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[h] Endocrinology Flashcards

[i] Master this session in just 2 Hours.

[q] Pharyngeal pouches lined with ………. but pharyngeal grooves or clefts are lined with ………..?. Pharyngeal arches composed of  ……….. and ……….?

[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]

[f]IGVuZG9kZXJtLCBlY3RvZGVybS4gbWVzb2Rlcm0gYW5kIG5ldXJvZWN0b2Rlcm0u

Cg==

Cg==[Qq]

[q] Mesoderm in pharyngeal arches gives rise to the ………., while neural crest cells give rise to …… and ………?

[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]

[f]IE11c2NsZSwgYm9uZXMgYW5kIGNhcnRpbGFnZS4=

Cg==

Cg==[Qq]

[q] In the middle ear, there are some bones (ossicles), the neural crest cells of the 1st arch give rise to ………..?. The neural crest cells of the 2nd arch give rise to ……..?

[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]

[f]IHRoZSBtYWxsZXVzIGFuZCBpbmN1cywgdGhlIHN0YXBlcy4=

Cg==

Cg==[Qq]

[q] There are also 2 muscles in the middle ear. ……… comes from the mesoderm of the 1st arch. ……….. comes from the mesoderm of the 2nd arch.

[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]

[f]IFRoZSB0ZW5zb3IgdHltcGFuaSBtdXNjbGUsIFRoZSBzdGFwZWRpdXMgbXVzY2xlLg==[Qq]

[q] ……….. is a cyst found in the lateral part of the neck in a child along the anterior border of sternomastoid. There is no movement of the cyst with swallowing or with protrusion of the tongue.

[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]

[f]IExhdGVyYWwgY2VydmljYWwgY3lzdCAocGhhcnluZ2VhbCBjeXN0KS4=

Cg==

Cg==[Qq]

[q] Triad of micrognathia, glossoptosis, U shaped cleft palate, airway obstruction due to abnormally located tongue are characteristic for ………?

[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]

[f]IFBpZXJyZSBSb2JpbiBzZXF1ZW5jZS4=

Cg==

Cg==[Qq]

[q] ………….. is autosomal dominant neural crest failure to migrate of the 1st and 2nd pharyngeal arches → craniofacial abnormalities (zygomatic bone and mandibular hypoplasia) often result in airway compromise and feeding difficulties, hearing loss due to absent or abnormal ossicles

[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]

[f]IFRyZWFjaGVyIENvbGxpbnMgc3luZHJvbWUu

Cg==

Cg==[Qq]

[q] Maxilla, zygomatic bone, mandible, malleus and incus and muscles of mastication are derivative from ……….. and are innervated by ……….?

[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]

[f]IDFzdCBwaGFyeW5nZWFsIGFyY2gsIG1hbmRpYnVsYXIgYnJhbmNoIG9mIHRyaWdlbWluYWwgbmVydmUu

Cg==

Jm5ic3A7

Cg==

[Qq]

[q] Stapes, Styloid process, lesser horn of hyoid and muscles of facial expression are derivative from ……….. and are innervated by ……….?

[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]

[f]IDJuZCBwaGFyeW5nZWFsIGFyY2gsIGZhY2lhbCBuZXJ2ZS4=

Cg==

Cg==[Qq]

[q] Greater horn of hyoid and stylopharyngeus muscle are derivative from ……….. and are innervated by ……….?

[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]

[f]IDNyZCBwaGFyeW5nZWFsIGFyY2gsIGdsb3Nzb3BoYXJ5bmdlYWwgbmVydmUu

Cg==

Cg==[Qq]

[q] Pharyngeal constrictor muscles except stylopharyngeus are derivative from ……….. and are innervated by ……….?

[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]

[f]IDR0aCBwaGFyeW5nZWFsIGFyY2gsIHN1cGVyaW9yIGxhcnluZ2VhbCBuZXJ2ZS4=

Cg==

Cg==[Qq]

[q] Laryngeal muscles except cricothyroid are derivative from ……….. and are innervated by ……….?

[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]

[f]IDZ0aCBwaGFyeW5nZWFsIGFyY2gsIHJlY3VycmVudCBsYXJ5bmdlYWwgbmVydmUu

Cg==

Cg==[Qq]

[q] 1st pharyngeal pouch develops into …………?

[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]

[f]IG1pZGRsZSBlYXIgY2F2aXR5LCBldXN0YWNoaWFuIHR1YmUsIG1hc3RvaWQgYWlyIGNlbGxzLg==

Cg==

Cg==[Qq]

[q] 2nd pharyngeal pouch develops into …………?

[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]

[f]IERldmVsb3BzIGludG8gZXBpdGhlbGlhbCBsaW5pbmcgb2YgcGFsYXRpbmUgdG9uc2lsLg==

Cg==

Cg==[Qq]

[q] 3rd pharyngeal pouch develops into …………?

[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]

[f]IGluZmVyaW9yIHBhcmF0aHlyb2lkIGFuZCB0aHltdXMu

Cg==

Cg==[Qq]

[q] 4th pharyngeal pouch develops into …………?

[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]

[f]IHN1cGVyaW9yIHBhcmF0aHlyb2lkIGFuZCBwYXJhZm9sbGljdWxhciAoQykgY2VsbHMgb2Y=
ClRoeXJvaWQu

Cg==

[Qq]

[q] Pharyngeal groove 1 give rise to the epithelial lining of external auditory meatus. Failure of a groove to be completely obliterated results in ………..?

[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]

[f]IGJyYW5jaGlhbCBjeXN0IG9yIGxhdGVyYWwgY2VydmljYWwgY3lzdC4=

Cg==

Cg==[Qq]

[q] The thyroid can form at any part along the thyroglossal duct’s usual path due to ……..?

[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]

[f]IGZhaWx1cmUgb2YgbWlncmF0aW9uLg==[Qq]

[q] …………. presents as anterior midline neck mass that moves with swallowing or protrusion of the tongue due to its relation to hyoid bone.

[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]

[f]IG1lZGlhbiBjZXJ2aWNhbCBjeXN0Lg==[Qq]

 

[q] ……… is an acquired fistula (never congenital) due to infection of thyroglossal cyst leading to rupture or inadequate excision of the cyst.

[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]

[f]IFRoeXJvZ2xvc3NhbCBmaXN0dWxhLg==[Qq]

[q] ……….. is presenting with hypocalcemia, recurrent viral and fungal infections, absent thymic shadow, and facial anomalies like short palpebral fissures, micrognathia, bifid uvula, and cleft palate.

[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]

[f]IERpR2VvcmdlIHN5bmRyb21lICgyMnExMSBkZWxldGlvbiku[Qq]

[q] ……….. also called the hypophysis, is a small gland that lies in the Sella turica, a bony cavity at the base of the brain, the arachnoid membrane (diaphragma sellae) separates it from and prevents cerebrospinal fluid from entering the Sella turcica.

[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]

[f]IFRoZSBwaXR1aXRhcnkgZ2xhbmQu

Cg==

Jm5ic3A7

Cg==

[Qq]

[q] Compression of the pituitary stalk by suprasellar tumor or neurosarcoidosis causes a decrease in all anterior pituitary hormones except ……… which increases.

[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]

[f]IHByb2xhY3Rpbi4=

Cg==

Cg==[Qq]

[q] ……….. is also known as adenohypophysis and originates from ……….?

[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]

[f]IHRoZSBSYXRoa2XigJlzIHBvdWNoLCB3aGljaCBpcyBhbiBlbWJyeW9uaWMgaW52YWdpbmF0aW9uIG9mIHRoZSBwaGFyeW5nZWFsIGVwaXRoZWxpdW0u[Qq]

[q] …………. is also known as the neurohypophysis and is derived from ………..?

[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]

[f]IG5ldXJvZWN0b2Rlcm0u[Qq]

[q] Most of the anabolic actions of growth hormone are an indirect result of increased production of growth factors, which are called ………?

[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]

[f]IHNvbWF0b21lZGluIEMsIG9yIGluc3VsaW4tbGlrZSBncm93dGggZmFjdG9yIEkgKElHRi0gSSku

Cg==

Cg==[Qq]

[q] If there is excess growth hormone before closure of the epiphysis, it is called …………….? but after closure of the epiphysis, the condition is called …………?

[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]

[f]IGdpZ2FudGlzbSwgYWNyb21lZ2FseS4=[Qq]

[q] What is the most likely diagnosis?

40 years old patient presenting with box shaped face with prominent cheeks, nasal bones, super ciliary ridges, and a protruded lower jaw (proganthism) with widely separated teeth. He had to change his ring and shoes size because the old one doesn’t fit him anymore. He has elevated IGF-I with failure of suppression in response to oral glucose?

[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]

[f]IEFjcm9tZWdhbHku

Cg==

Cg==[Qq]

[q] Prolactin secretion from anterior pituitary is tonically inhibited by ………. from hypothalamus.

[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]

[f]IGRvcGFtaW5lLg==

Cg==

Cg==[Qq]

[q] The most common hyperfunctioning (Hormone producing) pituitary adenoma is ……….?

[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]

[f]IFByb2xhY3Rpbm9tYS4=[Qq]

[q] What is the most likely diagnosis?

36 years old male presenting with galactorrhea, decreased libido, and impotence. He also reported headache with defect in peripheral vision while driving?

[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]

[f]IFByb2xhY3Rpbm9tYS4=[Qq]

[q] If hyperprolactinemia is not treated, prolonged hypogonadism (low estrogen) causes …………

[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]

[f]IGFjY2VsZXJhdGVkIGJvbmUgbG9zcyBleGFjdGx5IGFzIGl0IG9jY3VycyB3aXRoIHBvc3RtZW5vcGF1c2FsIG9zdGVvcGVuaWEvb3N0ZW9wb3Jvc2lzIGFuZCB2YWdpbmFsIGRyeW5lc3Mu[Qq]

[q] In treatment of pituitary adenoma that causes excess growth hormone production, you can use pharmacologic treatment like …………?  and in case of prolactinoma you can use ……….?

