Endocrine and Metabolic Diseases

  1. What is the most common cause of Hyperthyroidism?
    Graves' disease (diffuse toxic goiter)
  2. Describe the pathology of Graves' disease.
    An autoimmune disorder: A thyroid-stimulating immunoglobulin (Ig) G anti-body binds to the TSH receptors on the surface of thyroid cells and triggers the synthesis of excess thyroid hormone.
  3. What would a radioiodide scan of a patient with Graves' disease show?
    Diffuse uptake because every thyroid cell is hyper-functioning.
  4. Describe the pathology of Plummer's disease.
    It is a multinodular toxic goiter: characterized by hyper-functioning areas that produce high T4 and T3 levels, thereby decreasing TSH levels. As a result, the rest of the thyroid is not functioning (atrophy due to increased TSH).
  5. What would a thyroid scan of a patient with Plummer's disease show?
    Patchy uptake because only certain cells are hyper-functioning and producing high T3 and T4 levels which decrease TSH levels. So, the rest of the thyroid fails to function and starts to atrophy.
  6. Plummer's disease is more common in which patient population?
    The elderly.
  7. Which conditions can cause transient hyperthyroidism?
    Hashimoto's Thyroiditis and subacute (granulomatous) thyroiditis, also postpartum thyroiditis
  8. Describe the presentation of a thyroid gland in a patient with Graves' disease.
    A diffusely enlarged (symmetric), non-tender thyroid gland; a bruit may be present
  9. Describe the presentation of a thyroid gland in a patient with subacute thyroiditis.
    An exquisitely tender, diffusely enlarged gland (with a viral illness)
  10. Describe the presentation of the thyroid gland in Plummer's disease and Hashimoto's Thyroiditis.
    (if multi-nodularity is present) thyroid gland is bumpy, irregular and asymmetric
  11. Describe the presentation of a toxic adenoma.
    single nodule with an otherwise atrophic gland
  12. What causes proptosis in Grave's disease?
    edema of the extraocular muscles and retro-orbital tissue
  13. What skin changes are seen in hyperthyroidism?
    Warm and moist, pretibial myxedema (edema over tibial surface due to dermal accumulation of mucopolysaccharides)
  14. What is the initial test of choice for Hyperthyroidism?
    Serum TSH level (low): if the TSH is normal or high, hyperthyroidism is unlikely (TSH-induced hyperthyroidism is quite uncommon).
Card Set
Endocrine and Metabolic Diseases
Endocrine and Metabolic Diseases