Exam 3 - Chapter 9: Endocrine

Question 1

2

The endocrine system consists of highly integrated and widely distributed groups of organs called _____.

Answer 1

glands

Question 2

2

Glands create a state of _____ among the various organs of the body.

Question 3

2

Signaling by secreted molecules can be classified into what three types?

Question 4

3

Hormones act on target cells that are _____ from their ________.

Question 5

3

Endocrine hormone is frequently carried by ___ from its site of release to its ______.

Question 6

5

Production of several hormones from endocrine glands is stimulated by ________ released from the _______.

Question 7

5

The endocrine hormone inhibits production of the _____, a process known as _____.

Question 8

7

What are the 7 major endocrine glands?

Question 9

9

Endocrine diseases can be classified as diseases of ___________ and their resulting biochemical and clinical consequences. Or, they can be classified as diseases associated with the development of _______ that may be _____ or may be associated with _________.

Question 10

11

The pituitary gland is a ____ shaped structure at the base of the brain, within the ________.

Question 11

11

The pituitary gland function is controlled by the ______.

Question 12

11

The pituitary gland is connected to the hypothalamus by a _____ containing _____ extending from the hypothalamus and a __________.

Question 13

11

Along with the hypothalamus, the pituitary gland has a central role in regulating what?

Question 14

12

What is the name of the attachment between the hypothalamus and the pituitary?

Question 15

13

What are the 6 hormones associated with the anterior pituitary?

Question 16

13

What is the chemical class and effect of growth hormone?

Question 17

13

What is the chemical class and effect of prolactin?

Question 18

13

What is the chemical class and effect of thyroid stimulating hormone (TSH)?

Question 19

13

What is the chemical class and effect of adenocroticotropic hormone (ACTH)?

Question 20

13

What is the chemical class and effect of follicle-stimulating hormone (FSH)?

Question 21

13

What is the chemical class and effect of luteinizing hormone?

Question 22

14

What are the 2 hormones associated with the posterior pituitary lobe?

Question 23

14

What is the chemical class and effect of antidiuretic hormone?

Question 24

14

What is the chemical class and effect of oxytocin?

Question 25

15

What is the hormone associated with the intermediate zone of the pituitary?

Question 26

14

What is the chemical class and effect of melanocyte stimulating hormone?

Question 27

14

The posterior pituitary does not produce hormones, but rather it ________.

Question 28

15

______ cells in the hypothalamus release ______ or ______ into the posterior lobe of the pituitary gland. These hormones are stored or released into the blood via the _______.

Question 29

17

Are pituitary adenomas benign or malignant?

Question 30

17

What age group are pituitary adenomas most common in?

Question 31

17

What is the most common cause of hyperpituitarism?

Question 32

Pituitary adenomas are classified on the basis of _______ by the tumor cells.

Question 33

17

Large pituitary adenomas, particularly _____ ones, may cause _______.

Question 34

18

What is the seconnd most common functioning pituitary adenoma?

Question 35

18

What hormone is associated with somatotroph adenoma?

Question 36

18

What are the two disorders associated with somatotroph adenoma? When does each occur in relation to epiphyseal plate closure?

Question 37

18

What is the most common pituitary adenoma?

Question 38

18

What age and gender are most commonly affected by lactotroph adenomas?

Question 39

18

What hormone is involved in lactotroph adenoma?

Question 40

18

What are three disorders associated with lactotroph adenoma? Which genders are affected by each?

Question 41

18

What hormone is associated with thyrotroph adenoma?

Question 42

18

What is the associated disorder with thyrotroph adenoma?

Question 43

18

What is the hormone associated with cotricotrph adenoma?

Question 44

18

What disease is associated with corticotroph adenoma?

Question 45

18

What two hormones are associated with gonadotroph adenoma?

Question 46

18

What are the effects associated with gonadotroph adenoma?

Question 47

20

When does gigantism occur?

Question 48

20

At what ages do the epiphyseal growth plates close in boys vs. girls?

Question 49

20

In gigantism, the growth is usually _____ with long arms and long legs.

Question 50

20

What is superimposed with gigantism if increased GH levels persist beyond epiphyseal closure?

Question 51

20

In gigantism, failure of enlarged organs, especially the _____, may occur.

