p.10
Endocrine Pathology and Disorders
What is hypercortisolism characterized by?
Elevated serum cortisol levels and urine free cortisol.
p.11
Endocrine Pathology and Disorders
What defines osteoporosis according to the T-WHO definition?
Bone density that falls 2.5 standard deviations below the mean for young healthy adults of the same sex and race.
p.3
Thyroid Hormones and Disorders
What is the most common type of thyroid cancer?
Papillary Thyroid Carcinoma.
p.5
Endocrine Pathology and Disorders
What causes nephrogenic diabetes insipidus?
Insensitivity of the renal tubules to ADH.
p.8
Endocrine Pathology and Disorders
What are the most prominent features of Cushing's syndrome?
Upregulation of gluconeogenesis, lipolysis, and protein catabolism.
p.8
Endocrine Pathology and Disorders
What is the most important first step in managing suspected Cushing's syndrome?
Establish the correct diagnosis.
p.16
Diabetes Mellitus and Complications
What is the most common cause of hypoglycemia in diabetes?
Drugs used to treat diabetes or exposure to other drugs, including alcohol.
p.10
Calcium Homeostasis and Parathyroid Function
What is the primary regulator of calcium physiology?
Parathyroid hormone (PTH) from chief cells of the parathyroid gland.
p.16
Gonadal Hormones and Reproductive Health
What is the emerging method of choice for testosterone measurement?
Liquid chromatography tandem mass spectrometry (LC-MS/MS).
p.3
Thyroid Hormones and Disorders
What is a common presentation of Hashimoto's thyroiditis?
Insidious, painless goiter with local symptoms.
p.13
Diabetes Mellitus and Complications
What are classic signs of diabetic ketoacidosis (DKA)?
Kussmaul respirations and fruity odor.
p.3
Adrenal Hormones and Conditions
What syndrome is associated with acute primary adrenal insufficiency due to adrenal hemorrhage?
Waterhouse-Friderichsen Syndrome.
p.18
Metabolic Disorders Related to Lipids and Carbohydrates
What delivers cholesterol into cells?
LDL (Low-Density Lipoprotein).
p.8
Endocrine Pathology and Disorders
What is the accepted screening test for primary hyperaldosteronism?
Concurrent measurement of plasma renin and aldosterone with calculation of the aldosterone-renin ratio (ARR).
p.5
Endocrine Pathology and Disorders
What is the urine volume and osmolarity criteria for diagnosing Diabetes insipidus?
24-hour urine volume >40 mL/kg body weight and osmolarity <300 mosmol/L.
p.10
Endocrine Pathology and Disorders
What happens to cortisol levels in low-dose dexamethasone suppression tests in hypercortisolism?
Cortisol is not suppressed.
p.16
Gonadal Hormones and Reproductive Health
What defines infertility?
The inability to conceive after 12 months of unprotected sexual intercourse or after 6 months in women over 35.
p.11
Gonadal Hormones and Reproductive Health
What is the most common estrogen-deficient state leading to osteoporosis?
Cessation of ovarian function at menopause (average age 51).
p.12
Diabetes Mellitus and Complications
What is the most reliable test for identifying diabetes in asymptomatic individuals?
HbA1c or FPG (Fasting Plasma Glucose).
p.5
Endocrine Pathology and Disorders
What is the best-documented risk factor for autoimmune hypothyroidism?
HLA-DR polymorphisms (especially HLA-DR3, -DR4, and -DR5).
p.13
Diabetes Mellitus and Complications
What are the three ketone bodies associated with DKA?
Acetoacetate, beta-hydroxybutyrate, and acetone.
p.16
Diabetes Mellitus and Complications
What is the lower limit of fasting plasma glucose concentration?
Approximately 70 mg/dL (3.9 mmol/L).
p.16
Diabetes Mellitus and Complications
What causes hypoglycemia with increased C-peptide levels?
