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Questions and Answers
What syndrome is characterized by hypogonadotrophic hypogonadism and anosmia?
What syndrome is characterized by hypogonadotrophic hypogonadism and anosmia?
Kallman syndrome
What is the principal serum cortisol-binding protein?
What is the principal serum cortisol-binding protein?
Transcortin (corticosteroid-binding globulin)
What is the first line treatment for cortisol deficiency?
What is the first line treatment for cortisol deficiency?
Prednisolone
What syndrome is caused by genetic mutation affecting GnRH secretion?
What syndrome is caused by genetic mutation affecting GnRH secretion?
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What is the name of the test used to diagnose between unilateral and bilateral aldosteronism?
What is the name of the test used to diagnose between unilateral and bilateral aldosteronism?
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What is the test used to diagnose Conn's disease or BAH?
What is the test used to diagnose Conn's disease or BAH?
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What is the test used to diagnose pheochromocytoma?
What is the test used to diagnose pheochromocytoma?
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What is the name of the syndrome presenting with proximal muscle weakness?
What is the name of the syndrome presenting with proximal muscle weakness?
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What is the name of the syndrome presenting with elevated CK levels?
What is the name of the syndrome presenting with elevated CK levels?
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What is the condition characterized by destruction of adrenal gland causing primary adrenal insufficiency?
What is the condition characterized by destruction of adrenal gland causing primary adrenal insufficiency?
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What is the name of the syndrome caused by a mutation affecting growth hormone?
What is the name of the syndrome caused by a mutation affecting growth hormone?
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What is the name of the syndrome with high cortisol, but low renin?
What is the name of the syndrome with high cortisol, but low renin?
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What is the area supplied by the superior division of the left middle cerebral artery?
What is the area supplied by the superior division of the left middle cerebral artery?
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What is the name of the syndrome with hypersexuality, hyperoralilty, hyperphagia, and visual agnosia?
What is the name of the syndrome with hypersexuality, hyperoralilty, hyperphagia, and visual agnosia?
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What is the most common cause of bacterial meningitis?
What is the most common cause of bacterial meningitis?
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What are the inhibitors of dopamine into metabolites?
What are the inhibitors of dopamine into metabolites?
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What is the name of the structure that receives visual signals?
What is the name of the structure that receives visual signals?
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What nuclei are responsible for auditory sensations?
What nuclei are responsible for auditory sensations?
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What nuclei are responsible for motor function?
What nuclei are responsible for motor function?
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What is the name of the structure that transmits pressure, touch, pain, proprioception, body sensation?
What is the name of the structure that transmits pressure, touch, pain, proprioception, body sensation?
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What is the name of the structure that receives the spinal cord and sensory info before relaying it to the brain?
What is the name of the structure that receives the spinal cord and sensory info before relaying it to the brain?
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What is the name of the structure that receives the spinal cord info and sends it to the brain?
What is the name of the structure that receives the spinal cord info and sends it to the brain?
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What is the name of the structure that receives the sensory info from the body?
What is the name of the structure that receives the sensory info from the body?
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What is the sensory pathway from body to contralateral primary somatosensory cortex?
What is the sensory pathway from body to contralateral primary somatosensory cortex?
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What area is involved in voluntary movements?
What area is involved in voluntary movements?
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What are the nerves that carry sensory cell bodies?
What are the nerves that carry sensory cell bodies?
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What is the name of the structure that receives proprioception?
What is the name of the structure that receives proprioception?
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What is the name of the structure that controls the fine touch, vibration, deep pressure and play a role in proprioception?
What is the name of the structure that controls the fine touch, vibration, deep pressure and play a role in proprioception?
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What is the name of the structure that controls the cranial nerve nuclei?
What is the name of the structure that controls the cranial nerve nuclei?
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What is the structure that forms at the rising aspect of the neck of the fibulas?
What is the structure that forms at the rising aspect of the neck of the fibulas?
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What is the name of the structure that receives the optical canal?
What is the name of the structure that receives the optical canal?
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What is the name of the structure that receives the optic nerve?
What is the name of the structure that receives the optic nerve?
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What is the name of the structure that controls the facial nerve?
What is the name of the structure that controls the facial nerve?
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What is the structure that controls the tibial nerve?
What is the structure that controls the tibial nerve?
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What is the name of the structure that controls the motor function?
What is the name of the structure that controls the motor function?
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What is the name of the structure that controls the pressure, touch, pain, proprioception and body sensation?
What is the name of the structure that controls the pressure, touch, pain, proprioception and body sensation?
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What is the name of the structure that controls the sensory loss below the lesion and hyperreflexia?
What is the name of the structure that controls the sensory loss below the lesion and hyperreflexia?
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What is the name of the structure that controls the autonomic dysreflexia (above T6, sweating, hypertension and bradycardia)?
What is the name of the structure that controls the autonomic dysreflexia (above T6, sweating, hypertension and bradycardia)?
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What is the name of the structure that controls the motor deficits because the ventral (anterior) horns contain motor neurons?
What is the name of the structure that controls the motor deficits because the ventral (anterior) horns contain motor neurons?
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What is the structure that receives the subclavian artery so crosses the neck at a diagonal and is more likely to be injured under the left during neck surgery?
What is the structure that receives the subclavian artery so crosses the neck at a diagonal and is more likely to be injured under the left during neck surgery?
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Study Notes
Endocrinology
- Kallmann syndrome: Characterized by hypogonadotrophic hypogonadism and anosmia, resulting from neuronal migration failure.