Question 52

21

With acromegaly, there is growth noted in ____, ____, _____ and ______ of the face, hands, and feet.

Question 53

21

What are the three oral manifestations of acromegaly?

Question 54

21

What are the two treatment options for acromegaly?

Question 55

24

What is there excess production of in corticotroph adenoma?

Question 56

24

Corticotroph adenoma leads to _________ and the development of _________.

Question 57

25

Cushing disease is due to the excess production of _____ by __________ or _________.

Question 58

25

Cushing Syndrome is excess levels of _____ due to ______, ________, or ________.

Question 59

26

What are 8 signs and symptoms of Cushing Disease/Syndrome?

Question 60

28

The anterior pituitary gland receives arterial supply from the ________, which is a branch of the ______. This vessels first forms a capillary network around the _______. Blood from this network is then transported to a secondary capillary plexus surrounding the anterior pituitary. Known as the ______. this structure allows the hypothalamys to communicate with the anterior pituitary via the release of ______ into the blood.

Question 61

28

The infundibulum and posterior pituitary gland receive a rich blood supply from ______. The three major vessels are the _______.

Question 62

29

What percent of the anterior pituitary is destroyed in anterior pituitary gland hormone disorders?

Question 63

29

What is decreased in anterior pituitary gland hormone disorders?

Question 64

29

What is the associated disorder of anterior pituitary gland hormone disorders?

Question 65

29

What is decreased in posterior pituitary gland hormone disorders?

Question 66

29

What is the associated disorder of posterior pituitary gland hormone disorders?

Question 67

30

What is another name for Sheehan Syndrome?

Question 68

30

What is Sheehan Syndrome due to?

Question 69

30

During pregnancy, the anterior pituitary enlarges to _____. This physiologic expansion of the gland is not accompanied by _________. Hence, there is relative ______. Any further loss of blood supply caused by _______ or _____ may precipitate infarction of the anterior lobe.

Question 70

31

What are four symptoms of Sheehan syndrome?

Question 71

31

When may the Diagnosis for Sheehan syndrome be made?

Question 72

31

What is the treatment for Sheehan Syndrome?

Question 73

33

Diabetes insipidus is characterized by ________ due to the inability of the ______ to ________.

Question 73

33

What are 5 conditions that diabetes insipidus can be seen in?

Question 74

34

What are four symptoms associated with diabetes insipidus?

Question 75

34

What is the treatment for Diabetes Insipidus?

Question 76

36

The thyroid gland consists of _____ connected by a _____.

Question 77

36

Where is the thyroid gland located relative to the larynx?

Question 78

37

From what two main structures does the thyroid gland originate from?

Question 79

37

Early in gestation, the thyroid gland begins its descent anterior to the pharynx as a _______. It then continues to descend anterior of the hyoid bone and the cartilages of the larynx. By the _____ week, it reaches its destination ______to the upper trachea

Question 80

38

Where does the thyroid gland begin formation?

Question 81

39

The thyroid gland is divided by thin fibrous septae into _____ composed of _____ follicles.

Question 82

39

The follicles that compose the thyroid gland lobules are lined by ___ or _______ epithelium and filled with _______.

Question 83

40

In response to hypothalamic factors, TSH is released from the ______ into the ______.

Question 84

40

TSH binds to its receptors on thyroid ________.

Question 85

40

Thyroid follicular epithelial cells convert ______ into ______ and ________.

Question 86

43

What is the disease that is an autoimmune disorder of the thyroid gland?

Question 87

43

What is there excess of in Graves disease?

Question 88

43

What is the name for a hyperfunctioning benign tumor of the thyroid gland?

Question 89

44-

What are six hyperthyroidism clinical features?

Answer 89

1. increase in basal metabolic rate
2. cardiac manifestations
3. overactivity of the sympathetic NS
4. ocular changes
5. skeletal system effects
6. thyroid storm

Question 90

44

What are 4 things seen with the increase in basal metabolic rate in hyperthyroidism?

Question 91

44

What is the earliest and most consistent sign of hyperthyroidism?

Question 92

44

What are 4 examples of the cardiac manifestations associated with hyperthyroidism?

Question 93

45

What are four examples of overactivity of the sympathetic nervous system seen in hyperthyroidism?

