MedComplex-Endocrine2

Question 1

_________ of the thyroid or goiter is the MOST COMMON manifestation and reflects impaired synthesis of thyroid hormone, mostly from a deficiency of dietary_______

Answer 1

Enlargement….. iodine

Question 2

Low concentrations of T3 and T4 in the serum results in inadequate feedback inhibition of the pituitary, which responds to the low levels of thyroid hormones by OVERPRODUCING _____.

Answer 2

TSH

Question 3

Most patients are euthyroid, and it is far more common in females than males (about ___ to ___)

Answer 3

8 to 1

Question 4

________ Goiter? Enlargement of the thyroid without functional, inflammatory, or neoplastic alterations.

Answer 4

NON-Toxic

Question 5

2 types of NON-toxic goiters: The types are _______ nontoxic, seen mostly in adolescence and pregnancy, and _________ nontoxic goiters, usually seen in persons over the age of fifty.

Answer 5

diffuse…. multinodular

Question 6

What does the diffuse type of goiter represent?
It represents the early stages of the disease where the gland is diffusely enlarged with mildly enlarged follicles with minimal ______

Answer 6

colloid

Question 7

What does the ________ type represent? Reflects more of a chronic disease, with nodular enlargement and cyst formation with microscopically, larger follicles with increased colloid separated by dense fibrosis, focal calcifications and chronic inflammation.

Answer 7

multinodular

Question 8

Hyperfunctioning of the thyroid gland in the vast majority is caused by ________ (85%)

Answer 8

Graves Disease

Question 9

*TEST Q?? WOAH! What is the most PREVALENT AUTOIMMUNE DISEASE in the US?

Answer 9

Graves Disease

Question 10

Graves Disease is an autoimmune disease caused by antibodies to the _____ receptors on the surface of the thyroid follicular cells.

Answer 10

TSH

Question 11

The pathogenesis of Graves Disease relates to increased circulating antibodies (___) that bind to the surface of the thyroid cells, exerting a stimulus similar to the effects of TSH itself.

Answer 11

IgG

Question 12

Graves Disease: Elaboration of these thyroid-stimulating antibodies requires thyroid-specific helper (CD-4) positive T-Cells that recognizes the TSH receptors and activates the ___- cells.

Answer 12

B cells

Question 13

Which thyroid disorder? The colloid tends to be depleted and appears scalloped or “moth-eaten” where it abuts the epithelium.

Answer 13

Graves Disease

Question 14

The protrusion of the eyeballs is a common complication of _______, caused by enlargement of the orbital extraocular muscles.

Answer 14

graves disease

Question 15

What condition? Patients exhibit a gradual onset of nervousness, tremor, weakness and weight loss, although they have an increased appetite.

Answer 15

Graves

Question 16

If GRAVES IS left untreated, it progressively leads to thyroid failure with resultant _______thyroidism!!!

Answer 16

hypothyroidism

Question 17

Graves disease is a hyper or hypo thyroid condition?

Answer 17

hyper (until late stages when it becomes hypo c/o thyroid burnout)

Question 18

Primary Hypothyroidism is associated with which tissue?

Answer 18

the thyroid gland

Question 19

Secondary Hypothyroidism is associated with which tissue?

Answer 19

pituitary gland

Question 20

Tertiary Hypothyroidism is associated with which tissue?

Answer 20

hypothalamic tissue

Question 21

Myxedema Madness may develop from hyper or hypo thyroidism?

Answer 21

hypo

Question 22

What is Cretinism?

Congenital _____thyroidism that can either be endemic, sporadic, or genetic.

Answer 22

HYPOthyroidism

Question 23

Inflammation of the thyroid that is most often immune-mediated, characterized by gradual failure because of an immune destruction of the gland is describing WHAT?

Answer 23

hashimoto thyroiditis

Question 24

H.T. is more common in ______ (6:1) and most prevalent between 45 and 65 years of age.

Answer 24

women

Question 25

**** I WILL PROBABLY ASK THIS*** HASHIMOTO THYROIDITIS patients are at an increased risk for the development of WHICH TYPE OF CANCER?

Answer 25

B-cell Lymphomas

Question 26

Is Hashimoto's Thyroiditis hypo or hyper thyroid?

Answer 26

HYPO

Question 27

_______ Syndrome: Hypercortisolism due to either adrenal tumors or hyperplasias.

Answer 27

Cushing

Question 28

Cushing Syndrome: ______cortisolism due to either adrenal tumors or hyperplasias.

Answer 28

HYPER

Question 29

What is the difference between Cushing's Disease and Cushing's Syndrome?

Answer 29

Disease=pituitary causes....Syndrome = Adrenal Causes

Question 30

Which one can cause which between Cushing's Disease and Cushing's Syndrome?

