Endocrine & Diabetes

Question 1

A 30-year old woman who is not pregnant has not menstruated for 4 months and is now producing milk from her breasts. What is the diagnosis?

Answer 1

Pituitary adenoma (hyperprolactinemia)

Question 2

A 40-year old man noticed enlargement of his feet (suddenly ill-fitting shoes) and hands. He had prominent lower jaw and noticed that his teeth were becoming separated from one another. What is the name for this endocrine disorder? What could have caused these symptoms?

Answer 2

Acromegaly related to elevated growth hormone. The cause is a somatotrope adenoma (pituitary adenoma).

Question 3

A 45-year old woman presented with complaints of sweating a lot, feeling hot and being constantly tired. She had a fast pulse rate and reported feeling constantly hungry. On examination, she was found to have bulging eyes and an enlarged thyroid. What is the diagnosis? What is the pathogenesis of her disease?

Answer 3

Graves disease due to hyperthyroidism (autoimmune).

Question 4

A 30 year old woman noted a “swelling” on the anterior side of her lower neck. She had no other symptoms. What is the most likely diagnosis?

Answer 4

Nontoxic goiter (due to iodine deficiency)

Question 5

A 50-year old man became extremely obese, with fat accumulating most markedly on his trunk. He had a red rounded face and almost translucent skin that was prone to bruising. What is the first question that should be posed to this man?

Answer 5

He has cushing Syndrome. Is he taking corticosteroids?

ACTH independent

Question 6

A 40-year old man reported having sudden attacks of dizziness, blurred vision, and excruciating headaches. During these attacks his blood pressure was 180/120 mm Hg. What could cause these paroxysms of hypertension?

Answer 6

Pheochromocytoma (episodic hypertension)

Question 7

A 20-year old woman presented with a history of weight loss and urinary frequency (polyuria). She reportedly ate a lot and was always thirsty? What is the most likely diagnosis?

Answer 7

Type I diabetes mellitus

Question 8

The development of diabetic complications (e.g. atherosclerosis, renal failure and blindness) relates largely to the severity and chronicity of:

Answer 8

Hyperglycemia

Question 9

A rare tumor of chromaffin cells of the adrenal medulla that secret catecholamines. Patients with this present with episodic hypertension:

Answer 9

Pheochromocytoma

Question 10

A neoplasm of thymic epithelial cells. Ten percents (10%) of patients with myasthenia gravis have one:

Answer 10

Thymoma

Question 11

A malignant tumor of neural crest origin that originates from the adrenal medulla. One of the most important malignant tumors of childhood:

Answer 11

Nuroblastoma

Question 12

Caused by inappropriate secretion of aldosterone by hyperplastic adrenal glands or an adrenal adenoma. Most patients are diagnosed after the detection of asymptomatic hypertension:

Answer 12

Primary aldosteronism “Conn syndrome”

Question 13

A condition of adrenal cortical hyperfunction (hypercortisolism) that is dependent on chronic stimulation by ACTH. It can result from hypersecretion of ACTH by a pituitary adenoma or some other neuroendocrine tumor (e.g., small cell carcinoma of the lung):

Answer 13

Cushing disease

Question 14

A life-threatening medical emergency that reflects a sudden loss of adrenocortical function. The initial manifestations of adrenal crisis are hypotension and shock:

Answer 14

Acute adrenal insufficiency (adrenal crisis)

Question 15

A fatal wasting disorder caused by the failure of adrenocortical secretion. This disease is characterized by deficiencies of glucocorticoids, mineralocorticoids and androgens. If untreated, the disease is characterized by weakness, weight loss, gastrointestinal symptoms, hypotension, electrolyte disturbances and hyperpigmentation of the skin:

Answer 15

Chronic adrenal insufficiency (Addison disease)

Question 16

The most common histologic type of thyroid cancer:

Answer 16

Papillary carcinoma

Question 17

An autoimmune disease of the thyroid, characterized by the presence of circulating autoantibodies.

Answer 17

Hashimoto thyroiditis

Question 18

An autoimmune disorder characterized by goiter, hyperthyroidism, and exophthalmos. Patients are hyperthyroid owing to the presence of IgG antibodies directed against the TSH receptor. These antibodies stimulate the TSH receptor and thereby increase thyroid hormone (thyroxine) secretion.

Answer 18

Graves disease

Question 19

Signs and symptoms of this disease reflect a hypermetabolic state, and include nervousness, emotional lability, tremor, weakness, and weight loss.

Answer 19

Hyperthyroidism

Question 20

Hypothyroidism in pregnant women has grave neurological consequences for the fetus, expressed after birth. If thyroid hormone replacement therapy is not promptly provided, congenital hypothyroidism results in mentally retarded dwarfs. This is called:

Answer 20

Cretinism (congenital hypothyroidism)

Question 21

Symptoms of this disease include tiredness, lethargy, sensitivity to cold, and an inability to concentrate:

Answer 21

Hypothyroidism

Question 22

An enlargement of the thyroid that is NOT associated with functional, inflammatory, or neoplastic alterations.

Answer 22

Non-toxic goiter

Question 23

Characterized by an inability to concentrate urine, resulting in polyuria, thirst, and polydipsia. The biochemical basis of this disease is deficiency of vasopressin (antidiuretic hormone), which is secreted by the posterior pituitary.

Answer 23

Diabetes insipidus

Question 24

Benign neoplasms of the anterior pituitary. They are often associated with the excess secretion of pituitary hormones and endocrine hyperfunction:

Answer 24

Pituitary adenomas

Question 25

Panhypopituitarism caused by ischemic necrosis of the pituitary. This condition may follow an episode of hypotension (e.g., postpartum hemorrhage). Amenorrhea, hypothyroidism, and inadequate adrenal function are possible consequences of this syndrome:

Answer 25

Sheehan syndrome

Question 26

Deficient secretion of one or more hormones by the pituitary. Complete lack of pituitary function is referred to as panhypopituitarism.

Answer 26

Hypopituitarism

Question 27

Deficient iodine intake causes thyroid hormone deficiency, leading to thyroid hypertrophy and hyperplasia. This condition is termed:

Answer 27

Multinodular goiter

Question 28

Name a disease of the endocrine pancreas associated with lack of exercise and obesity:

Answer 28

Type 2 diabetes mellitus

Question 29

Characterized by few if any functional beta cells in the islets of Langerhans and substantially reduced (or nonexistent) insulin secretion. As a result, body fat is metabolized as a source of energy. This produces ketone bodies and leads to metabolic acidosis. Lack of insulin results in hyperglycemia:

Answer 29

Type 1 diabetes mellitus

Question 30

Hyperglycemia due to a failure of the beta cells to meet an increased demand for insulin. Increased demand for insulin is thought to be related, in part, to a reduced ability of peripheral target cells to bind insulin:

Answer 30

Type 2 diabetes mellitus

Question 31

Coronary heart disease is the major cause of death among adults with diabetes due to this:

Answer 31

Atherosclerosis

Question 32

Characteristic vascular changes seen in diabetics:

Answer 32

Hyaline arteriolosclerosis

Question 33

One of the most common complications of diabetes causing peripheral sensory and autonomic nerve dysfunction is:

Answer 33

Peripheral neuropathy