[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]

[f]IHNvbWF0b3N0YXRpbiBhbmFsb2dzIChvY3RyZW90aWRlKSwgZG9wYW1pbmUgYWdvbmlzdHMgKGJyb21vY3JpcHRpbmUsIGNhYmVyZ29saW5lKS4=[Qq]

[q] What is the most likely diagnosis?

7 years old child presenting with headaches, bitemporal hemianopia, fatigue, weight loss and hypotension. MRI was done and showed supratentorial mass lesion. Biopsy shows three components: solid (comprised of the actual tumor cells), cystic (filled with “machinery oil” liquid with thick brownish fluid that is rich in cholesterol), and a calcified component?

 

[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]

[f]IENyYW5pb3BoYXJ5bmdpb21hLg==[Qq]

[q] What is the most likely diagnosis?

24 years old pregnant who was in obstructed labor that was complicated with severe postpartum hemorrhage due to uterine atonia presenting with failure of lactation and breast feeding?

[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]

[f]IFNoZWVoYW4mIzgyMTc7cyBTeW5kcm9tZS4=[Qq]

[q] What is the most likely diagnosis?

40 years old patient with old complain since 3 months from headache, erectile dysfunction and galactorrhea is now presenting with acute sever headache, bitemporal hemianopia and ophthalmoplegia. Neuroimaging shows signs of hemorrhage?

[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]

[f]IFBpdHVpdGFyeSBBcG9wbGV4eS4=

Cg==

Cg==[Qq]

[q] A point mutation in neurophysin II could result in abnormal protein folding and removal from the ER, thereby decreasing availability of ………. for neurosecretory release causing ……….?

[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]

[f]IEFESCAodmFzb3ByZXNzaW4pLCBhdXRvc29tYWwgZG9taW5hbnQgaGVyZWRpdGFyeSBoeXBvdGhhbGFtaWMgZGlhYmV0ZXMgaW5zaXBpZHVzLg==

Cg==

Cg==[Qq]

[q] Secretion of ADH is most sensitive to (change in plasma osmolarity or change in volume).

[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]

[f]IGNoYW5nZSBpbiBwbGFzbWEgb3Ntb2xhcml0eS4=[Qq]

[q] Electrolyte disturbance that can cause nephrogenic Diabetes Insipidus are …………. and ………….?

[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]

[f]IEh5cGVyY2FsY2VtaWEgYW5kIGh5cG9rYWxlbWlhLg==[Qq]

[q] Drugs that can cause nephrogenic Diabetes Insipidus are …………. and ………….?

[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]

[f]IGxpdGhpdW0gYW5kIGRlbWVjbG9jeWNsaW5lLg==[Qq]

[q] What is the most likely diagnosis?

24 years old female presenting with excessive urination, polydipsia after feeling compelled to drink excessive amount of water. Blood glucose is normal. Urine osmolarity and sodium are low with low serum sodium. Water deprivation test for 3 hours showed increase in urine osmolarity to 523 mosm?

[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]

[f]IHBzeWNob2dlbmljIHBvbHlkaXBzaWEu

Cg==

Cg==[Qq]

[q] What is the most likely diagnosis?

34 years old patient presenting with excessive urination, polydipsia. Blood glucose is normal. Urine osmolarity and sodium are low with high serum sodium. Water deprivation test for 3 hours showed continued diluted urine. After injection of 5 units of vasopressin —–> increase in urine osmolarity to 523 mosm?

[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]

[f]IENlbnRyYWwgREkgKENESSku

Cg==

Cg==[Qq]

[q] What is the most likely diagnosis?

34 years old patient presenting with excessive urination, polydipsia. Blood glucose is normal. Urine osmolarity and sodium are low with low serum sodium. Water deprivation test for 3 hours showed continued diluted urine. After injection of 5 units of vasopressin —–> minimal increase in urine osmolarity?

[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]

[f]IE5lcGhyb2dlbmljIERJIChOREkpLg==

Cg==

Cg==[Qq]

[q] Central DI is treated with ………..?

[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]

[f]IGxvbmctdGVybSB2YXNvcHJlc3NpbiAoZGVzbW9wcmVzc2luKSB1c2Uu[Qq]

[q] Psychogenic polydipsia is treated with ………..?

[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]

[f]IEZsdWlkIHJlc3RyaWN0aW9uLg==[Qq]

[q] The graph below illustrates hyperosmotic volume contraction. This occurs in the setting of ………?

 

[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]

[f]IGRpYWJldGVzIGluc2lwaWR1cy4=[Qq]

[q] The graph below illustrates dilutional hyponatremia. This occurs in the setting of ………?

[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]

[f]IHBzeWNob2dlbmljIHBvbHlkaXBzaWEgYW5kIFNJQURILg==[Qq]

[q] Drugs that can cause nephrogenic Diabetes Insipidus are …………. and …………., but the drugs that cause SIADH are ………….. and ………..?

[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]

[f]IExpdGhpdW0gYW5kIGRlbWVjbG9jeWNsaW4uIGN5Y2xvcGhvc3BoYW1pZGUsIENhcmJhbWF6ZXBpbmUsIFNTUkku[Qq]

[q] What is the most likely diagnosis?

34 years old patient presenting with irritability, confusion, and low serum sodium (<130mosm) with urine osmolarity is higher than serum osmolarity?

[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]

[f]IFN5bmRyb21lIG9mIGluYXBwcm9wcmlhdGUgYW50aWRpdXJldGljIGhvcm1vbmUgc2VjcmV0aW9uIChTSUFESCku[Qq]

[q] The combination of hyponatremia and a lung mass is suggestive of …………?

[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]

[f]IHRoZSBzeW5kcm9tZSBvZiBpbmFwcHJvcHJpYXRlIGFudGlkaXVyZXRpYyBob3Jtb25lIHNlY3JldGlvbiAoU0lBREgpLg==[Qq]

[q] – In general, increased ADH causes water retention and extracellular fluid volume expansion without edema or hypertension, owing to ………..?

[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]

[f]IG5hdHJpdXJlc2lzLg==

Cg==

Cg==[Qq]

[q] Adrenal cortex is derived from …………., but adrenal medulla is derived from …………?

[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]

[f]IG1lc29kZXJtLCBuZXVyYWwgY3Jlc3Qu[Qq]

[q] The outer zona Glomerulosa → synthesizes …………. which is under the control of ………….?

[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]

[f]IG1pbmVyYWxvY29ydGljb2lkcywgUmVuaW4g4oCTIGFuZ2lvdGVuc2luLg==

Cg==

Cg==[Qq]

[q] The outer zona Fasciculata → synthesizes …………. which is under the control of ………….?

[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]

[f]IGNvcnRpc29sLCBBQ1RILg==

Cg==

Cg==[Qq]

[q] The outer zona Reticularis → synthesizes …………. which is under the control of ………….?

[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]

[f]IEFkcmVuYWwgYW5kcm9nZW4sIEFDVEgu

Cg==

Cg==[Qq]

[q] Excessive secretion of ACTH (primary adrenal insufficiency) causes darkening of the skin due to associated increase of ………?

[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]

[f]IG1lbGFub2N5dGUtc3RpbXVsYXRpbmcgaG9ybW9uZS4=[Qq]

[q] Cortisol has permissive effect on Blood pressure. It ↑ vascular reactivity of blood vessels to norepinephrine and epinephrine by ………….?

[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]

[f]IFVwcmVndWxhdGVzIM6xMS1yZWNlcHRvcnMgb24gYXJ0ZXJpb2xlcy4=

Cg==

Cg==[Qq]

[q] Cortisol cause neutrophilia due to …………?

[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]

[f]IGluaGlidGlvbiBvZiBXQkMmIzgyMTc7cyBhZGhlc2lvbiBhbmQgdHJhbnNtb2dyYXRpb24u[Qq]

[q] The main sensory input that controls secretion of aldosterone is ………… which are are modified smooth muscle cells which surround and directly monitor the pressure in the afferent arteriole.

[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]

[f]IHRoZSBqdXh0YWdsb21lcnVsYXIgY2VsbHMu

Cg==

Cg==[Qq]

[q] Angiotensin converting enzyme (ACE) is found mainly in ……….. and converts angiotensin I into angiotensin II.

[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]

[f]IGVuZG90aGVsaWFsIGNlbGxzIG9mIHB1bG1vbmFyeSB2ZXNzZWxzLg==

Cg==

Cg==[Qq]

[q] ………….. is hypercortisolism regardless of origin, including chronic glucocorticoid therapy.

[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]

[f]IEN1c2hpbmcgc3luZHJvbWUu[Qq]

[q] …………. is hypercortisolism due to an adenoma of the anterior pituitary.

[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]

[f]IEN1c2hpbmcgZGlzZWFzZS4=[Qq]

[q] ………… suppress the hypothalamic-pituitary-adrenal axis –> ↓ ACTH –> Bilateral adrenal atrophy.

[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]

[f]IEV4b2dlbm91cyBjb3J0aWNvc3Rlcm9pZHMu[Qq]

[q]  ……….. cause increase of endogenous corticosteroids –> ↓ ACTH with atrophy of the uninvolved adrenal gland.

[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]

[f]IFByaW1hcnkgYWRyZW5hbCBhZGVub21hLCBoeXBlcnBsYXNpYSwgb3IgY2FyY2lub21hLg==[Qq]

[q] ……… is best initial test for the presence of hypercortisolism.

