ENDOCRINE DISORDERS PART 1 of 1.1 (AB)

Question 1

Where is the pituitary gland located?

Answer 1

At the base of the brain just below the hypothalamus. behind the nose bridge. in the sella turcica of the sphenoid bone.

Question 2

Why can traumatic brain injury affect the pituitary gland?

Answer 2

Because the sella turcica is a thin layer of bone. impact may damage the pituitary gland and cause dysfunction.

Question 3

Why is the pituitary gland called the ‘master gland’?

Answer 3

Because it produces hormones that regulate many body functions and control other endocrine glands.

Question 4

What percentage of the pituitary gland is the anterior lobe?

Answer 4

0.8

Question 5

What percentage of the pituitary gland is the posterior lobe?

Answer 5

0.2

Question 6

What is the origin of the anterior pituitary gland?

Answer 6

Rathke pouch from oral ectoderm.

Question 7

What is the origin of the posterior pituitary gland?

Answer 7

Neuroectoderm.

Question 8

When does the pituitary gland start developing?

Answer 8

Week 4 of embryonic development.

Question 9

What is the arterial blood supply of the pituitary gland?

Answer 9

Inferior. middle. and superior hypophyseal arteries from the internal carotid.

Question 10

What does FLAT PiG stand for?

Answer 10

FSH. LH. ACTH. TSH. Prolactin. GH.

Question 11

Which cells secrete growth hormone?

Answer 11

Somatotrophs.

Question 12

Which cells secrete prolactin?

Answer 12

Lactotrophs.

Question 13

Which cells secrete thyroid-stimulating hormone?

Answer 13

Thyrotrophs.

Question 14

Which cells secrete proopiomelanocortin?

Answer 14

Corticotrophs.

Question 15

Which cells secrete LH and FSH?

Answer 15

Gonadotrophs.

Question 16

How many amino acids are in human growth hormone?

Answer 16

191

Question 17

How is growth hormone secreted?

Answer 17

In a pulsatile fashion regulated by hypothalamic hormones.

Question 18

What are stimulants of growth hormone secretion?

Answer 18

GHRH. ghrelin. sleep. exercise. physical stress. trauma. acute illness. puberty. fasting. hypoglycemia.

Question 19

What are inhibitors of growth hormone secretion?

Answer 19

Somatostatin. hyperglycemia. hypothyroidism. glucocorticoids.

Question 20

What are the biological effects of growth hormone?

Answer 20

Linear growth. bone thickness. soft tissue growth. protein synthesis. fatty acid release. insulin resistance. increased blood glucose.

Question 21

Where is IGF-1 primarily synthesized?

Answer 21

In the liver.

Question 22

What regulates IGF-1 levels?

Answer 22

GH levels and nutritional status.

Question 23

What inhibits prolactin secretion?

Answer 23

Dopamine.

Question 24

What increases serum prolactin levels?

Answer 24

Disruption of hypothalamus or pituitary stalk. dopamine antagonists. primary hypothyroidism. TRH administration. prolactinoma.

Question 25

What decreases serum prolactin levels?

Answer 25

Dopamine agonists. destruction of the pituitary.

Question 26

What is prolactin's primary physiologic role?

Answer 26

Initiation and maintenance of lactation.

Question 27

What are signs of hyperprolactinemia?

Answer 27

Galactorrhea. amenorrhea. infertility.

Question 28

What is TSH made of?

Answer 28

Alpha and beta glycoprotein chains.

Question 29

Which TSH subunit is specific?

Answer 29

Beta-subunit.

Question 30

What stimulates TSH release?

Answer 30

TRH from the hypothalamus.

Question 31

What inhibits TRH release?

Answer 31

Dopamine. somatostatin. glucocorticoids. stress. increased cortisol.

Question 32

What does TSH stimulate?

Answer 32

Release of T3 and T4 from the thyroid gland.

Question 33

What does TSH deficiency cause?

Answer 33

Inactivity and atrophy of the thyroid gland.

Question 34

What does TSH excess cause?

Answer 34

Hypertrophy and hyperplasia of the thyroid gland.

Question 35

What lab values suggest primary hypothyroidism?

Answer 35

High TSH. low T3 and T4.

Question 36

What lab values suggest primary hyperthyroidism?

Answer 36

Low TSH. high T3 and T4.

