Firecracker Endo III

Question 1

Drugs that can cause hypothyroidism

Answer 1

Lithium
Amiodarone
Sulfonamides

Question 2

5 causes of hypothyroidism

Answer 2

1. Hashimoto
2. Iodine deficiency
3. Surgery/radiation
4. Drugs
5. Subacute lymphocytic thyroiditis

Question 3

What is tertiary hyperparathyroidism?

Answer 3

Long standing hyperparathyroidism: progresses into autonomous hypersecretion of PTH even after correction of chronic hypocalcemia

Question 4

patients with Hashimoto thyroiditis are at increased risk of developing which malignancy?

Answer 4

B-cell non-Hodgkin lymphomas, especially extra nodal marginal zone lymphomas of MALT

Question 5

↑ urinary cAMP

Answer 5

reflects PTH action at the proximal tubule

Question 6

What is the most common cause of thyroid pain?

Answer 6

DeQuervain

Question 7

Medullary CA of thyroid is associated with which two MEN syndromes?

Answer 7

MEN 2A

MEN 2B

Question 8

• lymphocytic infiltrate

- multinucleate giant cells surrounding fragments of colloid

Answer 8

DeQuervain histology

Question 9

Fibrous tissue replaces thyroid parenchyma, with fibrosis extending beyond the thyroid capsule into surrounding tissue.

Answer 9

Reidel thyroiditis

Question 10

Parathyroid hyperplasia is commonly associated with what 2 MEN syndromes?

Answer 10

MEN 1 and MEN 2A

Question 11

May induce remission of hyperthyroidism by blocking new thyroid hormone production via inhibition of the organification and coupling steps of thyroid hormone synthesis.

Answer 11

Thioamides (PTU or methimazole)

- PTU (not methimazole) also inhibits peripheral conversion of T4 to T3.

Question 12

What are four common causes of hypomagnesemia?

Answer 12

diarrhea, aminoglycosides, diuretics, and alcohol abuse.

Question 13

Besides serum TSH, total T4, free T4, and 123I uptake, what other lab findings are associated with thyrotoxicosis? (Try to name 3)

Answer 13

1. hypercalcemia
2. hyperglycemia
3. hypocholesterolemia

Question 14

What effect does PTH have on bones?

Answer 14

PTH binds osteoblasts → secrete M-CSF and RANK-L –> osteoCLASTs break down bone to release calcium.

Question 15

goiter causes

Answer 15

graves and iodine deficiency

Question 16

• Fever
• Painful thyroid
• Painful cervical LAD

Answer 16

acute thyroiditis

Question 17

• Fine tremor (eg, of the hands)
• Anxiety
• Insomnia
• Emotional lability
• Inability to concentrate
• Brisk DTRs (deep tendon reflexes)

Answer 17

neurological effects of hyperthyroidism

Question 18

hyperparathryoidism –> hypercalcemia –> bones, stones, groans, and moans =

Answer 18

Oseitis fibrosa cystica
calcium nephrolithiassis
GI distress
psych disturbances (depression)
(also HF and arrhythmias)

Question 19

How does follicular thyroid carcinoma spread?

Answer 19

Hematogenously

Question 20

Ergocalciferol

Answer 20

vitamin D2

Question 21

cholecalciferol

Answer 21

vitamin D3

Question 22

• Slow DTRs with prolonged relaxation phase
• Fatigue
• Lethargy
• Mental slowness
• Mental retardation (perinatal)

Answer 22

hypothyroidism

Question 23

What is the most common cause of hyperparathyroidism?

Answer 23

Single benign adenoma

Question 24

What is the mechanism of action of β-blockers in treatment of hyperthyroidism?

Answer 24

control symptoms of ↑ SNS tone

Question 25

- brain trauma - surgery - pituitary tumor - histiocytosis X

Answer 25

cause central diabetes insipidus

Question 26

1. chronic renal failure 2. malabsorption syndromes 3. rickets 4. psuedohypoparathryoidism

Answer 26

4 causes of secondary hyperparathyroidism

Question 27

FSH, LH, ACTH, TSH, CRH, hCG, ADH (V2 receptor), MSH, PTH, calcitonin, GHRH, and glucagon use what signaling mechanism?

Answer 27

adenylate cyclase -cAMP signaling mechanism

Question 28

what is stimulated by mild decreases in Mg2+ but inhibited by severe decreases in Mg2+?

Answer 28

PTH

Question 29

drugs that inhibit thyroid peroxidase (TPO)

Answer 29

propylthiouracil and methimazole.

Question 30

What catalyzes the formation of vitamin D3 from 7-dehydrocholesterol?

Answer 30

sunlight!

Question 31

Can you name 3 immunologic mechanisms which may cause thyroid cell death in patients with Hashimoto thyroiditis?

Answer 31

1. CD8+ 2. cytokines 3. ADCC

Question 32

Hürthle cells

Answer 32

hashimoto

Question 32

Hürthle cells

Answer 32

hashimoto

Question 33

How does Thyroid Releasing Hormone affect prolactin secretion?

Answer 33

stimulates it!

Question 33

How does Thyroid Releasing Hormone affect prolactin secretion?

Answer 33

stimulates it!

Question 34

What is the function of calcitonin?

Answer 34

decrease bone resorption of calcium (i.e. put calcium on bones)

Question 34

What is the function of calcitonin?

Answer 34

decrease bone resorption of calcium (i.e. put calcium on bones)

Question 35

High levels of I- inhibit thyroid hormone synthesis by blocking the organification step.

Answer 35

Wolff-Chaikoff effect

Question 35

High levels of I- inhibit thyroid hormone synthesis by blocking the organification step.

Answer 35

Wolff-Chaikoff effect

Question 36

In the hypothalamic-pituitary system, which two hormones does somatostatin inhibit?

Answer 36

GH + TSH

Question 36

In the hypothalamic-pituitary system, which two hormones does somatostatin inhibit?

Answer 36

GH + TSH

Question 37

Name a viral cause of hemorrhagic cystitis.

Answer 37

adenovirus

Question 37

Name a viral cause of hemorrhagic cystitis.

Answer 37

adenovirus

Question 38

Associated with HLA-DR3 and HLA-B8

Answer 38

Graves

Question 38

Associated with HLA-DR3 and HLA-B8

Answer 38

Graves