[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]

[f]IOKGkSBmcmVlIGNvcnRpc29sIG9uIDI0LWhyIHVyaW5hbHlzaXMu

Cg==

[Qq]

[q] ………. is the best initial test to determine the cause (source) or location of hypercortisolism.

[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]

[f]IEFDVEggdGVzdGluZy4=

Cg==

[Qq]

[q] ACTH testing is the best initial test to determine the cause (source) or location of hypercortisolism. If ACTH level is low, this means the origin is in …………..? And if ACTH level high, this means the origin is either in ……….. or ……….?

[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]

[f]IHRoZSBhZHJlbmFsIGdsYW5kLCB0aGUgcGl0dWl0YXJ5IGdsYW5kIG9yIGZyb20gdGhlIGVjdG9waWMgcHJvZHVjdGlvbiBvZiBBQ1RILg==

Cg==

[Qq]

[q] Causes of ACTH dependent Cushing syndrome are ……….. and …………? To differentiate between them, you can use …………?. If high-dose dexamethasone suppresses the ACTH, the origin is ……… and if high-dose dexamethasone does not suppress the ACTH, the origin is ………?

[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]

[f]IHBpdHVpdGFyeSBhZGVub21hIG9yIGVjdG9waWMgcHJvZHVjdGlvbiBvZiBBQ1RIIGZyb20gc21hbGwgY2VsbCBjYXJjaW5vbWEgb2YgdGhlIGx1bmcsIHRoZSBwaXR1aXRhcnksIGVjdG9waWMgcHJvZHVjdGlvbiBvZiBBQ1RILg==

Cg==

[Qq]

[q] What is the most likely diagnosis?

46 years old patient presenting with develop significant hypotension, hyperkalemia, hyperchloremic acidosis, and hyperpigmentation of skin and oral mucosa. The patient also has DM and rheumatoid arthritis. The patient has low A.M cortisol and failure of cortisol to be raised after ACTH stimulation. Random ACTH measurement shows elevated ACTH?

[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]

[f]IFByaW1hcnkgYWRyZW5hbCBpbnN1ZmZpY2llbmN5Lg==

Cg==

Cg==[Qq]

[q] ……….. is the most common cause of primary adrenal insufficiency in developed countries? and ………. is the most common cause of primary adrenal insufficiency in developing countries.

[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]

[f]IEF1dG9pbW11bmUgYWRyZW5hbGl0aXMsIFR1YmVyY3Vsb3Npcy4=[Qq]

[q] What is the most likely diagnosis?

In case of adrenal insufficiency but the am or random cortisol result are inconclusive. The result of metyrapone stimulation test: Low ACTH and low 11 deoxycortisol?

[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]

[f]IFNlY29uZGFyeSBhZHJlbmFsIGluc3VmZmljaWVuY3ku

Cg==

Cg==[Qq]

[q] When pharmacological doses of glucocorticoid therapy are used for more than three weeks duration, treatment cessation should be gradual (steroid taper) to prevent development of ……….?

[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]

[f]IFRlcnRpYXJ5IGFkcmVuYWwgaW5zdWZmaWNpZW5jeS4=[Qq]

[q] Type 1 diabetes mellitus (due to autoimmune destruction of pancreatic B-cells) increases the risk of developing ……….?

[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]

[f]IG90aGVyIGF1dG9pbW11bmUgZGlzb3JkZXJzIHN1Y2ggYXMgSGFzaGltb3RvIHRoeXJvaWRpdGlzIGFuZCBhdXRvaW1tdW5lIGFkcmVuYWxpdGlzLg==[Qq]

[q] Meningococcal septicemia can cause adrenal hemorrhage leading to ……….?

[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]

[f]IGFjdXRlIGFkcmVuYWwgY3Jpc2lzIChXYXRlcmhvdXNlLUZyaWRlcmljaHNlbiBzeW5kcm9tZSku

Cg==

Cg==[Qq]

[q] What is the most likely diagnosis?

30 years old female with history of preexisting primary adrenal insufficiency presenting with fever, nausea, vomiting, profound hypotension, confusion, and coma after being admitted in ICU due to pneumonia?

[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]

[f]IEFkcmVuYWwgY3Jpc2lzLg==

Cg==

Cg==[Qq]

[q] Treatment with …………. is more important than testing in acute adrenal crisis.

[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]

[f]IGh5ZHJvY29ydGlzb25lIG9yIGRleGFtZXRoYXNvbmUu

Cg==

Cg==[Qq]

[q] Although aldosterone causes increased renal reabsorption of sodium, most patients do not have edema or clinically significant hypernatremia due to ………..?

[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]

[f]IGFsZG9zdGVyb25lIGVzY2FwZSBwaGVub21lbm9uLg==

Cg==

Cg==[Qq]

[q] What is the most likely diagnosis?

45 years old patient presenting with hypertension, hypokalemia, metabolic alkalosis, and muscular weakness or paresthesias with suppressed plasma renin?

[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]

[f]IFByaW1hcnkgaHlwZXJhbGRvc3Rlcm9uaXNtIChDb25u4oCZcyBzeW5kcm9tZSku

Cg==

Cg==[Qq]

[q] Symptoms of hyperaldosteronism + ↓ renin —> ……….?

[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]

[f]IHByaW1hcnkgaHlwZXJhbGRvc3Rlcm9uaXNtIChDb25uJiM4MjE3O3Mgc3luZHJvbWUpLg==[Qq]

[q] Symptoms of hyperaldosteronism + ↑ renin —-> ………..?

[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]

[f]IHNlY29uZGFyeSBoeXBlcmFsZG9zdGVyb25pc20u[Qq]

[q] What is the most likely diagnosis?

2 weeks old female child presenting with ambiguous genitalia with clitoromegaly, vomiting, hypotension, hyponatremia, and hyperkalemia, with increased renin activity and hypoglycemia. The child has high serum level of 17-hydroxyprogesterone?

[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]

[f]IDIxLWh5ZHJveHlsYXNlIGRlZmljaWVuY3ku

Cg==

Cg==[Qq]

[q] What is the most likely diagnosis?

2 weeks old female child presenting with ambiguous genitalia with clitoromegaly, low-renin hypertension, hypokalemia and hypoglycemia?

[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]

[f]IDExIM6yLWh5ZHJveHlsYXNlIGRlZmljaWVuY3ku

Cg==

Cg==[Qq]

[q] ……….. is a tumor of the chromaffin tissue of the adrenal medulla (arise from neural crest) that causes increased production of catecholamines (norepinephrine, epinephrine and dopamine).

[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]

[f]IFBoZW9jaHJvbW9jeXRvbWEu

Cg==

Cg==[Qq]

[q]………… are extraradrenal pheochromocytomas of sympathetic ganglia located primarily within the abdomen and that secrete norepinephrine.

[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]

[f]IFBhcmFnYW5nbGlvbWFzLg==[Qq]

[q] What is the most likely diagnosis?

36 years old patient presenting with episodic hypertension, headache, diaphoresis, and palpitations with ↑ catecholamines and metanephrines (homovanillic acid, vanillylmandelic acid) in urine and plasma?

[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]

[f]IFBoZW9jaHJvbW9jeXRvbWEu

Cg==

Cg==[Qq]

[q] What is the most likely diagnosis?

3 years old child presenting with is abdominal distension and a firm, irregular mass that cross the midline with increased Homovanilic acid and vanillylmandelic acid in urine. Biopsy shows Homer-Wright rosettes is characteristic (neuroblasts surrounding a central lumen) and Bombesin and neuron-specific enolase positive?

[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]

[f]IE5ldXJvYmxhc3RvbWEu

Cg==

Cg==[Qq]

[q] The normal thyroid gland takes up iodine against a concentration gradient using a sodium iodine symporter (NIS) in an energy-dependent process, called ……….?

[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]

[f]IGlvZGluZSB0cmFwcGluZy4=

Cg==

Jm5ic3A7

Cg==

[Qq]

[q] After dietary, inorganic iodine enters the thyroid follicular cells, it is oxidized to organic iodide by the enzyme ………?

[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]

[f]IHRoeXJvaWQgcGVyb3hpZGFzZS4=

Cg==

Cg==[Qq]

[q] ………… is responsible for the oxidation of inorganic iodine, the formation of mono and diiodotyrosine (organification), and the coupling that forms T3 and T4?

[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]

[f]IFRoeXJvaWQgcGVyb3hpZGFzZS4=

Cg==

Cg==[Qq]

[q] More than 99% of circulating thyroid hormones are bound to plasma proteins. The main protein responsible for binding circulating thyroid hormone is ………….?

[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]

[f]IHRoeXJvaWQgYmluZGluZyBnbG9idWxpbiAoVEJHKS4=

Cg==

Cg==[Qq]

[q] TBG ↓ in ……….. and ………….. and ↑ TBG in …………..and …………?

[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]

[f]IGhlcGF0aWMgZmFpbHVyZSBhbmQgbmVwaHJvdGljIHN5bmRyb21lIGR1ZSB0byBkZWNyZWFzZSBvZiBnbG9idWxpbiBzeW50aGVzaXMgYnkgdGhlIGxpdmVyIG9yIGxvc3Mgb2YgcGxhc21hIHByb3RlaW5zIGluIG5lcGhyb3RpYyBzeW5kcm9tZSwgcHJlZ25hbmN5IG9yIE9DUCB1c2UgKGVzdHJvZ2VuIOKGkSBUQkcpLg==[Qq]

[q] Most patients with hypothyroidism after starting oral estrogen (estrogen replacement therapy or oral contraceptives) require ……………?

[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]

[f]IGhpZ2hlciBkb3Npbmcgb2YgbGV2b3RoeXJveGluZSBtYXkgYmUgcmVxdWlyZWQu

Cg==

Cg==[Qq]

[q] ………… is the thyroid hormone that is produced in the greatest quantity by the thyroid gland?

