Question

1. What tests can be used to diagnose diabetes per the ADA criteria (choose all that apply a-g)?

a. Fructoasmine b. Glycated Hemoglobin c. Urine Glucose d. Fasting Glucose e. Random Glucose f. 2-hour Post Prandial Glucose g. 1 hour oral glucose tolerance test

2. A patient with secondary hypothyroidism will have a dysfunctioning ____ and their TSH will be ____.

a. thyroid, low b. pituitary, low c. thyroid, high d. pituitary, high

3. A patient with acromegaly has a 2-hour oral glucose tolerance test performed. After the 2 hours their growth hormone levels will be:

a. increased b. decreased c. normal

4. A patient with hypoparathyroidism will present with a prolonged ___ interval.

5. The etiology of most primary pituitary disorders is:

a. Infections b. Neoplastic c. Idiopathic d. Iatrogenic

6. A patient with primary hypothyroidism will have a dysfunctioning ___thyroid_, have a low ____, and a high ____

a. thyroid, TSH, thyroxine b. pituitary, thyroxine, TSH c. thyroid, thyroxine, TSH d. pituitary, TSH, thyroxine

7. A patient with tertiary hypothyroidism has undergone a TRH stimulation test. After the TRH is infused into their system, what should happen to the TSH value?

a. decrease b. increase c. remain unchanged

Answer 1

Answer is b,d,e,f

ADA for diagnosis of diabetes

1)HbA1C test measures your average blood sugar for the past 2 to 3 months.

Diabetes is diagnosed at an HbA1C of greater than or equal to 6.5%

2)Fasting blood glucose levels.
Diabetes is diagnosed at fasting blood sugar of greater than or equal to 126 mg/dl

3) Random blood glucose level
Diabetes is diagnosed at blood sugar of greater than or equal to 200 mg/dl

4) Post prandial blood glucose level
( after 2 hours of food )
Diabetes is diagnosed at 2 hour blood sugar of greater than or equal to 200 mg/dl

Option g) Incorrect as 2hr oral glucose- tolerance test is used and not 1hr.

Answer 2) b Pituitary ,Low TSH

A

Explanation Secondary Hypothyroisism means problem is in Pituitary gland .So TSH from Anterior Pituitary is not secreted hence low TSH so Action of TSH on Thyroid gland doesn't occur and no release of Thyroid hormones ( T3,T4) resulting in Hypothyroisism .

Answer 3)a) Increased

Acromegaly is Growth hormone secreting tumour .So excess of growth hormones are present in blood .For confirmation of Acromegaly we do Oral glucose tolerance test here 75 gram of oral glucose is given and after 2 hours GRowth hormone levels are measured if it is less than 1 ng/ ml It is normal .If it is more than 1 ng/ ml ----> Acromegaly .Normally Hyperglycaemia suppresses growth hormone release in Normal person .In Acromegaly excess Growth hormones present even after Oral glucose tolerance test .

Answer 4) Hypoparathyroidism ---Prolonged QT interval

>Hypocalcaemia because of Hypoparathyroidism is a recognised cause of QT prolongation via prolongation of the plateau phase of the cardiac action potential.

Answer 5) Neoplasm

Most common cause for Pituitary disorder is Pituitary Adenoma in which most common is Prolactinoma .

Answer 6)C ) Thyroid thyroid TSH

Primary Hypothyroidism means problem is in thyroid gland so thyroid hormones like throxine T4 not released in blood so Thyrooxine levels low in blood and negative feedback exerted by Thyrooxine on Pituitary is lost so Excess TSH released from Thyroid

Answer 7) b) Increase

Tertiary hypothyroism is problem in Hypothalamus form where Thyroid releasing hormone is not released ( TRH) so no TRH so Stimulation of Pituitary by TRH no TSH ( Thyroid stimulating hormone ) No TSH no thyroid hormones .

So if TRH is given from outside of will stimulate the thyroid gland to release TSH .