Question 37

What lab values suggest secondary hypothyroidism?

Answer 37

Low TSH. low T3 and T4.

Question 38

What is ACTH derived from?

Answer 38

Proteolytic cleavage of POMC.

Question 39

What else does POMC contain?

Answer 39

Lipotropins. melanocyte-stimulating hormone. beta-endorphin.

Question 40

What regulates ACTH secretion?

Answer 40

CRH from the hypothalamus.

Question 41

When are ACTH and cortisol levels highest?

Answer 41

Early morning after waking.

Question 42

What is ACTH's role in pigmentation?

Answer 42

Principal pigmentary hormone in humans.

Question 43

What stimulates CRH and ACTH release?

Answer 43

Vasopressin. oxytocin. angiotensin II. cholecystokinin. stress. fasting. hypoglycemia.

Question 44

What inhibits CRH and ACTH release?

Answer 44

Atrial natriuretic peptide. opioids. cortisol.

Question 45

What do LH and FSH have in common with TSH and hCG?

Answer 45

They share the same alpha subunit.

Question 46

What are FSH effects in females?

Answer 46

Stimulates ovarian follicle development.

Question 47

What are FSH effects in males?

Answer 47

Promotes spermatogenesis.

Question 48

What suppresses FSH secretion?

Answer 48

Inhibin from Sertoli cells.

Question 49

What are LH effects in females?

Answer 49

Triggers ovulation. stimulates corpus luteum formation.

Question 50

What are LH effects in males?

Answer 50

Stimulates testosterone production.

Question 51

What inhibits LH secretion?

Answer 51

Androgens and estrogens.

Question 52

What are posterior pituitary hormones?

Answer 52

ADH and oxytocin.

Question 53

Where are ADH and oxytocin produced?

Answer 53

Supraoptic and paraventricular nuclei of the hypothalamus.

Question 54

What does ADH regulate?

Answer 54

Water conservation at the kidney.

Question 55

How does ADH work on the kidney?

Answer 55

Stimulates V2 receptors in the collecting duct for water reabsorption.

Question 56

What do V1 receptors mediate?

Answer 56

Pressor and glycogenolytic effects via calcium mobilization.

Question 57

What do V3 receptors mediate?

Answer 57

Stimulation of ACTH secretion.

Question 58

How does oxytocin affect the uterus?

Answer 58

Stimulates contractions during labor.

Question 59

How does oxytocin affect the breast?

Answer 59

Stimulates milk let-down during suckling.

Question 60

What behaviors is oxytocin involved in?

Answer 60

Orgasm. social recognition. bonding. trust. maternal behavior.

Question 61

How does oxytocin affect appetite?

Answer 61

Induces anorexia and influences obesity regulation.

Question 62

What are the two main parts of the adrenal gland?

Answer 62

Adrenal cortex. Adrenal medulla.

Question 63

Which part of the adrenal gland is outermost?

Answer 63

Adrenal cortex.

Question 64

Which part of the adrenal gland is innermost?

Answer 64

Adrenal medulla.

Question 65

What hormone is secreted by the zona glomerulosa of the adrenal cortex?

Answer 65

Mineralocorticoids. Aldosterone.

Question 66

What hormone is secreted by the zona fasciculata of the adrenal cortex?

Answer 66

Glucocorticoids. Cortisol.

Question 67

What hormone is secreted by the zona reticularis of the adrenal cortex?

Answer 67

Adrenal androgens.

Question 68

What type of cells in the adrenal medulla secrete catecholamines?

Answer 68

Neuroendocrine. Chromaffin cells.

Question 69

What do glial cells in the adrenal medulla do?

Answer 69

Involved in calcium metabolism. Indirectly affect catecholamine production.

Question 70

What stimulates the hypothalamus to release CRH?

Answer 70

Stress. Low cortisol levels.

Question 71

What does CRH stimulate?

Answer 71

Anterior pituitary to secrete ACTH. Corticotropin.

Question 72

What does ACTH stimulate in the adrenal cortex?

Answer 72

Synthesis and release of cortisol and adrenal androgens.

Question 73

What is the feedback effect of cortisol on the HPA axis?

Answer 73

Negative feedback.

Question 74

What happens when cortisol levels are high?

Answer 74

Inhibit CRH from hypothalamus. Inhibit ACTH from anterior pituitary.