[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]

[f]IFQ0Lg==

Cg==

Cg==[Qq]

[q]  ………… is the most active thyroid hormone form because it binds with 10 times more affinity to thyroid receptors?

[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]

[f]IFQzLg==

Cg==

Cg==[Qq]

[q] ……….. is an inactive form of thyroid hormone?

[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]

[f]IFJldmVyc2UgVDMgKHJUMyku

Cg==

Cg==[Qq]

[q] In patient who is taking T3 as a thyroid replacement, what is the effect of this on the following: TSH, T4, rT3?

[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]

[f]IEFsbCBvZiB0aGVtIGRlY3JlYXNlLg==

Cg==

Cg==[Qq]

[q] Cold intolerance, decrease of sweating, weight gain, Dry, cool skin, brittle hair, diffuse alopecia, brittle nails, puffy facies, Constipation, fatigue, weakness, depressed mood, and decrease of deep tendon reflexes reflexes are characteristic for (Hyperthyroidism or Hypothyroidism)?

 [c]IFNob3cgbWUgdG hlIGFuc3dlcg==

Cg==[Qq]

[f]IEh5cG90aHlyb2lkaXNtLg==

Cg==

Cg==[Qq]

[q] Heat intolerance, increase of sweating, weight loss, Warm, moist skin, fine hair, diarrhea, restlessness, anxiety, insomnia,
fine tremors, Tachycardia, and palpitations are characteristic for (Hyperthyroidism or Hypothyroidism)?

[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]

[f]IEh5cGVydGh5cm9pZGlzbS4=

Cg==

Cg==[Qq]

[q] ……….. level is the single most important screening test in diagnosing thyroid disorders.

[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]

[f]IFNlcnVtIFRTSC4=[Qq]

[q] ……………. is the most common supraventricular arrhythmia and is a frequent complication of thyrotoxicosis?

[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]

[f]IEF0cmlhbCBmaWJyaWxsYXRpb24u

Cg==

Cg==[Qq]

[q] ………. should be excluded with measurement of thyroid-stimulating hormone levels in patients with unexplained CK elevation.

[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]

[f]IEh5cG90aHlyb2lkaXNtLg==[Qq]

[q] ………………. should be excluded in patients with unexplained hypercholesterolemia and unexplained menorrhagia.

[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]

[f]IEh5cG90aHlyb2lkaXNtLg==[Qq]

[q] ………….. by definition is the clinical syndrome whereby tissues are exposed to high levels of thyroid hormone (hyperthyroidism).

[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]

[f]IFRoeXJvdG94aWNvc2lzLg==[Qq]

[q] …………….. is simply an enlarged thyroid and does not designate functional status. A generalized enlargement of the thyroid is considered a …………..?. An irregular or lumpy enlargement of the thyroid is considered a …………?

[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]

[f]IEdvaXRlciwgZGlmZnVzZSBnb2l0ZXIsIG5vZHVsYXIgZ29pdGVyLg==[Qq]

[q] In the United States, the most common etiology of hypothyroidism in areas where iodine is sufficient is ……………., an autoimmune process that destroys the cells of the thyroid and affects women more than men?

[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]

[f]IEhhc2hpbW90byYjODIxNztzIHRoeXJvaWRpdGlzLg==[Qq]

[q] What is the most likely diagnosis?

40 years old female patient presenting with Cold intolerance, decrease of sweating, weight gain although decrease of appetite Constipation, fatigue, weakness, depressed mood, and decrease of deep tendon reflexes + high TSH, elevated antithyroid peroxidase (antimicrosomal) antibody, and antithyroglobulin antibodies + Biopsy shows intense mononuclear infiltration consisting of lymphocytes and plasma cells with several germinal centers, follicular epithelial cells undergo a metaplastic change, leading to the formation of large, oxyphilic cells with granular cytoplasm?

[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]

[f]IEhhc2hpbW90byYjODIxNztzIHRoeXJvaWRpdGlzLg==[Qq]

[q] What is the most likely diagnosis?

34 years old female presenting with fever, ↑ ESR, neck and jaw pain, and a tender goiter following flue-like symptoms + Histology shows Mixed, cellular infiltration with occasional multinucleate giant cells?

[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]

[f]IFN1YmFjdXRlIHRoeXJvaWRpdGlzIChkZSBRdWVydmFpbiYjODIxNztzIHRoeXJvaWRpdGlzKS4=[Qq]

[q] What is the most likely diagnosis?

36 years old female presenting with fixed, hard (rock-like), painless goiter, dyspnea and dysphagia + Thyroid Histology shows excessive fibrosis of stroma and inflammation of follicular cells?

[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]

[f]IFJpZWRlbCB0aHlyb2lkaXRpcy4=[Qq]

[q] What is the most likely diagnosis?

3 weeks child presenting with hypotonia, Pale, Puffy-faced child with Protruding umbilicus, Protuberant tongue?

[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]

[f]IENvbmdlbml0YWwgSHlwb3RoeXJvaWRpc20gKGNyZXRpbmlzbSku[Qq]

[q] The most common cause of Congenital Hypothyroidism is …………….?

[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]

[f]IHRoeXJvaWQgZHlzZ2VuZXNpcyAoVGhlIG1vc3QgY29tbW9uIGNhdXNlOyBhcGxhc2lhLCBoeXBvcGxhc2lhLCBvciBlY3RvcGljIGdsYW5kKSwgd2hpY2ggaGFzIGJlZW4gaW5jcmltaW5hdGVkIGluIDg1JSBvZiBjYXNlcy4=[Qq]

[q]  ………… is characterized by symptoms of hyopthyroidism with ↓ TSH and ↓ Free T4.

[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]

[f]IFNlY29uZGFyeSBoeXBvdGh5cm9pZGlzbSAoaHlwb3BpdHVpdGFyaXNtKS4=[Qq]

[q] ……….. explains why excessive iodine intake temporarily inhibits thyroid peroxidase –> ↓ iodine organifcation —> ↓ T3/T4 production.

[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]

[f]IFdvbGZmLUNoYWlrb2ZmIGVmZmVjdC4=[Qq]

[q] …………… is an autoimmune problem in which autoantibody (IgG) is directed against the thyroid receptor.

[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]

[f]IEdyYXZl4oCZcyBkaXNlYXNlICh0b3hpYyBkaWZmdXNlIGdvaXRlciku[Qq]

[q] Cytokines released by activated T-cells increase fibroblast proliferation and secretion of ………., resulting in mucinous edema and tissue expansion.

[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]

[f]IGdseWNvc2FtaW5vZ2x5Y2Fucy4=

Cg==

Cg==[Qq]

[q] What is the most likely diagnosis?

42 years old female presenting with Heat intolerance, increase of sweating, weight loss, Warm, moist skin, fine hair, diarrhea, restlessness, anxiety, insomnia, fine tremors, Tachycardia,  palpitations, exophthalmos and pretibial myxedema with induration and thickening of the skin over the shins + Radioactive iodine shows diffuse iodine uptake + Thyroid histology shows tall, crowded follicular epithelial cells; scalloped colloid?

[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]

[f]IEdyYXZlJiM4MjE3O3MgZGlzZWFzZS4=[Qq]

[q] …………… is Focal patches of hyperfunctioning follicular cells distended with colloid working independently of TSH due to mutation in TSH receptor. Radioactive uptake shows nodular uptake.

[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]

[f]IFRveGljIG11bHRpbm9kdWxhciBnb2l0ZXIu[Qq]

[q] …………… is an acute, life-threatening, hypermetabolic state induced by excessive release of thyroid hormones. Presents with fever, agitation, delirium, diarrhea, coma, and tachyarrhythmia (cause of death). May see increased ALP due to ↑ bone turnover.

[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]

[f]IFRoeXJvaWQgc3Rvcm0sIGFsc28gcmVmZXJyZWQgdG8gYXMgdGh5cm90b3hpYyBjcmlzaXMu[Qq]

[q] ………….. is iodine-induced hyperthyroidism in iodine-deficient areas.

[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]

[f]IEpvZC1CYXNlZG93IHBoZW5vbWVub24u[Qq]

[q] The most important difference between follicular adenoma and follicular carcinoma is ……………..?

[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]

[f]IGFic2VuY2Ugb2YgY2Fwc3VsYXIgb3IgdmFzY3VsYXIgaW52YXNpb24gKHVubGlrZSBmb2xsaWN1bGFyIGNhcmNpbm9tYSku

Cg==

Cg==[Qq]

[q] Transection of ……….. during ligation of inferior thyroid artery leads to dysphagia and dysphonia [hoarseness].

[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]

[f]IHJlY3VycmVudCBsYXJ5bmdlYWwgbmVydmUu[Qq]

[q] Injury to the …………. during ligation of superior thyroid vascular pedicle may lead to loss of tenor usually noticeable in professional voice users.

[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]

[f]IGV4dGVybmFsIGJyYW5jaCBvZiB0aGUgc3VwZXJpb3IgbGFyeW5nZWFsIG5lcnZlLg==[Qq]

[q] The most common type of thyroid cancer is ……….?

[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]

[f]IFBhcGlsbGFyeSBjYXJjaW5vbWEu[Qq]

[q] ……………. is a type of thyroid cancer that is characterized by large cells with overlapping nuclei containing finely dispersed chromatin giving them an empty or ground-glass appearance, Numerous intranuclear inclusions and grooves, Concentrically calcified structures (psammoma bodies).

[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]

[f]IFBhcGlsbGFyeSBUaHlyb2lkIGNhcmNpbm9tYS4=[Qq]

[q] ………… is the second most common thyroid cancer. Spreads hematogenously (unlike carcinoma) with distant metastasis to the lung and bone. Histologically may be well-differentiated, simulating normal thyroid morphology with capsular and vascular invasion.

