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Flashcards in XX - The Endocrine System (with pics) Deck (166)
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121

Most common form of clinically significant ischemic necrosis of the anterior pituitary. May present with amenorrhea ang infertility.

Sheehan syndrome(TOPNOTCH)Robbins Basic Pathology, 9th ed., p. 1081

122

Presents with hyponatremia, cerebral edema, absence of peripheral edema due to ectopic ADH secretion by malignant neoplasm, drugs, and a variety of CNS disorders.

SIADH(TOPNOTCH)Robbins Basic Pathology, 9th ed., p. 1082

123

May present with growth retardation in children, headache and visual disturbances. In adult, these neoplasm is thought to rise from vestigial remnant of Rathke pouch.

Craniopharyngoma(TOPNOTCH)Robbins Basic Pathology, 9th ed,. P. 1082

124

Histologic variant of craniopharyngioma most often observed in children

Adamantinomatous craniopharyngoma (TOPNOTCH)Robbins Basic Pathology, 9th ed., p. 1082

125

Histologic variant of craniopharyngioma most often observed in adults

Papillary craniopharyngoma (TOPNOTCH)Robbins Basic Pathology, 9th ed., p. 1082

126

Presents with rapidly enlarging bulky neck mass, dyspnea, dysphagia, hoarsenes, and cough. Histologic finding of pleomorphic giant cells, spindle cells or mixed. Highly fatal. SEE SLIDE 20.10.

Anaplastic carcinoma(TOPNOTCH)Robbins Basic Pathology, 9th ed., p. 1098

127

Most common clinically significant congenital anomaly of the thyroid.

Thyroglossal duct or cyst (TOPNOTCH)

128

Most common cause primary hyperparathyroidism

Solitary parathyroid adenoma(TOPNOTCH)Robbins Basic Pathology, 9th ed., p.1101

129

The combination of increased osteoclast activity, peritrabecular fibrosis, and cystic brown tumors

von Recklinghausen disease of bone/osteitis fibrosa cystica(TOPNOTCH)Robbins Basic Pathology, 9th ed., p. 1102

130

The most common mechanism through which osteolytic tumors induce hypercalcemia

Secretion of PTHrP(TOPNOTCH)Robbins Basic Pathology, 9th ed., p. 1103

131

Classic findings of hypocalcemia on physical examination

Chvostek sign and Trosseau sign(TOPNOTCH)Robbins Basic Pathology, 9th ed., p. 1105

132

The most frequent pattern in diabetic neuropathy

Distal symmetric polyneuropathy of the lower extremities(TOPNOTCH)Robbins Basic Pathology, 9th ed., p. 1120

133

The most common cause of hypercortisolism

Exogenous administration of steroids(TOPNOTCH)Robbins Basic Pathology, 9th ed., p. 1125

134

Most common adrenal finding in endogenous Cushing syndrome

Nodular hyperplasia(TOPNOTCH)Robbins Basic Pathology, 9th ed., p. 1125

135

Presents with hypertension, weight gain, moon facies, truncal obesity, elevated urinary steroid secetion, low ACTH

Cushing syndrome caused by an adrenal tumor(TOPNOTCH)

136

Presents with signs and symptoms of elevated cortisol levels, with failure of low-dose and high-dose dexamethasone to suppress cortisol secretion

Ectopic ACTH secretion(e.g ACTH production by tumors)(TOPNOTCH)

137

Most common form of Cushing syndrome, ACTH levels are elevated and cannot be suppressed by administration of low dose of dexamethasone.

Pituitary Cushing syndrome(TOPNOTCH)Robbins Basic Pathology, 9th ed., p. 1125

138

Most common manifestation of primary hyperaldosteronism

BP elevation(TOPNOTCH)Robbins Basic Pathology, 9th ed., p. 1126

139

Overproduction of aldosterone and decreased plasma renin activity, hypertension and hypokalemia

Primary aldosteronism(TOPNOTCH)Robbins Basic Pathology, 9th ed., p. 1127

140

Newborn presents with hyponatremia, hyperkalemia, hypotension, cardiovascular collapse, and virilization. What is the most likely diagnosis?

Salt-wasting syndrome, CAH(TOPNOTCH)

141

Presents with hyperkalemia, hyponatremia, volume depletion, hypotension, hyperpigmentation of sun-exposed areas, weakness, nausea vomiting, weight loss, abdominal pain.

