Endocrine

Question 1

Which hormones are secreted by the pituitary?

Answer 1

Posterior Pit

GH

PRL

ACTH

LH

FSH

TSH

Anterior Pit

ADH

Oxytocin

Question 2

Compare the signs of pituitary hyperfunction in children and adults.

Answer 2

Prepubertal = giantism

Post-pubertal = acromegaly

Question 3

What are the signs of pituitary hypofunction?

Answer 3

General weakness, cold intolerance, poor appetite, weight loss, hypotension, amenorrhea (w), impotence (m), dwarfism (children)

Question 4

What are the causes of hyperthyroidism?

Answer 4

1) graves disease
2) nodular goiter
3) toxic adenoma
4) exogenous thyroid medication
* T3 and T4 normally inhibit secretion of TSH, which accounts for the low concentraiton of TSH in these forms of hyperthyroidism.*

Question 5

What are the clinical features of hyperthyroidism?

Answer 5

• restlessness, nervousness
• emotional lability
• sweating
• tachycardia, palpitations
• muscle tremor
• diarrhea, weigh loss
• exopthalmoos

Question 6

What are the causes of hypothyroidism?

Answer 6

• developmental defects
• thyroiditis (immune)
• hashimotos’ thyroiditis (most common)
• thyroidectomy
• iodine deficiency

Question 7

What are the clinical features of hypothyroidism?

Answer 7

Children: cretinism (mental retardation) and dwarfism

• myxedema
• fatigue
• bradycardia
• constipation
• myalgia, weakness, stiffenss

Question 8

Correlate the pathologic and clinical features of nodular goiter.

Answer 8

Nodules consist of thyroid follicles . . . between nodules vessels and collagen fibers infiltrated with lymphocytes and macrophages. May have calcification, hemorrhage, and atrophy.

Compression of adjacent structures >> coughing, hoarseness

Question 9

List the most important thyroid neoplasms and discuss their prognosis.

Answer 9

Papillary

80%, 4x more common in women, favorable prognosis

Follicular

most > 40 yrs, can be treated with radioactive iodine

Medullary

derived from C cells, produce calcitonin, can be inherited MEN2

Anaplastic

very unfavorable prognosis

Question 10

What are the causes of hyperparathyroidism?

Answer 10

Adenomas (80%)

Hypocalcemmia

Question 11

What are the clinical features of hyperPTH?

Answer 11

• Decalcification >> fractures
• deposition of calcium salts >> nephrocalcinosis, urolithiasis
• lethargy, muscle weakness, arrhythmias

Question 12

What are the metabolic consequences of hyperparathyroidism?

Answer 12

Stimulates osteoclasts, leading to bone resorption and release of calcium into circulation. In kindeys promotes resorption of CA in urine and formation of active vitamin D.

Question 13

Compare the clinical features of hyperparathyroidism and hypoparathyroidism.

Answer 13

• neuromuscular excitability and muscular contraction
• tetany
• arrhythmias

Question 14

What are the causes of adrenocortical hyperfunction?

Answer 14

Hypersecretion of mineralocorticoids, glucocorticoids, sex steroids. Can be caused by hyperplasia or neoplasia.

Question 15

Describe the clinical features of the three most important syndromes caused by adrenocortical hyperfunction.

Answer 15

• Hyperaldosteronism (Conn’s syndrome)
• Cushings syndrome
• Adrenogenital syndrome

Question 16

What are the clinical features adrenocortical hyperfunction?

Answer 16

hypercortisolism: central obesity, moon face, buffalo humb, plethora, HTN, thin skin, glucose intolerance, fatigue, weakness

Androgenital: *virilization, *

Question 17

What are the causes of adrenocortical hypofunction?

Answer 17

Usually caused by adrenal destruction

acute >> waterhouse-friderichsen (meningococcal septicemia)

chronic >> autoimmune

Question 18

Compare neuroblastoma and pheochromocytoma.

Answer 18

Neuroblastoma

undifferentiated precursors of neural cells that are precursors of normal adrenal medullary cells. occur mostly in young children, fast growing abdominal masses, produce VMA

Pheochromocytoma

polygonal cells resembling normal adrenal medulla, adults, secrete catecholamines, elevated VMA