Endocrino Taller

• Contesta las siguientes preguntas usando la bibliografia proporcionada en bibliotecavirtual.

1

A 42-year-old man presents because recently he has had to change his shoe size from 9 to 101⁄2. He also says that his hands and jaw are now larger. The disorder is most likely mediated through the actions of excess• a. Prolactin• b. ACTH• c. Somatomedin• d. Antidiuretic hormone• e. Thyrotropin

2

A perimenopausal woman presents with increasing swallowing difficulty and fatigue. Physical examination reveals that her thyroid is enlarged (palpable goiter). Laboratory examination of her serum reveals T4 of 4.9mg/dL, free T4 of 2.5 ng/dL, and TSH of 5.5 mIU/mL. No thyroidstimulating immunoglobulins are identified in the serum, but antimicrosomal antibodies are present. Which one of the listed histologic findings, if present in a thyroid biopsy from this individual, would be most consistent with a diagnosis of Hashimoto’s thyroiditis?• a. Lymphocytic infiltrate without follicle formation• b. Intense lymphoplasmacytic infiltrate with lymphoid follicles and scattered• oxyphilic cells• c. Hyperplasia of follicular cells with scalloping of colloid at the margin of follicles• d. Granulomatous inflammation with multinucleated giant cells surrounding

fragments of colloid• e. Dense fibrosis within the thyroid gland extending into adjacent soft tissue

3

Graves’ disease is characterized clinically by finding

• a. Central obesity, “moon” face, and abdominal striae

• b. Hyperthyroidism, exophthalmus, and pretibial myxedema

• c. Polyuria, polydipsia, and hyponatremia

• d. Polyuria, polydipsia, and polyphagia

• e. Progressive lethargy, cold intolerance, and myxedema

4

The term goiter refers to• a. Any enlargement of the thyroid regardless of the

etiology• b. Any involution of the thyroid regardless of the

etiology• c. Enlargement of the thyroid secondary to Graves’

disease• d. Enlargement of the thyroid secondary to the

ingestion of goitrogens• e. Involution of the thyroid secondary to Hashimoto’s

thyroiditis

5

Which one of the listed signs or symptoms is more characteristic of hypocalcemia than of hypercalcemia?

• a. Calcium stones in the urine

• b. Metastatic calcification

• c. Peptic ulcers

• d. Psychiatric changes

• e. Tetany

6

A 52-year-old female presents with nausea, fatigue, muscle weakness, and intermittent pain in her left flank. Laboratory examination reveals an increased serum calcium and a decreased serum phosphorus. The patient’s plasma parathyroid hormone levels are increased, but parathyroid hormone–related peptide levels are within normal limits. Urinary calcium is increased, and microhematuria is present. The patient’s abnormality is most likely caused by• a. Primary hyperparathyroidism• b. Primary hypoparathyroidism• c. Pseudohypoparathyroidism• d. Secondary hyperparathyroidism• e. Secondary hypoparathyroidism

7

• A 65-year-old male presents with bone pain and is found to have hypocalcemia and increased parathyroid hormone. Surgical exploration of his neck finds all four of his parathyroid glands to be enlarged. Without any other information, which one of the following is most likely the cause of the enlargement of the parathyroid glands?

• a. Primary hyperplasia• b. Parathyroid adenoma• c. Chronic renal failure• d. Parathyroid carcinoma• e. Lung carcinoma

8

The clinical effects of excess serum cortisol are referred to as

• a. Addison’s disease

• b. Bartter’s syndrome

• c. Conn’s syndrome

• d. Cushing’s syndrome

• e. Schmidt’s syndrome

9

• A 42-year-old male presents with weakness and dizziness associated with stress. Physical examination reveals a slightly decreased blood pressure along with a diffuse increase in skin pigmentation. Laboratory examination reveals hyponatremia and hyperkalemic acidosis with decreased aldosterone, decreased cortisol, decreased glucose, increased ACTH, decreased sex steroids, and increased LH and FSH. Thyroid function tests are found to be within normal limits. The most likely cause of the signs and symptoms in this individual is

• a. A benign adenoma of the adrenal cortex• b. A malignant tumor of the adrenal medulla• c. Autoimmune destruction of the adrenal cortex• d. Bilateral hyperplasia of the adrenal cortex• e. Tuberculosis of the adrenal medulla

• FIN