[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]

[f]IEZvbGxpY3VsYXIgdGh5cm9pZCBjYW5jZXIgKEZUQyku[Qq]

[q] Activating mutations of the ………. are strongly associated with medullary thyroid cancer.

[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]

[f]IFJFVCBwcm90by1vbmNvZ2VuZS4=[Qq]

[q] ……….. is the type of thyroid cancer that is histologically characterized by uniform polygonal or spindle-shaped cells with extracellular amyloid deposits derived from secreted calcitonin. Amyloid stains with Congo red.

[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]

[f]IE1lZHVsbGFyeSB0aHlyb2lkIGNhcmNpbm9tYS4=[Qq]

[q] ………… is a type of thyroid cancer that doesn’t resemble thyroid tissue and consists of large pleomorphic cells and large multinucleated osteoclast-like cells.

[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]

[f]IFVuZGlmZmVyZW50aWF0ZWQvYW5hcGxhc3RpYyBjYXJjaW5vbWEu[Qq]

[q] ↑ H in acidosis will (increase or decrease) bound form of Ca

(increase or decrease) free Ca.

[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]

[f]IGRlY3JlYXNlLCBpbmNyZWFzZS4=

Cg==

Cg==[Qq]

[q] ↓ H in acidosis will (increase or decrease) bound form of Ca
(increase or decrease) free Ca.

[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]

[f]IGluY3JlYXNlLCBkZWNyZWFzZS4=

Cg==

Jm5ic3A7

Cg==

[Qq]

[q] ………….. ↑ bone resorption with release of Ca and PO4, ↑ kidney reabsorption of Ca in distal convoluted tubule, and ↓ reabsorption of PO4 in proximal convoluted tubule.

[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]

[f]IFBhcmF0aHlyb2lkIGhvcm1vbmUu

Cg==

Cg==[Qq]

[q] PTH (increase or decrease) serum Ca, (increase or decrease) serum (PO4), (increase or decrease) urine (PO4), (increase or decrease) urine cAMP (second messenger for PTH in the kidney).

[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]

[f]IEluY3JlYXNlLCBkZWNyZWFzZSwgaW5jcmVhc2UsIGluY3JlYXNlLg==[Qq]

[q] ↓ serum Ca, ↑ serum PO4, ↓ vitamin D are important physiologic signal regulating release of ……..?

[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]

[f]IFBUSC4=

Cg==

Cg==[Qq]

[q] Common causes of ↓ Mg include ………..?

[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]

[f]IGRpYXJyaGVhLCBkaXVyZXRpY3MsIGFtaW5vZ2x5Y29zaWRlcywgYWxjb2hvbCBhYnVzZSAoMkQsIDJBKS4=[Qq]

[q] High level of PTH stimulates osteoblast to secrete ………. which increases the differentiation of osteoclast precursors to osteoclast.

[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]

[f]IFJBTksgTC4=

Cg==

Cg==[Qq]

[q] ……….. reduces bone resorption by binding to RANK L preventing it from binding to its receptors –> ↓ osteoclast and bone resorption.

[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]

[f]IE9zdGVvcHJvZ2V0cmluIChPUEcpLg==

Cg==

Cg==[Qq]

[q] ………… is a peptide hormone secreted by the parafollicular cells (C cells) of the thyroid gland and lowers plasma calcium by decreasing the activity of osteoclasts, thus decreasing bone resorption.

[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]

[f]IENhbGNpdG9uaW4u[Qq]

[q] ……….. acts to raise plasma Ca and phosphate by ↑ absorption of dietary Ca and PO4 and ↑ bone resorption with release of Ca and PO4.

[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]

[f]IHZpdGFtaW4gRC4=

Cg==

Cg==[Qq]

[q] Primary hyperparathyroidism is caused by ………………?

[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]

[f]IGEgcGFyYXRoeXJvaWQgYWRlbm9tYSBpbiA4MC04NSUgb2YgcGF0aWVudHMgYW5kIGJ5IHBhcmF0aHlyb2lkIGh5cGVycGxhc2lhIGluIHRoZSByZW1haW5pbmcgMTAtMTUlLg==[Qq]

[q] What is the most likely diagnosis?

36 Years old patient presenting with muscle weakness, constipation, polyuria, polydipsia, and depression + lab values shows high parathyroid, high calcium, low phosphorus, high alkaline phosphatase, and high urine CAMP?

[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]

[f]IFByaW1hcnkgaHlwZXJwYXJhdGh5cm9pZGlzbS4=[Qq]

[q] Subperiosteal thinning with cystic degeneration is a characteristic feature of ……….?

[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]

[f]IFByaW1hcnkgaHlwZXJwYXJhdGh5cm9pZGlzbS4=

Cg==

Cg==[Qq]

[q] Cystic bone spaces filled with brown fibrous tissue is a characteristic feature of ……….?

[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]

[f]IFByaW1hcnkgaHlwZXJwYXJhdGh5cm9pZGlzbS4=

Cg==

IA==

[Qq]

[q] What is the most likely diagnosis?

45 years old patient with history of chronic kidney disease presenting with bone pain + Lab values shows high parathyroid, low calcium, high phosphorus, and low vitamin D?

[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]

[f]IFNlY29uZGFyeSBoeXBlcnBhcmF0aHlyb2lkaXNtLg==

Cg==

Cg==[Qq]

[q] What is the most likely diagnosis?

45 years old patient with history of hypertension on diuretics presenting with hypercalcemia and low parathyroid hormone?

[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]

[f]IE1lZGljYXRpb24gc2lkZSBlZmZlY3QgKEh5ZHJvY2hsb3JvdGhpYXppZGUpLg==[Qq]

[q] What is the most likely diagnosis?

35 years old patient presenting with mild hypercalcemia at the same time with hypocalciuria with family history of the same condition?

[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]

[f]IEZhbWlsaWFsIGh5cG9jYWxjaXVyaWMgaHlwZXJjYWxjZW1pYSAoRkhIKSBkdWUgdG8gZGVmZWN0aXZlIEctY291cGxlZCBDYSBzZW5zaW5nIHJlY2VwdG9yIG9uIHBhcmF0aHlyb2lkIGNlbGxzIGFuZCBraWRuZXkgdGlzc3VlLg==[Qq]

[q] What is the most likely diagnosis?

38 years old patient with long history of calcium carbonate intake for treatment of osteoporosis presenting with hypercalcemia, metabolic alkalosis and acute kidney failure?

[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]

[f]IE1pbGstYWxrYWxpIHN5bmRyb21lIChNQVMpLg==[Qq]

[q] What is the most likely diagnosis?

39 years old female presenting with muscular spasms and tetany after undergoing thyroidectomy for treatment of thyroid cancer + tapping of facial nerve (tap the Cheek) → contraction of facial muscles?

[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]

[f]IHByaW1hcnkgaHlwb3BhcmF0aHlyb2lkaXNtLg==[Qq]

[q] ……….. is very common in hospitalized alcoholics and can cause hypocalcemia by inducing resistance to parathyroid hormone (PTH) as well as by decreasing PTH secretion

[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]

[f]IEh5cG9tYWduZXNlbWlhLg==[Qq]

[q] What is the most likely diagnosis?

8 years old child presenting with shortened 4th/5th digits, short stature, round face, subcutaneous calcifications + lab values shows low calcium, high phosphorus although high level of parathyroid?

[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]

[f]IFBzZXVkb2h5cG9wYXJhdGh5cm9pZGlzbSB0eXBlIDFBLg==[Qq]

[q] What is the most likely diagnosis?

8 years old child presenting with shortened 4th/5th digits, short stature, round face, subcutaneous calcifications + lab values shows normal calcium, normal phosphorus normal level of parathyroid?

[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]

[f]IFBzZXVkb3BzZXVkb2h5cG9wYXJhdGh5cm9pZGlzbS4=[Qq]

[q] ………. constitute about 20% of the islet cells and secrete glucagon and tend to be located near the periphery of the islet.

[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]

[f]IEFscGhhIGNlbGxzLg==

Cg==

Cg==[Qq]

[q] ………….. constitute 60-75% of the islet cells and tend to be located near the center of the islet. It synthesize preproinsulin, which is cleaved to form proinsulin, which, in turn, splits into insulin and C peptide both of which are secreted in equimolar quantities.

[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]

[f]IEJldGEgY2VsbHMu

Cg==

Cg==[Qq]

[q] ……………….. constitute about 5% of the islet cells, are interspersed between the alpha and beta cells and secrete somatostatin.

[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]

[f]IERlbHRhIGNlbGxzLg==

Cg==

Cg==[Qq]

[q]The K-lowering action of insulin is used to treat acute, life-threatening hyperkalemia because insulin increases the activity of ………….. in most body tissues?

[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]

[f]IE5hL0stQVRQYXNlLg==[Qq]

[q] Transport of glucose across the cell membrane facilitated by transmembrane proteins without the expenditure of energy is called ………………….?

[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]

[f]IGZhY2lsaXRhdGVkIGRpZmZ1c2lvbiAoY2Fycmllci1tZWRpYXRlZCB0cmFuc3BvcnQpLg==[Qq]

[q] ………… is the insulin-sensitive transporter found in skeletal muscle cells and adipocytes?

[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]

[f]IEdMVVQ0Lg==[Qq]

[q] The most important controller of insulin secretion is ……..?

