UWorld

Question 1

hypotension, weight loss, hypoglycemia

Answer 1

ACTH deficiency (seen in hypopituitarism)

Question 2

fatigue, cold intolerance, slowed deep

Answer 2

hypothyroidism

Question 3

infertility, loss of libido

Answer 3

hypopituitarism –> decreases in gonadotropins

Question 4

etiology of hypopituitarism

Answer 4

pituitary causes: hemorrhage (apoplexy), ischemic infarction (sheehan syndrome),
infiltration (pituitary hypophysitis)

Question 5

sheehan syndrome

Answer 5

ischemic infarction of the pituitary- occurs during pregnancy (peripartum hemorrhage)

Question 6

most common symptom of sheehan syndrome

Answer 6

failure to lactate due to prolactin deficiency

Question 7

usually presents with acute severe heachage, opthalmoplegia, and altered sensorium

Answer 7

pituitary apoplexy (hemorrhage), often as the result of an adenoma

Question 8

the most common inflammatory condition of the pituitary

Answer 8

lymphocytic hypophysitis

Question 9

what causes sheehan syndrome

Answer 9

high levels of estrogen during pregnancy

Question 10

60 yo man had difficulty going up the stairs, dyspnea on exertion, darkening of the skin, lung mass, elevated serum cortisol levels. what is the appropriate lab to order?

Answer 10

high dose dexamethasone suppression test for cushing’s

Question 11

high dose dexamethasone test for cushing’s involving a pituitary adenoma

Answer 11

ACTH and cotisol would decrease

Question 12

high dose dexamathasone test for cushing’s involving a ectopic ACTH

Answer 12

ACTH and cortisol would be unchanged

Question 13

high dose dexamethasone test for cushing’s involving adrenals and adenoma/carcinoma

Answer 13

ACTH/cortisol would be unchanged

Question 14

man has a “cold” thyroid nodule on thyroid scan. FNA shows spindle shaped cells on amorphous background. serum calcitonin is elevated. what genetic alteration would we find?

Answer 14

activating mutation of the RET proto oncogene

Question 15

80% of medullary thyroid carcinomas are

Answer 15

sporadic

Question 16

20% of medullary thyroid carcinomas are

Answer 16

associated with MEN2B

Question 17

what mutation is found in over 95% of medullary thyroid carcinomas?

Answer 17

germline mutations in RET

Question 18

fatigue, constipation, weight gain…female patient, 45-65, diffuse enlargement of the thyroid. what would be found on fine needle aspiration?

Answer 18

mononuclear infiltrate, geminal centers, herthle cells, lymphocytes: hoshimoto’s thyroiditis

Question 19

branching papillary structures, concentric calcifications ground glass nuclei and intranuclear grooves

Answer 19

papillary carcinoma, thyroid

Question 20

branching papillary structures, concentric calcifications, ground class nuclei, intranuclear grooves, follicular hyperplasia and tall cells

Answer 20

tall cell variant of papillary thyroid carcinoma

Question 21

extensive fibrosis beyond the thyroid gland, thyroid hard and fixed

Answer 21

Ridel’s thyroiditis

Question 22

headaches, arthritic pain, erectile dysfunction, renal stones, high blood pressure, UA- glycosuria, hypercalcemia.

Answer 22

lactotroph-somatotroph pituitary tumor (prolactin and growth hormone secreting)