endocrine CUdental exam 4 revised
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- GH and prolactin are secreted by the _____ pituitary and are (acidophilic/basophilic).
- anterior; acidophilic
- ACTH, FSH, LH and TSH are secreted by the _____ pituitary and are (acidophilic/basophilic).
- anterior, basophilic
- ACTH is a ________troph, TSH is a ______troph, and FSH and LH are ____trophs.
- acth corticotroph, tsh thyrotroph, fsh and lh gonadotroph
- ADH and oxytosin are released from the ______ and produced in the ________.
- posterior pituitary; hypothalamus
- Hyperpituitarism is usually caused by an ______ of the ______ lobe of the pituitary
- adenoma; anterior
- Adenomas of the pituitary produce an excess of multiple hormones secreted by that part of the pituitary
- false (amost true), usually produces excess of one type of hormone
- Pituitary adenomas are present in ___% of autopsied people.
- 25%
- _________ is the most common hyperfunctioning pituitary andenoma causing amenorrhea, loss of libido, infertility and glactorrhea.
- Prolactinoma
- GH adenoma before poohberty causes ______; after pooberty ______.
- before gigantism; after acromegaly
- Cushings disease is condidered a _____ adenoma causing an increased production of _____.
- corticotroph, glucocorticoids (as happens in hyperproduction of ACTH)
- Pituitary _______ include prolactinoma, GH (somatotroph) and corticotroph adenomas as well as null-cell, gonadotroph, thyrotroph and mixed adenomas. These are all forms of hyper-hypo-pituitarism?
- adenomas, hyper**
- _________ syndrome is a partial pituitary hypofunction caused by herniation of arachnoid matter into the sella usually due to a membrane defect. It is usually seen in obese women with _________ pregnancies.
- Empty sella syndrome, multiple
- Anterior pitutitary hypofunction due to postpartum ischemic necrosis-
- Sheehan's Syndrome
- _______ resembles an ameloblastoma derived from remnant ectodermal tissue of ______ pouch causing a slow growing neoplasm.
- Craniopharyngioma, Rathke's
- Most frequesnt cause of hypopituitarism is ________.
- non-secretory pituitary adenomas
- An abrupt enlargement of a pituitary adenoma due to acute hemorrhage within the tumor is calld a ______.
- pituitary apoplexy
- No signifiact clinical abnormalities are shon due to abnormal amounts of which hormone? (hint: posterior pituitary)
- oxytocin
- ADH oversecretion is most often due to
- ADH producing tumor such (eg. oat cel carcinoma of the lung)
- Over secreation of ADH causes __________ a syndrome that results in renal retention of water with an inablilty to diulte causing hyponatremia (low Na+)
- Syndrome of inappropriate ADH (SIADH)
- Destruction of the posterior pituitary leads to ADH undersecretion causing _______.
- diabetes insipidus
- The thyroid gland stores _________ which is converted to T3 and T4 under the influence of TSH. Parafollicular (C-cells) synthesize and secrete _______.
- thyroglobulin, calcitonin (inc. Ca+ absorption)
- Warm skin, sweating, heat intolerance, hypermotility of GI tract, increased apetite, osteoporisis, iritabitly, tachycardia, arrhythmias, exopthalmos, fine oily hair and muscle weakness are symptoms of ________.
- hyperthyroidism
- The most common causes of hyperthyroidism include: Graves disease, excess ingested TSH, goiters and _______.
- adenomas
- A patient suddenly manifests high fever, tachycardiam arrhythmias and hypertension due to hyperthyroidism. The patient is suffering from a ________.
- thyroid storm
- what should you do in a thyroid storm (sudden attack of hyperthyroidism)
- stop dental proceedure, give O2, take vitals, give nitroglycerin and call 911
- Which is not a form of Hypothyroidism: Hashimotos, cretinism, myxedema, Grave's disease.
- Graves = hyper
- Cells of the thyroid are ineffiecient in converting iodine to thyroid hormone causing enlargement. Thyroid tissue is then replaced by lymphocytes causing inflamation and primary hypothyroidism in this disease.
