Bcacp Endocrine Exam Questions With 100% Correct Answers

Bcacp Endocrine Exam Questions With 100% Correct Answers Hyperthyroidism beta-blockers MOA - ANSWER- Manage symptoms Inhibit peripheral T4 conversion(propranolol/nadolol) Very quick onset of effect( hours) Hyperthyroidism beta-blocker dosing - ANSWER- Propranolol 120-160mg/day in 3-4 divided doses Nadolol 80mg/day in 1-2 divided doses PCOS - ANSWER- polycystic ovary syndrome PCOS clinical pearls - ANSWER- High risk of infertility (75%) Higher risk of endometrial cancer Insulin resistance PCOS causes - ANSWER- Insulin resistance Hypothalamus-pituitary-ovarian adnormality PCOS clinical manifestations - ANSWER- menstrual irregularity hyperandrogenism (acne and hirsutism or male-pattern hair loss) infertility (irregular menstruation) hyperinsulemia/insulin resistance PCOS Diagnosis Rotterdam criteria - ANSWER- Two of the following must be present: Anovulation Elevated concentration of circulating androgens Poly cystic ovaries defined by ovarian ultrasound PCOS treatment goals - ANSWER- Improve symptoms Increase fertility Prevent concomitant morbidity PCOS treatment - ANSWER- OCP, spironolactone, clomiphene, HMG, metformin PCOS treatment - ANSWER- 1. Weight reduction 2. Oral contraceptives (hirsutism) 3. Clomiphene citrate (infertility) PCOS OCP treatment - ANSWER- Estrogen-progestin combination with a non- androgenic progestin (norgestimate, desogestrel, drospirenone Controls hirsutism and acne Potential adverse effects on insulin resistance PCOS: spironolactone MOA - ANSWER- Possesses moderate anti-androgenic effects Use with OC because of risk in pregnancy PCOS: flutamide - ANSWER- Potent nonsterodial antiandrogen 250mg daily Hepatotoxic-LFT monitoring Contraindications:pregnancy and liver disease Adverse effects: hot flashes, galactorrhea, nausea PCOS insulin resistance treatment - ANSWER- Metformin Pioglitazone Hirsutism treatment or acne - ANSWER- OC, spironolactone, flutamide, metformin, pioglitazone amenorrhea - ANSWER- OC, metformin, pioglitazone ovulation induction - ANSWER- Clomid (clomiphene), metformin, pioglitazone insulin resistance - ANSWER- Metformin, pioglitazone Pituitary disease clinical pearls - ANSWER- Prolactinomas represent the most common type of pituitary tumor Prolactin is the erythrocytes sedimentation rate of the hypothalamus Multiple endocrine neoplasia type 1 syndrome (MEN1): three Ps (pituitary, parathyroid, pancreas) Growth hormone (GH) excess in childhood results in gigantism; GH excess in adults results in acromegaly Prolactinoma - ANSWER- benign tumor of the pituitary gland Secretes excessive amounts of prolactin Prolactin is the hormone that stimulates milk production of breasts Hyperprolactinemia - ANSWER- Prolactin concentration greater than 30ng/dL (Normal 15-25) Hyperprolactinemia causes - ANSWER- Prolactin-secreting tumor (200) Modest elevation (30-100): early pregnancy/lactation, stress, kidney failure, liver failure, medications Drug induced hyperprolactinemia - ANSWER- Dopamine antagonist: phenothiazines/antipsychotics, tricyclic antidepressants, metoclopramide SSRIs Estrogen-progesterone Methyldopa Verapamil GnRH analogs Hyperprolactinemia clinical presentation - ANSWER- Women: irregular menses, infertility, galactorrhea, reduction in sex drive, vision loss, osteoporosis Men: decreased libido, ED, loss of body hair, vision loss, osteoporosis Hyperprolactinemia diagnosis - ANSWER- Signs/symptoms, elevated prolactin level, imaging studies Hyperprolactinemia treatment - ANSWER- Discontinue the offending agent, surgery, radio therapy, drug therapy Drug therapy for hyperprolactinemia - ANSWER- D2 receptor agonist D2 receptor antagonists bromocriptine - ANSWER- High incidence of nausea Preferred for infertility Recommend in pregnancy Drug interactions: 3A4 inhibitors Contraindications: patients with ischemic heart disease, peripheral vascular disease, uncontrolled HTN Cabergoline - ANSWER- Better GI tolerance Drug interactions-3A4 inhibitors