Answer 30

Disease (pituitary) can cause syndrome (adrenal)

Question 31

________ Disease: Hyposecretion of adrenal cortical hormones due to autoimmune destruction of the gland

Answer 31

Addison

Question 32

Addison Disease: ______secretion of adrenal cortical hormones due to autoimmune destruction of the gland

Answer 32

HYPO

Question 33

Cushing Syndrome: A result of hypersecretion of __________ from adrenal cortical tumors or hyperplasias

Answer 33

glucocorticoids

Question 34

WHAT IS THE MOST COMMON CAUSE OF CUSHING SYNDROME?

Answer 34

Chronic Corticosteroid Rx

Question 35

Cushing _______ is five times more frequent than Cushing ________, associated with primary adrenal tumors or hyperplasias.

Answer 35

disease....syndrome

Question 36

Cushing disease is mostly seen in middle-aged ______ (25-45)

Answer 36

WOMEN

Question 37

Adrenal cortical tumors (benign adenomas or malignant carcinomas) are _____ because of their high _____ content.

Answer 37

yellow, lipid

Question 38

Which condition presents with MOON FACE?

Answer 38

Cushing Syndrome

Question 39

Which test can differentiate if a person has Cushing Disease vs Syndrome?

Answer 39

DexaMethaSone Suppression Test

Question 40

What is the Tx for exogenously induced Cushing Syndrome?

Answer 40

TAPER patient off of steroid tx

Question 41

Adrenal insufficiency is usually a consequence of adrenal destruction, ACUTELY (_______-______ Syndrome)

Answer 41

Waterhouse-Friderichsen

Question 42

Adrenal insufficiency is usually a consequence of adrenal destruction slowly by an autoimmune disease (_______ Disease)

Answer 42

Addison

Question 43

What is ACUTE adrenal insufficiency? What is chronic?

Answer 43

Waterhouse-Friderichsen is acute....Addison is chronic

Question 44

What is also known as Acute Meningococcemia: characterized by an overwhelming Neisseria meningitides septicemia?

Answer 44

Waterhouse-Friderichsen Syndrome

Question 45

________: Accounts for the vast majority (70-80%) of adrenal insufficiency today. Seen mostly in white women

Answer 45

Addison Disease

Question 46

What is the most unique physical manifestation of the gram negative epticemia aka waterhouse-friderichsen syndrome?

Answer 46

purpura

Question 47

Which gram negative bacterium is responsible for Waterhouse-Friderichsen Syndrome again?

Answer 47

Nisseria Meningitidis

Question 48

What is Primary chronic adrenal insufficiency due to autoimmune destruction of the adrenal gland?

Answer 48

Addison Disease

Question 49

In Addison Disease After 90% of the gland has been destroyed, clinical manifestations due to failure to produce ___________, ____________, and ________ appear.

Answer 49

glucocorticoids, mineralcorticoids, and androgens

Question 50

Clinically, Addison’s Disease presents with extreme weakness and ________, sometimes leading to bed rest, with weight loss, anorexia, nausea, and personality changes.

Answer 50

fatigue

Question 51

Affected Addison's patients are _________ (glucocorticoid deficiency) with electrolyte imbalances, (mineralcorticoid deficiency causing hyponatremia, hyperkalemia, with volume depletion leading to hypotension)

Answer 51

hypoglycemic

Question 52

Addison's = diffuse tan pigmentation usually develops on the skin related to increased pituitary _____ precursor hormone stimulation of melanocytes

Answer 52

ACTH

Question 53

__________: A rare neoplasm of _______ cells of the adrenal medulla that synthesizes and releases the Catecholamines (Epinephrine and Norepinephrine).

Answer 53

Pheochromocytoma....chromaffin

Question 54

Although uncommon, Pheochromocytoma give rise to a surgically correctable form of _________.

Answer 54

hypertension

Question 55

Addisons and Cushings are the adrenal ________, whereas Pheochromocytoma affect the adrenal _______

Answer 55

cortex...medulla

Question 56

Clinical Pheochromocytoma: Clinically, the dominant manifestation is _______, which classically is abrupt, with tachycardia, palpitations, H/A, sweating, and tremor, often associated with N/V, abdominal and chest pain

Answer 56

Hypertension

Question 57

exercise, lifting or bending can perpetuate the HTN affects of which condition?

Answer 57

Pheochromocytoma

Question 58

Pheochromocytoma: This sudden release may acutely precipitate pulmonary _______. Myocardial infarction, ventricular fibrillation, cerebrovascular accidents, and congestive heart failure.

Answer 58

edema

Question 59

What are the two markers in the urine to diagnose a Pheochromocytoma?

Answer 59

VMAs and MetaNephrines