- Klinefelter syndrome: Associated with poor coordination, muscle weakness, reading difficulties, gynecomastia, delayed secondary sexual characteristic development, taller than average stature, rounded body, and microorchidism.
- Turner syndrome: Features include short stature, widely spaced nipples, webbed neck, high-arched palate, and a phenotypically female appearance due to the absence of a Y chromosome.
- Grave's eye disease symptoms: Bulging eyes, eye irritation/dryness, double vision, swelling around the eyes, and eye pain with movement.
- Transcortin (corticosteroid-binding globulin): Principal serum cortisol-binding protein, with albumin binding approximately 20% of circulating cortisol in an inactive form.
- Bilateral adrenal hyperplasia: Can lead to Cushing's syndrome due to excess cortisol production.
- Polymyositis: Characterized by proximal muscle weakness, specifically in the hips and shoulders; non-fatiguable weakness. Prednisolone (steroid, glucocorticoid) is a first-line treatment due to its immunosuppressant properties.
- Cortisol catabolic effects: Bone resorption, immune system suppression, muscle proteolysis, and lipolysis.
- Cortisol anabolic effects: Gluconeogenesis.
- ADH (antidiuretic hormone): Released from the posterior pituitary via magnocellular neurons from the hypothalamus; stored in Herring bodies.
- CYP11b1 & CYP11B2: Code for 11β-hydroxylase and aldosterone synthase, respectively.
- Somatostatin and pegvisomant: Used to treat acromegaly by influencing GH secretion and action.
- Secondary adrenal insufficiency: Defined by chronic low ACTH stimulation, low ACTH, delayed cortisol recovery, and delayed cortisol rise after a synacthen test. Addison's disease shows no significant cortisol rise in a synacthen test.
- Dopamine: Inhibits prolactin.
- Hypopituitarism: Partial or complete loss of anterior pituitary function due to tumor, pituitary apoplexy, or long-term corticosteroid suppression. Lack of ACTH secretion impacts the zona fasciculata and reticularis. Low cortisol is associated with a lack of ADH inhibition on the posterior pituitary. High vasopressin causes ECF expansion, decreased Na+, and decreased K+ (dilutational hyponatremia).
Other Endocrine Conditions
- 5α-reductase: Converts testosterone to DHT (dihydrotestosterone), a more potent androgen involved in male secondary sexual characteristic development.
- PTH (Parathyroid Hormone): Increases bone resorption, renal calcium absorption, and active vitamin D synthesis.
- Endometriosis: Symptoms: dysmenorrhea, dyspareunia, infertility, and chocolate cyst on imaging.
- PCOS (Polycystic Ovary Syndrome): Symptoms: irregular periods and hyperandrogenism.
- Elevated FSH and LH with low estradiol: Indicates primary ovarian insufficiency.
- Spironaloctone: A mineralocorticoid antagonist with anti-androgen effects; used to manage hirsutism.
- Adapalene & Bromocriptine: Used for acne and infertility (prolactinaemia), respectively.
- Clomifene citrate: Treats female infertility due to ovulatory dysfunction (e.g., PCOS).
- Co-cyprindiol: Treats acne.
- Kallmann syndrome: Genetic mutation affecting GnRH secretion, associated with anosmia and delayed/absent puberty.
- Adrenal venous sampling: Diagnoses unilateral vs. bilateral aldosterone overproduction (Conn's disease or BAH).
- Renal artery Doppler ultrasound: Detects renal artery stenosis (secondary hyperaldosteronism).
- Adrenal MRI: Detects adrenal masses.
- 24-hour urinary metanephrines: Diagnoses pheochromocytoma.
- GnRH agonists: Downregulate the hypothalamic-pituitary-ovarian axis, reducing estrogen production, useful in endometriosis to control ectopic endometrial tissue growth and reduce symptoms.
- Keto diet: High fat, low carb.
- Metabolic syndrome: Clustering of CVD risk factors; underlying pathophysiology relates to insulin resistance and visceral/central obesity. Criteria: increased waist circumference, BMI > 30, dyslipidaemia (raised triglycerides or reduced HDL cholesterol), hypertension, impaired glucose tolerance.
Additional Endocrine Information
- Patients on long-term steroids: Doses should be doubled during intercurrent illness to combat infections, as their own steroid production is suppressed.
- Adrenal crisis: Immediate hydrocortisone IM injection can treat it. Stopping long-term steroids during illness precipitates Addisonian crisis.
- Steroid medications: List comparing different steroids based on their relative glucocorticoid and mineralocorticoid activity (Fludrocortisone, Hydrocortisone, Prednisolone, Dexamethasone, Betamethasone).
- Polymyositis: Autoimmune inflammatory myopathy; proximal muscle weakness and elevated CK levels.
- Myasthenia gravis: Fatiguable weakness without CK elevation.
- Rhabdomyolysis: Weakness associated with acute muscle damage; not chronic progression.
- Addison's disease: Destruction of adrenal gland (primary adrenal insufficiency); low aldosterone, low Na+, high K+, low cortisol, low glucose, high ACTH, high urea.
- Acromegaly: 75% due to pituitary macroadenoma, increased IGF-1, random GH levels inappropriate due to pulsatile release. Glucose tolerance test normally suppresses GH in normal individuals, but not in acromegaly cases.
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Description
Test your knowledge on key endocrinological syndromes such as Kallmann, Klinefelter, and Turner syndrome. This quiz also covers Grave's eye disease, adrenal hyperplasia, and important hormones. Engage with various conditions and their symptoms to assess your understanding of endocrinology.