Ingestion of an insulin secretagogue.
p.5
Endocrine Pathology and Disorders
What is SIADH characterized by?
Excess ADH causing excessive resorption of water and hyponatremia.
p.11
Endocrine Pathology and Disorders
What is the final common pathway in osteoclast development and activation?
Activation of RANK by RANKL.
p.15
Diabetes Mellitus and Complications
What is the hallmark of proliferative diabetic retinopathy?
Neovascularization in response to retinal hypoxia.
p.12
Diabetes Mellitus and Complications
What is the major susceptibility gene in Type 1 Diabetes Mellitus (T1DM)?
HLA region on chromosome 6.
p.8
Endocrine Pathology and Disorders
When do signs of proximal myopathy become most obvious in Cushing's syndrome?
When trying to stand up from a chair without using hands or when climbing stairs.
p.7
Adrenal Hormones and Conditions
What is Cushing's syndrome?
A constellation of clinical features resulting from chronic exposure to excess glucocorticoids.
p.7
Adrenal Hormones and Conditions
What is the most common cause of Cushing's syndrome?
ACTH-producing pituitary adenoma (Cushing disease).
p.2
Adrenal Hormones and Conditions
What are the three parts of the adrenal cortex from outer to inner?
Zona glomerulosa, Zona fasciculata, Zona reticularis.
p.6
Thyroid Hormones and Disorders
What is a major role in the pathogenesis of myxedema coma?
Hypoventilation, hypoxia, and hypercapnia.
p.15
Diabetes Mellitus and Complications
What does a wound that probes to the bone indicate?
Clinical evidence of osteomyelitis.
p.18
Metabolic Disorders Related to Lipids and Carbohydrates
What are the two secondary bile acids mentioned?
Deoxycholic acid and Lithocholic acid.
p.14
Diabetes Mellitus and Complications
When should bile acid-binding resins not be used?
If hypertriglyceridemia is present.
p.15
Diabetes Mellitus and Complications
What are the best predictors of the development of diabetic retinopathy?
Duration of diabetes mellitus and degree of glycemic control.
p.13
Diabetes Mellitus and Complications
What is necessary for DKA to develop?
Both insulin deficiency and glucagon excess.
p.6
Thyroid Hormones and Disorders
What is the most common symptom of hyperthyroidism?
Hyperactivity, irritability, dysphoria.
p.6
Thyroid Hormones and Disorders
What is the most common cardiovascular manifestation of hyperthyroidism?
Sinus tachycardia (associated with palpitations).
p.9
Adrenal Hormones and Conditions
What is the classic triad in pheochromocytoma?
Headache, sweating, and palpitations.
p.3
Thyroid Hormones and Disorders
What is a key marker for Medullary Thyroid Carcinoma?
Elevated serum calcitonin.
p.1
Hormonal Regulation and Functions
What is the function of Oxytocin?
Stimulates milk secretion and uterine contractions during pregnancy.
p.14
Diabetes Mellitus and Complications
What are the major side effects of alpha-glucosidase inhibitors?
Diarrhea, flatulence, abdominal distention.
p.1
Thyroid Hormones and Disorders
What hormone increases basal metabolic rate (BMR)?
Thyroid hormones (T4 and T3).
p.1
Calcium Homeostasis and Parathyroid Function
What triggers the release of Parathyroid Hormone (PTH)?
Hypocalcemia (low calcium levels).
p.15
Diabetes Mellitus and Complications
What is the most effective therapy for diabetic retinopathy?
Laser photocoagulation and/or anti-VEGF therapy (ocular injection).
p.11
Diagnostic Approaches in Endocrinology
What is the standard technique for measuring bone density?
Dual Energy X-Ray Absorptiometry (DXA).
p.15
Diabetes Mellitus and Complications
What is the optimal therapy for diabetic nephropathy?
Prevention by control of glycemia.
p.15
Diabetes Mellitus and Complications
Which cranial nerve is most commonly involved in mononeuropathy?
