Diseases of Organ systems ENDOCRINE -34%

Question 1

What is gigantism due to

Answer 1

Excess growth hormone from the pituitary before 18 years

Question 2

Gigantism may be associated with functioning _________ adenoma and presents with:

Answer 2

Adenoma

• overgrowth of tissues in the entire body-large hands and protruding jaw
• headache
• visual disturbance

Question 3

What is acromegaly due to

Answer 3

Excess GH from pituitary after growth plate has closed

Question 4

Acromegaly is associated with a functioning ________ adenoma presenting with:

Answer 4

• protruding jaw, large spatulate hands and large feet
• headache
• visual disturbance

Question 5

What is Cushing’s disease caused by? This causes ____ resulting in ______

Answer 5

Excess ACTH from a functioning pituitary adenoma

• excess cortisol production by the adrenal cortex resulting in:
• moon-face, buffalo hump, truncal obesity and hypertension
• purple striae on the abdomen and hyperpigmented skin creases
• muscle wasting in the extremities, recurrent infections

Question 6

What is a GH deficiency in children called?

Answer 6

Pituitary dwarfism

• may be related to a non-functioning pituitary tumor presenting with growth retardation

Question 7

What is Sheehan’s syndrome? What does it result in

Answer 7

Ischemic necrosis of anterior pituitary lobe following a severe postpartum hemorrhage

• after, there is no secretions from the anterior lobe resulting in amenorrhea, cessation of lactation and loss of axillary pubic hair

Question 8

What is hyperprolactinemia? What does it present with?

Answer 8

Secreting prolactin pituitary adenoma

• golactorrhea (Milkey discharge from a non-lactating breast)
• amenorrhea (absent menstraution, prolactin inhibits GnRH release form the hypothalamus)
• infertility

Question 9

What is golactorrhea

Answer 9

Milky discharge from a non-lactating breast

Question 10

What is amenorrhea

Answer 10

Absent menstruation

Question 11

What is diabetes insipidus? What can cause it? What does it present with?

Answer 11

ADH deficiency

• head injury, pituitary tumors, kidney disease and sarcoidosis
• polyuria (frequent copious diluted colorless urine)
• polydyspia (excessive water consumption)
• constant specific gravity of urine <1.006 in spite of dehydration

Question 12

What is hypothyroidism called in adults? Children?

Answer 12

Myxedema

Cretinism

Question 13

What are primary hypothyroidism levels of T3, T4 and TSH? What does it present with?

Answer 13

Low T3, T4 and high TSH

• fatigue, constipation, brittle hair, slow to relax reflexes, weight gain

Question 14

What are secondary hypothyroidism levels of T3, T4 and TSH?

Answer 14

Low T3, T4 and low TSH: pituitary hypofunctioning

Question 15

What is hashimoto’s thyoiditis?

Answer 15

Anti-thyroglobulin antibodies, goiter and hypothyroidism

Question 16

What is reidel’s thyroiditis?

Answer 16

Lymphocytic fibrotic thyroid disease leading to hypothyroidism

Question 17

What are primary hyperthyroidism levels of T3, T4 and TSH

Answer 17

Elevated T3, T4, low TSH

Question 18

What is Grave’s disease?

Answer 18

Most common form of hyperthyroidism

• autoimmune disorder-IgG antibodies bind to TSH receptors

Question 19

What are some signs of Grave’s disease?

Answer 19

exophthalmos (bilateral building eyes), goiter, fine tremors of the hands, nervousness, diarrhea,
weight loss despite increased appetite, HLA B8 predisposition

Question 20

What is Plummer’s disease?

Answer 20

Toxic multinodular goiter and no exopthalmos

Question 21

What are secondary hyperthyroidism levels of T3, T4 and TSH?

Answer 21

Elevated T3, T4 and high TSH: TSH secreting pituitary tumor

Question 22

What causes a hyperparathyroidism? what are the signs

Answer 22

Functioning parathyroid adenoma

• hypercalcemia
• fatigue
• brown bone cysts due to decomposed blood and hemosiderin pigment

Question 23

What causes hypoparathyroidism? What are the sings

Answer 23

Incidental removal of the parathyroid in total thyroidectomy.

• causes hypokalemia and tetany and muscle twitching

Question 24

What is Chvostek test?

Answer 24

Tapping the facial nerve in front of the ear causing facial twitching

• positive with hypoparathyroidism

Question 25

What is Addison’s disease? What are the blood levels? What are the signs?

Answer 25

Chronic underfunctioning of the adrenal cortex. May be an autoimmune disorder or associated with TB infection

• low Na, low BP, high K, high ACTH, low glucocorticoids and aldosterone
• hyperpigmented skin creases and bronze skin

Question 26

What is waterhouse-friderichsen syndrome?

Answer 26

Acute adrenal bleeding secondary to neisseria meningitides septicemia

Results in shock and hemorrhagic rash

Question 27

What is Conn’s disease? What are levels?

Answer 27

Overfunctioning of the zona glomerulosa layer of the adrenal cortex due to adrenal adenoma which produces excess mineralocorticoids

• low K, low renin, metabolic alkalosis and high BP

Question 28

What is Cushing’s syndrome

Answer 28

May be due to exogenous steroids or a tumor of the adrenal cortex

• truncated obesity, moon face and buffalo hump, hypertension, hyperglycemia, poor wound healing purple abdominal striae but no hyperpigmentation

Question 29

What is a neuroblastoma?

Answer 29

Most common adrenal medulla tumor in children, associated with the N-myc oncogene

Question 30

What is a pheochromocytoma?

Answer 30

Adrenal medulla tumor

• palpitation, perspiration, pressure headache, periodic hypertension
• vanilla mandelic acid is found in excess in urine

The 10% tumor,
- 10% are bilateral, 10% are malignant, 10% occur outside of the adrenal gland, 10% are familial