Endocrine

Question 1

Most common cause hyperpituitarism

Answer 1

adenoma ant lobe
GNAS1 most common mutation

Question 2

Morphology pituitary adenoma

Answer 2

cellular monomorphism
absence reticulin network

Question 3

Percentage loss for symptomatic hypopituitarism

Answer 3

75% parenchyma

Question 4

main cause ectopic ADH secretion

Answer 4

small cell carcinoma lung

Question 5

Most common cause hyperthyroid

Answer 5

85% graves - diffuse hyperplasia
multinodular goitre
thyroid adenoma

Question 6

Hashimotos

Answer 6

10x more women
autoimmune destruction thyroid gland
assoc other autoimmine and marginal zone b cell lymphoma thyroid

Question 7

granulomatous (de quervians) thyroiditis

Answer 7

painful
triggered by viral infection
multinucleate giant cells
transient hyperthyroid
no radioiodine uptake

Question 8

Graves

Answer 8

most common cause hyperthyroid
90% have thyroid stimulating immunoglobuln
Anti tsh ab

Question 9

diffuse non toxic goitre

Answer 9

enlarged follicles filled with colloid
main cause iodine deficiency
euthyroid

Question 10

Signs of thyroid neoplasm

Answer 10

solitary nodule
young male
previous radiation head / neck
takes up radioiodine

capsular and vascular invasion

Question 11

Most common thyroid cancer

Answer 11

papillary > follicular > medullary > anaplastic

Question 12

hypercalcaemia in malignancy

Answer 12

more likely to be symptomatic
from rankl activating osteoclasts
PTHrP from squamous cell carcinoma

Question 13

main cause hypercalcaemia

Answer 13

primary hyperthyroid - adenoma

Question 14

Cause of death DM

Answer 14

MI then renal

Question 15

T1DM immunological and genetic

Answer 15

destruction of beta cells by T lymphocytes
Class II MHC on chormosome 6
95% have HLA DR3 or DR4
viruses - cocksackie B, MMR, CMV, mono

Question 16

MEN1 syndrome

Answer 16

Pancreas Pituitary Parathyroid
assoc insulinoma and zollinger ellison (ulcers inc jejenum)

Question 17

Main causes hypercorisolism

Answer 17

main exogenous - steroids
non exogenous 70% pituitary microadenoma (cushings disease)
10 ectopic ACTH e.g. small cell carcinoma lung
10 adrenal adenoma
10 adrenal carcinoma

Question 18

Dexamethasone suppression test

Answer 18

in cushings disease small dose makes no difference, large dose suppresses ACTH and thus urinary steroids decreased

Question 19

Causes primary hyperaldosteonism

Answer 19

60% bilateral idiopathic
35% adenoma (conns)
or carcinoma

Question 20

CAH

Answer 20

autosomal recessive
main cause 21 hydroxylase deficiency
ciculatory collapse and virulisation

Question 21

waterhouse friedrichson syndrome

Answer 21

bilateral adrenal haemarrhage
caused by sepsis normally n meningitides
DIC and widespread purpura
circulatory collapse and death witout steroids

Question 22

Main causes addisons

Answer 22

autoimmune adrenalitis with ABs against IL17, 21 and 17 hydroxylase
TB
Aids
Metastatic Ca

Question 23

secondary adrenocortical insufficiency

Answer 23

pituitary
decreased sex hormones an cortisol but aldosterone maintained
no change in skin pigmentation

Question 24

Syndromes assoc adrenocortical neoplasms

Answer 24

li fraumeni 9TP53), beckwit wiedermann

Question 25

Phaeochromocytoma rule of 10s

Answer 25

10% extra adrenal
10% of sporadic bilateral
10% malignant
10% not assoc increased BP

Question 26

Acidophil cells

Answer 26

progenitors for both GH-producing somatotrophs and prolactin-producinglactotrophs

Question 27

Twin concordance T2DM

Answer 27

Up to 80%