Kendo 150-200

Front 1

Q150. Tx for adrenal insufficiency; what additional Tx for Addison's only?

Back 1

A150. Tx: Glucocorticoid replacement (especially at times of stress); additional for Addisons: Mineralcorticoid replacement

Front 2

Q151. What disease presents with the exact opposite of Addison's?

Back 2

A151. Cushing's Dz

Front 3

Q152. Definition: Symptoms of excess Cortisol production

Back 3

A152. Cushing's syndrome

Front 4

Q153. Definition: Cushing's syndrome caused by excess ACTH secretion of pituitary

Back 4

A153. Cushing's disease

Front 5

Q154. What lung cancer is associated with ectopic ACTH production?

Back 5

A154. Small (Oat) cell lung CA

Front 6

Q155. Etiology of Cushing's syndrome (Adrenal excess); (3)

Back 6

A155. Exogenous corticosteroid therapy;; Adrenal neoplasm;; Ectopic ACTH production

Front 7

Q156. Dx: HTN, hair loss, central obesity, hump on the back of neck, abdominal purplish striae, hirsuitism, proximal muscle weakness, osteoporosis

Back 7

A156. Cushing's syndrome

Front 8

Q157. How is the ectopic ACTH Sx different from the ACTH Sx released directly from the adrenals?; Why?

Back 8

A157. Ectopic ACTH Sx: Weight gain and proximal muscle weakness only; B/c: the ACTH in ectopic from is usually the inactive form.

Front 9

Q158. How can Cushing's Dz be distinguished from Cushing's Syndrome?

Back 9

A158. Cushing's Dz: presence of Hyperpigmentation

Front 10

Q159. Dx: 42-yo woman on long-term steroids for asthma has excess adipose tissue in her neck and upper trunk, a wide "moon face", and very fine hair

Back 10

A159. Cushing's Syndrome

Front 11

Q160. (2) main lab tests to Dx Cushing's Syndrome; which is more specific as to finding the etiology?

Back 11

A160. Overnight Dexamethasone Suppression test; High-Dose Dexamethasone Suppression test (more specific)

Front 12

Q161. Describe the Overnight Dexamethasone test

Back 12

A161. 1 mg of dexamethasone is given at night, then plasma cortisol is measured in the morning. if < 5ug/100mL, it EXCLUDES Cushing's as the Dx

Front 13

Q162. What are the 3 Dx from Dexamethasone Suppression test & ACTH that follows?; (3 results from test)

Back 13

A162. Give 8 mg dexamethasone, then measure ACTH: 1. If ACTH is decreased or undetectable with no supression = Adrenal etiology; 2. ACTH is Normal or Increased with no supression = Ectopic ACTH etiology; 3. ACTH is High with partial supression = Pituitary etiology

Front 14

Q163. What are the electrolyte (Cl, K and Na) findings with Cushing's syndrome?; (3); What is found in urine?

Back 14

A163. Hypochloremia;; HypoK;; HyperN; In Urine: 24-hour Urinary free cortisol > 100 ug/24hr

Front 15

Q164. Tx of Cushing's from Pituitary adenomas

Back 15

A164. Transsphenoidal surgery; (radiation for children and refractory to surgery)

Front 16

Q165. Tx of Cushing's from Adrenal Adenoma

Back 16

A165. Unilateral resection, followed by 3 to 12 months of glucocorticoid replacement (until normal adrenal comes out of suppression)

Front 17

Q166. Tx of Cushing's from Bilateral Adrenal Hyperplasia

Back 17

A166. Bilateral resection and lifelong replacements of glucocorticoids and mineralcorticoids

Front 18

Q167. Tx of Cushing's from Ectopic ACTH production

Back 18

A167. Remove source of neoplasm

Front 19

Q168. Definition: Isolated excess production of Aldosterone; Another name for it?

Back 19

A168. Hyperaldosteronism; "Conn's syndrome"

Front 20

Q169. Etiology of Conn's syndrome; (2); Which is MCC?

Back 20

A169. 1. Unilateral aldosterone-producing Adenoma (MCC); 2. Bilateral hyperplasia of ZoNa Glomerulosa (idiopathic)

Front 21

Q170. Dx: HTN, signs of HyperK (muscle cramps, palpitations), signs of glucose intolerance (polyuria, polydipsia); may also be asymptomatic

Back 21

A170. Conn's syndrome

Front 22

Q171. Dx test for Conn's syndrome

Back 22

A171. Measure plasma aldosterone to plasma renin activity ratio; a ratio > 20 = Conn's syndrome (hyperaldosteronism)

Front 23

Q172. Dx: 44-yo woman has HTN, muscle cramps and excessive thirst

Back 23

A172. Hyperaldosteronism; (Conn's syndrome)

Front 24

Q173. What is the Tx for Conn's syndrome if it is due to hyperplasia?; (2)

