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Endocrinology
FA review Round 1 2020
| Question | Answer |
|---|---|
| What are two examples of Thiazolidinones? | Pioglitazone and Rosiglitazone |
| What type of diabetic medication is Pioglitazone? | Thiazolidinone |
| What is the mode of action of Thiazolidinediones? | Act on Peroxisome-Activating Receptors (PPARs) to sensitize skeletal muscle and the liver to insulin |
| What is the most significant or recurrent adverse effect seen in Thiazolidinones? | Edema (water retention) |
| Which diabetic drugs act on PPARs? | Thiazolidinone |
| What enzyme regulates the Zona Glomerulosa of the Adrenal gland cortex? | AT II |
| Which part of the Adrenal gland is regulated by AT II? | Zona Glomerulosa |
| What hormone is secreted by Z. Glomerulosa? | Aldosterone |
| What type of hormone is secreted by Z. Glomerulosa? | Mineralocorticoid |
| What causes a Adrenal crisis? | Sudden cessation of HYDROCORTISONE therapy to treat adrenal insufficiency |
| What specific steroid is used to treat adrenal insufficiency? | Hydrocortisone |
| What are the classical features of Adrenal Crisis? | Hypotension, Hyponatremia, Hyperkalemia, Metabolic acidosis, and symptoms of fatigue and muscle pain |
| Adrenal insufficiency is seen with low levels of which electrolyte? | Sodium (hyponatremia) |
| Hyper- or Hypokalemia in Adrenal insufficiency? | Hyperkalemia |
| Hyperkalemia and Hyponatremia, hypotension, and darkening of mucosa, are features symptoms of which conditions? | Adrenal insufficiency |
| What type of hormones are decreased in 17-a hydroxylase deficiency? | Glucocorticoids and Sex hormones |
| Which type of hormones are hypersecreted in 17a- hydroxylase deficiency? | Mineralocorticoids |
| An excess secretion of mineralocorticoids may be represented histologically as: | Hypertrophy of Zona Glomerulosa |
| What is the typical clinical presentation of 17a-hydroxylase deficiency? | Hypertension, hypokalemia, and lack of sexual maturation |
| Elevated Aldosterone, and decreased androgens and Cortisol, due to a enzymatic deficiency. Dx? | 17a-hydroxylase deficiency |
| What typical causes of a decrease in Vitamin D intake? | Poor dietary intake and limited sunlight exposure |
| What are the important serum levels in Vitamin D deficiency? | A decrease in serum Calcium and Phosphate, but an increase in PTH. |
| What hormone is elevated in Vitamin D deficiency? | PTH |
| What is the type of Thyroid cancer that presents with a "cold" nodule and with Hx of previous radiation exposure? | Papillary Thyroid Carcinoma |
| What are the histological findings of Papillary Thyroid cancer? | 1. "Orphan Annie" eye nuclei 2. Nuclear grooves 3. Psammoma bodies |
| What is the MC type of Thyroid cancer? | Papillary Thyroid Carcinoma |
| At which part of the nephron is most glucose reabsorbed? | PCT |
| What channel or transport mechanism is used by glucose in PCT to be reabsorbed? | Sodium-Glucose Cotransporter system |
| At what level of serum glucose are the Na-glucose cotransporters saturated? | 300 mg/dL |
| What occurs when blood sugar reaches a level of 300 mg/dL? | It spill into urine producing glucosuria |
| What are the manifestations at birth of Dopamine B-hydroxylase deficiency? | Vomiting, hypotonia, and hypotonia |
| What is the late key manifestation of Dopamine B-hydroxylase? | Orthostatic hypotension |
| Which condition is associated with elevated levels of Dopamine accumulation and no production of catecholamines (NE and Epi)? | Dopamine B-hydroxylase deficiency |
| Increasing the Cut-Off value causes: | 1. Increase specificity and, 2. Decrease Sensitivity |
| Does Sensitivity or Specificity follows the movement, parallely, to changes to Cut Off value? | Specificity |
| Specificity moves same or opposite direction of Cut-Off value? | Same direction |
| Sensitivity moves same or opposite direction to Cut-Off value? | Opposite direction |
| An increase of False Negatives (FNs) is due to: | Decrease in sensitivity due to increasing Cut-Off value |
| What is the most common type of Pituitary adenoma? | Prolactinomas |
| What cell proliferation is causes Prolactinomas? | Lactotroph cells |
| Proliferation of Lactotrophs cells in the anterior pituitary. Dx? | Prolactinoma |
| Proliferation of corticotroph cells in the anterior pituitary. Dx? | ACTH-secreting pituitary adenoma |
