Rub/Rob Endocrine

Question 1

Rub 9: Most common cause of hypoPTism is

Answer 1

surgical resection of the parathyroids as a complication of thyroidectomy; think decreased serum Ca and PTH

Question 2

Rub 10: Nontoxic goiter refers to an

Answer 2

enlargement of the thyroid that is not associated with functional, inflamm, or neoplastic alterations; think dysphagia/inspiratory stridor with large goiters compressing esophagus or trachea

Question 3

Rub 12: In mixed somatotroph-lactotroph adenomas,

Answer 3

the two cell types elaborate growth hormone and prolactin, respectively

Question 4

Rub 16: WA syndrome is a

Answer 4

sex-linked, hereditary disease in which severe immunodeficiency is associated with a hypoplastic thymus, eczema, and thrombocytopenia

Question 5

Rub 38: Medullary thyroid carcinoma derived from

Answer 5

C cells of the thyroid, which secrete Ca-lowering hormone calcitonin; look for STROMAL AMYLOID (deposition of procalcitonin)

Question 6

Rub 41: Neuroblastoma is a

Answer 6

malignant tumor of neural crest origin that is composed of neoplastic neuroblasts; originates in the adrenal medulla or symp ganglia (vanillylmandelic acid in the urine!!)

Question 7

Rob 4: inadvertent removal of or damage to the parathyroid glands during ____ surgery can cause

Answer 7

thyroid; hypocalcemia secondary to hypoparathyroidism

Question 8

Rob 9: What is a common complication of long-standing diabetes mellitus?

Answer 8

Severe peripheral atherosclerotic disease; narrowing of the arteries to the lower legs can cause ischemia and gangrene!!!

Question 9

Rob 17: What HLA’s have the strongest linkage to T1DM?

Answer 9

HLA-DR3 and DR4; you’ll see autoAb’s to islet cell Ags such as glutamic acid decarboxylase and also insulitis caused by T-cell infiltration with CD4 cells and cytokines

Question 10

Rob 23: Addison disease most often results from

Answer 10

an idiopathic autoimmune condition; think of autoimmune adrenalitis

Question 11

Rob 32: Neuroblastomas are

Answer 11

neoplasms that occur in children and may be congenital; think the retroperitoneum in the adrenal glands or extra-adrenal paraganglia (think small blue cell tumors that can make catecholamine precursors and their metabolites, like HVA!!!)

Question 12

Rob 35: chronic adrenal insufficiency can present with

Answer 12

decreased cortisol production and decreased mineralocorticoid activity; skin hyperpigmentation results from increased corticotropin precursor hormone production, which stimulates melanocytes; most common cause is AUTOIMMUNE ADRENALITIS

Question 13

Rob 36: Patient with maturity-onset diabetes of the young due to

Answer 13

inherited AD mutation with inactivating mutation in glucokinase that increases the beta cell threshold for insulin release

Question 14

Rob 37: Lung mass here suggests a

Answer 14

primary carcinoma, and the bilaterally enlarged adrenal glands can be explained by adrenal metastases

Question 15

Rob 42: Anaplastic carcinoma with

Answer 15

pleomorphic spindle cells; aggressive, large size

Question 16

Rob 43: Papillary carcinoma has features of

Answer 16

papillary architecture and cells with clear nuclei; think of RET or NTRK1 proto-oncogenes belonging to family of receptor tyrosine kinases

Question 17

Rob 47: Toxic follicular adenoma is a

Answer 17

thyroid nodule that is well differentiated, noninvasive, and hyperfunctioning; think activating mutations of the TSH receptor signaling pathway

Question 18

Rob 53: Type 1 DM does not become overt until the

Answer 18

beta cells are markedly depleted, and insulin levels are greatly reduced; think KETOACIDOSIS!!

Question 19

Rob 55: MEN type 2A or maybe IIB will have

Answer 19

medullary carcinomas of the thyroid, pheochromocytomas, and parathyroid adenomas; HTN from a pheochromocytoma could arise in the adrenal medulla