Endocrine System Pathology 1

Question 1

What hormones are secreted by the most common adenomas, causing hyperpituitarism?

Answer 1

(1) Prolactinomas - secrete prolactin

(2) Somatotrope adenomas - secrete growth hormone

(3) Corticotrope adenomas - secrete acth

(4) Gonadotrope adenomas - secrete fsh and lh

(5) Thyrotrope adenomas - secrete tsh

Question 2

What are some of the causes of hypopituitarism?

Answer 2

(1) Adenoma impinging on pituitary

(2) Loss of blood supply

(3) Congenital agenesis

(4) Metastatic cancer

Question 3

The following symptoms of amenorrhea postpartum, loss of hair, weakness, hypopigmentation would point to what diagnosis?

Answer 3

Postpartum pituitary necrosis (Sheehan necrosis)

Question 4

In Sheehan necrosis what would happen when thyrotropin releasing hormone is administered?

Answer 4

There would be a lack of prolactin produced in response

Question 5

What occurs with diabetes insipidus?

Answer 5

Decreased ADH causes polydipsia and polyuria

Question 6

An open embryonic thyroglossal duct can cause what?

Answer 6

Thyroglossal duct cysts and fistulas with the potential for infection or in papillary cancer

Question 7

What are the symptoms of Graves’ disease?

Answer 7

(1) Diffuse toxic goiter

(2) Nervousness

(3) Palpitations

(4) Rapid pulse

(5) Fatigability

(6) Weight loss

(7) Sweating

(8) Emotional lability

(9) Menstrual changes

(10) Exophthalmos

Question 8

How does cretinism present in newborns?

Answer 8

Apathy

Sluggishness

Severe mental retardation

Stunted growth

Low body temperature

Cretinism is a congenital condition of iodine deficiency. This leads to insufficient thyroid hormone.

Question 9

Hashimoto’s thyroiditis is associated with what autoimmune conditions?

Answer 9

(1) Systemic lupus erythematosus (SLE)

(2) Rheumatoid arthritis

(3) Graves’ disease

(4) Pernicious anemia

(5) Sjogren’s syndrome

Many autoimmune conditions are comorbid with other autoimmune conditions.

Question 10

What are the phases of subacute thyroiditis?

Answer 10

Phase one: thyrotoxicosis

Phase two: hypothyroidism

Phase three: recovery to euthyroid state

Question 11

Granulomatous and silent subacute thyroiditis are most often seen after what type of infection?

Answer 11

Viral infection

Question 12

What are some causes of goiters?

Answer 12

(1) Physiologic enlargement

(2) Iodine deficiency

(3) Hashimoto’s thyroiditis

(4) Goitrogens

(5) Failure of thyroid hormone synthesis

Goiters are enlarged thyroid glands that can be caused by hyperthyroidism or hypothyroidism

Question 13

What are hot nodules?

Answer 13

Thyroid adenomas are benign nodules that are highly active and take up radioactive iodine

Question 14

What are the characteristics of thyroid cancer?

Answer 14

They are slow growing nodules that have lost function and do not take up radioactive iodine

Question 15

Medullary carcinoma of the thyroid (mtc) is genetically associate with what conditions?

Answer 15

Multiple endocrine neoplasia types 2A and 2B

Question 16

When is parathyroid hormone normally secreted?

Answer 16

It is secreted in response to low blood calcium levels. It increases reabsorption of calcium

Question 17

What causes primary hyperparathyroidism?

Answer 17

Parathyroid adenoma. Primary endocrine conditions affect the gland at the gland level itself (vs. the hypothalamus or pituitary).

Question 18

What causes secondary hyperparathyroidism?

Answer 18

Decreased serum calcium as a result of chronic renal disease. Secondary endocrine conditions are because of disorders of the pituitary. Tertiary conditions are due to hypothalamus dysfunction.

Question 19

What three types of hormones are produced by the adrenal cortex?

Answer 19

(1) Mineralocorticoids - aldosterone

(2) Glucocorticoids - cortisol

(3) Androgens - DHEA

Question 20

What is aldosterone’s effect in the body?

Answer 20

It increases sodium and water reabsorption by the kidneys

Question 21

What are the symptoms of Cushing’s syndrome?

Answer 21

(1) Redistribution of body fat

(2) Skin atrophy with easy bruising and striae

(3) Hirsutism

(4) Muscle weakness

(5) Osteoporosis

(6) Amenorrhea

(7) Hypertension

(8) Hyperglycemia

(9) Psychiatric dysfunction

Question 22

What is Conn’s syndrome?

Answer 22

Primary aldosteronism usually due to adrenocortical adenoma or hyperplasia that causes hyperproduction of adrenal mineralocorticoids.

Question 23

What is Addison’s disease?

Answer 23

Adrenal gland fails to produce cortisol, aldosterone, and androgens, causing hypotension, increased pigmentation of the skin, increased serum potassium, decreased serum sodium, chloride, glucose and bicarbonate. Patients may present with increased thirst.

Question 24

A mutation in the 21-hydroxylase gene (CYP21A2) causes what condition?

Answer 24

Congenital adrenal hyperplasia. 21-hydroxylase catalyzes the formation of cortisol and aldosterone (from progesterone).

Question 25

Is this condition autosomal recessive or dominate?

Answer 25

Autosomal recessive

Question 26

What is produced in the adrenal medulla?

Answer 26

Epinephrine and norepinephrine

Question 27

What is the primary symptom of pheochromocytoma?

Answer 27

Paroxysmal or persistent hypertension. Pheochromocytoma is an adrenal gland tumor that hypersecretes hormones.

Question 28

Where is insulin produced?

Answer 28

Pancreatic islet beta cells

Question 29

Where is glucagon produced?

Answer 29

Alpha cells of the pancreas

Question 30

What causes type I diabetes mellitus?

Answer 30

Failure of the beta cells of the pancreas to produce insulin from either autoimmune or genetic causes

Question 31

What causes type II diabetes mellitus?

Answer 31

Increased insulin resistance of cells associated with central obesity and sedentary lifestyle

Question 32

How do insulinomas clinically present?

Answer 32

Increased insulin secretion, confusion, anxiety, stupor, convulsions and coma (Whipple’s triad)

Question 33

What is the Zollinger-Ellison syndrome?

Answer 33

A gastroduodenal hyperacidity syndrome caused by a gastrin-secreting tumor (gastrinoma) in the pancreas or intestinal wall