- hashimotos thyroditis
- ______thyroidism in infancy due to dietary iodine deficiency causes wide set eyes, coarse facial features, protruding tongue and umbilicus and severe mental retardation (think eric) are manifestations of ________.
- hypo-, cretinism
- ______ is a kind of an version of cretinsm (lethargy,mental slowness, cold intolerance, broad face, tongue enlargement, coarse dry hair)
- myxedema
- Cretinism occurs in ______ while myxedema in _______. Both are forms of ____thyroidism.
- infants, late childhood-adult, hypo
- ______ is the most common cause of primary (endogenous) hyperthyroidism.
- graves disease
- Graves disease is manifested in 3 ways: pretibial myxedema (thickening of the skin over legs and dorsal foot), bulging eyes (exopthamos), and ________.
- thyroxicosis (hyperthyroidism)
- Graves disease is (hyper/hypo)secretion of what hormone and is most common in which gender
- hyperthyroidism, female 7:1
- HLA-DRS is to _____ as HLA DR3 is to _____
- non-specific lyphoid thyroiditis ; graves disease
- Either sporadic or endemic hyperplasia of the thyroid is referred to as a ______ goiter.
- Diffuse non-toxic goiter
- The most common cause of hypthyroidism in usa is?
- hashimotos thyroditis
- Types of thyroiditis include non-specific, hashimoto's, subacute granulomatous and ______.
- Reidel's
- Non-specific lymphoid thyroiditis is commonly found in (males/females) and shows mild gland enlargement with no ________ centers.
- germinal
- What autoimmune disease increases the risk of b-cell lymphoma, is more commonly found in females and is characterized histologically by Hurthle cells?
- hashimotos thyroditis
- Auto antibodies associated with Hashimotos include: anti- thyroid, thyroglobulin, TSH and iodine _________.
- receptors
- T/F de Quervain's thyroiditis is synonymous with subacute (granulomatous) thyroiditis, causing acute onset granulomatous inflamation.
- TRUE
- Fibrous tissue replaces normal thyroid tissue in ________ thyroiditis.
- Reidel's
- Thyroid neoplasms are usually benign? T/F
- TRUE
- Benign thyroid adenomas cause papillary change. T/F
- false
- Of the four main subtypes of thyroid carcinomas, papilary, follicular, medullary and anaplastic, which is most common?
- Papilary 75-80%
- Papilary projections containing ground glass, clear "orphan annie" nuclei are seen in _______ which typically has a good prognosis even when adjacent lymph nodes are invloved.
- papillary carcinoma
- Prognosis for papillary carcinoma of the thyroid is ______, anaplastic (undifferentiated) carcinoma of thyroid is _____.
- good, poor
- Medulary carcinoma arises from ________ cells causing secretion of calcitonin. It normally presents as a neck mass in 50-60 years of age and can be associated with
- parafolicular (C-cells), MEN syndrome Iia and IIb (III)
- Uniform folicles invading surrounding tissue and "cold" nodules are characterisitc of _______.
- follicular carcinoma of the thyroid
- T/F The parathyroid is stimulated hormonally?
- False - [Ca+] decrease --> stimulates osteoclasts, increased renal asn GI absorption Ca+, inc vit D synthesis
- Primary hyperparathyroidism is most often caused by ____ or _____ of the glands.
- adenoma, hyperplasia
- Stones groans moans and bones refers to what disorder
- primary hyperparathyroidism
- Increased serum phosphorus and decreased serum alkaline phosphatase occur in hyperparathyroidism. T/F
- False - other way around
- The most common cause of secondary hyperparathyroidism is ________.
- renal failure
- Hypoparathyroidism is less common and usually caused iatrogenically, or in rare instances by DiGeorge's syndrome and is accompanied by two signs _______ and ______.