Question 94

45

What are two ocular changes seen with hyperthyroidism?

Question 95

45

True thryoid opthalmia associated with ____ occurs only in _______.

Question 96

46

In hyperthyroidism, affects on the skeletal system stimulates _____, increased _______ and reducing _________ causing osteoporisis and increased risk of fractures.

Question 97

46

Thyroid storm is a _______. It is an abrupt onset of _________ that occurs most commonly in patients with Graves disease.

Question 98

50

Graves disease is an _____ disorder.

Question 99

50

Graves disease has a peak incidence in people between _____ years of age.

Question 100

50

What is the ratio of women to men affected with Graves disease?

Question 101

50

Graves disease is chaaracterized by the production of _____ against _______, most importantly the _______.

Question 102

50

Graves disease is the most common cause of __________.

Question 103

51

What is localized, infiltrative dermopathy, aka pretibial myxedema?

Question 103

51

What is the triad of clinical findings seen in Graves disease?

Question 104

54

What lab values are elevated in Graves disease?

Question 105

54

What lab values are decreased in Graves disease?

Question 106

57

What is hypothyroidism in children called?

Question 107

55

What are three sources of treatment for Graves Disease?

Question 108

57

What is hypothyroidism in adults called?

Question 109

57

What is Hashimoto thyroiditis?

Question 110

58

Hypothyroidism is a condition caused by a ______ that interferes with the production of thyroid hormone.

Question 111

58

Hypothyroidism prevlance ____ with age.

Question 112

58

What is the ration of women to men affected by hypothyroidism?

Question 113

59

What are 5 clinical features of creatinism?

Question 114

61

Early symptoms of myxedema include _______, ____, and ______ which mimics depression.

Question 115

61

In myxedema, _____ and _______ are slowed.

Question 116

61

Myxedema patients are _____, _____ intolerant, and frequently ______.

Question 117

61

Do patients have an increased or decreased cardiac output in myxedema?

Question 118

63

Lab values play a vital role in the diagnosis of suspected hypothyroidism because of the _________ of symptoms.

Question 119

63

TSH levels are _____ in primary hypothyroidism.

Question 120

63

TSH levels are not increased if hypothyroidism takes place at the ________ or _________ levels.

Question 121

63

What is the most sensitive screening test for hypothyroidism?

Question 122

68

Hashimoto Thyroiditis is caused by what?

Question 123

68

Hashimoto Thyroiditis predisposition has a strong ______ component.

Question 124

69

Hashimoto Thyroiditis is ______ enlargement of the thyroid gland associated with some degree of hypothyroidism.

Question 125

69

What group has a higher prevalence of hashimoto thyroiditis?

Question 126

69

The enlargement of the thyroid seen in Hashimoto Thyroiditis is ____ and _____.

Question 127

69

People with Hashimoto thyroiditis are at an increased risk of _______ and ______.

Question 128

70

What lab values are decreased in Hashimoto thyroiditis?

Question 129

70

What lab values are increased in Hashimoto thyroiditis?

Question 130

72

What is a goiter?

Question 131

72

Goiter may be associated with ______ in thyroid function or with _________ or __________.

Question 132

73

What are the two types of goiter?

Question 133

75

What are the two neoplasms of the thyroid?

Question 134

75

Is thyroid adenoma benign or cancerous?

Question 135

75

Is thyroid carcinoma benign or cancerous?

Question 136

76

The major concern in persons presenting with thyroid nodules is the possibility of ________.

Question 137

76

Benign thyroid neoplasms outnumber malignant neoplasms by a ratio of ______.

Question 138

76

Most of the thyroid malignancies are ___, meaning they mostly do not ______.

Question 139

76

A history of _______ to the head and neck region is associated with an increased incidence of thyroid malignancy.

Question 140

78

Thyroid adenomas are typically ____, ____ masses derived from ________.

Question 141

78

With thyroid adenomas are there more functional or nonfunctional adenomas?

Question 142

78

Are thyroid adenomas painful or painless masses?

Question 143

78

Larger thyroid adenomas may produce difficulty in ______.

Question 144

81

What is the 5 year survival rate for thyroid carcinoma?

Question 145

78

What is the treatment for thyroid adenomas?

