endocrine Flashcards
In graves disease of the thyroid, what is the best pathological process happening?
A. hypertrophy
B. atrophy
C. hyperplasia
D. metaplasia
C. Hyperplasia
Lots of thyroid follicles hence a lot of cells.
which of these thyroid malignancies has the worst prognosis?
A. Follicular adenoma
B. Follicular carcinoma
C. Anaplastic carcinoma
D. Papillary carcinoma
Anaplastic carcinoma
medullary thyroid carcinoma arises from which cells
A. thyroid endothelial cells
B. thyroid parafollicular C cells
C. thyroid medullary cells
D. thyroid follicular cells
thyroid parafollicular c cells
also: paraneoplastic syndrome includes VIP secretion- diarrhea, ACTH- cushing syndrome
important!! look out for MEN syn related tumours
Patient with hypercalcemia also has low phosphate. Possible diagnosis include
A. Vitamin D excess
B. vitamin D deficiency
C. primary hyperparathyroidism
D. untreated renal failure
C. primary hyperparathyroidism
A and B and D would affect both calcium and phosphate in the same way- having the same change. (increase or decrease)
PTH is the only option which reduces phosphate reabsorption while increase calcium reabsorption in the kidney
which syndrome is associated with thyroid medullary carcinoma
A. MEN
B. PTEN
C. Downs
D. FAP
A. MEN
Most thyroid lymphomas arise in the background of
A. Hashimoto thyroiditis
B. Papillary thyroid carcinoma
C. normal thyroid
D. Graves Disease
A. Hashimoto thyroiditis
Which of these hormones is produced in the posterior pituitary?
A. TSH
B. FSH
C. GH
D. ACTH
E. ADH
ADH and oxytocin are the only 2 hormones produced from posterior pituitary.. m1 content!!
In a patient with a thyroid malignancy and only lymph node metastasis, which is the most likely diagnosis?
A. medullary thyroid carcinoma
B. anaplastic thyroid carcinoma
C. poorly differentiated thyroid carcinoma
D. papillary thyroid carcinoma
D. papillary thyroid carcinoma
what syndrome is pheochromocytoma associated with?
A. downs
B. MEN
C. FAP
D. PTEN
MEN
What is the test for Addison disease
A. Ultrasound test
B. Synacthen test
C. 24hr urinary metanephrines
D. overnight dexamethasone test
B. synacthen test
overnight dexamethasone test is for cushing!!
Which of the following thyroid lesions is associated with a bruit sound
A. Papillary thyroid carcinoma
B. Follicular adenoma
C. Hashimoto
D. Graves
D. graves
hyperactive thyroid- release a lot of T3/T4, so need to have blood vessels supplying to drain the T3/T4 into circulation, blood vessels in engorged thyroid
Which one of these is a midline lesion
A. thyrogossal duct
B. branchial cleft cyst
C. carotid body tumour
D. submandibular tumour
A. thyroglossal duct cyst
recall thyroid descends from foramen cecum of the tongue to the neck area, the thyroglossal duct links the foramen cecum to the thyroid isthmus which is at the midline of the neck hence midline lesion
Which one of the following will you see Hurtle Cells AND lymphocytes on fine needle aspiration?
A. graves disease
B. Hashimoto’s disease
C. hurtle cell carcinoma
D. lymphoma
Hashimoto’s disease, associated with hurtle cell adenoma, not carcinoma!!
which of the following lesion moves when you ask patient to stick out tongue??
A. neck lipoma
B. thyroglossal duct cyst
C. papillary thyroid carcinoma
D. sternocleidomastoid tumour
B. thyroglossal duct cyst
connects the tongue from the foramen cecum to the isthmus of the thyroid gland.
Papillary thyroid carcinoma is most commonly associated with which of the following genetic aberrations?
A. RET
B. TP53
C. TERT
D. PAX8
A. RET/PTC rearrangements and BRAF mutation is involved in papillary thyroid carcinoma
follicular adenoma and follicular carcinoma: RAS mutations; PPARy/ PAX8 rearrangements
high grade : Poorly differentiated thyroid carcinoma and differentiated high grade thyroid carcinoma
+
undifferentiated: anaplastic thyroid carcinoma
-> mutations/ rearrangements AND TERT, TP53 mutations
low grade: papillary thyroid carcinoma: BRAF mutations; RET/PTC rearrangements
Medullary carcinoma: RET mutations (not rearrangements)