CN III, often heralded by diplopia.
p.15
Diabetes Mellitus and Complications
What is the most common pattern of dyslipidemia in diabetes?
Hypertriglyceridemia and reduced HDL.
p.1
Hormonal Regulation and Functions
What are the effects of Growth Hormone (GH)?
Increases blood glucose and has direct and indirect effects via IGF-1.
p.7
Endocrine Pathology and Disorders
What is a common manifestation of MEN2A?
Medullary thyroid carcinoma.
p.3
Endocrine Pathology and Disorders
What condition is characterized by elevated PTH in patients with chronic kidney disease?
Secondary Hyperparathyroidism.
p.8
Endocrine Pathology and Disorders
What oral agents have established efficacy in treating Cushing's syndrome?
Metyrapone and Ketoconazole.
p.8
Endocrine Pathology and Disorders
What is the clinical hallmark of mineralocorticoid excess in primary hyperaldosteronism?
Hypokalemic hypertension.
p.7
Diagnostic Approaches in Endocrinology
What are sonographic characteristics suggestive of thyroid malignancy?
Hypoechoic solid nodules with infiltrative borders and microcalcifications.
p.8
Endocrine Pathology and Disorders
What characteristics differentiate benign from malignant adrenal lesions?
Benign lesions are rounded and homogenous; malignant lesions are lobulated and inhomogeneous.
p.17
Metabolic Disorders Related to Lipids and Carbohydrates
What are the two primary bile acids?
Cholic acid and Chenodeoxycholic acid.
p.13
Diabetes Mellitus and Complications
What potassium level is acceptable to start an insulin drip in DKA?
Initial serum K+ of 3.3 meq/L.
p.14
Diabetes Mellitus and Complications
What are the macrovascular complications of diabetes mellitus?
Coronary heart disease, peripheral arterial disease, cerebrovascular disease.
p.14
Diabetes Mellitus and Complications
What primarily causes severe vision loss in progressive diabetic retinopathy?
Significant macular edema and new blood vessel formation.
p.13
Diabetes Mellitus and Complications
What are the major side effects of GLP-1 agonists?
Nausea, vomiting, and diarrhea.
p.3
Thyroid Hormones and Disorders
What characterizes Follicular Thyroid Carcinoma?
Capsular and/or vascular invasion.
p.1
Hormonal Regulation and Functions
What inhibits Prolactin secretion?
Hypothalamic Dopamine (Prolactin Inhibiting Hormone, PIH).
p.7
Endocrine Pathology and Disorders
What type of tumors are associated with MEN2B?
Medullary thyroid carcinoma, pheochromocytoma, and mucosal neuromas.
p.2
Hormonal Regulation and Functions
What hormones are derived from proopiomelanocortin (POMC)?
MSH, ACTH, β-Lipotropin, β-Endorphin.
p.2
Hormonal Regulation and Functions
Where is ADH/vasopressin synthesized?
In the supraoptic nuclei of the anterior hypothalamus.
p.17
Gonadal Hormones and Reproductive Health
What is the most common cause of female infertility?
Abnormalities in menstrual function.
p.1
Hormonal Regulation and Functions
What is the role of Insulin in the body?
Increases pathways associated with the well-fed state, such as glycolysis and lipid synthesis.
p.14
Diabetes Mellitus and Complications
What are the features of non-proliferative diabetic retinopathy?
Retinal vascular microaneurysms, blot hemorrhages, and cotton wool spots.
p.6
Thyroid Hormones and Disorders
What is the most serious manifestation of Graves ophthalmopathy?
Compression of the optic nerve at the apex of the orbit.
p.6
Thyroid Hormones and Disorders
What is the most common cause of acute thyroiditis in children and young adults?
Presence of a piriform sinus (predominantly left-sided).
p.12
Endocrine Pathology and Disorders
What is the recommended method for measuring bone mass in patients on long-term glucocorticoids?
