endocrine conditions 8-14

Question 1

What is thyroid cancer?

Answer 1

Cancer that develops in the thyroid gland, often manifesting as a nodule.

Question 2

What are the primary risk factors for thyroid cancer?

Answer 2

Female gender, white and Asian ethnicities, history of head and neck radiation during childhood, heavy radiation exposure, and history or family history of goiter.

Question 3

What is the main manifestation of thyroid cancer?

Answer 3

A painless, palpable thyroid nodule.

Question 4

What other symptoms may accompany thyroid cancer?

Answer 4

Palpable lymph nodes (lymphadenopathy) and difficulty swallowing, talking, or breathing.

Question 5

How is thyroid cancer diagnosed?

Answer 5

Through ultrasound, CT, MRI, PET scans (to evaluate for metastases), ultrasound-guided fine needle biopsy, and thyroid nuclear scan.

Question 6

What is hyperparathyroidism?

Answer 6

A condition characterized by increased levels of parathyroid hormone (PTH), leading to hypercalcemia and hypophosphatemia.

Question 7

What are the two main types of hyperparathyroidism?

Answer 7

Primary (due to benign or cancerous tumors on the parathyroid glands) and secondary (due to severe calcium or vitamin D deficiency, or chronic kidney failure).

Question 8

What are common manifestations of hyperparathyroidism?

Answer 8

Hypercalcemia, hypophosphatemia, loss of appetite, fatigue, muscle weakness, and constipation.

Question 9

What are potential complications of hyperparathyroidism?

Answer 9

Osteoporosis, renal failure, kidney stones, and bone fractures.

Question 10

How is hyperparathyroidism diagnosed?

Answer 10

By measuring serum levels of PTH, calcium, phosphate, and creatinine; performing DEXA scans for bone density; and using radiologic scans and ultrasound.

Question 11

What is hypoparathyroidism?

Answer 11

A condition characterized by inadequate circulating parathyroid hormone (PTH), leading to hypocalcemia.

Question 12

What are common etiologies of hypoparathyroidism?

Answer 12

Iatrogenic (surgery on the thyroid or parathyroid), autoimmune disorders, and idiopathic causes.

Question 13

What are classic manifestations of hypoparathyroidism?

Answer 13

Tetany, Trousseau sign (wrist spasms), Chvostek sign (cheek contraction), tingling of lips, stiffness in extremities, and spasms of smooth and skeletal muscles.

Question 14

What are additional symptoms of hypoparathyroidism?

Answer 14

Dysphagia, laryngospasms, lethargy, anxiety, and behavioral changes.

Question 15

How is hypoparathyroidism diagnosed?

Answer 15

Through history and physical examination (H&P) and serum calcium level testing.

Question 16

What is Cushing Syndrome?

Answer 16

A collection of signs and symptoms caused by prolonged high cortisol levels.

Question 17

What are three common causes of Cushing Syndrome?

Answer 17

Chronic corticosteroid use, ACTH-secreting pituitary mass, inherited disorders.

Question 18

What are the common areas for fat distribution in Cushing Syndrome?

Answer 18

Trunk (truncal adipose tissue), face (“moon face”), back of neck (“buffalo hump”).

Question 19

What causes muscle wasting in Cushing Syndrome?

Answer 19

Cortisol breaks down muscle tissue to use for energy.

Question 20

What physical changes are typical in Cushing Syndrome?

Answer 20

Weight gain, striae (stretch marks), moon face, buffalo hump, muscle weakness.

Question 21

Why does osteoporosis develop in Cushing Syndrome?

Answer 21

Chronic high cortisol levels weaken bone density.

Question 22

How is Cushing Syndrome diagnosed?

Answer 22

Cortisol level tests, low-dose dexamethasone suppression test, radiographic imaging (to check for adrenal or pituitary masses).

Question 23

What symptom is characterized by a rounded, full face?

Answer 23

Moon face.

Question 24

What is a buffalo hump?

Answer 24

Fat accumulation on the back of the neck, a classic sign of Cushing Syndrome.

