Endocrinology

Question 1

Deficiency of GH with or without deficiency of other pituitary hormones

Answer 1

Hypopituitarism

Question 2

Short stature, vomiting, visual field defect, thin dry hair, increased thirst and fluid intake, increased urination, hypotonia, poor balance, constipation are symptoms of

Answer 2

Craniopharyngioma (because they are usually located in the optic chiasm)

Question 3

Most common cause of pituitary gigantism

Answer 3

pituitary adenoma

Question 4

Normal range for height but over time, it starts falling off the height curve

Answer 4

Pathologic short stature

Example: malnutrition or underlying medical problem

Question 5

Normal range for height; normal final adult height is reached but the growth spurt and puberty are delayed

Answer 5

Constitutional short stature

Question 6

Stay parallel to the growth curve; due to Genetics

Answer 6

Familial Short stature

Question 7

Parallel to the growth curve but is much more marked; Very low birth weight (500-100g)

Answer 7

Prenatal short stature

Question 8

Criteria for stopping growth hormone therapy: Growth rate _____ and bone age ______in girls and _________ in boys

Answer 8

Growth rate 14 years in girls and>16 in boys

Question 9

How is bone age determined?

Answer 9

X-ray of left wrist

Question 10

More precise and cost-effective diagnostic method for hyperpituitarism

Answer 10

Serum IGF-1/Somatomedin C (Uniformly increased in untreated cases)

GH levels fluctuate and have short serum half-life (22 mins)

Question 11

Surgical management if with well circumscribed pituitary adenoma:

Answer 11

transsphenoidal surgery (complete removal of thetumor)

Question 12

Earliest signs of sexual maturity in girls

Answer 12

breast bud

Question 13

Earliest signs of sexual maturity in boys

Answer 13

testicular swelling

Question 14

Onset of secondary sex characteristics before 8 years old in girls and 9 years old in boys

Answer 14

PRECOCIOUS PUBERTY

Question 15

Given to true precocious puberty patients

Answer 15

Leuprolide acetate – 0.25-0.3 mg/kg IM once every 4weeks

Question 16

Definitive treatment for Grave’s disease

Answer 16

radioactive iodine ablation or thyroidectomy

Question 17

Most common etiology of congenital hypothyroidism

Answer 17

Thyroid dysgenesis

Question 18

Most common cause of thyroid disease in children & adolescents

Answer 18

THYROIDITIS Lymphocytic / Hashimoto / Autoimmune

Question 19

2 Human Leukocyte Antigen (HLA) associated with an increased risk of goiter & thyroiditis

Answer 19

HLA-DR4, HLA-DR5

Question 20

Secreted by parafollicular cells of thyroid gland

Answer 20

Calcitonin

Question 21

Inhibits bone resorption by decreasing the number and activity of bone-resorping osteoclasts

Answer 21

Calcitonin

Question 22

Tapping of cheeks at the area of the facial nerve produces facial twitching

Answer 22

Chvostek sign; in hypocalcemia

Question 23

Thumb is adducted and the other fingers are extended; exhibited when you get the BP and let it stay in the mean blood pressure

Answer 23

Trosseau sign or laryngeal & carpopedal spasm; hypocalcemia

Question 24

Emergency treatment for neonatal tetany:

Answer 24

5-10 ml of 10% solution of calcium gluconate IV at a rate o f0.5-1 mL/min while HR is monitored

1,25-dihydroxycholecalciferol (calcitriol) should be given – initial dose 0.25 ug/day & maintenance dose 0.01-0.1 ug/kg/day; given in 2 equal divided doses

Question 25

Characterized by hyperplasia or neoplasia of the endocrine pancreas, the anterior pituitary & parathyroid glands

Answer 25

multiple endocrine neoplasia (MEN) syndrome

Question 26

Most consistent X-ray finding in hyperparathyroidism

Answer 26

resorption of subperiosteal bone of the phalanges

Question 27

A useful test to determine CAH

Answer 27

serum 17-hydroxyprogesterone

Question 28

Rounded face, prominent cheeks, moon facies, buffalo hump, generalized obesity, abnormal masculinization, impaired growth, hypertension, increased susceptibility to infection

Answer 28

Cushing syndrome

Question 29

Tumors of pheochromocytoma is most often found on what laterality

Answer 29

Right

Question 30

Syndrome of males and females with normal karyotypes who have certain phenotypic features that occur also in females with Turner syndrome

Answer 30

NOONAN SYNDROME Autosomal Dominant

Question 31

47, XXY chromosome

Answer 31

KLINEFELTER SYNDROME

Question 32

Most common sex chromosomal aneuploidy in males

Answer 32

KLINEFELTER SYNDROME

Question 33

Tall, slim, underweight, long legs, small testes & penis, gynecomastia, azoospermia, associated with leukemia& lymphoma; with mental retardation & psychosocial, learning, or school adjustment problems

Answer 33

KLINEFELTER SYNDROME

Question 34

45, X chromosomal complement

Answer 34

TURNER SYNDROME

Question 35

Most common endocrine-metabolic disorder of childhood & adolescence

Answer 35

DIABETES MELLITUS

Question 36

MPattern of undetected hypoglycemia followed by hyperglycemia that typically occurs in the middle of the night

Answer 36

SOMOGYI PHENOMENON

Question 37

Elevations of blood glucose occur between 5-9 am without preceding hypoglycemia

Answer 37

DAWN PHENOMENON Reflects the waning effects of insulin probably due to increased clearance of insulin & nocturnal surges of GH that antagonize insulin’s metabolic effects