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WorksheetsEndocrine Disorders Quiz
Total questions: 25
Worksheet time: 25mins
A 45-year-old patient presents with visual field defects and elevated intracranial pressure. Imaging reveals a well-circumscribed lesion in the sella turcica extending superiorly. This is most consistent with which morphological feature of pituitary adenomas?
Infiltration into adjacent bone in 30% of cases
Compression of the optic chiasm due to suprasellar extension
Exclusive encapsulation without mass effects
Hemorrhage leading to apoplexy in all large lesions
Which of the following is the most common cause of hypopituitarism associated with posterior pituitary dysfunction, such as diabetes insipidus?
Pituitary adenomas
Hypothalamic lesions
Sheehan syndrome
Traumatic brain injury
In Sheehan syndrome, the primary pathogenesis involves which sequence of events?
Postpartum enlargement of the pituitary followed by hypotensive shock and ischemic necrosis
Chronic inflammation leading to fibrosis of the anterior lobe
Metastatic carcinoma causing direct destruction
Radiation-induced atrophy of the posterior lobe
A patient with acromegaly shows excessive growth hormone secretion after closure of epiphyseal plates. Which of the following is a key pathophysiological feature?
Direct stimulation of osteoblasts by GH leading to bone elongation
Activation of insulin-like growth factor-1 (IGF-1) causing soft tissue and bone overgrowth
Suppression of gonadotropins leading to delayed puberty
Mutant G-protein eliminating the need for GHRH in all cases
Which complication of acromegaly is directly related to hypersecretion of growth hormone affecting connective tissue and bone?
Sleep apnea due to soft tissue enlargement
Uterine fibroids from estrogen imbalance
Colonic polyps from mucosal hyperplasia
All of the above
Gigantism differs from acromegaly primarily in that it occurs:
After puberty with disproportionate bone growth
Before closure of epiphyseal plates leading to proportionate excessive growth
Exclusively in males due to testosterone synergy
With hypopituitarism as a secondary feature
In hyperprolactinemia, which mechanism primarily regulates prolactin secretion under normal conditions?
Tonic inhibitory control by dopamine via D2 receptors
Stimulatory control by thyrotropin-releasing hormone (TRH) alone
Pulsatile release independent of hypothalamic input
Feedback from estrogen levels in females only
In Cushing's syndrome caused by ACTH-secreting pituitary adenomas, what is the most common underlying lesion?
Macroadenoma with CRH overproduction
Microadenoma leading to nodular cortical hyperplasia
Corticotroph cell hyperplasia secondary to ectopic ACTH
Adrenal carcinoma with feedback inhibition
Which clinical feature of Cushing's syndrome is due to the catabolic effects of hypercortisolism on collagen and bone?
Truncal obesity and moon facies
Thin, fragile skin with easy bruising and osteoporosis
Hypertension and glucose intolerance
Hirsutism and menstrual irregularity
Syndrome of Inappropriate Antidiuretic Hormone (SIADH) results in hyponatremia primarily due to:
Impaired water excretion from continued ADH secretion despite normal plasma volume
Increased sodium reabsorption in renal tubules
Hypo-osmolality leading to aquaporin-2 channel suppression
Volume depletion sensed by baroreceptors
A 45-year-old man is diagnosed with hypothyroidism. His lab results show: TSH: 15 μU/mL (elevated) Free T4: 0.5 ng/dL (low) What is the typical lab finding in primary hypothyroidism?
Low TSH, Low T4
High TSH, Low T4
Low TSH, High T4
High TSH, High T4
A doctor orders a thyroid function test for a patient. The patient asks why the doctor is measuring free T4 instead of total T4. What is the reason for preferring free T4 over total T4?
It measures only protein-bound hormone
It avoids interference from protein binding
It is cheaper than total T4
It is less affected by iodine intake
A 30-year-old woman presents with symptoms of hyperthyroidism, including weight loss and palpitations. Her lab results show: Free T3: 500 pg/dL (elevated) Free T4: 1.2 ng/dL (normal) Which test is most useful in detecting T3 toxicosis?
