Quiz On Endocrine Pathology

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Quiz On Endocrine Pathology - Quiz

Quiz on Endocrine Pathology


Questions and Answers
  • 1. 

    A patient presents with weight loss, polyphagia, polydypsia, increased tiredness, vomiting, and hyperventilation. He is young and his parents are also diagnosed with the same disease. Which of the following is the most common etiological factor associated with this disease seen in older populations?

    • A.

      Smoking

    • B.

      Obesity

    • C.

      Hypertension

    • D.

      Infections

    • E.

      Tumors

    Correct Answer
    B. Obesity
    Explanation
    Obesity is the most common etiological factor associated with the given disease in older populations. This is because obesity can lead to insulin resistance and ultimately result in the development of type 2 diabetes, which presents with symptoms such as weight loss, polyphagia, polydypsia, increased tiredness, vomiting, and hyperventilation. The fact that the patient's parents are also diagnosed with the same disease suggests a genetic predisposition, which can be influenced by lifestyle factors such as obesity.

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  • 2. 

    A patient presents with increased growth of skeletal and soft tissue, hypertension, arthritis, menstrual disturbances, and diabetes mellitus. Upon administration of oral glucose, which of the following levels would increase?

    • A.

      GH

    • B.

      IGF

    • C.

      GH and IGF

    • D.

      ADH

    • E.

      None of the above

    Correct Answer
    C. GH and IGF
    Explanation
    In this scenario, the patient is exhibiting symptoms of acromegaly, a condition characterized by excessive growth hormone (GH) production. GH stimulates the liver to produce insulin-like growth factor (IGF). Therefore, when oral glucose is administered, both GH and IGF levels would increase. This is because glucose triggers the release of GH, which in turn stimulates the production of IGF. The other options, ADH and none of the above, are not relevant to this particular scenario.

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  • 3. 

     A patient presents with polyuria and thirst. There appears to be no elevation of glucose in the body, however, the serum osmolality appears to be low. Upon performing the water deprivation test, the osmolatity is still low. Which of the following is true?

    • A.

      The problem is in the pituitary

    • B.

      The problem is in the kidneys

    • C.

      The patient has diabetes mellitus

    • D.

      The patient has high ADH in the serum

    • E.

      B and D

    Correct Answer
    E. B and D
    Explanation
    The correct answer is B and D. The patient presenting with polyuria and thirst, along with low serum osmolality even after the water deprivation test, suggests a problem in the kidneys. This is because the kidneys are not properly reabsorbing water, leading to excessive urine production and low serum osmolality. The presence of high ADH (antidiuretic hormone) in the serum further supports the idea of a kidney problem, as ADH is responsible for water reabsorption in the kidneys. This combination of symptoms and test results indicates a dysfunction in the kidneys rather than the pituitary or diabetes mellitus.

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  • 4. 

    A blood test in performed on a patient and it discovered that the patient has very low levels of sodium. It is also known that the patient has just undergone an operation. In addition he appears to have a small cell tumor of the lung. Which of the following conditions is most linked to the disease the patient has?

    • A.

      Diabetes mellitus

    • B.

      Cushings syndrome

    • C.

      Hyperthyroidism

    • D.

      Diabetes insipitus

    • E.

      None of the above

    Correct Answer
    D. Diabetes insipitus
    Explanation
    Diabetes insipitus is a condition characterized by the inability of the body to regulate water balance due to a deficiency of antidiuretic hormone (ADH). ADH is produced in the hypothalamus and stored in the pituitary gland, which is located near the brain. A small cell tumor of the lung can cause a condition called paraneoplastic syndrome, where the tumor cells produce ADH-like substances that interfere with the normal regulation of water balance. This can lead to low levels of sodium in the blood, as seen in the patient's blood test results. Therefore, diabetes insipitus is most linked to the disease the patient has.

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  • 5. 

    A patient presents with weight loss, sweating, palpitations, tachycardia, tremors, lid lag, exopthalmosis, and a goiter. Upon taking a thyroid scan, there appears to be an increased amount of iodine. What is the pathogenesis of his disease?

    • A.

      Autoimmune mediated

    • B.

      Immune complex mediated

    • C.

      Unknown

    • D.

      Infection

    • E.

      None of the above

    Correct Answer
    A. Autoimmune mediated
    Explanation
    The patient's symptoms, including weight loss, sweating, palpitations, tachycardia, tremors, lid lag, exophthalmos, and a goiter, are consistent with hyperthyroidism. The increased amount of iodine on the thyroid scan suggests that the thyroid gland is overactive, which is commonly seen in autoimmune thyroid diseases such as Graves' disease. In Graves' disease, the immune system mistakenly produces antibodies that stimulate the thyroid gland to produce excessive amounts of thyroid hormones. This autoimmune-mediated process is the most likely explanation for the patient's symptoms and findings.

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  • 6. 

    A patient presents with lethargy, tiredness, cold intolerance, dryness of skin and hair, hoarsness of voice and weight gain. He also has psychosis and his heart rate appears to be lower than normal. Which of the following is not associated with the presenting symptoms?

    • A.

      Hashimoto's disease

    • B.

