How much do you know about endocrine pathology? Here’s a little quiz to help you find out. Answers with nice explanations will be posted tomorrow.
1. Which of the following is true of papillary thyroid carcinoma?
A. May have psammoma bodies
B. The least common kind of thyroid carcinoma
C. The type of thyroid carcinoma with the worst prognosis
D. Occurs in patients with MEN II
E. Most common in elderly patients
2. The most common cause of hypothyroidism in underprivileged countries is:
A. Pituitary dysfunction
B. DeQuervain’s thyroiditis
C. Graves’ disease
D. Hashimoto’s thyroiditis
E. Iodine deficiency
3. Which of the following hormones, in addition to participating in the initiation of labor, may play a role in trust, monogamy, and the desire to cuddle?
A. Cortisol
B. Thyroid hormone
C. Parathormone
D. Oxytocin
E. Antidiuretic hormone
4. A patient with Cushing syndrome might present with any of the following EXCEPT:
A. Obesity
B. A buffalo hump
C. Moon facies
D. Bronze or hyperpigmented skin
E. Glucose intolerance
5. Patients with diabetes have an increased risk of all of the following EXCEPT:
A. Cataracts
B. Infections
C. Increased atherosclerosis
D. Peripheral neuropathy
E. Pancreatic carcinoma
6. Which of the following is true regarding multiple endocrine neoplasia (MEN) I syndrome?
A. Virtually all patients develop medullary thyroid carcinoma
B. The genetic abnormality involves the RET gene
C. The genetic abnormality involves a proto-oncogene
D. Many patients develop parathyroid hyperplasia
E. Some patients may have a Marfanoid habitus
7. Which of the following is true regarding pheochromocytoma?
A. It can cause hypertension
B. It is usually an aggressive, malignant tumor
C. It only occurs in the adrenal gland
D. It is derived from neural crest cells
E. Many tumors have a 1p deletion
8. Which of the following is true regarding Addison’s disease?
A. It is characterized by an overproduction of catecholamines
B. Most cases are due to infection
C. It is also called primary chronic adrenal insufficiency
D. The onset is sudden
E. Patients are often hypertensive
9. You are seeing a 41-year old male who is very tall and has a large jaw. You wonder if he might have acromegaly due to a pituitary adenoma. What laboratory test would be best for making this diagnosis?
A. Insulin-like growth factor level
B. Random serum growth hormone level
C. Prolactin level
D. Hemoglobin
E. Lactate dehydrogenase
10. Your sister is complaining that she is always tired, despite getting enough sleep. You notice that she seems pale, and when you feel her pulse it is quite slow. She also mentions that she can’t stand the cold these days. What two lab tests would be most helpful in diagnosing her condition?
A. FSH and LH levels
B. Free T4 and TSH levels
C. Calcium, phosphate, and parathyroid hormone levels
D. Insulin-like growth factor and prolactin levels
E. Cortisol and ACTH levels
It’s here! The first Pathology Student study guide!
It’s a short guide, targeted just at the anemias (obviously), and intended for someone who has very little time but needs to get through the essential facts before a test. This would work for boards or for your typical intro pathology course. Here’s what’s inside:
- An introduction to the examination of blood, with a review of the CBC and blood smear.
- An easy-to-read, one-page summary of each anemia, with a quick review of pathogenesis, morphology and treatment
- Images of each anemia
- Helpful summary hints in the margins
If you’re interested, sign up in the box to the right and I’ll send you the file right away.
I hope you find this guide useful! Let me know how you are using it, and if you’d like to see more study guides in the future.
Q. We heard in class today that steroids are used for autoimmune diseases, and I’ve heard this before but never understood why. What is it about steroids that make them effective as immunosuppressants?
A. There are lots of mechanisms by which steroids dampen the immune response. Here are a few of them:
1. Suppression of T cells. Steroids interfere with production of cytokines (like interleukins), which are critical in the proliferation and interaction of T cells.
2. Suppression of B cells. Steroids interfere with the binding of interleukins to B cells, which means that the B cells have a hard time proliferating and making antibodies.
3. Suppression of neutrophils. Steroids inhibit just about everything that neutrophils do: adhesion, chemotaxis, phagocytosis, and the release of toxic substances.
4. Suppression of macrophages. Steroids down-regulate the expression of Fc receptors on macrophages – so macrophages are less able to phagocytose opsonized things.
5. Diminished production of prostaglandins and leukotrienes. Steroids inhibit cyclooxygenase and phospholipase A2, which decreases the production of pro-inflammatory arachadonic acid metabolites.
Steroids are used in a ton of different immune and inflammatory disorders, like asthma, vasculitis, arthritis, gout, multiple sclerosis, sarcoidosis, alopecia areata…the list goes on and on.
I’ve started a couple new features and wanted you to be the first to know! Now there are two opportunities to get yummy pathology content delivered fresh, right to your email inbox. There are two separate email lists:
1. Pathology Student blog posts.
If you would like to get our posts delivered to you by email, then sign up for this list. Then you don’t have to remember to check back here; every time something is posted (which should be about twice a week, Monday and Wednesday), you’ll get that post by email.
2. Pathology Bites
Wouldn’t it be nice if someone would send you a little yummy digestible boards-worthy pathology fact each day? Â And wouldn’t it be even nicer if there was a reference in there too, on the off chance that you had a little time or energy to read a bit more? Well, there you go: over on the right, there’s a box for that.
Let me know if this is working out for you, or if it’s not (so I can make it better).
Happy studying!
Q. I have a question. Why do you see a decreased glomerular filtration rate in nephritic syndrome? I read on your blog and other places that it’s due to “hemodynamic changes”– from Robbins I’m assuming this is compensatory stuff- but wouldn’t that increase GFR?
A. It’s because of what’s going on in the glomerulus! In a normal glomerulus, the capillaries are all nice and open and patent. Blood flows through the capillaries like a little river, fluid gets filtered out into the urinary space, and the GFR is normal. But in nephritic syndrome, the glomeruli are stuffed full of cells, and blood flow slows way down.
Take a look at post-streptococcal glomerulonephritis, a common cause of nephritic syndrome. In that disorder, the glomeruli are huge and hypercellular, with tons of neutrophils in there (and probably some other proliferating glomerular cells as well). The poor capillaries are compressed by all that extra stuff, and you can imagine how hard it is for the poor blood to flow through there! If the blood can’t flow through at the same rate, then the filtration of fluid from blood into urine is decreased (and the GFR slows down to a sad little dribble).
Q. I’ve heard a lot about iron-deficiency anemia being quite common in long distance runners. Why is this? (more…)
There are a few terms in pathology that should automatically make you think of specific diseases. (more…)
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