TSH
Free T3
Free T4
Thyroglobulin
A 40-year-old woman has a history of thyroid cancer and has undergone a total thyroidectomy. Her doctor orders a thyroglobulin test to monitor for cancer recurrence. What is the main use of thyroglobulin?
Diagnosis of hyperthyroidism
Screening for hypothyroidism
Monitoring thyroid cancer recurrence
Detecting autoimmune thyroid disease
A 50-year-old man presents with symptoms of hyperthyroidism, including weight loss and tremors. His lab results show: TSH: 0.1 μU/mL (low) Free T4: 2.5 ng/dL (high) What is the most likely diagnosis?
Primary hypothyroidism
Secondary hypothyroidism
Primary hyperthyroidism
Euthyroid sick syndrome
A 35-year-old woman is diagnosed with Hashimoto's thyroiditis. Her doctor orders an antibody test to confirm the diagnosis. Which antibody is most commonly positive in Hashimoto's thyroiditis?
Anti-TPO antibody
Anti-thyroglobulin antibody
TSH receptor blocking antibody
TSI antibody
A 40-year-old woman presents with symptoms of hyperthyroidism, including weight loss and exophthalmos. Her doctor suspects Graves' disease. Which antibody is most strongly associated with Graves' disease?
Anti-TPO antibody
Anti-thyroglobulin antibody
TSH receptor blocking antibody
TSI antibody
A 30-year-old woman presents with symptoms of hyperthyroidism, including weight loss and palpitations. Her lab results show: Free T3: 400 pg/dL (elevated) Free T4: 1.2 ng/dL (normal) What is the most likely diagnosis?
Hashimoto's thyroiditis
T3 toxicosis
Euthyroid sick syndrome
Subclinical hypothyroidism
A 40-year-old woman has a history of thyroid cancer and has undergone a total thyroidectomy. Her thyroglobulin level is detectable. What does this suggest?
Adequate therapy
Recurrent or residual cancer
Graves' disease
Subclinical hypothyroidism
A 65-year-old man is admitted to the hospital with confusion and seizures. His lab results show: Serum sodium: 120 mmol/L (low) Urine sodium: 40 mmol/L (elevated) Serum osmolality: 250 mOsm/kg (low) In SIADH, key diagnostic points include all except:
Serum sodium concentration and plasma tonicity
Urine sodium concentration and clinical volume status
Signs of dehydration or edema making diagnosis likely
Hypo-osmolality with impaired water excretion
A 50-year-old woman presents with sudden onset of severe headache, visual disturbances, and altered mental status. An MRI reveals a pituitary tumor with hemorrhage. Pituitary apoplexy is associated with:
Chronic inflammation in adenomas
Acute hemorrhage into an adenoma causing sudden symptoms
Slow growth without mass effects
Exclusive posterior lobe involvement
A 40-year-old man is diagnosed with a pituitary tumor. His doctor explains that most hormone-secreting tumors are adenomas rather than carcinomas. Hyperpituitarism from pituitary carcinomas is less common than adenomas because:
Carcinomas are always non-functional
Adenomas account for the majority of hormone-secreting tumors
Carcinomas lead to hypopituitarism only
Genetic mutations favor adenoma formation
A 30-year-old woman is diagnosed with a prolactinoma. Her doctor explains that some pituitary adenomas can secrete multiple hormones. In prolactinomas, co-secretion with growth hormone occurs in some cases because:
Both are derived from corticotrophs
Some adenomas are plurihormonal, with GH and PRL being common
Prolactin suppresses GH release
Hypothalamic TRH stimulates only PRL
Positive feedback is exemplified by pituitary hormones declining and causing:
Reduction in hormone production.
LH surge due to estradiol at mid-cycle.
Negative feedback loop activation.
Homeostasis maintenance.
Vitiligo on skin examination may indicate which autoimmune-related endocrine disorder?
Addison's disease (often associated).
Cushing's syndrome.
Acromegaly.
Conn's syndrome.