Question 75

What regulates aldosterone secretion?

Answer 75

Renin-angiotensin-aldosterone system. Serum potassium levels.

Question 76

What are the stimuli for aldosterone release?

Answer 76

Low blood volume or pressure. High serum potassium.

Question 77

What are the effects of aldosterone?

Answer 77

Sodium retention. Potassium excretion. Water reabsorption.

Question 78

What is the fetal consequence of 21-hydroxylase deficiency?

Answer 78

Excess androgens. Virilization.

Question 79

What time is cortisol highest in a normal diurnal cycle?

Answer 79

8 AM.

Question 80

What cortisol level pattern is lost in Cushing syndrome?

Answer 80

Normal diurnal pattern. Cortisol remains high at midnight.

Question 81

What causes primary adrenal insufficiency?

Answer 81

Defect in adrenal glands. Addison's disease.

Question 82

What are lab findings in primary adrenal insufficiency?

Answer 82

Low cortisol. High ACTH.

Question 83

What causes secondary adrenal insufficiency?

Answer 83

Pituitary defect. Low ACTH and cortisol.

Question 84

What causes tertiary adrenal insufficiency?

Answer 84

Hypothalamic dysfunction. CRH deficiency. Low ACTH and cortisol.

Question 85

What is the most common cause of congenital adrenal hyperplasia?

Answer 85

21-hydroxylase deficiency.

Question 86

What is the hallmark lab test for CAH diagnosis?

Answer 86

Very high 17-hydroxyprogesterone.

Question 87

What are the effects of salt-wasting form of CAH?

Answer 87

Glucocorticoid and mineralocorticoid deficiency. Salt-wasting crisis.

Question 88

What are symptoms of virilization in females with CAH?

Answer 88

Clitoromegaly. Labial fusion. Phallus-like clitoris.

Question 89

What are symptoms of late-onset CAH in adolescent girls?

Answer 89

Hirsutism. Acne. Irregular menses or amenorrhea.

Question 90

What is the core management of CAH?

Answer 90

Hormonal therapy. Glucocorticoids and mineralocorticoids.

Question 91

What complications may occur with overtreatment of CAH?

Answer 91

Growth stunting. Weight gain. Cushingoid features.

Question 92

What complications may occur with undertreatment of CAH?

Answer 92

Early puberty. Excessive height. Testicular adrenal rest tumors.

Question 93

What causes Addison’s disease?

Answer 93

Autoimmune destruction of adrenal cortex.

Question 94

What is the most definitive test for Addison’s disease?

Answer 94

ACTH stimulation test.

Question 95

What are common lab findings in Addison’s disease?

Answer 95

Low cortisol and sodium. High ACTH. Hyperkalemia. High plasma renin.

Question 96

What is the first-line fluid treatment in Addisonian crisis?

Answer 96

D5NSS. Corrects hypoglycemia and hypovolemia.

Question 97

What is the corticosteroid of choice for long-term replacement in Addison’s disease?

Answer 97

Hydrocortisone.

Question 98

What is the most common cause of Cushing syndrome?

Answer 98

Exogenous corticosteroid use.

Question 99

What is the most common endogenous cause of Cushing syndrome in children?

Answer 99

ACTH-secreting pituitary microadenoma. Cushing disease.

Question 100

What are clinical signs of Cushing syndrome?

Answer 100

Central obesity. Moon facies. Striae. Hypertension. Hirsutism. Osteoporosis.

Question 101

What is a classic lab finding in Cushing syndrome?

Answer 101

Increased 24-hour urinary cortisol.

Question 102

What test shows loss of cortisol suppression in Cushing syndrome?

Answer 102

Dexamethasone suppression test.

Question 103

What is the treatment of choice for pituitary Cushing disease?

Answer 103

Transsphenoidal pituitary microsurgery.

Question 104

What is pheochromocytoma?

Answer 104

Catecholamine-secreting tumor of chromaffin cells.

Question 105

What is the classic triad of pheochromocytoma?

Answer 105

Hypertension. Headache. Palpitations.

Question 106

What are the sensitive markers for pheochromocytoma?

Answer 106

Increased blood and urinary metanephrines.

Question 107

What is the treatment for pheochromocytoma?

Answer 107

Surgical removal. Microscopic adrenalectomy.