Science Medicine
ENDOCRINOLOGY BOARDS ABIM EXAM
LATEST VERSION 2024-2025 ACTUAL EXAM 180
QUESTIONS AND CORRECT DETAILED
ANSWERS WITH RATIONALES
Leave the first rating
100% SCORE 1 /7
HA, diplopia, visual field defect, seizures; occasionally can get CNS
rhinorrhea
Give this one a try later!
1 Pituitary adenoma cell types Mass effect sx of pituitary mass
Anterior pituitary - hormones and
3 Acromegaly sx 4
controls (6 hormones)
Don't know?
Terms in this set (140)
, Primary - problem with the gland that secretes the
hormone (ie: thyroid doesn't produce thyroid
hormone)
Secondary - problem is the gland that controls the
What are primary,
primary gland (ie. pituitary doesn't produce TSH to
secondary, and tertiary
stimulate the thyroid)
disease?
Tertiary - problem with the gland that controls the
secondary gland that controls the primary gland (ie.
hypothalamus not producing TRH ->no TSH from
pituitary -> no T3/T4 from thyroid)
How does the Controls the anterior pituitary via hormones
hypothalamus control the Controls the posterior pituitary via neurohypophysis
pituitary? - direct nerve stimulation
Posterior pituitary Secrete ADH and oxytocin
functions
Anterior pituitary - osmoreceptors to control ADH
release and thirst
Increased release rapidly with elevated osmolarity
Also see increased release with nausea
ADH regulation ADH osmolar release set point is affected by:
Lower set point (release at lower osm) with
pregnancy and pre-menses
Higher set point with chronic hypovolemia, acute
HTN, corticosteroids
, 1. ACTH - peak 3-4 am, nadir 10-11pm; stimulates
corticosteroids and androgens from adrenals;
increase with corticotropin releasing hormone,
physical/psych stress
2. Growth hormone - GHRH increases, somatastatin
decreases, both from hypothalamus
3. LH & FSH - produced by gonadotrophs;
Anterior pituitary - increased by pulsatile secretion of GnRH from
hormones and controls hypothalamus; Inhibin from ovary & testes
(6 hormones) decreases FSH (only) production
4. PRL - tonic inhibition from hypothalamic
dopamine; increase with sleep, stress, lactation,
nipple stimulation; Metaclopramine, phenothiazines
(decrease dopamine) increase PRL; Hypothyroid
modestly increases PRL
5. TSH - stim by TRH from hypothalamus, inhibited
by T3, T4, somatastatin
1. Lactotrophs - secrete PRL; tied, most common
macroademona
2. Gonadotrophs -tied, most common
macroademona; presents as mass effect +/- silent or
Pituitary adenoma cell panhypopit or gonadotropin hypersecretion
types 3. Somatotrophs- acromegaly
4. Corticotrophs - cushings
5. Thyrotrophs - hyperthyroidism (least common)
6. Mixed (somatotrophs+lactotrophs) - acromegaly +
hyperPRL
Mass effect sx of pituitary HA, diplopia, visual field defect, seizures;
mass occasionally can get CNS rhinorrhea
, Sx first
Check MRI
Labs - PRL, IGF-1 (for acromegaly), 24 hr urine free
cortisol or 1mg overnight dexamethasone
suppression test (for excess) or ACTH stim test (for
Dx of pituitary adenoma deficiency), TSH, FT4, alpha subunit of FSH, LH
(confirms pituitary origin)
If mass on MRI, but all labs normal, likely a non-
pituitary tumor - craniopharyngioma, meningioma,
eosinophilic granuloma, histiocytosis X, pituitary
mets
Can be misread and be normal
multiparous women in 90% - pituitary compressed
Empty sella syndrome
by CSF, but functions normally
No treatment if no hormone abnormalities
Most common functional tumors; usually
microadenomas, can be space occupying lesions
Elevated PRL->decreased release of GnRH-
>decreased LH/FSH-> decreased libido, ED in men,
amennorhea and hirsutism in females; Increased
Symptoms and labs in size=increased PRL, so if > 1cm and PRL<100, it's not a
prolactinoma prolactinoma
Men present later->only decreased libido, so
present as space occupying lesion (visual field
defects)
Can cause galactorrhea in women, decreased bone
mineralization
Prolactinoma, phenothiazines, amitriptyline,
metaclopramide (all decreased dopamine),
Causes of increased PRL
estrogen (inhibits dopamine->elevated PRL in
pregnancy), hypothyroidism
ENDOCRINOLOGY BOARDS ABIM EXAM
LATEST VERSION 2024-2025 ACTUAL EXAM 180
QUESTIONS AND CORRECT DETAILED
ANSWERS WITH RATIONALES
Leave the first rating
100% SCORE 1 /7
HA, diplopia, visual field defect, seizures; occasionally can get CNS
rhinorrhea
Give this one a try later!