DXA (Dual-energy X-ray Absorptiometry).
p.11
Endocrine Pathology and Disorders
What are the chief clinical manifestations of osteoporosis?
Vertebral and hip fractures.
p.7
Thyroid Hormones and Disorders
What is the most common type of thyroid cancer?
Papillary Thyroid Carcinoma.
p.10
Calcium Homeostasis and Parathyroid Function
What is the definitive therapy for hyperparathyroidism?
Surgical excision of abnormal parathyroid tissue.
p.2
Hormonal Regulation and Functions
Where is oxytocin synthesized?
In the paraventricular nuclei of the anterior hypothalamus.
p.1
Hormonal Regulation and Functions
What is the primary function of Aldosterone?
Increases sodium reabsorption and potassium secretion in the kidneys.
p.13
Diabetes Mellitus and Complications
What is the prototypical patient profile for hyperglycemic hyperosmotic state (HHS)?
Elderly individual with type 2 DM, history of polyuria, weight loss, and diminished oral intake.
p.19
Metabolic Disorders Related to Lipids and Carbohydrates
What syndrome presents with eruptive xanthomas and is associated with hypercholesterolemia?
Familial chylomicronemia syndrome.
p.9
Adrenal Hormones and Conditions
What is the most sensitive test for pheochromocytoma that is less susceptible to false positives?
Measurement of plasma metanephrine.
p.16
Diabetes Mellitus and Complications
What are the components of Whipple's Triad in insulinoma?
1. Symptoms consistent with hypoglycemia 2. Low plasma glucose measured with a precise method 3. Relief of symptoms after the plasma glucose level is raised.
p.7
Endocrine Pathology and Disorders
What are the Multiple Endocrine Neoplasia (MEN) syndromes?
MEN1, MEN2A, MEN2B, MEN4, and MEN3.
p.13
Diabetes Mellitus and Complications
What causes the fruity odor in DKA?
Metabolic acidosis and increased acetone.
p.18
Metabolic Disorders Related to Lipids and Carbohydrates
What mediates reverse cholesterol transport?
HDL (High-Density Lipoprotein).
p.11
Endocrine Pathology and Disorders
What is Denosumab?
A fully human monoclonal antibody to RANKL.
p.2
Endocrine Pathology and Disorders
What is the most common type of pituitary adenoma?
Nonfunctioning pituitary adenomas.
p.2
Endocrine Pathology and Disorders
What is pituitary apoplexy?
An endocrine emergency that may result in severe hypoglycemia, hypotension, and shock.
p.9
Adrenal Hormones and Conditions
What is the first step in the diagnosis of pheochromocytoma?
Measurement of catecholamines.
p.9
Adrenal Hormones and Conditions
What are standard approaches in pheochromocytoma surgery?
Minimally invasive techniques such as laparoscopy or retroperitoneoscopy.
p.4
Pituitary Gland Disorders
What may be required to distinguish pituitary tumors from ectopic ACTH-secreting tumors?
Bilateral inferior petrosal sinus ACTH sampling.
p.5
Hormonal Regulation and Functions
What is the most important physiological action of AVP?
Reabsorb water and promote concentration of urine.
p.1
Hormonal Regulation and Functions
What is the role of GHRH in hormone regulation?
It stimulates the release of Growth Hormone (GH).
p.1
Hormonal Regulation and Functions
What is the primary action of Vasopressin (ADH)?
Inserts Aquaporin in renal collecting ducts and causes vasoconstriction.
p.1
Hormonal Regulation and Functions
What are the effects of Cortisol?
Anti-inflammatory effects, increases blood sugar, and promotes lipolysis.
p.15
Diabetes Mellitus and Complications
What are eosinophilic, PAS+ nodules in diabetic nephropathy known as?
Nodular glomerulosclerosis or Kimmelstiel-Wilson nodules.
p.11
Metabolic Disorders Related to Lipids and Carbohydrates
What is the preferred source of calcium for osteoporosis management?
