Endocrine 2

Question 1

thyroid hormone, in which 25% is secreted by thyroid, 80% formed by liver and kidney; is more free

Answer 1

T3

Question 2

what is the onset of action of T3?

Answer 2

2-3 hours

Question 3

thyroid hormones that is produced and mostly secreted by the thyroid, 99% bound to proteins

Answer 3

T4

Question 4

what is the onset of action of T4?

Answer 4

2-3 days

Question 5

why does T4 have more storage than T3?

Answer 5

T4 has high affinity for proteins

Question 6

a disorder of low proteins will cause a disorder in what?

Answer 6

T3 and T4 levels

Question 7

what is the main function of thyroid hormones?

Answer 7

glucose metabolism

Question 8

a condition of low thyroid hormone that slows metabolism

Answer 8

hypothyroidism

Question 9

failure of the thyroid gland itself

Answer 9

primary hypothyroidism

Question 10

pituitary or hypothalamic disease causing reduced TSH/TRH

Answer 10

secondary hypothryoidism

Question 11

what are 2 things that can cause hypothryoidism?

Answer 11

iodine deficiency
damaged thyroid due to radiation

Question 12

condition that presents as swollen face, large tongue/fontanelle, distended abdomen, umbilical hernia, and scaley skin

Answer 12

congenital hypothyroidism

Question 13

the most common type of acquired hypothyroidism, in which autoantibodies attack and destroy thyroid glands

Answer 13

hashimoto’s disease

Question 14

what are the lab findings in hashimoto’s disease? (3)

Answer 14

decreased free T4
increased TPO antibody
increased TSH

Question 15

what is enlargement of the thyroid gland called?

Answer 15

goiter

Question 16

what is the treatment for hypothyroidism?

Answer 16

levothyroxine

Question 17

what test should we start with when we suspect thyroid problems?

Answer 17

TSH

Question 18

elevated thyroid hormones

Answer 18

hyperthyroidism

Question 19

what are the lab findings in hyperthyroidism?

Answer 19

high T3/T4
low TSH

Question 20

what is the metabolic consequences of excess thyroid hormones called?

Answer 20

thyrotoxicosis

Question 21

what is the most common cause of hyperthyroidism?

Answer 21

grave’s disease

Question 22

what are 3 symptoms seen in hyperthryoidism?

Answer 22

puffy eyes
anxiety
tremor

Question 23

4 treatment options for hyperthyroidism

Answer 23

beta blockers
antithyroid meds
radioiodine therapy
surgery

Question 24

an indirect measure of FT3/FT4

Answer 24

thyroid binding globulin (TBG)

Question 25

which lab test will assess pituitary function and reflect long term thyroid status?

Answer 25

TSH

Question 26

which test will reflect acute changes, is sensitive, and measures both free and bound thyroid hormone? (affected by TBG)

Answer 26

total T4

Question 27

which test is an indicator of hyperthyroidism, and measures both bound and free thyroid hormone? (affected by TBG)

Answer 27

total T3

Question 28

which test measures unbound T4 and is the most accurate reflection of thyrometabolic status?

Answer 28

free T4

Question 29

what 2 things can cause low TBG levels?

Answer 29

high androgen nephrotic syndrome

Question 30

what 2 things can cause high TBG levels?

Answer 30

high estrogen pregnancy

Question 31

indirect measure of serum thyroid hormone binding capacity

Answer 31

T3 resin uptake

Question 32

what is the relationship between T3 resin uptake and TBG binding sites?

Answer 32

inversely proportional

Question 33

gives an indirect measure of free thyroid hormone levels

Answer 33

free T4 index

Question 34

how would the free T4 index present in hyperthyroidism?

Answer 34

high

Question 35

how would the free T4 index present in hypothyroidism?

Answer 35

low

Question 36

what test would indicate autoimmune disorders if it is positive?

Answer 36

antithyroid antibodies

Question 37

what increases circulating TBG and may increase the T4 dosage requirements in women with primary hypothyroidism?

Answer 37

estrogen/hormone therapy

Question 38

what type of cushing's syndrome is characterized by a tumor on the adrenal gland of the kidney?

Answer 38

adrenal cushing's syndrome

Question 39

what type of cushing's syndrome is characterized by the pituitary producing too much ACTH?

Answer 39

pituitary cushing's syndrome

Question 40

what type of cushing's syndrome is characterized by a tumor or mass releasing additional cortisol?

Answer 40

ectopic cushing's syndrome

Question 41

what are 4 manifestations of cushing's syndrome?

Answer 41

moon face buffalo hump obesity hypertension

Question 42

what should I ask a patient if they present with striae?

Answer 42

recent steroid use

Question 43

a test that measures the response of the adrenal glands to ACTH

Answer 43

dexamethasone suppression test

Question 44

what would indicate an abnormal response to a dexamethasone suppression test?

Answer 44

no cortisol suppresion

Question 45

what is the cause of an abnormal response to a dexamethasone suppression test?

Answer 45

primary overproduction - adrenal tumor

Question 46

where is 90% of plasma cortisol?

Answer 46

bound to corticosteroid binding globulin (CBG)

Question 47

where is CBG synthesized?

Answer 47

liver

Question 48

what labs would be found in addison's disease?

Answer 48

high ACTH low cortisol

Question 49

a disease characterized by hypo-adrenal function

Answer 49

addison's disease

Question 50

what does an elevated ACTH level indicate in an ACTH stimulation test?

Answer 50

primary adrenal insufficiency

Question 51

what does a low/normal ACTH level indicate in an ACTH stimulation test?

Answer 51

secondary adrenal insufficiency

Question 52

a disorder in which the pituitary gland produces insufficient ADH, so the kidneys make a lot of urine

Answer 52

diabetes insipidus

Question 53

diabetes insipidus in which there is a decreased excretion of ADH due to damage to the hypothalamus or pituitary gland

Answer 53

central DI

Question 54

diabetes insipidus in which the kidney is resistant to ADH

Answer 54

nephrogenic DI

Question 55

what test can be used to determine type of diabetes insipidus?

Answer 55

water deprivation test

Question 56

what kind of diabetes insipidus does our patient have if in a water deprivation test, there is no change in urine osmolality, but increased urine osmolality after given a vasopressor

Answer 56

central Di

Question 57

what kind of diabetes insipidus does our patient have if in a water deprivation test, there is no change in urine osmolality, even after given a vasopressor

Answer 57

nephrogenic DI

Question 58

what is the most often used medication for diabetes insipidus, especially in pregnancy?

Answer 58

desmopressin