1 Pituitary adenoma cell types Mass effect sx of pituitary mass
Anterior pituitary - hormones and
3 Acromegaly sx 4
controls (6 hormones)
Don't know?
Terms in this set (140)
, Primary - problem with the gland that secretes the
hormone (ie: thyroid doesn't produce thyroid
hormone)
Secondary - problem is the gland that controls the
What are primary,
primary gland (ie. pituitary doesn't produce TSH to
secondary, and tertiary
stimulate the thyroid)
disease?
Tertiary - problem with the gland that controls the
secondary gland that controls the primary gland (ie.
hypothalamus not producing TRH ->no TSH from
pituitary -> no T3/T4 from thyroid)
How does the Controls the anterior pituitary via hormones
hypothalamus control the Controls the posterior pituitary via neurohypophysis
pituitary? - direct nerve stimulation
Posterior pituitary Secrete ADH and oxytocin
functions
Anterior pituitary - osmoreceptors to control ADH
release and thirst
Increased release rapidly with elevated osmolarity
Also see increased release with nausea
ADH regulation ADH osmolar release set point is affected by:
Lower set point (release at lower osm) with
pregnancy and pre-menses
Higher set point with chronic hypovolemia, acute
HTN, corticosteroids
, 1. ACTH - peak 3-4 am, nadir 10-11pm; stimulates
corticosteroids and androgens from adrenals;
increase with corticotropin releasing hormone,
physical/psych stress
2. Growth hormone - GHRH increases, somatastatin
decreases, both from hypothalamus
3. LH & FSH - produced by gonadotrophs;
Anterior pituitary - increased by pulsatile secretion of GnRH from
hormones and controls hypothalamus; Inhibin from ovary & testes
(6 hormones) decreases FSH (only) production
4. PRL - tonic inhibition from hypothalamic
dopamine; increase with sleep, stress, lactation,
nipple stimulation; Metaclopramine, phenothiazines
(decrease dopamine) increase PRL; Hypothyroid
modestly increases PRL
5. TSH - stim by TRH from hypothalamus, inhibited
by T3, T4, somatastatin
1. Lactotrophs - secrete PRL; tied, most common
macroademona
2. Gonadotrophs -tied, most common
macroademona; presents as mass effect +/- silent or
Pituitary adenoma cell panhypopit or gonadotropin hypersecretion
types 3. Somatotrophs- acromegaly
4. Corticotrophs - cushings
5. Thyrotrophs - hyperthyroidism (least common)
6. Mixed (somatotrophs+lactotrophs) - acromegaly +
hyperPRL
Mass effect sx of pituitary HA, diplopia, visual field defect, seizures;
mass occasionally can get CNS rhinorrhea
, Sx first
Check MRI
Labs - PRL, IGF-1 (for acromegaly), 24 hr urine free
cortisol or 1mg overnight dexamethasone
suppression test (for excess) or ACTH stim test (for
Dx of pituitary adenoma deficiency), TSH, FT4, alpha subunit of FSH, LH
(confirms pituitary origin)
If mass on MRI, but all labs normal, likely a non-
pituitary tumor - craniopharyngioma, meningioma,
eosinophilic granuloma, histiocytosis X, pituitary
mets
Can be misread and be normal
multiparous women in 90% - pituitary compressed
Empty sella syndrome
by CSF, but functions normally
No treatment if no hormone abnormalities
Most common functional tumors; usually
microadenomas, can be space occupying lesions
Elevated PRL->decreased release of GnRH-
>decreased LH/FSH-> decreased libido, ED in men,
amennorhea and hirsutism in females; Increased
Symptoms and labs in size=increased PRL, so if > 1cm and PRL<100, it's not a
prolactinoma prolactinoma
Men present later->only decreased libido, so
present as space occupying lesion (visual field
defects)
Can cause galactorrhea in women, decreased bone
mineralization
Prolactinoma, phenothiazines, amitriptyline,
metaclopramide (all decreased dopamine),
Causes of increased PRL
estrogen (inhibits dopamine->elevated PRL in
pregnancy), hypothyroidism