Question 146

81

What sex is thyroid carcinoma more common in?

Question 147

81

After what age is thyroid carcinoma more common in?

Question 148

81

Thyroid carcinoma frequently presents ________.

Question 149

81

What is the sign associated with thyroid carcinoma?

Question 150

81

What symptom is associated with thyroid carcinoma?

Question 151

82

What are the four subtypes of thyroid carcinoma?

Question 152

82

What percent of the time is papillary thyroid carcinoma seen?

Question 153

82

What percent of the time is follicular carcinoma seen?

Question 154

82

What percent of the time is poorly differentiated and anaplastic carcinoma seen?

Question 155

82

What percent of the time is medullary carcinoma seen?

Question 156

82

From what cells does medullary carcinoma arise from?

Question 157

83

Lymphoma of thyroid may occur in the setting of _______.

Question 158

83

Is lymphoma of the thyroid curable?

Question 159

85

Parathyroid glands are derived from the ________.

Question 160

85

Parathyroid glands are located on the _______ and _______ of each thyroid lobes.

Question 161

85

How many parathyroid glands are there?

Question 162

85

What are the 2 cell types in parathyroid glands?

Question 163

85

Oxyphil cells have _______ containing ________.

Question 164

87

What is the number 1 function of parathyroid glands?

Question 165

87

The activity of the parathyroid gland is controlled by the levels of ________.

Question 166

87

Decreased levels of free calcium stimulates the ____ and ____ of the ____ hormone.

Question 167

89

What are three associated disorders of primary hyperparathyroidism?

Question 168

89

What percent of the time is hyperplasia seen in primary hyperparathyroidism?

Question 169

89

What percent of the time is adenoma seen in primary hyperparathyroidism?

Question 170

89

What percent of the time is carcinoma seen in primary hyperparathyroidism?

Question 171

89

What disorder is associated with secondary hyperparathyroidism?

Question 172

89

What disorder is associated with tertiary hyperparathyroidism?

Question 173

90

Primary hyperparathyroidism has elevated levels of ____.

Question 174

90

What is one of the most common endocrine disorders?

Question 175

90

Is primary hyperparathyroidism more common in adults or children?

Question 176

90

Is primary hyperparathyroidism more common in women or men?

Question 177

90

Primary hyperparathyroidism can be ____ or _____.

Question 178

90

What are the four clinical manifestations of primary hyperparathyroidism if it is symptomatic?

Question 179

91

In what percent of primary hyperparathyroidism patients are renal stones seen?

Question 180

91

What are three issues associated with the bones of patients with primary hyperparathyroidism?

Question 181

91

What are two abdominal issues with with patients with primary hyperparathyroidism?

Question 182

91

Peptic ulcers in patients with primary hyperparathyroidism are associated with _____ that ____ after surgical excision.

Question 183

91

What causes the moans of primary hyperparathyrodism?

Question 184

92

Detection via screenings of what two things would indicate primary hyperparathyroidism?

Question 185

92

What is a treatment for primary hyperparathyroidism?

Question 186

93

Brown tumors are _______ that may appear in severely affected primary hyperparathyroidism patients.

Question 187

93

Brown tumors of primary hyperparathyroidism have excessive _____ activity.

Question 188

93

What gives the brown appearance of brown tumors?

Question 189

93

Brown tumors appear identical to what?

Question 190

93

What is the most severe skeletal manifestation of primary hyperparathyroidism?

Question 191

93

Osteitis fibrosa cystica develops from _______ and _____ of long-standing brown tumors.

Question 192

95

The endocrine pancreas consists of ____ clusters of cells known as ________.

Question 193

95

Iselts of Langerhans contain ___ major and ___ minor types of cells.

Question 194

95

What are the four major types of cells of the endocrine pancreas?

Question 195

95

What are the two minor cell types of the endocrine pancreas?

Question 196

96

Beta cells of the endocrine pancrease produce ____, which regulates _______ in tissues and reduced _____ levels.

Question 197

96

Alpha cells of the endocrine pancreas secrete _____, which stimulates _____ in the liver and thus _____ blood sugar.

Question 198

96

Delta cells of the endocrine pancreas secrete _____, which suppresses ________ release.