Primary adrenal insufficiency(TOPNOTCH)

142

The dominant clinical manifestation of pheochromocytoma

Hypertension(TOPNOTCH)Robbins Basic Pathology, 9th ed., p. 1135

143

Presents with paroxysmal episodes of hypertension, tachycardia, palpitations, headache, sweating, tremor, apprehension, elevated urinary vanillylmandelic acid and metanephrines.

Pheochromocytoma(TOPNOTCH)Robbins Basic Pathology, 9th ed., p. 1146

144

The principal secretory product of pineal gland

Melatonin(TOPNOTCH)Robbins Basic Pathology, 9th ed., p. 1137

145

A 33 year old female presents with blurring of vision, galactorrhea and amenorrhea. A cranial CT shows a pituitary mass. She undergoes surgery to excise the mass. Her tumor (A) is associated with MEN-1 in >50% of cases (B) is composed of lobules of distinct cell populations of cells , some acidophilic, others basophilic (C) is composed of a uniform cell population and absent a reticulin network (D) is most probably of acidophilic morphology due to her prolactinemic signs and symptoms

Is composed of a uniform cell population and absent a reticulin network (A - MEN-1 association in 3%; B - normal pituitary; D - functional status cannot be predicted from its histologic appearance) SEE SLIDE 20.1. (TOPNOTCH)Robbins Basic Pathology, 8th ed., pp 754-755

146

A 40 year old female presents with an anterior left neck mass. She undergoes a left thyroid lobectomy. The specimen has a solitary well-circumscribed nodule on the inferior pole. Which microscopic finding points to an adenoma, rather than a dominant nodule in a multinodular goiter? (A) well defined, intact capsule and compressed adjacent thyroid parenchyma (B) follicles of different sizes, resembling the surrounding thyroid parenchyma (C) presence of nuclear enlargement, nuclear grooves, and some with clearing (D) small follicles invading the capsule

Well defined, intact capsule and compressed adjacent thyroid parenchyma (B - multinodular goiter; C - papillary carcinoma; D - follicular carcinoma) (TOPNOTCH)Robbins Basic Pathology, 8th ed., pp766-769)

147

A 36 year old female presents with an anterior neck mass, and palpable cervical lymph nodes. She undergoes total thyroidectomy and neck dissection. On her right thyroid lobe is a 6 cm solid tan mass. Some of the lymph nodes also have a solid tan cut surface. Which of the following histologic findings is definite evidence of papillary thyroid carcinoma? (A) cells with enlarged nuclei, fine chromatin, some with nuclear grooves and clearing (B) follicles containing papillary infoldings, lined by thyrocytes with dark round nuclei (C) follicles with thick, pink colloid (D) follicles lined by tall columnar cells, and colloid with a scalloped appearance

cells with enlarged nuclei, fine chromatin, some with nuclear grooves and clearing (TOPNOTCH)Robbins Basic Pathology, 8th ed., p 768

148

A 15 year old male presents with an anterior neck mass. A deceased uncle also had an anterior neck mass in his teen years. The thyroid is excised, and histopathology showed polygonal to spindle shaped tumor cells in nests and trabeculae, admixed with amyloid deposits. Which of the following is most accurate? (A) the amyloid deposits are composed of altered calcitonin molecules (B) the patient is likely hypocalcemic (C) the patient's surrounding thyroid parenchyma has no C cell hyperplasia (D) most cases of this tumor are familial

the amyloid deposits are altered calcitonin molecules (medullary thyroid carcinoma) (B - hypocalcemia is not a feature; C - multicentric C cell hyperplasia is a feature in familial forms; D - most cases are sporadic) (TOPNOTCH)Robbins Basic Pathology, 8th ed., pp 770-771

149

Which of the following renal histologic findings is most characteristic of diabetes? (A) focal mild pyelonephritis (B) diffuse mesangial sclerosis (C) arteriosclerosis of efferent arterioles of the glomerulus (D) crescentic glomerulonephritis

Arteriosclerosis of the efferent arterioles of the glomerulus (TOPNOTCH)Robbins Basic Pathology, 8th ed., pp783-784

150

Of the pancreatic endocrine neoplasms or islet cell tumors, which is most commonly benign? (A) insulinomas (B) gastrinomas (C) VIPomas (D) nonfunctioning islet cell tumors

Insulinomas (TOPNOTCH)Robbins Basic Pathology, 8th ed., p. 788