Endocrine

Question 1

Hashimoto Thyroiditis

Answer 1

present with painless goiter with clinical signs of hypothyroidism (most common cause). Associated with HLA-DR5. Have thyroid peroxidase and thyroglobulin antibodies. Tx: levothyroxine

Question 2

Graves Disease

Answer 2

Most common form of hyperthyroidism. Thyroid stimulating immunoglobulin stimulates TSH receptor. High T3/T4, low TSH. Presents with goiter, pretibial myxedema, exopthalmos (both due to TSH receptors producing GAG) Tx: 131 Iodine, Thyroidectomy

Question 3

MEN 1

Answer 3

3P’s 1. Pancreatic islet tumor 2. Pituitary tumors 3. Parathyroid adenomas Associated with menin gene mutation (tumor suppressor gene. Autosomal Dominant

Question 4

MEN2A

Answer 4

2P’s 1. Parathyroid Adenomas 2. Pheochromocytoma 3. Medullary Thyroid Carcinoma Mutation in RET gene Autosomal Dominant

Question 5

MEN2B

Answer 5

1P 1. Pheochromocytoma 2. Medullary Thyroid Carcinoma 3. Mucosal Neuromas (oral/intestinal ganglioneuromatosis) Mutation RET gene Autosomal Dominant

Question 6

Papillary Carcinoma

Answer 6

Most common type of thyroid cancer. Excellent prognosis. Staining shoes “Orphan Annie Eyes”, psamomma bodies (calcification rings), nuclear grooves. Increased risk with RET and BRAF mutations