hypoprolactinemia

Question 14

What is the testing of TSH used for?

Answer 14

Diagnosing Thyroid Disease

Question 15

What is considered the most useful and sensitive test for assessing Thyroid function?

Answer 15

TSH measurement

Question 16

What are some signs and symptoms of Hyperthyroidism?

Answer 16

Weight Loss
Excessive Sweating
Increased Pulse Pressure
Heat intolerance
Eyelid Retraction

Question 17

What is the most common cause of Hyperthyroidism?

Answer 17

Grave’s Disease

Question 18

What causes Grave’s Disease?

Answer 18

Development of an IgG antibody against TSH receptor

Question 19

Administration of anti-thyroid drugs, Radioiodine ablation, and Surgical removal of the Thyroid are all what?

Answer 19

Treatment strategies for Hyperthyroidism

Question 20

What is another term for severe Hypothyroidism?

Answer 20

Myxedema

Question 21

What is Myxedema in newborns known as?

Answer 21

Cretinism

Question 22

What can happen when elevated levels of TSH remain over time?

Answer 22

Thyroid enlargement
Goiter

Question 23

What is the most common cause of Primary Hypothyroidism and occurs due to an auto immune process?

Answer 23

Hashimoto Thyroiditis

Question 24

What is the most common cause of Primary Nongoitrous Hypothyroidism?

Answer 24

Surgical removal or ablation of the Thyroid Gland

Question 25

What is the most common cause of Goitrous Hypothyroidism?

Answer 25

Iodine deficiency

Question 26

What occurs in Central Thyroid Disease?

Answer 26

Hypothalamic disease is caused by a deficiency in TSH, TRH, or both

Question 27

Which analytes are tested for Thyroid Disease?

Answer 27

T4 or FT4 T3 or FT3 Binding Proteins Presence and type of antibodies

Question 28

Primary Hyperparathyroidism or Hungry bone syndrome is the most common cause of what?

Answer 28

Hypercalcemia

Question 29

What can Hypercalcemia induce?

Answer 29

Nephrogenic Diabetes Insipidus Increased thirst Increased urination

Question 30

Hypoalbuminemia, Chronic renal failure, Magnesium deficiency, and Hypoparathyroidism are all causes of what?

Answer 30

Hypocalcemia

Question 31

What is the most common cause of Decreased total calcium?

Answer 31

Hypoalbuminemia

Question 32

What is characteristic of Cushing Disease?

Answer 32

The Pituitary Gland is directly responsible for the elevated Cortisol levels

Question 33

What is characteristic of Cushing Syndrome?

Answer 33

Elevated Cortisol is not caused by the Pituitary Gland

Question 34

What are the most obvious symptoms of Cushing?

Answer 34

Moon Face Buffalo Hump Purple Striae Truncal obesity

Question 35

What is another name for Primary Adrenal Insufficiency?

Answer 35

Addison Disease

Question 36

What causes Addison Disease?

Answer 36

Progressive Destruction of: Autoimmune Processes Systemic & Genetic Disorders Infection

Question 37

What is the most common cause of Tertiary Cortisol Insufficiency?

Answer 37

Long term administration of Glucocorticoids that suppress CRH

Question 38

What is the nest screening test for Cushing related disease?

Answer 38

Measurement of Urinary Cortisol

Question 39

What has been recommended as the first line diagnostic test?

Answer 39

Salivary Cortisol

Question 40

When is it best to collect a specimen for Cortisol testing?

Answer 40

0700 - 100 Fasting patient Supine Position

Question 41

Why is ACTH NOT preferred over Cosyntropin?

Answer 41

Short half life Labile Need to be immediately ran or stored

Question 42

What is the purpose of the CRH stimulation test?

Answer 42

Direct test of Anterior Pituitary Gland Funtion

Question 43

What is the preferred method of testing free cortisol?

Answer 43

LC-MS-MS