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Endocrinology

FA review Round 1 2020

QuestionAnswer
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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