Answer 20

20.  Choice D is the correct answer.  Craniopharyngiomas are mixed solid and cystic lesions that arise from the remnants of Rathke's pouch.  These are benign lesions.  Chordomas are locally aggressive tumors that metastasize from the pituitary gland.  Primary Central Nervous System Lymphoma involves both pituitary and hypothalamus.  These are malignant tumors.  Germ Cell Pituitary Tumors are ectopic pinealomas that are malignant.

Question 20

20.  Which of the following brain tumors are not malignant?

A.  Chordomas
B.  Germ Cell Pituitary Tumors
C.  Primary Central Nervous System Lymphoma
D.  Craniopharyngiomas

Answer 19

19.  Choice D is the  correct answer.  Thin skin is is a physical finding associated with Cushing Syndrome not thick skin.  Other physical finding associated with Cushing Syndrome include red cheeks, moon face, a buffalo hump, high blood pressure, thin arms and legs, poor wound healing, truncal obesity, and red striation on the abdomen.  

Question 19

19.  Which of the following is not a physical finding associated with Cushing Syndrome?

A.  Truncal Obesity
B.  Moon Face
C.  Thin Arms and Legs
D.  Thick Skin

Answer 18

18.  Choice B is the correct answer.  Patients that are deficient in Vitamin D deficiency cannot utilize the existing calcium efficiently.  Malignancy typically presents with high calcium.  Lithium decreases the parathyroid gland sensitivity to calcium and causes hypercalcemia.  Thiazide diuretics cause a decrease of calcium excretion and thereby cause hypercalcemia.

Question 18

18.  Your patient is a 54 year old female with osteoporosis.  During the course of your work up you discover that her PTH is high and her Calcium is normal.  Which of the following is a likely etiology of this clinical picture?

A.  Malignancy
B.  Vitamin D Deficiency
C.  Thiazide Diuretics
D.  Lithium

Answer 17

17.  Choice C is the correct answer.  Since the CRH, ACTH, and Cortisol are all low this implies tertiary adrenal insufficiency.  The hormones are all low because there is no stimulation beginning with the CRH in the hypothalamus.  If the CRH and ACTH are high, and the Cortisol is low, this implies primary adrenal insufficiency.  If the CRH is high, and the ACTH and the Cortisol is low this implies secondary adrenal insufficiency.  Cushing syndrome is when there is high cortisol and low ACTH.  

Question 17

17.  Your patient is a 54 year old male that presents with the following lab values:  CRH=low, ACTH=low and Cortisol=low.  Which of the following is the correct diagnosis?

A.  Primary Adrenal Insufficiency
B.  Secondary Adrenal Insufficiency
C.  Tertiary Adrenal Insufficiency
D.  Cushing Syndrome

Answer 16

16.   Choice D is the correct answer.  Post partum thyroiditis occurs within a year of childbirth.  It is usually painless.  Infectious thyroiditis can be acute or chronic caused by staph or strep.  Radiation thyroiditis is painful and develops 5-10 days after radiation therapy.  Palpation or trauma Induced Thyroiditis occurs after a trauma or manipulation from a fine need aspirate biopsy.  Drug Induced Thyroiditis can occur from taking interferon alpha, amiodarone, lithium, or interleukin 2.

Question 16

16.  Which of the following thyroiditis tends to be painless?

A.  Infectious Thyroiditis
B.  Radiation Thyroiditis
C.  Drug Induced Thyroiditis
D.  Post Partum Thyroiditis