Pathology III

Question 1

What byproduct is produced from dopamine in catecholamine synthesis?

Answer 1

HVA (homovanillic acid) (p.297)

Question 2

What byproducts are produced from norepinephrine in catecholamine synthesis?

Answer 2

Normetanephrine, VMA (p.297)

Question 3

What byproducts are produced from epinephrine in catecholamine synthesis?

Answer 3

Metanephrine, VMA (p.297)

Question 4

What is a neuroblastoma?

Answer 4

Most common tumor of the adrenal medulla in children (p.297)

Question 5

Where do neuroblastomas occur?

Answer 5

Can occur anywhere along the sympathetic chain (p.297)

Question 6

What lab findings are consistent with a diagnosis of neuroblastoma?

Answer 6

Homovanillic acid (HVA), a breakdown product of dopamine is elevated in urine (p.297)

Question 7

What symptoms are distinguish pheochromocytoma from neuroblastoma?

Answer 7

Neuroblastomas tend not to cause hypertension (p.297)

Question 8

What oncogene is associated with rapid tumor progression in neuroblastoma?

Answer 8

Overexpression of N-myc oncogene (p.297)

Question 9

Describe the signs and symptoms of hypothyroidism.

Answer 9

Cold intolerence (decreased heat production), weight gain, decreased appetite, hypoactivity, lethargy, fatigue, weakness, constipation, decreased reflexes, myxedema (facial/periorbital), dry cool skin, coarse brittle hair, bradycardia, dyspnea on exertion (p.298)

Question 10

Describe the signs and symptoms of hyperthyroidism.

Answer 10

Heat intolerance (increased heat production), weight loss, increased appetite, hyperactivity, diarrhea, increased reflexes, pretibial myxedema (Graves’), warm moist skin, fine hair, chest pain, palpitations, arrythmias, increased beta adrenergic receptors (p.298)

Question 11

What are the lab findings in a patient with hypothyroidism?

Answer 11

Increased TSH (sensitive test for primary hypothyroidism); decreased free T4 (p.298)

Question 12

What are the lab findings in a patient with hyperthyroidism?

Answer 12

Decreased TSH (if primary); increased total or free T4 and T3 (p.298)

Question 13

What are the four most common causes of hypothyroidism?

Answer 13

Hashimoto’s thyroiditis, cretinism, subacute thyroiditis (de Quervain’s), Riedel’s thyroiditis (p.298)

Question 14

What is Hashimoto’s thyroiditis?

Answer 14

The most common cause of hypothyroidism; an autoimmune disorder involving thyroid peroxidase and antithyroglobulin antibodies (p.298)

Question 15

What antibodies are associated with Hashimoto’s thyroiditis?

Answer 15

Thyroid peroxidase and antithyroglobulin antibodies (p.298)

Question 16

What HLA type is Hashimoto’s associated with?

Answer 16

HLA-DR5 (p.298)

Question 17

What condition are patients with Hashimoto’s at increased risk for?

Answer 17

Non-Hodhkin’s lymphoma (p.298)

Question 18

What is seen in histology of the thyroid in a patient with Hashimoto’s?

Answer 18

Hurthle cells, lymphocytic infiltrate with germinal centres (p.298)

Question 19

What clinical findings are associated with Hashimoto’s?

Answer 19

Moderately enlarged, nontender thyroid (p.298)

Question 20

What condition may manifest early on in the course of disease in a patient with Hashimoto’s?

Answer 20

May be hyperthyroid early on due to thyrotoxicosis during follicular rupture (p.298)

Question 21

What causes cretinism?

Answer 21

Severe fetal hypothyroidism (p.298)

Question 22

What is the difference between endemic and sporadic cretinism?

Answer 22

Endemic cretinism occurs wherever endemic goiter is prevalent (lack of dietary iodine); sporadic cretinism is caused by a defect in T4 formation or developmental failure in thyroid formation (p.298)

Question 23

What are five clinical findings in a patient with cretinism?

Answer 23

Pot belly, pale, puffy faced, protruding umbilicus, protuberant tongue (p.298)

Question 24

What is subacute thyroiditis (de Quervain’s)?

Answer 24

Self-limited hypothyroidism often following a flu-like illness (p.298)

Question 25

What is seen in histology of the thyroid in a patient with subacute thyroiditis (de Quervain’s)?

Answer 25

Granulomatous inflammation (p.298)

Question 26

What condition may manifest early on in the course of disease in a patient with subacute thyroiditis (de Quervain’s)?

Answer 26

May be hyperthyroid early in course (p.298)