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Flashcards in XX - The Endocrine System Deck (166)
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151

Most common manifestation of primary hyperaldosteronism

BP elevation(TOPNOTCH)Robbins Basic Pathology, 9th ed., p. 1126

152

Overproduction of aldosterone and decreased plasma renin activity, hypertension and hypokalemia

Primary aldosteronism(TOPNOTCH)Robbins Basic Pathology, 9th ed., p. 1127

153

Newborn presents with hyponatremia, hyperkalemia, hypotension, cardiovascular collapse, and virilization. What is the most likely diagnosis?

Salt-wasting syndrome, CAH(TOPNOTCH)

154

Presents with hyperkalemia, hyponatremia, volume depletion, hypotension, hyperpigmentation of sun-exposed areas, weakness, nausea vomiting, weight loss, abdominal pain.

Primary adrenal insufficiency(TOPNOTCH)

155

The dominant clinical manifestation of pheochromocytoma

Hypertension(TOPNOTCH)Robbins Basic Pathology, 9th ed., p. 1135

156

Presents with paroxysmal episodes of hypertension, tachycardia, palpitations, headache, sweating, tremor, apprehension, elevated urinary vanillylmandelic acid and metanephrines.

Pheochromocytoma(TOPNOTCH)Robbins Basic Pathology, 9th ed., p. 1146

157

The principal secretory product of pineal gland

Melatonin(TOPNOTCH)Robbins Basic Pathology, 9th ed., p. 1137

158

A 33 year old female presents with blurring of vision, galactorrhea and amenorrhea. A cranial CT shows a pituitary mass. She undergoes surgery to excise the mass. Her tumor (A) is associated with MEN-1 in >50% of cases (B) is composed of lobules of distinct cell populations of cells , some acidophilic, others basophilic (C) is composed of a uniform cell population and absent a reticulin network (D) is most probably of acidophilic morphology due to her prolactinemic signs and symptoms

is composed of a uniform cell population and absent a reticulin network (A - MEN-1 association in 3%; B - normal pituitary; D - functional status cannot be predicted from its histologic appearance) (TOPNOTCH)Robbins Basic Pathology, 8th ed., pp 754-755

159

A 40 year old female presents with an anterior left neck mass. She undergoes a left thyroid lobectomy. The specimen has a solitary well-circumscribed nodule on the inferior pole. Which microscopic finding points to an adenoma, rather than a dominant nodule in a multinodular goiter? (A) well defined, intact capsule and compressed adjacent thyroid parenchyma (B) follicles of different sizes, resembling the surrounding thyroid parenchyma (C) presence of nuclear enlargement, nuclear grooves, and some with clearing (D) small follicles invading the capsule

well defined, intact capsule and compressed adjacent thyroid parenchyma (B - multinodular goiter; C - papillary carcinoma; D - follicular carcinoma) (TOPNOTCH)Robbins Basic Pathology, 8th ed., pp766-769)

160

A 36 year old female presents with an anterior neck mass, and palpable cervical lymph nodes. She undergoes total thyroidectomy and neck dissection. On her right thyroid lobe is a 6 cm solid tan mass. Some of the lymph nodes also have a solid tan cut surface. Which of the following histologic findings is definite evidence of papillary thyroid carcinoma? (A) cells with enlarged nuclei, fine chromatin, some with nuclear grooves and clearing (B) follicles containing papillary infoldings, lined by thyrocytes with dark round nuclei (C) follicles with thick, pink colloid (D) follicles lined by tall columnar cells, and colloid with a scalloped appearance

cells with enlarged nuclei, fine chromatin, some with nuclear grooves and clearing (TOPNOTCH)Robbins Basic Pathology, 8th ed., p 768

161

A 15 year old male presents with an anterior neck mass. A deceased uncle also had an anterior neck mass in his teen years. The thyroid is excised, and histopathology showed polygonal to spindle shaped tumor cells in nests and trabeculae, admixed with amyloid deposits. Which of the following is most accurate? (A) the amyloid deposits are composed of altered calcitonin molecules (B) the patient is likely hypocalcemic (C) the patient's surrounding thyroid parenchyma has no C cell hyperplasia (D) most cases of this tumor are familial

the amyloid deposits are altered calcitonin molecules (medullary thyroid carcinoma) (B - hypocalcemia is not a feature; C - multicentric C cell hyperplasia is a feature in familial forms; D - most cases are sporadic) (TOPNOTCH)Robbins Basic Pathology, 8th ed., pp 770-771

162

Which of the following renal histologic findings is most characteristic of diabetes? (A) focal mild pyelonephritis (B) diffuse mesangial sclerosis (C) arteriosclerosis of efferent arterioles of the glomerulus (D) crescentic glomerulonephritis

arteriosclerosis of the efferent arterioles of the glomerulus (TOPNOTCH)Robbins Basic Pathology, 8th ed., pp783-784

163

Of the pancreatic endocrine neoplasms or islet cell tumors, which is most commonly benign? (A) insulinomas (B) gastrinomas (C) VIPomas (D) nonfunctioning islet cell tumors

Insulinomas (TOPNOTCH)Robbins Basic Pathology, 8th ed., p. 788

164

A 44 year old male presents with intermittent, intense epigastric pain unrelieved by antacids or H2 blockers. He also has occasional diarrhea. An endoscopy revealed multiple gastric, duodenal, and jejunal ulcers. Zollinger-Ellison syndrome is considered. Where can the tumor be located? (A) pancreas (B) duodenum (C) peripancreatic soft tissues (D) all of the above

all of the above ("gastrinoma triangle") (TOPNOTCH)Robbins Basic Pathology, 8th ed., pp788-789

165

Which of the following is the commonest cause of Cushing syndrome? (A) anterior pituitary tumor (B) adrenocortical neoplasm (C) small cell lung carcinoma (D) medication

medication (TOPNOTCH)Robbins Basic Pathology, 8th ed., pp 789-790

166

Which of the following findings is most compatible with adrenal Cushing syndrome? (A) elevated ACTH, elevated cortisol (B) decreased ACTH, decreased cortisol (C) decreased ACTH, elevated cortisol (D) elevated ACTH, decreased cortisol

decreased ACTH, elevated cortisol (TOPNOTCH)Robbins Basic Pathology, 8th ed., p 789

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