- Chvostek's (unilateral spasm in face by tapping on facial nerve), Trouseau's (hand/arm in tetany position similar to nerve compression)
- The adrennal cortex secretes __________, _________, and ________
- glucocorticoids (cortisol), Mineralcorticoids (aldosterone), androgens
- Which is not a form of adrenal hyperfuction: Cushing's, Hyperaldosteronism (Conn's), Virilism, Addison's
- Addison's is hypo
- Cushings disease is an increased production of _____, that cuases adrenal (atrophy/hypertrophy)
- glucocorticoids, atrophy or hypertrophy (****depending on whether it is caused by exogenous corticosteroids being administered (atrophy) or an adrenal or ectopic tumor producing ACTH (hyperplasia))
- Which is not a symptom of Cushing's: moon face, buffalo hump, weight gain, extremity muscle wasting, stretch marks, osteoporosis, menstrual abnormalities, hirsutism, mental disturbances, hypertension, glycosuria, increased ACTH.
- increased ACTH, Cushing's = dec. ACTH (hypo)
- The most common form of Cushing's is caused by _________.
- exogenous steroid medications
- cushing's syndrome can be caused by adrenal tumor producing cortisol. This causes nodular hyperplasia.
- true; true
- Hyperaldosteronism causes Na+ retention, K+ excretion and hypertension. T/F
- TRUE
- An example of _____ hyperaldosteronism is Conn's syndrome which is due to _______ serum renin caused by negative feed back of hypertension.
- primary, decreased
- secondary aldosteronism is due to renal ischemia, edema or nephroticsyndrome and exhibits _______ serum renin.
- increased *** opposite of primary
- Adrenal virulism is caused by ____ defects or a ____ of the adrenal cortex producing virulism in females and precocious pubecent males.
- enzymatic, tumor (virulism = hyper-aldosteronism)
- Adrenal hypofunction (hypocorticism) is characterized by a ____ of glucocorticoids and often mineralcorticoids.
- deficiency
- Which is not a symptom of Addison's disease: somnolence, cardiac problems, hyperpigmentation, adrenal hypertrophy, weight loss, amenorrhea, loss of pubes (hotcoles still dosen't have any) and muscle weakness.
- Hypertrophy is wrong. Addison's = hypocorticism = atrophy of adrenals
- Tb was once the most common cause of Addison's but now it is due to _________ adrenal atrophy.
- idiopathic/autoimmune
- Which two diseases are asssociated with adrenal hypofuncion
- addisions' and waterhous-friderichsen disease
- Waterhous-friderichsen disease is caused by a _____ collapse often associated with ___.
- vascular, DIC (sepsis from meningococcal meningitis)
- The rule of tens applies to ___________ which is overproduction of epinephrine, norepinephrine and VMA that causes hypertension.
- pheochromocytoma (rule = 10% bilateral, 10% children, 10% malignant)
- Pheochromocytoma can be corrected surgically. T/F
- TRUE
- ________ is a highly malignant catacholamine-producing tumor of early childhood (0-3 yrs) presenting as an ________ mass causing hypertension.
- neuroblastoma, abdominal
- Multiple endocrine neoplasia (MEN) syndromes are autosomal ______ in which one or more endocrine organs is ________.
- dominant, hyperfunctional
- MEN 1 is commonly called _____, linked to chromosome ___ , which causes tumors of the 3 p's: pituitary, _______ and pancrease.
- Wermer syndrome, 11, pancrease (not penis you perv)
- More than one of the following are involved: pituitary, parathyroid, pancreatic islets, adrenal cortex
- MEN I (wermer syndrome)
- Sipple syndrome is also called ____. Nearly all have medullary carcinoma of the ______ which is usually multifocal and aggressive.
- MEN II, thyroid
- MEN II (Sipple) is linked to chromosome 10 and causes ____ of the parathyroid (hyperparathyroidism).
- hyperplasia
- MEN Iib (MEN III) is simliar to MEN ___, but does not cuase hyperparathyroiditis. It is linked to mutations of the ret proto-oncogene and include pheocytochroma, medullary carcinoma and _______.
- Iia (Sipple), oral mucosal neuromas