3- Endocrine

Question 1

What are pituitary adenomas

Answer 1

usually benign and encapsulated

can be hyper or hypo functioning- most are hormonally active

Question 2

What do pituitary adenomas cause if they compress adjacent structures

Answer 2

hypopituitarism or diabetes insipidus

Question 3

What causes diabetes insipidus

Answer 3

posterior pituitary hypo function or pituitary tumor compressing the stalk= no ADH released= polydipsia and polyuria

Question 4

What is Gigantism

Answer 4

Excess GH due to somatotropin adenoma before the epiphyseal plates close
-Causes longitudinal growth

Question 5

What causes dwarfism

Answer 5

Pituitary insufficiency in childhood

Question 6

What causes cretinism

Answer 6

Thyroid deficiency causing retarded mental development

Question 7

What causes Myxedema

Answer 7

Thyroid deficiency slowing function of all organs in the body
-Causes puffy skin, lethargy, little mental awareness and endurance

Question 8

What are symptoms of Myxedema madness

Answer 8

depression, megacolon, bradyarrhythmia

Question 9

What are thyroid levels related to hypothyroid

Answer 9

T3 and T4 are low, but TSH is compensatorily high

-Tx with lifelong synthetic thyroid hormones

Question 10

What is acromegaly

Answer 10

Excess GH from somatotropic adenomas after epiphyseal plates close
-Surgically removed due to Macroscopic size

Question 11

What are symptoms of acromegaly

Answer 11

enlarged hands, tongue, nose, jaw, heart, liver, spleen

-Hyperglycemia, hypercalcemia

Question 12

What is Grave’s disease

Answer 12

AI disease with IgG to TSH receptors on the surface of thyroid follicular cells causing constant T3 T4 secretion (thyrotoxicosis)
W>M

Question 13

What are symptoms of Grave’s disease

Answer 13

restless, nervous, emotionally labile, sweating, tachycardia, palpitations, tremors, diarrhea, weight loss, increased appetite
Exophthalmos (collagen deposits in EOM)

Question 14

What is the goiter in Graves disease made of

Answer 14

hyperplasia follicles, hyperactive tall cuboidal cells, lymphoid follicles

Question 15

What is Hashimoto’s disease

Answer 15

-Immune destruction (lymphocytes and plasma cells) of thyroid (destroyed follicles )
-gradual failure and hypothyroidism
-Goiter due to body trying to compensate
W 45-65

Question 16

What are thyroid adenomas

Answer 16

solitary nodules encapsulated with fibrous tissue and thyroid follicles, that concentrate radioactive iodine
-Start euthyroid and suddenly become thyrotoxic (hyper)

Question 17

Do you treat thyroid adenomas

Answer 17

Not normally

If they are atypical and invade into the capsule, then Tx is more aggressive

Question 18

What are the types of thyroid carcinoma

Answer 18

Papillary, follicular, and anaplastic- from follicular cells
Medullary- from parafollicular C-cells
W>M, no RF

Question 19

What are papillary carcinomas

Answer 19

80% of thyroid cancers, low grade malignancy

Hormonally inactive and occur early in life- favorable prognosis

Question 20

What are medullary carcinomas

Answer 20

Round neuroendocrine cells with amyloid (beta pleated sheet) in the stroma, that produce calcitonin

Question 21

What are anaplastic carcinomas

Answer 21

Undifferentiated large or small tumor cells that don’t resemble thyroid cells
Rare, VERY poor prognosis (most die w/in 1 year)

Question 22

What kind of thyroid neoplasms are most common

Answer 22

Benign thyroid neoplasms- mets to bone

Question 23

What is Cushing’s DISEASE

Answer 23

Increased Pituitary stimulation causing hyper secretion of ACTH (corticotropic) from a pituitary adenoma

Question 24

What is Cushing’s SYNDROME

Answer 24

Adrenocortical tumor causes zona fasciculata (adrenal cortex) to produce too many glucocorticoids leading to hypercortisolism

Question 25

What are symptoms of Cushing’s Syndrome

Answer 25

central obesity (buffalo hump and moonface)
red face (HTN and thin skin)
fatigue
weakness
glucose intolerance

Question 26

What do adrenocortical tumors look like

Answer 26

yellow (high lipid), well circumscribed

can be benign or malignant

Question 27

What is the MCC of Cushing’s syndrome

Answer 27

EXOgenous steroid hormones (for AI, renal dz, and skin disorders) causing adrenals to shut off
*Taper off steroids to prevent avoid

Question 28

What is Waterhouse Friedrichsen Syndrome

Answer 28

acute adrenal destruction due to Nisseria meningitides getting into the blood and causing hemorrhage

Question 29

What are symptoms of waterhouse Friedrichsen syndrome

Answer 29

Massive purport (in babies, adrenals become blood bags)

Question 30

What can cause the pituitary to enlarge

Answer 30

lactotrophic, somatotrophic, or corticotropic cells

Question 31

What is the most common pituitary adenoma

Answer 31

Prolactinoma- small (microscopic) benign tumor made of PRL secreting cells

Question 32

What are symptoms of Prolactinoma

Answer 32

Amenorrhea, galactorrhea, infertility (high PRL= low LH= no ovulation)
Men: galactorrhea, impotence, no libido

Question 33

How can you inhibit PRL secretion

Answer 33

Bromocriptine

may need transnasal surgery to sella tursica if the tumor is large

Question 34

What is Panhypopituitarism

Answer 34

dysfunction of ALL pituitary cells- Simmond’s disease

Question 35

What causes pituitary hypo function

Answer 35

congenital necrosis
ischemia
Sheehan’s disease (postpartum pituitary necrosis)

Question 36

What are symptoms of Simmond’s disease

Answer 36

weakness
cold intolerance
poor appetite 
weight loss
hypotension 
W: Amenorrhea
M: Impotence