AG-ACNP Endocrine Test Questions
and Answers
What does the ACTH stimulation test help do? Correct Ans-differentiate between pituitary
causes vs adrenal causes
What is SIADH? Correct Ans-Syndrome of Inappropriate not diuresing hormone
What happens in SIADH? Correct Ans-Release of the ADH occurs independent of osmolality
or volume dependent stimulation
What is characterized in SIADH? Correct Ans-WATER RETENTION
What are causes of SIADH? Correct Ans-tumor producing ADH
SKull fx/head trauma
CNS d/o
Chronic lung disease
What are s/s of SIADH? Correct Ans-Neuro changes(from hyponatremia)
Decreased DTR
hypothermia
Wt gain/edema
n/v
,cold interolerance
What are labs assc w/SIADH? Correct Ans-HYPOnatremia (yet euvolemic)
DECREASED serum osmolality (<280)
INCREASED urine osmolality (>100)
Urine sodium >20
Renal, Cardiac, thyroid fxn all are NORMAL
How do you manage SIADH? Correct Ans-Treat underlying cause
If serum NA >120, restrict total fluids to 1L/day and monitor
If serum NA 110-120 WO neuro symptoms, restrict fluids to 500ml/day and monitor.
If serum Na < 110 OR neuro symptoms present, replace w/isotonic or HYPERtonic saline and
Lasix at 1-2mEq/hr, monitor Na and K losses hourly and replace
What is Diabetes Insipidus? Correct Ans-It is a diuresing disease
What are the types of DI? Correct Ans-central
nephrogenic
psychogenic:refer
What is the cause of central DI? Correct Ans-related to pituitary or hypothalamus damage
resulting in ADH deficiency such as idiopathic, damage to pituitary, trauma, infxn, carcinoma
, What is nephrogenic DI? Correct Ans-a result of a defect in the renal tubules resulting in
renal insensitivity to ADH
What are the causes of nephrogenic DI? Correct Ans-familial X-linked trait
acquired during pyelonephritis
What are s/s of DI? Correct Ans-thirst/craving for water
Polyuria (2-20L/day and nocturia)
wt loss/fatigue
changes in LOC
dizziness
tachycardia
hypotension
What labs are assc w/DI:? Correct Ans-HYPERnatremia
elevated BUN/cr
Serum osmolality >290
Urine osmolality < 100
Low urine specific gravity
What test is done to differentiate central DI from nephrogenic DI? Correct Ans-a Vasopressin
challenge test
and Answers
What does the ACTH stimulation test help do? Correct Ans-differentiate between pituitary
causes vs adrenal causes
What is SIADH? Correct Ans-Syndrome of Inappropriate not diuresing hormone
What happens in SIADH? Correct Ans-Release of the ADH occurs independent of osmolality
or volume dependent stimulation
What is characterized in SIADH? Correct Ans-WATER RETENTION
What are causes of SIADH? Correct Ans-tumor producing ADH
SKull fx/head trauma
CNS d/o
Chronic lung disease
What are s/s of SIADH? Correct Ans-Neuro changes(from hyponatremia)
Decreased DTR
hypothermia
Wt gain/edema
n/v
,cold interolerance
What are labs assc w/SIADH? Correct Ans-HYPOnatremia (yet euvolemic)
DECREASED serum osmolality (<280)
INCREASED urine osmolality (>100)
Urine sodium >20
Renal, Cardiac, thyroid fxn all are NORMAL
How do you manage SIADH? Correct Ans-Treat underlying cause
If serum NA >120, restrict total fluids to 1L/day and monitor
If serum NA 110-120 WO neuro symptoms, restrict fluids to 500ml/day and monitor.
If serum Na < 110 OR neuro symptoms present, replace w/isotonic or HYPERtonic saline and
Lasix at 1-2mEq/hr, monitor Na and K losses hourly and replace
What is Diabetes Insipidus? Correct Ans-It is a diuresing disease
What are the types of DI? Correct Ans-central
nephrogenic
psychogenic:refer
What is the cause of central DI? Correct Ans-related to pituitary or hypothalamus damage
resulting in ADH deficiency such as idiopathic, damage to pituitary, trauma, infxn, carcinoma
, What is nephrogenic DI? Correct Ans-a result of a defect in the renal tubules resulting in
renal insensitivity to ADH
What are the causes of nephrogenic DI? Correct Ans-familial X-linked trait
acquired during pyelonephritis
What are s/s of DI? Correct Ans-thirst/craving for water
Polyuria (2-20L/day and nocturia)
wt loss/fatigue
changes in LOC
dizziness
tachycardia
hypotension
What labs are assc w/DI:? Correct Ans-HYPERnatremia
elevated BUN/cr
Serum osmolality >290
Urine osmolality < 100
Low urine specific gravity
What test is done to differentiate central DI from nephrogenic DI? Correct Ans-a Vasopressin
challenge test
