Endocrine Disorders 1

Question 1

How are hormones inhibited?

Answer 1

They are inhibited by their own release.

Question 2

What are the hormones found in the anterior lobe of the pituitary gland? (6)

Answer 2

Growth hormone (GH)
Adrenocorticotropic hormone (ACTH)
Thyroid stimulating hormone (TSH)
Follicle stimulating hormone (FSH)
Leutinizing hormone (LH)
Prolactin (PRL)

Question 3

What are the hormones found in the posterior lobe of the pituitary gland?

Answer 3

Oxytocin
Vasopressin/Anti-diuretic Hormone (ADH)

Question 4

What is the most common cause of adult pituitary dysfunction?

Answer 4

Pituitary adenoma (tumor of pituitary gland)

Question 5

Are micro or macro adenomas more prevalent?

Answer 5

Micro adenoma

Question 6

What percent of people is thought to have a micro adenoma?

Answer 6

About 20%

Question 7

How big is a micro pituitary adenoma?

Answer 7

under 1 cm
Under 10 mm

Question 8

How big is a macro pituitary adenoma?

Answer 8

1 cm or more
10 mm or more

Question 9

What is the most common type of pituitary adenoma?

Answer 9

Prolactinoma (36%-57%)

Question 10

What is the second most common type of pituitary adenoma?

Answer 10

Nonfunctioning adenoma (28-37%)

Question 11

What is the most rare type of pituitary adenoma?

Answer 11

Thyrotropinoma (1%)

Question 12

You have a male patient that has breast enlargement and increased female characteristics, what type of pituitary adenoma might they have?

Answer 12

Prolactinoma

Question 13

You have a patient that has gigantism and acromegaly. What type of pituitary adenoma might they have?

Answer 13

Somatotropinoma (GH)

Question 14

What type of pituitary adenoma does not respond to medication very well?

Answer 14

Corticotropinoma

Question 15

What visual effects can be caused by a macro pituitary adenoma? Where do the effects begin?

Answer 15

Bi-temporal visual field loss from pressure on the optic chiasm. Effects begin more superior and continue inferiorly.

Question 16

Term for sudden vascular damage to the pituitary

Answer 16

Pituitary apoplexy

Question 17

What can pituitary apoplexy result in?

Answer 17

Loss of hormone release due to ischemia or hemorrhages, resulting in other systems to shut down.

Question 18

Are males or females more likely to experience pituitary apoplexy?

Answer 18

Males 3:1

Question 19

Are males or females more likely to experience pituitary apoplexy?

Answer 19

Males 3:1

Question 20

What are some signs and symptoms of pituitary apoplexy?

Answer 20

Headache
nausea/vomiting, syncope
Visual field defects
diplopia
blurred vision

Question 21

A patient is experiencing hypotension, hypoglycemia, and subarachnoid hemorrhage, what could this patient have?

Answer 21

Adrenal insufficiency

Question 22

What is the most common cause of pituitary apoplexy?

Answer 22

pituitary adenoma

Question 23

What is it called when the pituitary has insufficient blood supply due to loss of blood during pregnancy?

Answer 23

Sheehan’s syndrome. Patient goes into shock.

Question 24

What are some complications from gigantism (somatotropinoma- GH)?

Answer 24

Type 2 diabetes
Cardiomegaly
Heart failure
Sleep apnea

Question 25

What is the disease when excess Gh is present after the growth plates close?

Answer 25

Acromegaly

Question 26

A patient notices his shoe size/ ring size increasing, facial features enlarging, and a deepening of the voice, what disease might this be?

Answer 26

Acromegaly (Corticotropinoma- GH)

Question 27

What two diseases are in response to corticotropinomas?

Answer 27

Gigantism (before growth plates close) Acromegaly (after growth plates close)

Question 28

Disease that results in high cortisol levels

Answer 28

Cushing's Disease

Question 29

Disease that has excessive production and release of catecholamines

Answer 29

Pheochromocytoma

Question 30

Disease that has low cortisol or low aldosterone

Answer 30

Addison's disease

Question 31

Explain Cushing's disease vs Cushing's syndrome

Answer 31

Cushing's disease: Pituitary adenoma that results in excessive anterior pituitary secretion of ACTH. Cushing's syndrome: Causes increase in cortisol from other parts of the body.

Question 32

What is the most common exogenous source of increased cortisol levels that may cause Cushing's syndrome?

Answer 32

Prednisone medication

Question 33

What things can cause Cushing's syndrome?

Answer 33

Adrenal adenoma Adrenal carcinoma Ectopic ACTH (cancer) Exogenous steroid use (Prednisone)

Question 34

A patient is experiencing hyperglycemia, hypertension, and osteoporosis, what disease may this person have?

Answer 34

Cushing's syndrome

Question 35

What ocular complications could you see from Cushing's syndrome?

Answer 35

1)Central serous choroidopathy 2) Posterior Subscapular Cataracts 3) Steroid-Response glaucoma 4) Visual field defects (adenoma) 5) Microvascular retinopathy

Question 36

What percent of patients experience ocular complications from Cushing's syndrome?

Answer 36

5%

Question 37

Tumor of the adrenal medulla

Answer 37

Pheochromocytoma

Question 38

What are some signs and symptoms of Pheochromocytoma?

Answer 38

Increased sympathetic nervous system so: Hypertension Headache Flushing Diaphoresis Tachycardia Heat intolerance Weight loss

Question 39

What can pheochromocytoma lead to if it is bad enough?

Answer 39

Hypertensive crisis

Question 40

If you take a serum and urine test to look at catecholamines, what disease are you looking for?

Answer 40

Pheochromocytoma

Question 41

What is Von Hippel-Lindau Syndrome? What can it be associated with?

Answer 41

VHL is a tumor supressor gene that is absent in this syndrome. It can be associated with Pheochromocytoma.

Question 42

What kind of genetic inheritance is Von Hippel-Lindau syndrome?

Answer 42

Autosomal dominant

Question 43

What is unregulated in Von Hippel-Lindau syndrome?

Answer 43

VEGF

Question 44

You see a retinal capillary hemangioma, what disease causes this?

Answer 44

Von Hippel-Lindau syndrome. Look for a pheochromocytoma

Question 44

You see a retinal capillary hemangioma, what disease causes this?

Answer 44

Von Hippel-Lindau syndrome. Look for a pheochromocytoma

Question 45

Lack of ADH produced in pituitary that causes inability to concentrate urine.

Answer 45

Diabetes Insipidus

Question 46

What is the most common type of dwarfism? What is a lack of?

Answer 46

Disproportionate (80%) Lack of growth hormone in 70% of cases.

Question 47

When does Addisons disease occur?

Answer 47

at 90% destruction

Question 48

Is Addisons disease a primary or secondary insufficiency?

Answer 48

Primary

Question 49

What is the most common cause of Addison's disease?

Answer 49

Autoimmune Disease

Question 50

How do you check for Addison's disease?

Answer 50

Give ACTH to patient and observe ATCh levels. If ATCH levels don't rise, they have Addison's disease.

Question 51

Life threatening condition caused by low cortisol levels

Answer 51

Addison's Crisis

Question 52

What can cause Addison's crisis?

Answer 52

Corticosteroid withdrawal Stress Trauma