[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]

[f]IHBsYXNtYSBnbHVjb3NlLg==

Cg==

Cg==[Qq]

[q] For glucose to promote insulin secretion, it must not only enter the β-cell but also be metabolized, so as to increase intracellular ……….. concentration. This causes the ATP-gated potassium channels in the cellular membrane to …………..?. The ensuing rise in positive charge inside the cell, due to the increased concentration of potassium ions, leads to ……. of the cell. The net effect is the activation of ………………, which transport calcium ions into the cell.

[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]

[f]IEFUUCwgY2xvc2UgdXAsIGRlcG9sYXJpemF0aW9uLCB2b2x0YWdlLWdhdGVkIGNhbGNpdW0gY2hhbm5lbHMu

Cg==

Cg==[Qq]

[q] Oral glucose leads to an increase in insulin secretion more than when glucose in administered intravenously, this is due to ………….?

[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]

[f]IEdsdWNhZ29uIGxpa2UgUGVwdGlkZS0xIChHTFAtMSkgYW5kIGdhc3RyaWMgaW5oaWJpdG9yeSBwZXB0aWRlIChhbHNvIGtub3duIGFzIGdsdWNvc2UgZGVwZW5kZW50IGluc3VsaW5vdHJvcGljIHBvbHlwZXB0aWRlIG9yIEdJUCkuIEJvdGggb2YgdGhlbSBhcmUgY2FsbGVkIGluY3JldGlucy4=

Cg==

Cg==[Qq]

[q] …………….. stimulate a decrease in blood glucose level by causing an increase in the amount of insulin released from pancreatic beta cells after eating, before blood glucose level become elevated. They also inhibit the release of glucagon from alpha cells, delay gastric emptying, and decrease appetite.

[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]

[f]IGluY3JldGlucy4=

Cg==

Cg==[Qq]

[q] Glucagon (stimulates or inhibits) insulin release.

[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]

[f]IHN0aW11bGF0ZXMu[Qq]

[q] Insulin (stimulates or inhibits) Glucagon release.

[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]

[f]IGluaGliaXRzLg==[Qq]

[q] Somatostatin (stimulates or inhibits) insulin release.

[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]

[f]IGluaGliaXRzLg==[Qq]

[q] Parasympathetic stimulation of muscarinic M3 receptors (stimulates or inhibits) insulin secretion and is induced by the smell and/or sight of food.

[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]

[f]IHN0aW11bGF0ZXMu[Qq]

[q] Stimulation of beta-2 receptors (stimulates or inhibits)

insulin secretion while stimulation of alpha-2 receptors (stimulates or inhibits) insulin release. However, ………..  is predominant, causing sympathetic stimulation to lead to overall (stimulates or inhibits) of insulin secretion.

[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]

[f]IHN0aW11bGF0ZXMsIGluaGliaXRzLCB0aGUgYWxwaGEtMi1tZWRpYXRlZCBpbmhpYml0b3J5IGVmZmVjdCwgaW5oaWJ0aW9uLg==[Qq]

[q] ………. is made by α cells of pancreas and elevates blood sugar levels to maintain homeostasis when bloodstream glucose levels fall too low (fasting state).

[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]

[f]IEdsdWNhZ29uLg==[Qq]

[q] The primary target for glucagon action is ……….?

[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]

[f]IHRoZSBsaXZlciBoZXBhdG9jeXRlLg==[Qq]

[q] ………. accounts for 5-10% of diabetes worldwide. The age of onset is usually age <30 (Onset in childhood). There is an increased prevalence of autoantibodies to islet cells. Not related to obesity. Patients usually have a lean body build and are prone to ketosis owing to absent insulin production.

[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]

[f]IFR5cGUgMSBETSAoaW5zdWxpbi1kZXBlbmRlbnQgb3IganV2ZW5pbGUgb25zZXQpLg==[Qq]

[q] ………….. is the most common type of diabetes, accounting for 90% of cases. Age of onset is usually ˃ 40 (Onset in adulthood). Directly related to obesity. Defined as insulin resistance.

[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]

[f]IFR5cGUgMiBETSAobm9uLWluc3VsaW4tZGVwZW5kZW50IG9yIG1hdHVyaXR5IG9uc2V0KS4=[Qq]

[q] In the United States, fasting blood sugar is the most preferred way to screen patients for diabetes mellitus. Two fasting blood glucose measurements ≥ ………. after Fasting for > 8 hours.

[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]

[f]IDEyNiBtZy9kTC4=[Qq]

[q] Hemoglobin A1c ≥ …….. is a diagnostic criterion and is the best test to follow response to therapy over the last several months. HbA1c levels are affected by alterations in red blood cell survival; conditions that ………. can cause falsely low HbA1c levels.

[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]

[f]IDYuNSUsIGluY3JlYXNlIHJlZCBibG9vZCBjZWxsIHR1cm5vdmVyIChoZW1vbHl0aWMgYW5lbWlhKS4=[Qq]

[q] ………. play a causative role in beta cell apoptosis and defective insulin secretion in patients with type 1 DM.

[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]

[f]IElzbGV0IGxldWtvY3l0aWMgaW5maWx0cmF0ZS4=

Cg==

Cg==[Qq]

[q] ………. play a causative role in beta cell apoptosis and defective insulin secretion in patients with type 2 DM.

[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]

[f]IElzbGV0IGFteWxvaWQgcG9seXBlcHRpZGUgKElBUFApIGRlcG9zaXRzLg==

Cg==

Jm5ic3A7

Cg==

[Qq]

[q] Measuring of the waist-to-hip ratio (WHR) indirectly measures the visceral fat to subcutaneous fat as the abdomen contains mainly viscera and hips have only subcutaneous fat. A high waist hip ratio is associated with ………..?

[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]

[f]IG1ldGFib2xpYyBzeW5kcm9tZSwgaW5zdWxpbiByZXNpc3RhbmNlLCBhbmQgdHlwZSAyIGRpYWJldGVzIG1lbGxpdHVzLg==[Qq]

[q] ………… is a known mechanism of insulin resistance induced by TNF-alpha, glucagon, and glucocorticoids because it interferes with down-stream signaling.

[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]

[f]IFNlcmluZSBwaG9zcGhvcnlsYXRpb24u

Cg==

Cg==[Qq]

[q] Non-enzymatic glycosylation (NEG) of large- and medium-sized vessels leads to atherosclerosis and its resultant complications. ……….. is the leading cause of death among diabetics.

[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]

[f]IENvcm9uYXJ5IGFydGVyeSBkaXNlYXNlcy4=[Qq]

[q] PoIyoI pathway impairment cause accumulation of sorbitol and fructose leading to ………. of Schwan cells and lens.

[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]

[f]IG9zbW90aWMgY2VsbHVsYXIgaW5qdXJ5Lg==[Qq]

[q] ……….. is the most common cause of adult kidney failure in the developed world.

[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]

[f]IERpYWJldGVzIG1lbGxpdHVzLg==[Qq]

[q] ………. presents with symptoms of anorexia, nausea, vomiting, early satiety, postprandial fullness, and impaired glycemic control. Hypoglycemic episodes can occur with insulin administration prior to meals.

[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]

[f]IERpYWJldGljIGdhc3Ryb3BhcmVzaXMgKGRlbGF5ZWQgZ2FzdHJpYyBlbXB0eWluZyku[Qq]

[q] What is the most likely diagnosis?

35 years old female with history of type 1 DM presenting with nausea and vomiting, severe abdominal pain, dry mucous membranes and lethargy, polyuria, fruity odor on her breath, and deep and rapid breath + Lab values shows hyperglycemia, high anion gap metabolic acidosis, and hyperkalemia?

[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]

[f]IERpYWJldGljIEtldG9hY2lkb3Npcy4=

Cg==

Cg==[Qq]

[q] The main 2 causes of paradoxical hyperkalemia in patients with diabetic acidosis are ……………… and ………….?

[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]

[f]

Cg==

byBFeHRyYWNlbGx1bGFyIHNoaWZ0IG9mIHBvdGFzc2l1bSBpbiBleGNoYW5nZSB0byBoeWRyb2dlbiBpb24sIHdpdGggcmVzdWx0YW50IGludHJhY2VsbHVsYXIgcG90YXNzaXVtIGRlZmljaXQu

Cg==

[Qq]

o Impaired insulin-dependent cell entry of the potassium ion.

[q] Hyperkalemia in diabetic ketoacidosis is sometimes called paradoxical because ………………….?

[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]

[f]IHRoZSBib2R5IHBvdGFzc2l1bSByZXNlcnZlcyBhcmUgYWN0dWFsbHkgZGVwbGV0ZWQgZHVlIHRvIGluY3JlYXNlZCBnYXN0cm9pbnRlc3RpbmFsIGxvc3NlcyBhbmQgb3Ntb3RpYyBkaXVyZXNpcy4=[Qq]

[q] ………….. is characterized by severe hyperglycemia (frequently >1000 mg/dL) and increased serum osmolality (>320 mOsm/kg). There is little or no ketonemia or acidosis present, and most patients have pH >7.3 and serum bicarbonate >20 mEq/L. It frequently develop neurologic symptoms (focal signs, lethargy, blurry vision, and obtundation) due to severe hyperglycemia and elevated serum osmolality.

[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]

[f]IEh5cGVyb3Ntb2xhciBoeXBlcmdseWNlbWljIHN0YXRlIChISFMpLg==

Cg==

Cg==[Qq]

[q] There are two important causes of hypoglycemia in non-diabetic patients with elevated insulin level:
1. Insulinoma (beta cell tumor).
2. Surreptitious use of insulin or sulfonylurea.

How to differentiate between them?

[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]

[f]IEFmdGVyIG1lYXN1cmluZyBDLXBlcHRpZGU6

Cg==

JiM4MjExOyBJZiB0aGVyZSBpcyBsb3cgQy1wZXB0aWRlIHRoaXMgbWVhbnMgaXQmIzgyMTc7cyBkdWUgdG8gaGlnaCBleG9nZW5vdXMgaW5zdWxpbi4=

Cg==

[Qq]

– If there is high C-peptide ask for urine drug assay, if it’s positive —-> it’s due to sulfonylurea, if negative —> sulfonylurea.

