Question 1

A 50-year-old man who is showing signs of acromegaly is found to have an elevated concentration of growth hormone and another hormone in blood that was apparently derived from the liver. Which other hormone is most likely increased in this patient's blood?

A) Glucagon
B) Somatostatin
C) Insulin growth factor I
D) Cholecystokinin
E) Secretin

Insulin growth factor I

Accepted Answer

Growth hormone stimulates the liver to produce insulin-like growth hormone I (somatomedin C), which causes many of the clinical manifestations seen in patients with growth hormone-secreting pituitary adenomas.

Question 2

Vascular endothelial growth factor (VEGF) is implicated in the pathogenesis of which complication of diabetes?&#10;A) Cerebral infarcts&#10;B) Intraretinal microangiopathy&#10;C) Diabetic glomerulosclerosis&#10;D) Gangrene of the foot&#10;E) Peripheral neuropathy

Accepted Answer

21-Hydroxylase deficiency results in a deficiency of glucocorticoids (cortisol) and mineralocorticoids (aldosterone). The synthesis of androstenedione and testosterone actually is increased, resulting in virilization in female infants.

Question 3

This lymph node was removed from the lateral side of the neck of a 38-year-old woman who had a thyroidectomy. She had an enlarged, painless thyroid but had no signs of altered thyroid function. The lymph node shows signs of

A) autoimmune disease
B) bacterial infection
C) hyperplasia
D) neoplasia
E) metaplasia

neoplasia

Accepted Answer

This lymph node contains foci of papillary carcinoma with calcifications (psammoma bodies). Such tumors are typically metastases from a primary papillary carcinoma of the thyroid.

Question 4

Calcifications of the basal ganglia are complications associated with parkinsonian-like movement disorders and calcification of the lens with cataract formation. These complications are most often associated with which of the following conditions?

A) Parathyroid adenoma
B) Secondary parathyroid hyperplasia
C) Tertiary hyperparathyroidism
D) Parathyroid carcinoma
E) Hypoparathyroidism

Accepted Answer

Hypothyroidism is associated with calcification of the basal ganglia, causing parkinsonian movement disorders and calcification of the lens. These are complications of hypoparathyroidism.

Question 5

The best characterized molecular abnormality in pituitary adenomas involves which of the following?&#10;A) Cell surface receptors&#10;B) G-proteins mediating signal transduction&#10;C) Adenylate cyclase related cytoplasmic effectors&#10;D) Nuclear receptors&#10;E) DNA repair enzymes

Accepted Answer

G-protein mutations are the best characterized molecular abnormalities found in pituitary adenomas. G-proteins are involved in the transmission of signals from cell surface receptors stimulated with hypothalamic release factors and intracellular effectors, such as the adenylate cyclase system.

Question 6

Thyroid ophthalmopathy is typically found in patients who have which of the following disorders?  &#10;A) Graves disease&#10;B) Multinodular goiter&#10;C) Toxic (hyperfunctioning) adenoma of the thyroid&#10;D) Hashimoto thyroiditis&#10;E) Riedel thyroiditis

Accepted Answer

Thyroid ophthalmopathy, which is characterized by a wide-eyed staring gaze and exophthalmos, is a feature of Graves disease. It is not found in other forms of hyperthyroidism caused by multinodular goiter or toxic adenoma, or in hypothyroidism caused by Hashimoto or Riedel thyroiditis.

Deck 19: Endocrine System