path-endocrine

Question 1

high cortisol in general

Answer 1

cushing’s

Question 2

nu,ber one cause of cushing’s

Answer 2

exogenous steroids

Question 3

most common causes of endogenous cushing’s

Answer 3

1) high ACTH from pituitary adenoma
2) ectopic ACTH from lung tumor (small cell)
3) adrenal tumor

Question 4

moon facies, truncal obesity, striea, ammenoria, immune supression

Answer 4

cushing’s

Question 5

result of dex test in ACTH pituitary tumor

Answer 5

low dose - cortisol remains elevated

high dose - cortisol is suppressed

Question 6

hypertension, hypokalemia, metabolic alkalosis, low plasma renin

Answer 6

primary hyperaldosteronism

Question 7

cause of primary hyperaldosteronism

Answer 7

sdrenal hyperplasia or aldosterone secreting adrenal adenoma

Question 8

treatment for primary hyperaldosteronism

Answer 8

surgery to remove the tumor and/or spirolactone (aldosterone antagonist)

Question 9

cause of secondary hyperaldosteronism

Answer 9

high plasma renin from renal artery stenosis, chronic renal failure, CHF, cirrhosis or nephrotic syndrome

Question 10

tx for secondary hypersldosteronism

Answer 10

spirolactone

Question 11

hypotension, hyperkalemia, acidosis, skin hyperpigmentation

Answer 11

addison’s dx

Question 12

cause of addison’s

Answer 12

adrenal atrophy or distruction by disease

Question 13

part of the adrenal spared by addison’s

Answer 13

medulla

Question 14

bug that causes waterhouse-friderichsen syndrome

Answer 14

N meningitis

Question 15

pheo dereived from

Answer 15

chromaffin cells of neural crest

Question 16

pheo is tumor of

Answer 16

adrenal medulla

Question 17

pheos secrete

Answer 17

catchecolamines

Question 18

syndromes associated with pheo

Answer 18

MEN 2A/B and NF1

Question 19

test for pheo

Answer 19

VMA in urine

Question 20

drug given before pheo removal

Answer 20

phenoxybenzamine (irreversable alpha antagonist), then B blockers

Question 21

most common tumor of adrennal medulla in kids

Answer 21

neuroblastoma

Question 22

test for sympathetic chain neuroblastoma

Answer 22

HVA in urine

Question 23

gene asociated with rapid neurblastoma progressions

Answer 23

n-myc

Question 24

facial myxedema, dry cool skin, brittle hair, dyspenea on exertion

Answer 24

hypOthyroidism

Question 25

pretibial myxedema, diarrhea, warm moistskin, fine hair

Answer 25

hyperthyroidism

Question 26

most common cause of hypothyroidism

Answer 26

hashimoto's

Question 27

HLA-DR5

Answer 27

hashimoto's

Question 28

moderatly enlarged, non-tender thyroid with lymphocytic infiltrate in germinal centers

Answer 28

hashimoto's

Question 29

caused by severe fetal hypothyroidism

Answer 29

cretinism

Question 30

pot-bellied, pale, puffy kid with protuding umbilicus and tound

Answer 30

cretinism

Question 31

self-limiting hypothyroidism following flu-like illness. granulomatoius inflammation. Tender thyroid, elevated ESR, jaw pain

Answer 31

subacute thyroiditis

Question 32

fibrotic change in thyroid - fixed, hard (rock-like) painless goiter

Answer 32

reidel's thyroiditis

Question 33

focal patches of hyperfunctiing thyroid follicular cells working independatly of TSH

Answer 33

toxic multinodular goiter

Question 34

autoimmune ahyperthyroidism with thyroid stimulating immunoglobulns

Answer 34

grave's dx

Question 35

stress induced catchecohomaine surge leading to death by arrythmia - serious complication of grave's

Answer 35

thyroid storm

Question 36

most common thyroid cancer

Answer 36

papillary (execellent prognosis)

Question 37

orphan annie eyes, psmmoma bodies

Answer 37

papillary carcinoma

Question 38

common cause of paillary carcinoma

Answer 38

childhood irradiation

Question 39

thyroid cancer associated with MEN 2

Answer 39

medullary carcinoma

Question 40

type of cell in meduillary carcinoma

Answer 40

parafollicular "C" cells

Question 41

produces calcitonin, sheets of cells in amyloid stroma

Answer 41

medullary carcinoma

Question 42

poor prognosis thyroid cancer

Answer 42

undifferentiated/anaplastic

Question 43

renal stones, hypercalcimia/uria, high PTH and alakaline phosphatase, weakness, constipation

Answer 43

primary PTHism

Question 44

bone lesion in primary PTHism

Answer 44

osetitis fibrosa cystica

Question 45

cause of secondary hyper PTHism

Answer 45

chronic renal dx leading to low gut Ca absorption and high phostphate

Question 46

causes of hypoPTHs

Answer 46

removal if PT during thyroidectomy, autoimmune destruction, or DiGeorge

Question 47

tapping of facial nerve gives contraction of facial muscles

Answer 47

chvostek's sign (hypoPTHism)

Question 48

amenorrhea, galactorhhea, low libido, infertility, bitemporal hemianopia

Answer 48

pituitary ademoma

Question 49

treament of pituitary ademoma

Answer 49

dopamine agonists (bromocriptine or cabergoline)

Question 50

dx of acromegaly

Answer 50

high serum IGF-1, failure to suppress GH following oral glucose tolerance test

Question 51

tx for central Diabetes insipidis

Answer 51

intranasal desmopression

Question 52

tx for nephrogenic diabietss inspidids

Answer 52

HCTZ, indomethacin, or amiloride

Question 53

sx of DM1

Answer 53

ploydipsia, polyuria, polyphagia, weight loss, DKA

Question 54

DM type with strongest genetic predisposition

Answer 54

II

Question 55

type of DM with amyloid deposit

Answer 55

II

Question 56

precipitates DKA in DM1

Answer 56

stress (infection)

Question 57

labs in DKA

Answer 57

hyperglycemia, high acidity, low bicarb, high keones, high plasma K+ (but low intracellular K+

Question 58

Tx for DKA

Answer 58

IV fluids, IV insulin, and K+

Question 59

gastrin secreting tumor of pancreas/duodeoem

Answer 59

zollinger-ellison (stomach shows rugal thickening)

Question 60

MEN 1 tumors

Answer 60

pituitary, parathyroid, pancreas

Question 61

MEN 2A tumors

Answer 61

parathyroids and pheo

Question 62

Men 2B

Answer 62

Pheo, thyroid