Endocrine

Question 1

Parathyroid gland oxyphil cells

Answer 1

Appear after puberty

Question 2

Hypoparathyroidism symptoms

Answer 2

Tingling in hands, muscle cramps, depression, paranoid, convulsions, psychosis

Question 3

Pseudohypoparathyroidism

Answer 3

Hypocalcemia and ELEVATED, cAMP response to PTH is impaired

Question 4

Primary hyper parathyroidism

Answer 4

Excessive secretion of PTH

Hypercalcemia, elevated PTH, low phosphorus

Question 5

Non toxic goiter

Answer 5

Ability to produce thyroid hormone is impaired, TSH secretion is increased, usually iodine deficiency

Question 6

Diffuse vs. multi nodular non toxic goiter

Answer 6

Diffuse- diffusely enlarged, adolescents and pregnancy

Multi nodular- chronic, irregular nodules, large amount of colloid, people over 50

Question 7

Cretinism hypothyroidism

Answer 7

Usually thyroid dysgenesis, usually infants

Question 8

Graves hyperthyroidism

Answer 8

IgG antibodies to bind to TSH receptor, anti TSH receptor antibodies stimulate thyroid hormone synthesis

Bulding eyes, highly vascular, dark and red, muscle wasting, etc.

Question 9

Toxic multi nodular goiter hyperthyroidism

Answer 9

Women over 50, accumulation of iodine in one or two nodules

Question 10

Hashimoto thyroiditis

Answer 10

T cells stimulate antibody production, induce cell death from CD8 T cells. Leads to hypothyroidism, circulation antibodies and elevated TSH

Question 11

Papillary thyroid cancer

Answer 11

20-50 ages, mostly females, dense fibrosis, nuclear atypism, pale and firm on exam, typically invades cervical lymph nodes

Question 12

Thyroglossal duct cyst

Answer 12

Failure of duct to involute completely, cystic fluid filled remnant, common in children, surgery to remove

Question 13

Dowager’s hump

Answer 13

Indicated the presence of multiple vertebral fractures and decreased bone volume in the elderly, may be a sign of osteoporosis

Question 14

Primary osteoporosis lab tests

Answer 14

Serum calcium, phosphate, and PTH are normal , alk phos would be elevated in a fracture, vitamin D deficiency is common

Question 15

Bone densitometry scores

Answer 15

> -1 is normal

Between -1 and -2.5 is osteopenia

Question 16

Rickets/osteomalacia

Answer 16

Epiphyses of the bone are open, inadequate mineralization of the newly formed bone matrix

**vitamin D deficiency important in this disease process

Bowed legs, milk-looser zones, low calcium and phosphate with high alk. Phos lab, aches and pains, fractures

Question 17

Acidophilic cells

Answer 17

Lactotropes and somatotropes

Question 18

Sheehan syndrome

Answer 18

Ischemic necrosis of the gland, often from hypotension due to post partum hemorrhage

Clinical cause of panhypopituitarism

Question 19

Hemochromatosis

Answer 19

Iron deposits in the pituitary, destroying the gland

Clinical cause of panhypopituitarism

Question 20

Macroadenoma effects

Answer 20

Impingement of optic chiasm, invasion of cavernous sinuses (palsies), invasion of hypothalamus (temp regulation, hyperphagia)

Question 21

Lactotrope adenoma

Answer 21

Hyperprolactemia, chromophobic, psammoma bodies and endocrine amyloid deposition

Question 22

Somatotrope adenoma

Answer 22

Excess secretion of growth hormone, gigantism or acromegaly

Acidophilic with abundant secretory granules- slow growing
Chromophobic with sparse granules- fast growing and invasive

Question 23

Corticotrope adenoma

Answer 23

Excess ACTH, Cushing syndrome, typically microadenoma

Basophilic
If chromophobic, more aggressive

Question 24

Cushing syndrome

Answer 24

Moon facies, abdominal striae, central obesity.

Found in corticotrope adenoma

Question 25

Gonadatrope adenoma

Answer 25

Mainly middle aged men, headaches/visual disturbances/hypogonadism.

Mainly macroadenoma, chromophobic or somewhat acidophilic

Question 26

Thyrotrope adenoma

Answer 26

Rarest, hyperthyroidism, goiter, TSH and thyroid hormone increase.

Chromophobic, PAS positive, polyhedral or columnar cells, secretory granules

Question 27

Central diabetes insipidus

Answer 27

Due to diease of posterior pituitary, unable to concentrate urine due to lack of ADH (poluria, thirst, polydipsia)

Question 28

SIADH

Answer 28

Water retention, weight gain, hypo osmolality of the blood

Question 29

Parathyroid gland chief cells

Answer 29

Make PTH