Dairy products and other foods.
p.15
Diabetes Mellitus and Complications
What is the most common form of diabetic neuropathy?
Distal symmetric polyneuropathy.
p.15
Diabetes Mellitus and Complications
What are the primary gastrointestinal symptoms in diabetes?
Delayed gastric emptying and altered bowel motility.
p.9
Adrenal Hormones and Conditions
What is the 'Rule of 10s' in pheochromocytoma?
10% are bilateral, 10% are extraadrenal, and 10% are malignant.
p.4
Pituitary Gland Disorders
What is the sequence of tropic hormone failure associated with pituitary compression or destruction?
GH > FSH > LH > TSH > ACTH.
p.4
Pituitary Gland Disorders
What is the most validated test to distinguish pituitary-sufficient patients from AGHD?
Insulin-induced hypoglycemia test.
p.10
Calcium Homeostasis and Parathyroid Function
What are the symptoms of hypercalcemia often summarized as?
Bones (bone pain), Groans (abdominal pain), and Psychiatric Overtones (decreased sensorium, psychosis).
p.7
Thyroid Hormones and Disorders
What surgical treatment is commonly performed for well-differentiated thyroid cancer?
Near-Total Thyroidectomy.
p.10
Calcium Homeostasis and Parathyroid Function
What is the striking feature of malignancy-associated hypercalcemia?
The rapidity of the course.
p.1
Hormonal Regulation and Functions
What is the precursor to Insulin?
Proinsulin, which splits into insulin and C peptide.
p.14
Diabetes Mellitus and Complications
When is the most crucial period of glycemic control in pregnancy?
Soon after fertilization.
p.9
Adrenal Hormones and Conditions
What syndromes are associated with pheochromocytoma?
Neurofibromatosis Type 1 (NF 1) and Multiple endocrine neoplasia (MEN) type 2A and type 2B.
p.19
Metabolic Disorders Related to Lipids and Carbohydrates
What condition is characterized by severe hypoglycemia and cirrhosis due to aldolase B deficiency?
Hereditary Fructose Intolerance.
p.18
Metabolic Disorders Related to Lipids and Carbohydrates
What transports triglycerides from the liver to tissues?
VLDL (Very Low-Density Lipoprotein).
p.2
Adrenal Hormones and Conditions
What are the two main products of the adrenal medulla?
Epinephrine (80%) and norepinephrine (20%).
p.11
Endocrine Pathology and Disorders
What is the primary use of biochemical markers in osteoporosis?
Monitoring response to treatment.
p.15
Diabetes Mellitus and Complications
What is the most common site of foot ulcers in diabetes?
Great toe or metatarsophalangeal (MTP) areas.
p.6
Thyroid Hormones and Disorders
What are the earliest manifestations of Graves ophthalmopathy?
Sensation of grittiness, eye discomfort, and excess tearing.
p.6
Thyroid Hormones and Disorders
What is the most common pattern of sick euthyroid syndrome?
Decrease in total and unbound T3 levels (low T3 syndrome) with normal levels of T4 and TSH.
p.7
Thyroid Hormones and Disorders
What is the most common type of thyroid lymphoma?
Diffuse large-cell lymphoma.
p.13
Diabetes Mellitus and Complications
What is the preferred method for detecting ketones in DKA?
Serum or plasma assays for beta-hydroxybutyrate.
p.14
Diabetes Mellitus and Complications
What are the characteristics of Type 1 Diabetes Mellitus?
Usually occurs in those <30 y.o., autoimmune causes, DKA is the most common complication.
p.14
Diabetes Mellitus and Complications
What are the microvascular complications of diabetes mellitus?
Retinopathy, neuropathy, nephropathy.
p.6
Thyroid Hormones and Disorders
What are the major etiologies of hyperthyroidism?