| Proliferation of Somatotroph cells in the anterior pituitary. Dx? | GH-secreting pituitary adenoma |
| What cells are proliferated in ACTH-secreting pituitary adenomas? | Corticotroph cells |
| Which cells are excessively proliferated in GH-secreting pituitary adenomas? | Somatotroph cells |
| What is the common name for Primary Adrenal Insufficiency? | Addison disease |
| What is Addison disease? | Autoimmune disease that destroy the adrenal cortex resulting in decreased levels of glucocorticoids, mineralocorticoids, and androgens |
| Which condition is know to be autoimmune and destroying the adrenal gland cortex, leading to decreased levels of aldosterone, cortisol, and sex hormones? | Addison disease |
| Chronic Primary Adrenal insufficiency is known as: | Addison disease |
| What compound/hormone is elevated in Addison's disease? | ACTH |
| Autoimmune disease that leads to elevated levels of ACTH? | Addison disease |
| What are the common signs of Addison disease? | - Orthostatic hypotension, - Skin hyperpigmentation, - Hyponatremia - Hyperkalemia - Salt cravings - Decrease weight |
| How are the levels of sodium and potassium in Addison disease? | Low sodium and elevated potassium |
| What is the MCC of Waterhouse-Friderichsen syndrome? | N. meningitidis |
| What are the clinical features of Waterhouse-Friderichsen syndrome? | Adrenal failure, septic shock, DIC, and petechiae |
| What are the main clinical symptoms of Septic Shock? | Low blood pressure, pale and cool arms and legs, chills, difficulty breathing, and decreased urine output |
| What is the MCC of Phenylketonuria (PKU)? | Deficiency of Phenylalanine hydroxylase (PAH) |
| What enzyme is deficient or absent in PKU? | Phenylalanine hydroxylase (PAH) |
| Deficiency in PAH (Phenylalanine hydroxylase). Dx? | Phenylketonuria |
| What is the result of PKU in hormonal synthesis effects? | Accumulation of Phenylalanine, and catastrophic inability to produce catecholamines, or anything downstream in the pathway. |
| What is the associated elevated ratio in Ethanol metabolism (alcoholism)? | NAD+ : NADH |
| Elevated NAD+: NADH is seen with: | Ethanol abuse (alcoholism) |
| What is inhibited by an elevated NAD+: NADH ratio? | Gluconeogenesis |
| Is excessive EtOH metabolism seen with Hypoglycemia or Hyperglycemia? | Hypoglycemia |
| Which generation of Sulfonylureas are associated with Disulfiram-like reactions? | 1st generation |
| Which are two common 1st generation Sulfonylureas? | Tolbutamide and Chlorpropamide |
| 1st or 2nd generation Sulfonylurea. Tolbutamide? | 1st generation |
| 1st or 2nd generation Sulfonylurea. CHLORPROPAMIDE? | 1st generation |
| How is a Disulfiram-like reaction presented clinically? | Headache, blurry vision, hypotension, and facial flushing |
| List of drugs that are associated to develop an adverse Disulfiram-like reaction: | 1. 1st generation Sulfonylureas 2. Metronidazole 3. Griseofulvin 4. Chloramphenicol 5. Some Cephalosporins |
| What happens to TBG levels in causes in a elevation or increase in Estrogen levels? | Increases |
| An elevation to TBG generates: | 1. Overall increase in Total T4/T3, 2. Setting of normal TSH and Normal free T3/T4 |
| Which levels remain normal with an increase of TBG? | TSH and free T3/T4 |
| What is a common cause for reversible hypertension in adults? | Pheochromocytoma |
| Which MEN subtypes are associated in Pheochromocytoma? | MEN2A and MEN2B |
| What type of thyroid cancer is associated with MEN2A & MEN2B? | Medullary cancer of Thyroid |
| What is the precursor to Tyrosine? | Phenylalanine |
| What is synthesized by Tyrosine residues? | Thyroid hormone |
| What are the two main effects in women with Prolactinomas? | 1. Prolactin- induced milk production 2. Hypoestrogenism |
| What causes hypoestrogenism in women in Prolactinomas? | Secondary to prolactin suppression of GnRH |
| What are common clinical features of Hypoestrogenism in women? | Increased risk for Oligo-/amenorrhea, anovulation, decreased bone density, and vaginal atrophy |
| What is Subacute Thyroiditis? | Self-limiting disease that follow a flu-like illness |
| What is the process that follows Subacute Thyroiditis? | Hyperthyroidism, then hypothyroidism, tender, large thyroid, and fever |
| What is the common histology description of Subacute thyroiditis? | Inflammatory infiltrate with multinucleated giant cells |
Created by:
rakomi
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