      Cretinism

    • C.

      Protruding tongue, potbelly appearance, dwarflike features

    • D.

      Iodine deficiency

    • E.

      Increased iodine levels

    Correct Answer
    E. Increased iodine levels
    Explanation
    Increased iodine levels are not associated with the presenting symptoms. The symptoms described are consistent with hypothyroidism, which can be caused by Hashimoto's disease, cretinism, and iodine deficiency. Increased iodine levels, on the other hand, can lead to hyperthyroidism, which is characterized by symptoms such as weight loss, irritability, heat intolerance, and increased heart rate. Therefore, increased iodine levels do not align with the symptoms described in the question.

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  • 7. 

    A patient presents with a bump on his neck. Upon taking a tissue sample, there appears to be parafollicular cells. The tumor is also associated with MEN II, although most of the time it is sporadic. What is the best way to moniter treatment?

    • A.

      Measure thyroid hormone levels

    • B.

      Measure iodine levels

    • C.

      Measure TSH levels

    • D.

      Measure calcitonin levels

    • E.

      Measure iron levels

    Correct Answer
    D. Measure calcitonin levels
    Explanation
    The presence of parafollicular cells and association with MEN II suggest that the patient may have a medullary thyroid carcinoma (MTC). MTC is a tumor that arises from the parafollicular cells of the thyroid gland and is known to produce calcitonin. Therefore, measuring calcitonin levels would be the most appropriate way to monitor treatment for this patient. Monitoring calcitonin levels can help assess the effectiveness of treatment and detect any recurrence or progression of the tumor. Measurement of other hormone or nutrient levels mentioned in the options, such as thyroid hormone, iodine, TSH, and iron, would not be specific or relevant for monitoring treatment of MTC.

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  • 8. 

    A patient presents with tiredness, weakness, anorexia, apathy, abdominal pain, hyperpigmentation and postural hypertension. Upon infection he appears to be in cardiogenic shock  and his blood volume is depleted. His sodium levels are low, potassium levels are high. Which of the following would also be elevated?

    • A.

      TSH

    • B.

      T4

    • C.

      Adrenal hormone

    • D.

      ACTH

    • E.

      ADH

    Correct Answer
    D. ACTH
    Explanation
    In this scenario, the patient is presenting with symptoms of Addison's disease, which is caused by adrenal insufficiency. Adrenocorticotropic hormone (ACTH) is responsible for stimulating the adrenal glands to produce cortisol. In Addison's disease, the adrenal glands are not functioning properly, leading to low cortisol levels. As a compensatory mechanism, the body increases the production of ACTH in an attempt to stimulate the adrenal glands. Therefore, in this case, the ACTH levels would be elevated.

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  • 9. 

    A patient presents with a moon face, truncal obesity, hypertension, purple straiae, buffalo hump, fragile skin and impaired glucose tolerance. The opposite of the current increased levels of the prime hormone involved in this patient is seen in:

    • A.

      Addison's disease

    • B.

      Pheochromocytoma

    • C.

      Hyperaldosteronism

    • D.

      Cushing's syndrome

    • E.

      None of the above

    Correct Answer
    A. Addison's disease
    Explanation
    In Addison's disease, there is a deficiency of adrenal hormones, including cortisol. This leads to a decrease in cortisol levels, which is the prime hormone involved in the patient's symptoms. The opposite of increased levels of cortisol seen in the patient's condition is therefore seen in Addison's disease.

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  • 10. 

    A patient presents with hypertension, anxiety, palpitations, headache, excessive sweating, and arrhythmias. There appears to be increased levels of catecholamines. The other diseases that also occur in the same area as this tumor would be:

    • A.

      Cushing's

    • B.

      Addisions

    • C.

      Hyperthyroidism

    • D.

      Goiter

    • E.

      A and B

    Correct Answer
    E. A and B
    Explanation
    The patient's symptoms, such as hypertension, anxiety, palpitations, and excessive sweating, are consistent with excessive catecholamine release, which is seen in pheochromocytoma. Cushing's disease and Addison's disease are endocrine disorders that affect the adrenal glands, which are located in the same area as the tumor. Therefore, A and B (Cushing's and Addison's) are the other diseases that can occur in the same area as this tumor. Hyperthyroidism and goiter are unrelated to the adrenal gland and would not occur in the same area as the tumor.

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  • 11. 

    A patient presents with a tumor of the adrenal gland. It is determined that the levels of renin-angiotensin is low. Which of the following would lead to increased renin-angiotensin levels?

    • A.

      Cushing's syndrome

    • B.

      Secondary hyperaldosteronism

    • C.

      Primary hyperaldosteronism, Conn's syndrome

    • D.

      A and B

    • E.

      None of the above

    Correct Answer
    D. A and B
    Explanation
    Cushing's syndrome is a condition characterized by excess cortisol production, which can suppress the renin-angiotensin system. On the other hand, secondary hyperaldosteronism is caused by an increase in renin production, leading to increased levels of renin-angiotensin. Therefore, both Cushing's syndrome and secondary hyperaldosteronism can result in increased renin-angiotensin levels.