Question 199

96

PP cells of the endocrine pancreas secrete ______, which exert several ___ effects, such as stimulation of secretion of _______ and inhibition of _____.

Question 200

98

D1 cells of the endocrine pancrease secrete _________, a hormone that induces _____ and ______.

Question 201

98

Enterochromaffin cells of the endocrine pancreas synthesize _______.

Question 202

99

Diabetes mellitus is a group of ______ sharing the common feature of _______.

Question 203

99

Diabetes mellitus is caused by defects in _______, ______, or most commonly, _____.

Question 204

100

What are five consequences of diabetes mellitus?

Question 205

101

In hyaline arteriolosclerosis, there is deposition of _______ and ________ in vascular walls, making them ______.

Question 206

101

Hyaline arteriolosclerosis is most evident in the ____, ______, ____, and _______.

Question 207

102

Atherosclerosis occurs in most diabetes within ________ years of onset of Diabetes Mellitus, regardless of _____.

Question 208

102

5% of nondiabetics _____ years old have ________ atherosclersoso vs. ___ of diabetics.

Question 209

102

What is the most common cause of death in diabetics?

Question 210

104

What is the most severely damaged organ in diabetics?

Question 211

104

What are three conditions seen in people with diabetic nephropathy?

Question 212

104

What is the name of the lesion seen in the kidneys of people with poorly controlled diabetes mellitus?

Question 213

105

Diabetic retinopathy includes retinal _____. ______, and ______.

Question 214

105

Diabetic retinopathy involves retinal damage due to ______, which is the ________.

Question 215

105

What are two consequences of diabetic retinopathy that contribute to visual impairment.

Question 216

105

_____% of patients develop some form of diabetic retinopathy _____ years after diagnosis.

Question 217

106

Diabetic neuropathy is _____ neuropathy involving both the _____ and _______ nerves of legs.

Question 218

106

Diabetic neuropathy may affect _________ nervous system leading to ____ and _____ dysfunction and impotence.

Question 219

107

What are two oral manifestations of diabetes?

Question 220

109

The adrenal gland is a ____ endocrine gland consisting of a ___ and a ____, which differ in their development, structure, and function.

Question 221

109

What are the three zones of the adrenal cortex?

Question 222

109

What does the zona glomerulosa synthesize?

Question 223

109

What two things does the zona reticularis synthesize?

Question 224

109

What does the zona fasciculata synthesize?

Question 225

109

The adrenal medulla is composed of ______ cells that synthesize _____, mainly ______.

Question 226

110

What are the two mineralocorticoids produced by the zona glomerulosa?

Question 227

110

What are the two glucocorticoids produced by the zona fasciculata?

Question 228

110

What are the two androgens produced by the zona reticularis?

Question 229

110

What are the two catecholamines and the two peptides produced by the medulla of the adrenal gland?

Question 230

112

What is the disorder associated with hyper cortisol?

Question 231

112

What is the disorder associated with hyper aldosterone?

Question 232

112

What is the disorder associated with hyper androgens?

Question 233

114

Cushing syndrome is a disorder caused by conditions that produce _________.

Question 234

114

What is the ration of women to men affected by Cushing Syndrome?

Question 235

115

What is the sequence of four common symptoms seen in people with Cushing Syndrome?

Question 236

116

What are 7 common findings of Cushing Syndrome?

Question 237

118

What disorder is associated with Hypoadrenocorticism?

Question 238

120

Clinical features of Addison disease do not begin to appear until at least ____% of the glandular tissue has been destroyed.

Question 239

120

In Addison disease, with gradual destruction of the adrenal cortex, there is insidious onset of what 5 symptoms?

Question 240

121

What is bronzing in Addison disease?

Question 241

121

In Addison disease, bronzing is more prominent in ____ skin and over ________.

Question 242

121

In Addison disease, bronzing is caused by elevated levels of __________, derived from the _________ and is a precursor of both ______ and _________.

Question 243

123

What are the oral manifestations seen in Addison disease?

Question 244

123

What is the first manifestation of Addison disease?

Question 245

125

What are the levels of ACTH in primary hypoadrenocorticism?

Question 246

125

What are the ACTH in secondary hypoadrenocorticism?

Question 247

126

What is the treatment for Addison Disease?

