Endo

Question 1

Elevated levels of calcitonin can result from what type of cancer and produce what type of symptoms?

Answer 1

Medullary thyroid cancer

Produce DIARRHEA and occasional flushing

pathologic findings reveal the local production of amyloid, which present as protein that demonstrates apple-green birefringence when viewed under polarized light with Congo Red stain. When comparing thyroid cancers, the presence of amyloid is unique to medullary thyroid cancer. The amyloid derives from precipitated calcitonin

Question 2

List drugs that would be contraindicated in a Type 2 DM pt with

Renal dysfunction

hx heart failure

sulfa allergy

Answer 2

renal-metformin (Metformin is contraindicated for use in males with a creatinine ≥ 1.5 mg/dL and females with a creatinine ≥ 1.4 mg/dL.)

heart-thiazolidinediones (rosiglitazone and pioglitazone)

Sulfonureas (glipizide etc)

Question 3

Describe the microscopic appearance of the following:

Invasive ductal carcinoma

Colloid (mucinous) carcinoma

Invasive lobular carcinoma:

Medullary carcinoma:

Answer 3

IDC: numerous small invasive glandular structures surrounded by desmoplastic stromal response

CC: malignant cells with abundant mucin secretion

ILC: single-file distribution of invasive cancer cells

MC: sheets of tumor cells surrounded by abundant lymphoplasmacytic reaction

Question 4

In a pt with MEN2B what diseases will most likely arise?

If this pt had an enlarged thyroid what would you expect to be elevated in the serum and why?

Answer 4

Medullary thyroid cancer, Pheochromocytoma, and mucosal nueromas

Elevated caclitonin because medullary thyroid cancer is from parafollicular “C” cells

Question 5

Exercise can induce what in diabetic patients?

Answer 5

Hypoglycemia

Infection, pain, and sleep deprivation tend to cause hyperglycemia

Question 6

Why do patients with Turner syndrome have primary ammenorrhea?

Answer 6

in utero degeneration of the ovarian follicles (gonadal dysgensis). This is there is no breast development, because breast development is estrogen dependent and the pt is not making estrogen

Question 7

How do Beta blockers help treat thyrotoxicosis?

Answer 7

decrease effect of sympathetic adrenergic impulses on target organs (dreased HR/BP) and also decrease the rate of peripheral conversion of T4 to T3