[q] If IV access cannot be established in a patient with hypoglycemia, the patient can be given ………?

[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]

[f]IGludHJhbXVzY3VsYXIgZ2x1Y2Fnb24gaW5qZWN0aW9uLg==[Qq]

[q] Infants of diabetic mothers at risk of macrosomia due to …………?. They also at risk of transient hypoglycemia that persist for several days after delivery due to ………….?

[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]

[f]IGJldGEgY2VsbCBoeXBlcnBsYXNpYSwgdHJhbnNpZW50IGh5cGVyaW5zdWxpbmVtaWMgc3RhdGUu[Qq]

[q] What is the most likely diagnosis?

36 years old patient presenting with confusion, disorientation, headache that resolves after drinking juice + the patient has high insulin, C-peptide and negative urine dug assay?

[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]

[f]IEluc3VsaW5vbWEu[Qq]

[q] What is the most likely diagnosis?

30 years old patient presenting with diarrhea, recurrent multiple duodenal ulcers that extend to jejunum and resistant to treatment + Gastrin levels remain elevated after administration of secretin?

[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]

[f]IFpvbGxpbmdlci1FbGxpc29uIHN5bmRyb21lIChnYXN0cmlub21hKS4=[Qq]

[q] Workup of all patients with newly diagnosed gastrinoma or inslinoma should include measurement of serum calcium, PTH, and pituitary hormones, because of the association with …….?

[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]

[f]IE1FTi1JLg==

Cg==

Cg==[Qq]

[q] What is the most likely diagnosis?

29 years old patient presenting with hyperglycemia + elevated painful and pruritic rash typically affecting the face, groin, and extremities. Over time, coalesce to form large lesions with central clearing of bronze-colored induration, Normocytic normochromic anemia, diarrhea, anorexia and abdominal pain?

 

[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]

[f]wqAgR2x1Y2Fnb25vbWEu

Cg==

Jm5ic3A7

Cg==

[Qq]

[q] What is the most likely diagnosis?

34 years old patient presenting with hyperglycemia, steatorrhea (excessive fat in the feces), and gallbladder stones with low level of secretin, cholecystokinin, and gastrin?

[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]

[f]IFNvbWF0b3N0YXRpbm9tYS4=[Qq]

[q] What is the most likely diagnosis?

19 years old patient presenting with neck lump that increase in size, biopsy shows polygonal cells with background amyloid deposits, high calcium and parathyroid, episodic headache, hypertension, sweating and palpitation, and elevated metanephrines in plasma with elevated urine vanillylmandelic acid?

[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]

[f]IE1FTiAyQS4=

Cg==

Cg==[Qq]

[q] What is the most likely diagnosis?

19 years old patient presenting with neck lump that increase in size, biopsy shows polygonal cells with background amyloid deposits, flesh-colored nodules on his lips and tongue, tall and slender with disproportionately long arms, legs, and fingers, episodic headache, hypertension, sweating and palpitation, and elevated metanephrines in plasma with elevated urine vanillylmandelic acid?

[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]

[f]IE1FTiAyQi4=

Cg==

Cg==[Qq]

[q] The genetic defect associated with MEN 2A and 2B is …….?

[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]

[f]IGEgZ2VybS1saW5lIG11dGF0aW9uIG9mIHRoZSBSRVQgcHJvdG8tb25jb2dlbmUu[Qq]

[q] ……. is produced by stomach and stimulates hunger (orexigenic effect) and GH release (via GH secretagog receptor) by acting on lateral area of hypothalamus (hunger center) to ↑ appetite.

[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]

[f]IEdocmVsaW4uIEdocmVsaW4gbWFrZXMgeW91IGh1bmdocmUgYW5kIGdocm93Lg==[Qq]

[q] ……. is produced by adipose tissue and acts on ventromedial area of hypothalamus (satiety center) to ↓ appetite.

[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]

[f]IExlcHRpbi4gTGVwdGluIGtlZXBzIHlvdSB0aGluLg==[Qq]

[q] Steroids, thyroid hormones, vitamin D are examples of (Lipid-Soluble Hormones or Water-Soluble Hormones).

[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]

[f]IExpcGlkLVNvbHVibGUgSG9ybW9uZXMu

Cg==

Cg==[Qq]

[q] Anterior pituitary Basophils and glucagon use ……. as a second messenger to transduce its intracellular signaling pathway.

[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]

[f]IGNBTVAu

Cg==

Cg==[Qq]

[q] GnRH, Oxytocin, ADH (V1-receptor), TRH use ……. as a second messenger to transduce its intracellular signaling pathway.

[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]

[f]IElQMy4=[Qq]

[q] Insulin and growth factors use (Intrinsic tyrosine kinase or Receptor-associated tyrosine kinase) receptors.

[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]

[f]IEludHJpbnNpYyB0eXJvc2luZSBraW5hc2Uu

Cg==

Jm5ic3A7

Cg==

[Qq]

[q] Anterior pituitary acidophils and cytokines use (Intrinsic tyrosine kinase or Receptor-associated tyrosine kinase) receptors.

[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]

[f]IFJlY2VwdG9yLWFzc29jaWF0ZWQgdHlyb3NpbmUga2luYXNlLg==

Cg==

Jm5ic3A7

Cg==

[Qq]

[q] G protein-coupled receptors that bind glycoprotein hormones contain 3 major domains. ………. is made up of nonpolar, hydrophobic amino acids (alanine, valine, leucine, isoleucine, phenylalanine, tryptophan, methionine, proline, glycine). These amino acids are arranged in an alpha-helical fashion and project their hydrophobic R groups outwardly, anchoring the transmembrane region of the protein to the hydrophobic core of the phospholipid bilayer.

[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]

[f]IFRoZSB0cmFuc21lbWJyYW5lIGRvbWFpbi4=

Cg==

Jm5ic3A7

Cg==

[Qq]

[q] PI3K pathway of insulin promotes glycogen synthesis by activating ……… an enzyme that dephosphorylates glycogen synthase, leading to its activation.

[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]

[f]IHByb3RlaW4gcGhvc3BoYXRhc2Uu

Cg==

Cg==[Qq]

[q] Protein kinase A is primarily responsible for the intracellular effects of the ………. second messenger system.

[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]

[f]IEctcHJvdGVpbi9hZGVueWxhdGUgY3ljbGFzZS4=[Qq]

[q] Inositol 1,4,5-triphosphate (IP3) produces most of the intracellular effects of Gq pathway by increasing intracellular calcium, and elevated intracellular calcium and DAG activates ………?

[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]

[f]IHByb3RlaW4ga2luYXNlIEMu

Cg==

Cg==[Qq]

[q] Ras proteins exist in 2 different states: an inactive …… bound state and an active …… bound state.

[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]

[f]IEdEUC0sIEdUUC0u

Cg==

Cg==[Qq]

[q] RAS gene mutations can lead to decreased intrinsic ………., this results in a constitutively activated Ras protein that causes constant and unregulated cell proliferation.

[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]

[f]IEdUUGFzZSBhY3Rpdml0eS4=

Cg==

Cg==[Qq]

[q] When phosphoinositide 3-kinase (PI3K) is activated, it phosphorylates PIP2 found in the plasma membrane to PIP3. This leads to activation of a protein called Akt (or protein kinase B), a serine/threonine-specific protein kinase. Subsequently, Akt activates mTOR, which ……..?

[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]

[f]IHRyYW5zbG9jYXRlcyB0byB0aGUgbnVjbGV1cyB0byBpbmR1Y2UgZ2VuZXMgaW52b2x2ZWQgaW4gY2VsbCBzdXJ2aXZhbCwgYW50aS1hcG9wdG9zaXMsIGFuZCBhbmdpb2dlbmVzaXMu

Cg==

Cg==[Qq]

[q] ………….. starts working 30 minutes after subcutaneous injection, with peak effects occurring between 2-4 hours. Preferred for DKA (because it can be used intravenously), hyperkalemia (with glucose to prevent hypoglycemia), stress hyperglycemia.

[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]

[f]IFNob3J0IGFjdGluZyBpbnN1bGluIChSZWd1bGFyKS4=

Cg==

Cg==[Qq]

[q] ……………. onset of action is under 15 minutes and peaks between 45-75 minutes, a pattern that closely mimics the endogenous postprandial insulin response of normal individuals.

[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]

[f]IFJhcGlkIGFjdGluZyBpbnN1bGluIChMaXNwcm8sIEFzcGFydCwgR2x1bGlzaW5lKS4=

Cg==

Cg==[Qq]

[q] ………….. is a type of insulin that is good for about 18 hours (shots given twice a day).

[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]

[f]IEMuIEludGVybWVkaWF0ZSBhY3RpbmcgaW5zdWxpbiAoTlBIKS4=

Cg==

Cg==[Qq]

[q] ………… is insulin analog with no peak “peakless”, used to supply a constant background level and administered as once-a-day shots.

[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]

[f]IExvbmctYWN0aW5nIGluc3VsaW4gKERldGVtaXIsIEdhbGFyZ2luZSku

Cg==

Cg==[Qq]

[q] The most common side effects of insulin are …….. and …….?

[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]

[f]IGh5cG9nbHljZW1pYSBhbmQgd2VpZ2h0IGdhaW4u[Qq]

[q] In patients with advanced chronic kidney disease and diabetes mellitus, decreased renal clearance of insulin can lead to ………….?

