Endocrine 2 practice

Question 1

What is the most common cause of hyperprolactinemia?
a) Prolactinoma
b) Hypothyroidism
c) Acromegaly
d) Renal failure
e) Pregnancy

Answer 1

a) Prolactinoma

Question 2

What is the first line treatment for adenoma-induced hyperprolactinemia? Select two
a) Cabergoline
b) Metoclopramide
c) Bromocriptine
d) Promethazine
e) Prochlorperazine
f) Octreotide
g) Lanreotide
h) Phenoxybenzamine
i) Phentolamine

Answer 2

a) Cabergoline
c) Bromocriptine

Question 3

What is NOT one of the three tests you do to diagnose a GH tumor?
a) Insulin-like growth factor test
b) Low-dose dexamethasone suppression test
c) Prolactin levels
d) Oral glucose suppression test

Answer 3

b) Low-dose dexamethasone suppression test

Question 4

What is the first line Tx for GH tumors that cannot be resected? Select two
a) Cabergoline
b) Metoclopramide
c) Bromocriptine
d) Promethazine
e) Prochlorperazine
f) Octreotide
g) Lanreotide
h) Phenoxybenzamine
i) Phentolamine

Answer 4

f) Octreotide
g) Lanreotide

Question 5

Those with post partum hemorrhage may experience what?
a) GH deficiency
b) Hyperprolactinemia
c) Hypopituitarism
d) Hypocortisolism
e) Hypercortisolism
f) SIADH
g) DI

Answer 5

c) Hypopituitarism

Question 6

What is the correct order of the 4 tests for hypercortisolism?

Answer 6

1) Late night cortisol or 24-hour urine (most specific)
2) Low-dose dexamethasone suppression test
3) ACTH
4) High-dose dexamethasone suppression test

Question 7

Define Addison’s disease (choose the best answer).
a) Primary adrenal insufficiency (low aldosterone and cortisol, high ACTH)
b) Secondary adrenal insufficiency (low cortisol, normal aldosterone and ACTH)

Answer 7

a) Primary adrenal insufficiency (low aldosterone and cortisol, high ACTH)

Question 8

What two things should you use to Tx Addison’s disease?
a) Dexamethasone
b) Hydrocortisone
c) Prochlorperazine
d) Fludrocortisone
e) Lanreotide

Answer 8

b) Hydrocortisone
d) Fludrocortisone

Question 9

You get a patient’s 8am renin and cortisol levels because you think they have Addison’s. Their renin is high. You then do a high-dose ACTH cosyntropin stim test and their cortisol does not rise.
What is the suspected diagnosis?
a) Addison’s
b) Secondary hypocortisolism

Answer 9

a) Addison’s

Question 10

Which of the following is NOT a part of the triad of hyperaldosteronism?
a) Hypokalemia
b) Hypertension
c) Hypotension
d) Metabolic alkalosis

Answer 10

c) Hypotension

Question 11

Renal hypoperfusion, like in CKD, may cause what?
a) Hypercortisolism
b) Hypocortisolism
c) Hyperaldosteronism
d) Hypoaldosteronism
e) SIADH

Answer 11

c) Hyperaldosteronism

Question 12

How is hyperaldosteronism treated? (1st line and 2nd line Txs)

Answer 12

1st line = Spironolactone
2nd line = ACE inhibitors, CCBs

Question 13

Subarachnoid hemorrhage and small cell lung cancer may cause what?
a) Hypercortisolism
b) Hypocortisolism
c) Hyperaldosteronism
d) Hypoaldosteronism
e) SIADH
f) DI

Answer 13

e) SIADH

Question 14

A patient has euvolemic hypoosmolar hyponatremia. What condition should you suspect?
a) Hypercortisolism
b) Hypocortisolism
c) Hyperaldosteronism
d) Hypoaldosteronism
e) SIADH
f) DI
g) Pheochromocytoma

Answer 14

e) SIADH

Question 15

Conivaptan and tolvaptan can correct moderate-severe what?
a) Hyponatremia
b) Hypernatremia
c) Hypovolemia
d) Hypervolemia

Answer 15

a) Hyponatremia

Question 16

You give a patient you suspect has DI ADH. Their urine osmolality rises. What is the result of this test?
a) They have psychogenic polydipsia
b) They have DI

Answer 16

a) They have psychogenic polydipsia

Question 17

Which of the following is a catecholamine-secreting adrenal tumor of chromaffin cells?
a) Pituitary adenoma
b) Pheochromocytoma
c) Adrenocortical Carcinoma (ACC)
d) Paraganglioma

Answer 17

b) Pheochromocytoma

Question 18

Phenoxybenzamine and Phentolamine, then beta blockers/ CCBs, are the treatment for what?
a) Hypercortisolism
b) Hypocortisolism
c) Hyperaldosteronism
d) Hypoaldosteronism
e) SIADH
f) DI
g) Pheochromocytoma

Answer 18

g) Pheochromocytoma

Question 19

Which is matched appropriately?

1) MEN 1 = assoc with RET proto-oncogene .
-MEN 2 = aka Wermer’s syndrome, assoc with Menin gene defect.

2) MEN 1 = aka Wermer’s syndrome, assoc with Menin gene defect.
-MEN 2 = assoc. with RET proto-oncogene

Answer 19

2) MEN 1 = aka Wermer’s syndrome, assoc with Menin gene defect.
MEN 2 = assoc. with RET proto-oncogene

Question 20

T/F: With the oral glucose suppression test, growth hormone levels increase in acromegaly.

Answer 20

True

Question 21

T/F: Most pituitary tumors are posterior.

Answer 21

False (anterior)

Question 22

T/F: Cabergoline is successful for tumors that secrete prolactin and/or GH.

Answer 22

True (but surgery is first line Tx)

Question 23

T/F: Amenorrhea, infertility, vaginal dryness, galactorrhea, and hypogonadism are all Sx of hyperprolactinemia.

Answer 23

True

Question 24

T/F: Secondary hypercortisolism is an ACTH dependent illness.

Answer 24

True

Question 25

T/F: Ketoconazole may cause hypercortisolism

Answer 25

False (may cause Addison’s)

Question 26

T/F: Hyperkalemia may occur due to low cortisol

Answer 26

False (may be due to low aldosterone)

Question 27

T/F: Normally, giving salt would decrease aldosterone

Answer 27

True

Question 28

T/F: In SIADH, pts have concentrated blood, dilute urine, and high sodium

Answer 28

False (it’s the opposite)

Question 29

T/F: For Central DI, desmopressin is first line Tx, and carbamazepine is second line

Answer 29

True

Question 30

T/F: Parathyroid, pancreas, and pituitary can all be affected by MEN I

Answer 30

True