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  • 12. 

    A girl presents with delayed puberty, absent secondary sexual characteristics, and primary amenorrhea. She also appears to be hypertensive and hypokalemia. Which of the following enzymes is increased if there is virilization of a person?

    • A.

      11bHydroxylase

    • B.

      17ahydroxylase

    • C.

      21 b-hydroxylase

    • D.

      Pyruvate kinase

    • E.

      Alcohol dehydrogenase

    Correct Answer
    A. 11bHydroxylase
    Explanation
    11β-Hydroxylase is the correct answer because an increase in this enzyme can cause virilization, which is the development of male secondary sexual characteristics in a female. This is consistent with the girl presenting with delayed puberty, absent secondary sexual characteristics, and primary amenorrhea. Additionally, the mention of hypertension and hypokalemia suggests that there may be an excess production of mineralocorticoids, which can occur due to increased 11β-Hydroxylase activity.

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  • 13. 

    Dopamine and homovanillic acid are secreted in _

    Correct Answer
    Neuroblastoma
    Adenoma
    Pheochromocytoma
    Explanation
    Dopamine and homovanillic acid are secreted in neuroblastoma, adenoma, and pheochromocytoma. These substances are neurotransmitters and metabolites that play important roles in the nervous system. Neuroblastoma is a type of cancer that develops from immature nerve cells and can secrete dopamine. Adenoma refers to a benign tumor that can occur in various glands, including the adrenal gland, which can secrete dopamine and homovanillic acid. Pheochromocytoma is a rare tumor of the adrenal gland that can secrete dopamine and other hormones. Therefore, all three conditions can lead to the secretion of dopamine and homovanillic acid.

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  • 14. 

    A patient presents with polyuria and thirst, stones, and nephrocalcinosis. He also has muscle weakness and bone cysts. All of the following is associated with his disease except:

    • A.

      Hyperparathyroidism

    • B.

      Excessive vitamin D

    • C.

      High bone turnover

    • D.

      Paget's disease

    • E.

      Less sunlight

    Correct Answer
    E. Less sunlight
    Explanation
    The patient's symptoms of polyuria and thirst, stones, nephrocalcinosis, muscle weakness, and bone cysts are consistent with a diagnosis of hyperparathyroidism. Hyperparathyroidism is characterized by excessive production of parathyroid hormone (PTH), which leads to increased calcium levels in the blood and urine, resulting in symptoms such as kidney stones and nephrocalcinosis. Muscle weakness and bone cysts can also be attributed to the effects of high calcium levels on the muscles and bones. Less sunlight exposure is not associated with hyperparathyroidism, therefore it is the correct answer.

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  • 15. 

    A patient presents with a decreased amount of T cells in the body. He presents with tetany , parasthesias, and muscle cramps. His condition has similarities to all of the following except:

    • A.

      Rickets

    • B.

      Hypoparathyroidism

    • C.

      Osteomalacia

    • D.

      Acute pancreatitis

    • E.

      Hypercalcemia

    Correct Answer
    E. Hypercalcemia
    Explanation
    The patient's symptoms of tetany, paresthesias, and muscle cramps are consistent with hypocalcemia, which is caused by a decreased amount of T cells in the body. Rickets, hypoparathyroidism, and osteomalacia are all conditions that can lead to hypocalcemia. Acute pancreatitis, on the other hand, is not typically associated with hypocalcemia. Hypercalcemia, which is an increased amount of calcium in the blood, would not cause the symptoms described by the patient.

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  • 16. 

    A patient presents with rhabdomyolysis and depletion of 2-3-diphosphoglycerate. A common complication of high levels of the molecule being affected in this patient would be:

    • A.

      Metastatic calcification

    • B.

      Dystrophic calcification

    • C.

      Heart failure

    • D.

      Respiratory failure

    • E.

      None of the above

    Correct Answer
    A. Metastatic calcification
    Explanation
    High levels of 2-3-diphosphoglycerate (2-3-DPG) being affected in this patient can lead to a common complication of metastatic calcification. 2-3-DPG is an important regulator of oxygen release from hemoglobin in red blood cells. When its levels are depleted, it impairs the release of oxygen to tissues, leading to tissue hypoxia. This can result in the deposition of calcium salts in various tissues, including the kidneys, lungs, and blood vessels, causing metastatic calcification. This complication is commonly seen in conditions associated with tissue hypoxia, such as rhabdomyolysis.

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  • 17. 

    A patient with renal failure and high magnesium level would later have _ and _

    Correct Answer
    cardiac arrest
    respiratory paralysis
    liver encephalopathy
    death from hemorrhage
    Explanation
    In renal failure, the kidneys are unable to properly filter and excrete waste products, including magnesium. As a result, the magnesium levels in the blood can become elevated. High magnesium levels can lead to cardiac arrest and respiratory paralysis as it affects the electrical conduction of the heart and the function of the muscles involved in breathing. Additionally, high magnesium levels can also cause liver encephalopathy, which is a neurological condition resulting from liver dysfunction. In severe cases, renal failure combined with high magnesium levels can lead to death from hemorrhage, possibly due to the effects on blood clotting.

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