[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]

[f]IHN5bXB0b21hdGljIGh5cG9nbHljZW1pYS4=[Qq]

[q] ………….. decreases blood sugar by inhibition of hepatic gluconeogenesis and the action of glucagon, ↑ glycolysis, peripheral glucose uptake (↑ insulin sensitivity). There is no risk of hypoglycemia with metformin use “Euglycemic” and causes modest weight loss (often desired).

[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]

[f]IEJpZ3VhbmlkZXMgKE1ldGZvcm1pbiku[Qq]

[q] The major side effects of metformin are …….. and ………?

[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]

[f]IGdhc3Ryb2ludGVzdGluYWwgdXBzZXQgYW5kIGxhY3RpYyBhY2lkb3Npcy4=[Qq]

[q] Renal failure Patients are contraindicated to take metformin as oral hypoglycemic drugs due to increased risk of ……….?

[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]

[f]IGxhY3RpYyBhY2lkb3Npcy4=[Qq]

[q] ………. is monitored periodically in patients taking metformin.

[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]

[f]IFNlcnVtIGNyZWF0aW5pbmUu[Qq]

[q] ………… close K channel in β-cell membrane —> cell depolarizes —> insulin release via ↑ Ca influx —> Stimulate release of endogenous insulin in type 2 DM and useless in type 1 DM. It causes disulfiram-like effects in alcoholics.

[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]

[f]IEZpcnN0IGdlbmVyYXRpb27CoFN1bGZvbnlsdXJlYXM6IENobG9ycHJvcGFtaWRlLCBUb2xidXRhbWlkZS4=

Cg==

Cg==[Qq]

[q] ………… close K channel in β-cell membrane —> cell depolarizes —> insulin release via ↑ Ca influx —> Stimulate release of endogenous insulin in type 2 DM and useless in type 1 DM. It causes hypoglycemia as a side effect and risk of hypoglycemia ↑ in renal failure.

[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]

[f]IMKgU2Vjb25kIMKgZ2VuZXJhdGlvbiBTdWxmb255bHVyZWFzOiBHbGltZXBpcmlkZSwgR2xpcGl6aWRlLCBHbHlidXJpZGUu

Cg==

Cg==[Qq]

[q]  ……….. are short-acting glucose-lowering medications. They are functionally similar to sulfonylureas and act by binding to and closing the ATP-dependent K channel (membrane ion channels) in the pancreatic beta cell membrane but have a weaker binding affinity and faster dissociation from the binding site. Their short half-life requires frequent dosing, typically with each meal, but may reduce the risk of hypoglycemia.

[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]

[f]IE1lZ2xpdGluaWRlcyAocmVwYWdsaW5pZGUsIG5hdGVnbGluaWRlKS4=

Cg==

Cg==[Qq]

[q] ………. exert their glucose-lowering effect by decreasing insulin resistance through transcription modulation.

 

[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]

[f]IFRoaWF6b2xpZGluZWRpb25lcyAoUGlvZ2xpdGF6b25lLFJvc2lnbGl0YXpvbmUpLg==[Qq]

[q] ……… bind to peroxisome proliferator activated receptor gamma (PPAR-gamma, nuclear receptors), which is a transcriptional regulator of the genes involved in glucose and lipid metabolism. One of the most crucial genes regulated by PPAR-gamma is adiponectin, which is a cytokine secreted by fat tissue (adipocytokine).

[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]

[f]IFRoaWF6b2xpZGluZWRpb25lcyAoUGlvZ2xpdGF6b25lLFJvc2lnbGl0YXpvbmUpLg==

Cg==

Cg==[Qq]

[q] As the glucose lowering effect of …………. requires alteration in gene transcription and protein synthesis, it takes days to weeks after initiation of therapy to observe a significant reduction in glucose levels.

[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]

[f]IFRoaWF6b2xpZGluZWRpb25lcyAoUGlvZ2xpdGF6b25lLFJvc2lnbGl0YXpvbmUpLg==

Cg==

Jm5ic3A7

Cg==

[Qq]

[q] The main side effects of ………… are fluid retention, weight gain, and the precipitation of congestive heart failure from fluid retention. This excess fluid can exacerbate underlying congestive heart failure. It also increases the risk of bone fracture.

[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]

[f]IFRoaWF6b2xpZGluZWRpb25lcyAoUGlvZ2xpdGF6b25lLFJvc2lnbGl0YXpvbmUpLg==

Cg==

Jm5ic3A7

Cg==

[Qq]

[q] ……. was the first TZD released for clinical use but was withdrawn from the market due to a high incidence of severe hepatotoxicity.

[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]

[f]IFRyb2dsaXRhem9uZS4=[Qq]

[q] Incretins, especially GLP-1 and GIP are secreted by K and L cells in the gut and stimulate a decrease in blood glucose level by causing an increase in the amount of insulin released from pancreatic beta cells after eating, before blood glucose level become elevated. They also inhibit the release of glucagon from alpha cells. They have an outstanding effect on slowing gastric motility and promoting weight loss (often desired).

[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]

[f]IEdMUC0xIGFuYWxvZ3MgKEV4ZW5hdGlkZSwgTGlyYWdsdXRpZGUpLg==

Cg==

Cg==[Qq]

[q] ……… inhibit DPP-4 leaving GLP-1 and GIP without inactivation to ↑ insulin release and ↓ glucagon secretion from alpha cells. It causes mild urinary or respiratory infections

[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]

[f]IERQUC00IGluaGliaXRvcnMgKFNheGFnbGlwdGluIGFuZCBzaXRhZ2xpYnRpbiku[Qq]

[q] ……………. decrease the activity of disaccharides on the intestinal brush border (disaccharides are membrane-bound enzymes).

[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]

[f]IEFscGhhLWdsdWNvc2lkYXNlIGluaGliaXRvcnMgKEFjYXJib3NlLCBNaWdsaXRvbCku[Qq]

[q] The major side effects of ……………. are flatulence, gastrointestinal bloating, abdominal pain, and rash.

[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]

[f]IEFscGhhLWdsdWNvc2lkYXNlIGluaGliaXRvcnMgKEFjYXJib3NlLCBNaWdsaXRvbCku[Qq]

[q] The major side effects of …………. are flatulence, gastrointestinal bloating, abdominal pain, and rash.

[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]

[f]IEFscGhhLWdsdWNvc2lkYXNlIGluaGliaXRvcnMgKEFjYXJib3NlLCBNaWdsaXRvbCku[Qq]

[q] ………. block reabsorption of glucose in PCT. It cause Glycosuria, UTIs, vaginal yeast infections.

[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]

[f]IFNHTFQtMiBpbmhpYml0b3JzIChDYW5hZ2xpZmxvemluLCBkYXBhZ2xpZmxvemluLCBlbXBhZ2xpZmxvemluKS4=[Qq]

[q] The effectiveness of ………… inhibitors is dependent on glomerular filtration of glucose, which is decreased in patients with chronic kidney disease. Serum creatinine should be measured prior to therapy.

[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]

[f]IFNHTFQtMiBpbmhpYml0b3JzIChDYW5hZ2xpZmxvemluLCBkYXBhZ2xpZmxvemluLCBlbXBhZ2xpZmxvemluKS4=[Qq]

[q] …………. work by ↓ gastric emptying, ↓ glucagon release and cause Hypoglycemia, nausea, diarrhea.

[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]

[f]IEFteWxpbiBhbmFsb2dzIChQcmFtbGludGlkZSku

Cg==

Cg==[Qq]

[q] Thionamides (methimazole and propylthiouracil) act as antithyroid medications by decreasing the formation of thyroid hormones via inhibition of the enzyme ………..?. …………… also decreases the peripheral conversion of T 4 to T3.

[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]

[f]IHRoeXJvaWQgcGVyb3hpZGFzZSwgUHJvcHlsdGhpb3VyYWNpbC4=

Cg==

Cg==[Qq]

[q] ……… is a rare but very serious complication of antithyroid drugs. A WBC count with a differential is necessary in any patient receiving either methimazole or PTU who presents with a fever and sore throat.

[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]

[f]IEFncmFudWxvY3l0b3Npcy4=[Qq]

[q]Administration of potassium iodide may also prevent thyroid absorption of radioactive iodine isotopes by ………… and is often administered following nuclear accidents to protect the thyroid and prevent development of radiation- induced thyroid carcinoma.

[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]

[f]IGNvbXBldGl0aXZlIGluaGliaXRpb24u

Cg==

Cg==[Qq]

[q] ………. such as prednisone are used to control severe Graves’ ophthalmopathy. They are helpful in decreasing the severity of inflammation and decreasing extraocular volume. Conventional antithyroid drugs do not improve ophthalmopathy.

[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]

[f]IEhpZ2gtZG9zZSBnbHVjb2NvcnRpY29pZHM=[Qq]

[q] The acute effects of corticosteroids on the CBC include increased neutrophil count, and decreased lymphocyte, monocyte, basophil, and eosinophil counts. The increase in neutrophil count results from …………. of neutrophils previously attached to the vessel wall.

[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]

[f]IGRlbWFyZ2luYXRpb24u[Qq]

[q] ………… is synthetic analog of aldosterone with little glucocorticoid effects. It can be used as a mineralocorticoid replacement in 1° adrenal insufficiency.

[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]

[f]IEZsdWRyb2NvcnRpc29uZS4=[Qq]

[q] ………… sensitizes Ca-sensing receptor (CaSR) in parathyroid gland to circulating Ca2+ à ↓ PTH. It can be used for treatment of Hypercalcemia due to 1° or 2° hyperparathyroidism.

[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]

[f]IENpbmFjYWxjZXQu[Qq]

[q] ……………. is nonabsorbable phosphate binder that prevents phosphate absorption from the GI tract. It can be used for treatment of Hyperphosphatemia in CKD.

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[/qwiz]