2. ⢠Contesta las siguientes preguntas usando la
bibliografia proporcionada en biblioteca
virtual.
3. 1
A 42-year-old man presents because recently he
has had to change his shoe size from 9 to 101â2. He
also says that his hands and jaw are now larger. The
disorder is most likely mediated through the actions
of excess
⢠a. Prolactin
⢠b. ACTH
⢠c. Somatomedin
⢠d. Antidiuretic hormone
⢠e. Thyrotropin
4. 2
A perimenopausal woman presents with increasing swallowing difficulty and fatigue.
Physical examination reveals that her thyroid is enlarged (palpable goiter). Laboratory
examination of her serum reveals T4 of 4.9mg/dL, free T4 of 2.5 ng/dL, and TSH of 5.5
mIU/mL. No thyroidstimulating immunoglobulins are identified in the serum, but
antimicrosomal antibodies are present. Which one of the listed histologic findings, if
present in a thyroid biopsy from this individual, would be most consistent with a
diagnosis of Hashimotoâs thyroiditis?
⢠a. Lymphocytic infiltrate without follicle formation
⢠b. Intense lymphoplasmacytic infiltrate with lymphoid follicles and scattered
⢠oxyphilic cells
⢠c. Hyperplasia of follicular cells with scalloping of colloid at the margin of follicles
⢠d. Granulomatous inflammation with multinucleated giant cells surrounding
fragments of colloid
⢠e. Dense fibrosis within the thyroid gland extending into adjacent soft tissue
5. 3
Gravesâ disease is characterized clinically by finding
⢠a. Central obesity, âmoonâ face, and abdominal
striae
⢠b. Hyperthyroidism, exophthalmus, and pretibial
myxedema
⢠c. Polyuria, polydipsia, and hyponatremia
⢠d. Polyuria, polydipsia, and polyphagia
⢠e. Progressive lethargy, cold intolerance, and
myxedema
6. 4
The term goiter refers to
⢠a. Any enlargement of the thyroid regardless of the
etiology
⢠b. Any involution of the thyroid regardless of the
etiology
⢠c. Enlargement of the thyroid secondary to Gravesâ
disease
⢠d. Enlargement of the thyroid secondary to the
ingestion of goitrogens
⢠e. Involution of the thyroid secondary to Hashimotoâs
thyroiditis
7. 5
Which one of the listed signs or symptoms is
more characteristic of hypocalcemia than of
hypercalcemia?
⢠a. Calcium stones in the urine
⢠b. Metastatic calcification
⢠c. Peptic ulcers
⢠d. Psychiatric changes
⢠e. Tetany
8. 6
A 52-year-old female presents with nausea, fatigue, muscle
weakness, and intermittent pain in her left flank. Laboratory
examination reveals an increased serum calcium and a
decreased serum phosphorus. The patientâs plasma
parathyroid hormone levels are increased, but parathyroid
hormoneârelated peptide levels are within normal limits.
Urinary calcium is increased, and microhematuria is present.
The patientâs abnormality is most likely caused by
⢠a. Primary hyperparathyroidism
⢠b. Primary hypoparathyroidism
⢠c. Pseudohypoparathyroidism
⢠d. Secondary hyperparathyroidism
⢠e. Secondary hypoparathyroidism
9. 7
⢠A 65-year-old male presents with bone pain and is
found to have hypocalcemia and increased parathyroid
hormone. Surgical exploration of his neck finds all four
of his parathyroid glands to be enlarged. Without any
other information, which one of the following is most
likely the cause of the enlargement of the parathyroid
glands?
⢠a. Primary hyperplasia
⢠b. Parathyroid adenoma
⢠c. Chronic renal failure
⢠d. Parathyroid carcinoma
⢠e. Lung carcinoma
10. 8
The clinical effects of excess serum cortisol are
referred to as
⢠a. Addisonâs disease
⢠b. Bartterâs syndrome
⢠c. Connâs syndrome
⢠d. Cushingâs syndrome
⢠e. Schmidtâs syndrome
11. 9
⢠A 42-year-old male presents with weakness and dizziness
associated with stress. Physical examination reveals a slightly
decreased blood pressure along with a diffuse increase in skin
pigmentation. Laboratory examination reveals hyponatremia and
hyperkalemic acidosis with decreased aldosterone, decreased
cortisol, decreased glucose, increased ACTH, decreased sex
steroids, and increased LH and FSH. Thyroid function tests are found
to be within normal limits. The most likely cause of the signs and
symptoms in this individual is
⢠a. A benign adenoma of the adrenal cortex
⢠b. A malignant tumor of the adrenal medulla
⢠c. Autoimmune destruction of the adrenal cortex
⢠d. Bilateral hyperplasia of the adrenal cortex
⢠e. Tuberculosis of the adrenal medulla