40 Questions
What is the primary clinical feature of central diabetes insipidus?
Decreased serum osmolality
Which condition is characterized by impaired renal response to ADH?
Nephrogenic diabetes insipidus
What is the recommended treatment for SIADH?
Free water restriction
Which condition leads to hyponatremia and low serum osmolality?
SIADH
What is the characteristic feature of the urine in central diabetes insipidus?
Low osmolality
Which medication can cause nephrogenic diabetes insipidus?
Lithium
What is the effect of a water deprivation test in diagnosing central diabetes insipidus?
Has no effect on urine osmolality
What is the pathophysiology behind the clinical features of SIADH?
Retention of free water leading to cerebral edema
What is the most common cause of congenital adrenal hyperplasia?
21-hydroxylase deficiency
What is the typical treatment for a patient with an ectopic source of ACTH?
Resection of ectopic source with hormone replacement
Which scenario can lead to enlargement of a pituitary adenoma, resulting in hyperpigmentation, headaches, and bitemporal hemianopsia?
Bilateral adrenalectomy in refractory cases
What is a characteristic feature of Nelson syndrome?
Hyperpigmentation
Why might mineralocorticoids and androgens be increased or decreased in congenital adrenal hyperplasia?
Enzymatic defects in cortisol production
In which condition would a patient likely require bilateral resection of hyperplasia with hormone replacement?
Congenital adrenal hyperplasia
What is a potential treatment option if surgical resection is not possible for a patient with androgen excess due to elevated ACTH?
Ketoconazole or metyrapone therapy
What symptom may indicate enlargement of a pituitary adenoma due to bilateral adrenalectomy in refractory cases?
Hyperpigmentation
Which of the following is a complication of diabetes?
All of the above
What is the primary function of the glomerulosa layer of the adrenal cortex?
Produce mineralocorticoids
Which of the following is a characteristic of insulinomas?
Presents as episodic hypoglycemia with mental status changes
Which of the following hormones are derived from cholesterol in the adrenal cortex?
Cortisol
What is the leading cause of blindness in the developed world?
Diabetes
Which of the following is a characteristic of gastrinomas?
Presents as treatment-resistant peptic ulcers
What is the mechanism by which aldose reductase contributes to diabetic complications?
Converts glucose to sorbitol, resulting in osmotic damage
Which layer of the adrenal cortex produces weak androgens?
Reticularis
Which of the following is a symptom associated with high cortisol levels in Cushing's syndrome?
Muscle weakness with thin extremities
Which of the following physical features is associated with Cushing's syndrome?
Moon facies and truncal obesity
What is the likely cause of abdominal striae (stretch marks) in Cushing's syndrome?
Impaired collagen synthesis
Which of the following is a common feature of hypertension in Cushing's syndrome?
Hypokalemia and metabolic alkalosis
What is the initial diagnostic test for Cushing's syndrome?
24-hour urine cortisol level or late night salivary cortisol level
What is the purpose of the low-dose dexamethasone suppression test in the diagnosis of Cushing's syndrome?
To suppress cortisol production in normal individuals but not in Cushing's syndrome
What is the next step after determining that Cushing's syndrome is ACTH-independent?
Perform a CT scan of the adrenal glands
What is the purpose of the high-dose dexamethasone suppression test in the diagnosis of Cushing's syndrome?
To differentiate between pituitary and ectopic ACTH sources
What causes the buildup of glycosaminoglycans, inflammation, fibrosis, and edema leading to exophthalmos and pretibial myxedema in Graves' disease?
TSH activation of fibroblasts behind the orbit and overlying the shin
Which of the following is NOT a typical laboratory finding in Graves' disease?
Decreased total and free T4 levels
What is the primary mechanism of action of propylthiouracil (PTU) in the treatment of Graves' disease?
Inhibiting the peroxidase-mediated steps of thyroid hormone synthesis
What is the primary cause of multinodular goiter?
Relative iodine deficiency
What is the characteristic microscopic appearance of Graves' disease?
Irregular follicles with scalloped colloid and chronic inflammation
Which of the following is NOT a potential complication of Graves' disease?
Thyroid lymphoma
What is the treatment for thyroid storm, a potentially fatal complication of Graves' disease?
Propylthiouracil, β-blockers, and steroids
What is the primary cause of toxic multinodular goiter?
TSH-independent hormone production by nodules in a multinodular goiter
This quiz covers the clinical features and diagnosis of Central Diabetes Insipidus, including causes such as ADH deficiency and hypothalamic or posterior pituitary pathology. Learn about the symptoms of polyuria, polydipsia, hypernatremia, and the diagnostic criteria involving water deprivation tests.
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