Goljan 22-2 Endocrine

Front 1

Hypothyroidism = ?

Back 1

patients are hypometabolic

Front 2

what does the brain need in Hypothyroidism?

Back 2

brain requires thyroxine for maturation

Front 3

What is the most common cause for Cretinism?

Back 3

most often caused by maternal hypothyroidism before fetal thyroid is developed

Front 4

Cretinism
Clinical findings?

Back 4

severe mental retardation

Front 5

Hashimoto's thyroiditis
clinical findings?

Back 5

muscle weakness (common complaint), weight gain, dry/brittle hair
cold intolerance, constipation,
hypertension from sodium retention; delayed reflexes

Front 6

Hashimoto's thyroiditis :
periorbital puffiness, and hoarse voice are signs of ____?

Back 6

myxedema

Front 7

Primary Hypothyroidism
lab findings?

Back 7

↓ serum T4/FT4;
↑ serum TSH, cholesterol

Front 8

Myxedema coma
clinical findings?

Back 8

stupor, hypothermia, hypoventilation; IV levothyroxine, corticosteroids

Front 9

Thyrotoxicosis
describes what condition?

Back 9

hormone excess from any cause

Front 10

Hyperthyroidism =?

Back 10

thyrotoxicosis due to excess synthesis of thyroid hormone

Front 11

most common cause of hyperthyroidism + thyrotoxicosis

Back 11

Graves' disease

Front 12

Graves' disease
pathogenesis?

Back 12

anti-TSH receptor antibody, type II hypersensitivity

Front 13

Clinical findings unique to Graves' disease?

Back 13

exophthalmos, pretibial myxedema, thyroid acropachy
Transient hyperthyroidism in fetus

Front 14

Thyroid acropachy = ?

Back 14

digital swelling and clubbing

Front 15

Graves' disease in the elderly = ?

Back 15

cardiac and muscle findings predominate; apathetic appearing

Front 16

Toxic multinodular goiter = ?

Back 16

one or more nodules in a multinodular goiter becomes TSH- independent

Front 17

Thyrotoxicosis
constitutional signs?

Back 17

weight loss with a good appetite; heat intolerance; diarrhea
oligomenorrhea, lid stare

Front 18

Thyrotoxicosis
cardiac findings?

Back 18

sinus tachycardia; systolic hypertension; brisk reflexes

Front 19

Atrial fibrillation in Thyrotoxicosis?

Back 19

always order a TSH test to rule out hyperthyroidism

Front 20

Graves' hyperthyroidism
lab findings?

Back 20

↑ serum T4/FT4,
↑ 131I uptake,
↓ serum TSH

Front 21

Thyrotoxicosis
conditions that develop?

Back 21

↑ glucosee,
calcium,
lymphocytes; ↓ cholesterol

Front 22

Treatment for Graves' disease?

Back 22

β-blockers,
thionamides

Front 23

Thyroid storm
clinical findings?

Back 23

tachyarrhythmias, hyperpyrexia, coma, shock

Front 24

ESS (Euthyroid sick syndrome)
epidemiology?

Back 24

serum T3 and T4 abnormalities; normal gland function

Front 25

ESS (Euthyroid sick syndrome)
pathogenesis?

Back 25

block in outer ring deiodinase conversioni of T4 to t3;
T3 converted to inactive reverse T3

Front 26

ESS
what is the most common variant?

Back 26

↓ serum T3
↑ reverse T3

Front 27

Goiter = ?

Back 27

thyroid enlargement

Front 28

Nontoxic goiter
pathogenesis?

Back 28

absolute or relative deficiency of thyroid hormone
hyperplasia/hypertrophy followed by involution; initially diffuse then nodular

Front 29

Goiter
complications?

Back 29

Toxic nodular goiter ; one or more nodules become TSH-independent

Front 30

solitary nodule in a woman vs.
man/ child
likelihood of being malignant?

Back 30

woman: majority are benign; 15% malignant
man: more likely to be malignant

Front 31

Solitary nodule with history of radiation exposure:
likelihood of being malignant?

Back 31

more likely to be malignant (40%)

Front 32

First step in management of solitary thyroid nodule?

Back 32

fine needle aspiration

Front 33

what is the most common benign thyroid tumor?

Back 33

Follicular adenoma

Front 34

what is the most common cause of papillary carcinoma?

Back 34

psammoma bodies

Front 35

Papillary carcinoma
microscopic findings?

Back 35

lymphatic invasion

Front 36

what is the most common cause of thyroid cancer?

Back 36

Follicular carcinoma; presenting as a solitary cold nodule

Front 37

Follicular carcinoma
spreads?

Back 37

hematogenous rather than lymphatic spread

Front 38

MEN IIa syndrome =?

Back 38

medullary carcinoma, HPTH, pheochromocytoma

Front 39

NEM IIb (III) syndrome = ?

Back 39

medullary carcinoma, mucosal neuromas lips/ tongue, pheochromocytoma

Front 40

Medullary carcinoma
pathogenesis?

Back 40

derives from C cells; calcitonin is tumor marker
calcitonin convered into amyloid

Front 41

Primary B-cell lymphoma
derived from?

Back 41

Hashimoto's thyroiditis

Front 42

Anaplastic thyroid cancer= ?

Back 42

rapidly aggressive; uniformally fatal

Front 43

Superior and inferior parathyroids

derive from?

Back 43

derive from 4th 3rd pharyngeal pouch, respectively

Front 44

Parathyroid Gland Disorders (PTH)

re-absorption rates? [calcium, phosphorus, bicarbonate?]

Back 44

↑renal calcium reabsorption;

↓ renal phosphorus, bicarbonate reabsorption

Front 45

PTH in relation to hypocalcemia/hyperphosphatemia
&
hypercalcemia/ hypophosphatemia

Back 45

hypocalcemia/hyperphosphatemia = ↑ PTH

hypercalcemia/ hypophosphatemia = ↓ PTH

Front 46

Sunlight is a major source of ______?

Back 46

vitamin D

Front 47

what is the role of the liver in production of Vitamin D?

Back 47

25-hydroxylase converts cholecalciferol to 25-(OH)D (calcidiol)

Front 48

what is the role of the kidney in production of Vitamin D?

Back 48

1α-hydroxylase converts 25-(OH)D to 1,25-(OH){subcase 2}D (calcitriol)

Front 49

Calcitriol
functions?

Back 49

↑ calcium/phosphorus reabsorption in bowel; ↑ osteoclast production

Front 50

Calcitiol feedback =?

Back 50

hypocalcemia increases synthesis,
hypercalcemia decreases synthesis

Front 51

Total serum calcium = ?

Back 51

calcium bound + calcium free (ionized)

Front 52

Hypoalbuminemia = ?

Back 52

↓ total serum calcium, normal ionized calcium and PTH

Front 53

Alkalosis in serum calcium= ?

Back 53

normal total serum calcium; decreased ionized calcium, increased PTH; tetany

Front 54

Tetany is due to decreased ionized calcium level:
what happens to the potentials?

Back 54

E⇣t (threshold potential)comes close to E⇣m(membrane potential); initiates action potential

Front 55

Tetany:
clinical findings?

Back 55

thumb adduct into palm; facial twitching after tapping facial nerve