Endocrinology Exam Review: Parathyroid, Thyroid, Pituitary, Adrenal, Diabetes & Lipids for Physician Assistants

Prepare for your physician assistant certification exam with this comprehensive endocrinology review based on A Comprehensive Review for the Certification and Recertification Examinations for Physician Assistants by Claire Babcock O'Connell and Thea Cogan-Drew. This summary covers key endocrine disorders—parathyroid, thyroid, pituitary, adrenal, diabetes, and lipid metabolism—ensuring you master high-yield concepts and clinical management for exam success and patient care.

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Parathyroid Disorders

• Hyperparathyroidism: Caused by adenomas, hyperplasia, or carcinoma. Leads to hypercalcemia, bone pain, renal stones, and psychiatric symptoms. Treated with hydration, bisphosphonates, or surgery.
• Hypoparathyroidism: Results in hypocalcemia—muscle spasms, tetany, Chvostek’s and Trousseau’s signs. Management includes calcium and vitamin D supplementation.

Thyroid Disorders

• Hyperthyroidism (Thyrotoxicosis): Most often due to Graves’ disease. Symptoms: weight loss, anxiety, atrial fibrillation. Treated with beta-blockers, thioamides, radioactive iodine, or surgery.
• Hypothyroidism: Commonly caused by Hashimoto’s thyroiditis. Presents with fatigue, cold intolerance, myxedema. Treated with levothyroxine.
• Thyroiditis: Includes infectious and inflammatory types. Management ranges from supportive care to antibiotics and steroids.
• Thyroid Cancer: Papillary, follicular, medullary, and anaplastic carcinomas. Managed with surgery, radioactive iodine, lifelong T4 replacement.

Pituitary Gland Disorders

• Acromegaly & Gigantism: Excess growth hormone causes enlarged extremities and organomegaly. Treated with surgery and hormone antagonists.
• Diabetes Insipidus (DI): Central (ADH deficiency) and nephrogenic (renal resistance) types. Symptoms: intense thirst and polyuria. Treated with desmopressin or thiazide diuretics.

Diabetes Mellitus

• Type 1 DM: Autoimmune beta-cell destruction. Managed with insulin, dietary changes, close glucose monitoring.
• Type 2 DM: Insulin resistance and beta-cell dysfunction. Treated with lifestyle changes, oral agents, and insulin as needed.
• Complications: Acute (DKA, HHS) and chronic (retinopathy, nephropathy, neuropathy, cardiovascular disease).

Adrenal Gland Disorders

• Cushing Syndrome: Excess cortisol from pituitary or adrenal tumors, or steroid use. Symptoms: central obesity, hypertension, osteoporosis. Managed with surgery or medications.
• Addison Disease: Primary adrenal insufficiency (autoimmune or other causes). Presents with fatigue, weight loss, hyperpigmentation, orthostatic hypotension. Treated with glucocorticoid and mineralocorticoid replacement.

Lipid Disorders

• Hyperlipidemia: Elevated cholesterol and triglycerides, increasing cardiovascular risk. Managed by lifestyle changes, statins, and fibrates.

Glossary of Key Terms

• Hypercalcemia: Elevated calcium levels in the blood, often due to parathyroid disease.
• Thyrotoxicosis: Excess thyroid hormone causing increased metabolic rate.
• Myxedema: Severe hypothyroidism with skin/tissue swelling.
• Acromegaly: Overgrowth syndrome caused by excess growth hormone.
• Diabetic Ketoacidosis (DKA): Dangerous complication of diabetes with hyperglycemia and ketones.
• Addison Crisis: Life-threatening acute adrenal insufficiency.
• Hyperlipidemia: High blood lipid levels, linked to atherosclerosis.

Conclusion: Succeed in Endocrinology Exam Prep

Success in the endocrinology section of the physician assistant exam requires recognizing core symptoms, clinical presentations, and evidence-based management of common and emergency endocrine disorders. Review diagnostic approaches, hormone physiology, and first-line treatments for exam success and better clinical outcomes.

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