Question 248

126

The physiologic dose of glucocorticoids for Addison disease treatment is approximately ______ mg of hydrocortisone or its equivalent per day in divided doses.

Question 249

126

Under stressful conditions, someone with Addison disease may need additional hormone above the physiologic dose. However, this adjustment is not required for dental procedures performed using ____ and lasting ______.

Question 250

129

In normal situations, cortisol is critical for function of the body, particularly in dealing with _____.

Question 251

129

As cortisol is metabolized and serum levels drop, feedback to the _____ signals it to produce _____, which stimulates the adrenal gland to produce _______.

Question 252

130

In Addison disease, therapeutic corticosteroids have what effect? What may be precipitated as a result of this?

Question 253

132

To avoid Addisonian crisis, the clinician must be aware of the potential side effects of _________ and must be able to adapt the treatment of the patient accordingly.

Question 254

132

For stressful dental and surgical procedures it is often necessary to increase the ______ because of the greater need of cortisol. Consultation with the physician who is managing the corticosteroid therapy is advised.

Question 255

133

How are cortisol, aldosterone, ACTH, and CRH levels affected in primary adrenal insufficiency when there is negative feedback?

Question 256

133

How are cortisol, aldosterone, ACTH, and CRH levels affected in secondary adrenal insufficiency when there is negative feedback?

Question 257

133

How are cortisol, aldosterone, ACTH, and CRH levels affected in tertiary adrenal insufficiency when there is negative feedback?

Question 258

134

What is the most common cause of hypoadrenocorticism in Western countries?

Question 259

134

What are three examples of infections that can cause hypoadrenocorticism?

Question 260

134

What are 4 things that rarely cause hypoadrenocorticism?

Question 261

137

The adrenal medulla is composed of ____ cells and their supporting cells known as ______ cells.

Question 262

137

The adrenal medulla is a major source of _____ in the body.

Question 263

137

_______ cells like chromaffin cells are widely dispersed in an _______ system of clusters and nodules that together with the adrenal medulla make up the ________ system.

Question 264

138

What is pheochromocytoma?

Question 265

138

What are neuroblastic tumors?

Question 266

139

What do pheochromocytomas synthesize and release?

Question 267

139

It is important to recognize pheochromocytomas because they are a rare cause of _______.

Question 268

141

Traditionally, the features of pheochromocytomas have been summarized by the _______.

Question 269

141

The rule of 10s for pheochromocytomas:

1. 10% of pheochromocytomas are _____.
2. 10% of sporadic adrenal pheochromocytomas are ______.
3. 10% of adrenal pheochromocytomas are biologically ______.
4. 10% of adrenal pheochromocytomas are not associated with _____.

Question 270

141

The traditional 10% rule that has now been modified for pheochromocytomas pertains to _______. ___% of individuals with pheochromocytomas and paragangliomas harbor a _______.

Question 271

143

What is the dominant feature of pheochromocytoma and in what percent of cases is it seen?

Question 272

143

What are two treatment options for pheochromocytomas?

Question 273

144

Neuroblastoma is a cancer composed of ________.

Question 274

144

Neuroblastomas most commonly arise in and around _____ which have similar origin to ______.

Question 275

144

Neuroblastomas are a common malignant tumor in _____. The median age at presentation is _____, with peak ages _____.

Question 276

144

Neuroblastomas are slightly more common in what sex?

Question 277

146

What are the three types of multiple endocrine neuroplasia syndromes?

Question 278

146

Which multiple endocrine neuroplasia syndrome has oral manifestations?

Question 279

147

What is another name for MEN1 syndrome?

Question 280

147

What is the inheritance pattern for MEN1?

Question 281

147

MEN1 is a syndrome characterized by mutations in the _______.

Question 282

147

MEN1 Syndrome involves the development of _______.

Question 283

147

What are the 3 P’s of MEN1 syndrome?

Question 284

150

What is another name for MEN-2A syndrome?

Question 285

150

What three things characterize MEN-2A syndrome?

Question 286

151

What 5 things do patients with MEN-2B Syndrome develop?

Question 287

151

How does medullary carcinoma of the thyroid in MEN-2B compare to that of MEN-2A?

Question 288

152

What are the oral manifestations seen in MEN-2B?