Question 25

What is the purpose of a dexamethasone suppression test?

Answer 25

To determine if cortisol production is being suppressed properly.

Question 26

What is adrenocortical insufficiency?

Answer 26

A condition where the adrenal gland or pituitary underfunctions, reducing adrenal steroid production.

Question 27

What is Addison’s disease?

Answer 27

A disorder where all three classes of adrenal steroids (mineralocorticoids, glucocorticoids, and adrenal androgens) are decreased.

Question 28

What is the effect of reduced mineralocorticoids like aldosterone?

Answer 28

Hyperkalemia and low blood pressure.

Question 29

How does a lack of glucocorticosteroids like cortisol affect the body?

Answer 29

The body is not prepared for stress responses.

Question 30

What are some common causes of adrenocortical insufficiency?

Answer 30

Addison’s disease (autoimmune), adrenal infections, cancer metastases, pituitary dysfunction, or abrupt stopping of steroids.

Question 31

What are early symptoms of adrenocortical insufficiency?

Answer 31

Initially asymptomatic, followed by slow onset of anorexia, weakness, fatigue, and weight loss.

Question 32

What is the classic skin symptom in Addison’s disease?

Answer 32

Bronzing of the skin due to ACTH stimulating melanocytes to produce melanin.

Question 33

What cardiovascular symptom is common in adrenocortical insufficiency?

Answer 33

Hypotension.

Question 34

How is adrenocortical insufficiency diagnosed?

Answer 34

History and physical exam, early morning cortisol levels, and ACTH stimulation test.

Question 35

What happens if steroids are stopped without tapering?

Answer 35

It can lead to adrenal insufficiency because the body becomes dependent on external steroids.

Question 36

What is hyperaldosteronism?

Answer 36

A condition where there is excessive secretion of aldosterone from the adrenal glands or elevated aldosterone levels related to renal dysfunction.

Question 37

What are some causes of hyperaldosteronism?

Answer 37

Small benign adrenal tumors, renal artery stenosis, renin-secreting tumors, or chronic kidney disease (CKD).

Question 38

What is the classic combination of symptoms in hyperaldosteronism?

Answer 38

Hypertension, headaches, and hypernatremia due to sodium retention.

Question 39

What electrolyte imbalance is associated with cardiac dysrhythmias in hyperaldosteronism?

Answer 39

Hypokalemia.

Question 40

How does CKD-related hyperaldosteronism affect acid-base balance?

Answer 40

It can cause metabolic acidosis.

Question 41

What are some general symptoms of hyperaldosteronism?

Answer 41

Fatigue, hypertension, headaches, cardiac dysrhythmias, and hypernatremia.

Question 42

How is hyperaldosteronism diagnosed?

Answer 42

History and physical exam, aldosterone, sodium, and potassium levels, and plasma tests.

Question 43

What is pheochromocytoma?

Answer 43

A hormone-secreting tumor in the adrenal glands that triggers excessive production of catecholamines.

Question 44

What are risk factors for pheochromocytoma?

Answer 44

Rare inherited disorders associated with lesions and benign tumors.

Question 45

What causes attacks in pheochromocytoma?

Answer 45

Intermittent tumor activation leading to excessive catecholamine release, triggered by trauma, pressure on the tumor, stress, or medications.

Question 46

What are the key symptoms of pheochromocytoma?

Answer 46

Severe hypertension, severe headache, tachycardia with palpitations, profuse diaphoresis, and chest/abdominal pain.

Question 47

What serious complications can occur if pheochromocytoma is untreated?

Answer 47

Cardiomyopathy, multi-organ failure, and death.

Question 48

How does pheochromocytoma affect the heart?

Answer 48

It can lead to an enlarged heart that pumps inefficiently, affecting multiple organs.

Question 49

How is pheochromocytoma diagnosed?

Answer 49

History and physical exam, 24-hour urine collection for metanephrines, fractionated catecholamines, and creatinine, as well as CT/MRI to locate the tumor.