Graves disease, toxic multinodular goiter, toxic adenoma.
p.6
Thyroid Hormones and Disorders
What is the least common symptom of hyperthyroidism?
Oligomenorrhea, loss of libido.
p.19
Metabolic Disorders Related to Lipids and Carbohydrates
What condition is caused by hypoglycin from unripe akee fruit?
Jamaican Vomiting Sickness.
p.4
Pituitary Gland Disorders
What is the most common presentation of tropic hormone failure?
Growth retardation in childhood.
p.4
Pituitary Gland Disorders
What is the treatment of choice for prolactinomas?
Dopamine agonists (Cabergoline and Bromocriptine).
p.8
Endocrine Pathology and Disorders
What is the preferred approach for unilateral lesions in hyperaldosteronism?
Laparoscopic adrenalectomy.
p.18
Metabolic Disorders Related to Lipids and Carbohydrates
What is the major component of lung surfactant?
Dipalmitoylphosphatidylcholine (Lecithin).
p.11
Endocrine Pathology and Disorders
What is Teriparatide?
An exogenous PTH analogue.
p.19
Metabolic Disorders Related to Lipids and Carbohydrates
What is the clinical diagnosis for Familial Hypercholesterolemia?
Substantial hypercholesterolemia with LDL-C >190 mg/dL and family history.
p.9
Adrenal Hormones and Conditions
What should blood pressure be before surgery for pheochromocytoma?
Consistently <160/90 mmHg.
p.15
Diabetes Mellitus and Complications
What is the preferred therapy for diabetic nephropathy when GFR approaches 20 mL/min?
Renal transplantation from a living related donor.
p.2
Calcium Homeostasis and Parathyroid Function
What effect does Vitamin D have on calcium and phosphate?
Decreases calcium and phosphate excretion but increases intestinal calcium absorption.
p.2
Gonadal Hormones and Reproductive Health
What hormone do Sertoli cells produce in response to FSH?
Inhibin, which supports sperm production.
p.9
Adrenal Hormones and Conditions
What characterizes adrenal insufficiency?
Loss of both glucocorticoid and mineralocorticoid secretion.
p.19
Metabolic Disorders Related to Lipids and Carbohydrates
What deficiency results in galactosemia and cataracts in early childhood?
Galactokinase deficiency.
p.9
Adrenal Hormones and Conditions
What major factors determine poor survival in adrenal carcinoma?
Metastasis at diagnosis and primary treatment in a nonspecialist center.
p.6
Thyroid Hormones and Disorders
What is the most frequent site of thyroid dermopathy?
Anterior and lateral aspects of the lower leg (Pretibial myxedema).
p.6
Thyroid Hormones and Disorders
What are the clinical manifestations of most goiters?
Asymptomatic, but can include venous distention over the neck and difficulty breathing (especially when arms are raised).
p.4
Pituitary Gland Disorders
What are the hallmarks of hyperprolactinemia?
Amenorrhea, galactorrhea, infertility.
p.4
Pituitary Gland Disorders
What is the initial treatment for most patients with acromegaly?
Surgical resection of GH-secreting adenomas.
p.4
Endocrine Pathology and Disorders
What is the precise and cost-effective screening test for Cushing's syndrome?
Measurement of 24-h urine free cortisol.
p.6
Thyroid Hormones and Disorders
What is the most frequent cause of acquired hypoparathyroidism?
Surgery for hyperthyroidism.
p.4
Pituitary Gland Disorders
What are the side effects associated with somatostatin analogues used in acromegaly?
Suppression of gastrointestinal motility and secretion.
p.4
Endocrine Pathology and Disorders
What is required to distinguish ACTH-independent from ACTH-dependent Cushing's syndrome?
Basal plasma ACTH levels.
p.19
Metabolic Disorders Related to Lipids and Carbohydrates
What disease is characterized by recurrent pyogenic infections due to impaired respiratory burst?
Chronic Granulomatous Disease.
