Endocrine System

Question 1

What is Grave’s disease

Answer 1

Grave’s disease is an autoimmune thyroid disorder which the most common cause of endogenous hyperthyroidism and is characterized by a triad of clinical findings:

1. Hyperthyroidism associated with diffuse enlargement of the thyroid gland
2. Infiltrative ophthalmopathy with resultant exophthalmos
3. Localized, infiltrative dermopathy (sometimes called pretibial myxedema)

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Question 2

What is goiter

Answer 2

Goiter means any enlargement of the thyroid gland which is caused by compensatory hypeeplasia and hypertrophy of the follicular epithelium in response to thyroid hormone deficiency.

Question 3

Morphology of papillary carcinoma of thyroid

Answer 3

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Question 4

Define DM

Answer 4

Here is the first line of the definition:

“Diabetes mellitus is a group of metabolic disorders characterized by hyperglycemia resulting from defects in insulin secretion, insulin action, or both.”

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Question 5

Types of Dm

Answer 5

A. Type 1 diabetes (T1D) (β-cell destruction, usually leading to absolute insulin deficiency)
Immune-mediated
Idiopathic (autoantibody-negative)

B. Type 2 diabetes (T2D) (combination of insulin resistance and β-cell dysfunction)

C. Other types:

1. Genetic defects of β-cell function
   Maturity-onset diabetes of the young (MODY)
   Insulin gene mutations
   Defects in proinsulin conversion
   Maternally inherited diabetes and deafness (MIDD)
   Neonatal diabetes
2. Genetic defects in insulin action
   Type A insulin resistance
   Lipoatrophic diabetes
3. Exocrine pancreatic defects (“pancreatogenic” or type 3C diabetes)
   Chronic pancreatitis
   Pancreatic cancer
   Pancreatectomy / trauma
   Haemochromatosis
   Cystic fibrosis
   Fibrocalculous pancreatopathy
4. Endocrinopathies
   Cushing syndrome
   Acromegaly
   Pheochromocytoma
   Hyperthyroidism
   Glucagonoma
5. Infections
   Cytomegalovirus (common in immunocompromised)
   Coxsackie B virus
   Congenital rubella
6. Drugs
   Glucocorticoids (most common drug-induced diabetes)
   Thiazides
   β-adrenergic agonists
   Protease inhibitors
   Phenytoin (Dilantin)
   Thyroid hormone
   Interferon-α
   Nicotinic acid
   Vacor
7. Genetic syndromes associated with diabetes
   Down syndrome
   Turner syndrome
   Klinefelter syndrome
   Prader-Willi syndrome
8. Gestational diabetes mellitus

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Question 6

Complications of DM

Answer 6

Acute:
1. Diabetic ketoacidosis
2. Hypoglycemic coma
3. Hyperglycemic hyperosmolar state
4. Lactic acidosis

Chronic:
A. Microvascular:
1. Diabetic retinopathy
2. Diabetic nephropathy
3. Diabetic neuropathy
4. Autonomic neuropathy
5. Diabetic foot disease
B. Macrovascular:
1. Coronary circulation
2. Cerebral circulation
3. Peripheral circulation

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