Back 24

A173. 1. Spirolactone or ACEi to control BP; 2. Low-sodium diet

Front 25

Q174. Definition: tumor of the adrenal medulla resulting in the intermittent release of catecholamine excess

Back 25

A174. Pheochromocytoma

Front 26

Q175. (4) Disease Etiologies of Pheochromocytomas

Back 26

A175. MEN II: (Pheochromocytoma, PTH tumor, medullary thyroid CA);; MEN III: (Pheochromocytoma, PTH tumor, mucosal Neuromas);; Neurofibromatosis;; Von Hippel-Lindau Dz

Front 27

Q176. Dx: Pheochromocytoma, retinal angioma, CNS hemangioblastomas, renal cell CA, pancreatic pseudocysts, ependymal cystenoma

Back 27

A176. Von Hippel-Lindau Dz

Front 28

Q177. Dx: 38-yo woman on labetalol presents with poorly controlled hypertension, frequent headaches and palpitations

Back 28

A177. Pheochromocytoma

Front 29

Q178. what are the 5 "H" Sx of pheochromocytoma?

Back 29

A178. HA;; HTN;; Hot (diaphoretic);; Heart palpitations;; Hyperhidrosis (hand sweating)

Front 30

Q179. Dx test for Pheochromocytoma

Back 30

A179. Elevated urine Vanillylmandelic Acid; (urine catecholamines)

Front 31

Q180. Tx for pheochromocytoma; (2)

Back 31

A180. Surgical resection of mass;; Alpha-adrenergic blocker (may also add B-blocker)

Front 32

Q181. What is a possible misdiagnosis of Pheochromocytoma?

Back 32

A181. Anxiety disorder

Front 33

Q182. What Dx is known for the "Rule of 10s": 10% are extra- adrenal; 10% are bilateral; 10% are malignant; 10% are familial; 10% are pediatric; 10% calcify; 10% recur after resection

Back 33

A182. Pheochromocytoma

Front 34

Q183. Where is the anterior pituitary derived from?

Back 34

A183. Rathke's pouch

Front 35

Q184. Where is the posterior pituitary derived from?

Back 35

A184. Hypothalamic neuronal axon terminals of the brain

Front 36

Q185. what multiendocrine problem includes pituitary tumors?

Back 36

A185. MEN-1; (pituitary, pancreas, parathyroid)

Front 37

Q186. where is the site of the primary tumors of the pituitary?

Back 37

A186. Anterior pituitary only; (none in posterior)

Front 38

Q187. MC pituitary tumor, it presents with glactorrhea and amenorrhea; Tx?

Back 38

A187. Prolactinoma; Tx: Bromocriptine (DA agonist)

Front 39

Q188. Dx: pituitary tumor that presents with visual changes or slightly high prolactin levels; Tx?

Back 39

A188. Nonfunctioning Tumor; Tx: surgery

Front 40

Q189. Definition: MC tumor of the suprasellar region in children that arises from the remnants of Rathke's pouch and is solid or cystic; usually calcified

Back 40

A189. Craniopharyngioma

Front 41

Q190. Dx: HA, compression of optic chiasm "tunnel vision", signs of increased intracranial pressure

Back 41

A190. Craniopharyngioma

Front 42

Q191. Dx Test for Craniopharayngioma; (3)

Back 42

A191. X-ray - shows enlarged sella; CT / MRI; Hormone studies: excess deficiencies

Front 43

Q192. Tx for craniopharyngioma; (3 together)

Back 43

A192. 1. Surgery; 2. Hormone replacement; 3. Dopamine agonist if prolactin-related Sx are noticed

Front 44

Q193. specific Etiology of Acromegaly

Back 44

A193. pituitary Somatotrophic Adenoma secreting GH

Front 45

Q194. Dx: progressive enlargement of the peripheral body parts, particularly head, hands, and feet; decreased glucose tolerance; hyperphosphatemia

Back 45

A194. Acromegaly

Front 46

Q195. Acromegaly in children

Back 46

A195. Gigantism

Front 47

Q196. What hormone in excess is related to acromegaly?

Back 47

A196. GH

Front 48

Q197. Dx tests that confirm Acromegaly; (3)

Back 48

A197. 1. Serum GH levels - measured in bed in am; 2. Lack of GH suppression by glucose; 3. Elevated serum IGF-I levels

Front 49

Q198. Aside from surgery and radiation, what is the medicine used to Tx Acromegaly?

Back 49

A198. GH receptor blocker: Pegvisomant (Somavert)

Front 50

Q199. Dx: 29-yo woman with inability to lactate after childbirth. Delivery was complicated by blood loss and hypotension

Back 50

A199. Sheehan's syndrome

Front 51

Q200. Etiology of Hypopituitraism; (3)

Back 51

A200. Tumors;; Medical/surgical destruction;; Sheehan's syndrome