Endocrine Board Review Take Home Quiz

1.  What is the annual growth rate for the following ages and gender?

  1. 2 y to puberty 5-6 cm/year
  1. Puberty – Girls 6-11cm/year
  1. Puberty – Boys 7-13 cm/year

2.  Puberty

  1. Puberty in boys starts when the testicular volume is _____>4_____mL.
  1. The first sign of puberty is girls is ___breast______development.

3.  Name the factors that provide positive and negative feedback to the following hormones

Hormone Positive Negative

  1. GH ______GHRH______somatostatin, GH___
  1. ACTH ______CRF______cortisol, steroids_____
  1. LH/FSH ______GnRH______estrogen, inhibin, testosterone_
  1. TSH ______TRH______thyroid hormone_____

4.  Posterior Pituitary

  1. What is the function of Vasopression – released when osmotic pressure increases and maintains water balance. It increases reabsorption of water in the collecting ducts of the kidney and increases thirst. It may also cause arteriolar vasoconstriction
  1. What diagnosis and lab findings are associated with. . .
  2. Overproduction of Vasopressin – SIADH – decreased osmolarity
  1. Underproduction of Vasopressin – DI – increased osmolarity

5.  What are the typical lab findings (including antibody studies) in the following?

  1. Graves Disease – decreased TSH, increased fT4, +TSH receptor antibodies
  1. Hashimoto’s Thyroiditis – increased TSH, decreased fT4, = antithyroperoxidase and antithyroglobulin antibodies

6.  Name the actions of PTH on the following

  1. Bone – increases Ca and Phos release
  1. Intestine – increases resorption of Ca and Phos
  1. Kidney – increases Phos excretion and decreases Ca excretion, stimulates Vit D3 synthesis

7.  CAH

  1. What are the typical lab findings? Hyponatremia (salt wasting), hyperkalemia
  1. How do you diagnose 21-hydroxylase deficiency? Elevated 17-hydroxyprogesterone levels
  1. What is the typical presentation of 21-hydroxylase deficiency? Ambiguous genitalia

8.  What are the causes of ambiguous genitalia and which one will present with nonpalpable gonads? CAH (No palpable gonads, Leydig cell hypoplasia, inborn errors of testosterone synthesis, androgen insensitivity

9.  What is the difference between precocious puberty, premature thelarche and premature adrenarche?

Precocious puberty – from the HPG axis and will follow typical pattern of development seen in puberty

Premature thelarche – breast development only, diagnosis of exclusion, may be caused by exogenous estrogen

Premature adrenarche – hair development, body odor or acne, no other signs of development, caused by increased androgens

10.  Name the comorbidities associated with obesity.

Insulin resistance, dyslipidemia, HTN, Non-alcoholic fatty liver disease