Endocrine Disorders

Question 1

treatment for hypotensive patients with diabetes insipidus

Answer 1

normal saline

Question 2

treatment for normotensive patients with diabetes insipidus

Answer 2

hypotonic saline (.45% saline or D5%)

Question 3

17 alpha-hydroxylase deficiency

Answer 3

hypertension, hypokalemia, decreased sex hormones
XY: externally female, no internal structures
XX: externally female, normal internal structures, lacks secondary sex characteristics

Question 4

21-hydroxylase deficiency

Answer 4

most common form
hypotension, hyperkalemia, increased renin
elevated 17-hydroxyprogesterone
masculinization, female pseudohermaphroditism

Question 5

11 beta-hydroxylase deficiency

Answer 5

hypertension and masculinization

Question 6

partial 21-hydroxylase deficiency

Answer 6

present in early adulthood with hyperandrogenism, not usually accompanied by salt wasting
increased levels of 17-hydroxyprogesterone, confirm with ACTH stimulation test

Question 7

hypokalemia, alkalosis, normotensive blood pressure

urine chloride concentration is high

Answer 7

bartter syndrome
gitelman syndrome
diuretic abuse

Question 8

most reliable indicator of metabolic recovery in patients with DKA

Answer 8

serum anion gap or arterial pH

Question 9

acid/base status in primary hyperaldosteronism

Answer 9

metabolic acidosis
hypokalemia causes potassium to move out of cells into extracellular space, hydrogen ions then move into cells to maintain electrical neutrality

Question 10

defective mineralization of bone

Answer 10

osteomalacia: vitamin D deficiency in adults

Question 11

defective mineralization of bone and cartilage

Answer 11

rickets: vitamin D deficiency in children

Question 12

disordered skeletal remodeling

Answer 12

paget’s disease

Question 13

defective formation of collagen

Answer 13

osteogenesis imperfecta

Question 14

low bone mass with normal mineralization

Answer 14

osteoporosis: low bone mass but bone is normally mineralized per unit volume

Question 15

most common cause of death in patients with acromegaly

Answer 15

congestive heart failure

Question 16

MEN2a syndrome

Answer 16

medullary thyroid cancer
pheochromocytoma
parathyroid adenoma

ret gene

Question 17

MEN2b syndrome

Answer 17

medullary thyroid cancer
pheochromocytoma
mucosal neuroma
marfinoid habitus

ret gene

Question 18

MEN1 syndrome

Answer 18

pituitary adenoma
parathyroid adenoma
pancreatic islet cell tumor

menin tumor suppressor gene

Question 19

treatment of pituitary adenoma

Answer 19

< 10 mm = microadenoma, treat with bromocriptine or cabergoline
surgery reserved for patients who do not respond to medication
radiation reserve for patients refractory still, as it has a slower response rate

Question 20

cause of hypertension in thyrotoxicosis

Answer 20

systolic hypertension caused by hyperdynamic circulation

Question 21

cause of hypertension in hypothyroidism

Answer 21

diastolic hypertension caused by increased systemic vascular resistance

Question 22

causes of thyrotoxicosis with low radioactive iodine uptake

Answer 22

subacute painless thyroiditis
subacute granulomatous thyroiditis
iodine-induced thyroid toxicosis
levothyroxine overdose
struma ovarii

Question 23

myxedema madness

Answer 23

paranoia and hallucinations in hypothyroidism

Question 24

carpal tunnel syndrome with amyloid fibril deposition

Answer 24

amyloidosis secondary to end-stage renal disease or chronic hemodialysis

Question 25

carpal tunnel syndrome with tenosynovial inflammation

Answer 25

rheumatoid arthritis

Question 26

carpal tunnel syndrome with accumulation of matrix substances

Answer 26

hypothyroidism

Question 27

carpal tunnel syndrome with accumulation of fluid in the carpal tunnel

Answer 27

pregnancy related volume overload

Question 28

carpal tunnel syndrome with synovial tendon hyperplasia

Answer 28

acromegaly

Question 29

where DHEA is produced

Answer 29

ovaries and adrenals

Question 30

where DHEAS is produced

Answer 30

adrenals

Question 31

hypothyroid symptoms with elevated T3, T4, and normal TSH

Answer 31

generalized resistance to thyroid hormone

Question 32

hashimoto's thyroiditis can lead to this type of malignancy

Answer 32

thyroid lymphoma

Question 33

treatment for diabetic neuropathy

Answer 33

amitriptylline | second line: TCAs may worsen urinary symptoms and orthostatic hypotension, so use gabapentin in these patients

Question 34

diagnostic test for acromegaly

Answer 34

measuring growth hormone following an oral glucose load