Endocrine Weight Loss Endocrine Pathology 3 — Questions and Answers
Question 1: Which of the following is a characteristic lab finding in a patient with primary hypothyroidism causing weight gain?
- Low TSH with low free T4
- Elevated TSH with low free T4 (Correct answer)
- Low TSH with elevated free T4
- Elevated TSH with elevated free T4
Correct answer: Elevated TSH with low free T4
Primary hypothyroidism shows elevated TSH (pituitary compensating) and low free T4 (insufficient thyroid production).
Question 2: A tumor of the pancreatic islet cells that secretes excess insulin, causing hypoglycemia and compensatory overeating with weight gain, is called a:
- Gastrinoma
- Glucagonoma
- Insulinoma (Correct answer)
- VIPoma
Correct answer: Insulinoma
Insulinoma is a rare pancreatic beta-cell tumor that autonomously secretes insulin, causing recurrent hypoglycemia and reactive overeating.
Question 3: Which endocrine disorder is characterized by elevated prolactin, weight gain, amenorrhea, and galactorrhea in women?
- Hyperthyroidism
- Hyperprolactinemia (Correct answer)
- Primary hyperparathyroidism
- Adrenal insufficiency
Correct answer: Hyperprolactinemia
Hyperprolactinemia (often from a pituitary prolactinoma) suppresses gonadal hormones and can cause weight gain, amenorrhea, and galactorrhea.
Question 4: In metabolic syndrome, which combination of features must be present according to standard diagnostic criteria?
- Obesity, hypoglycemia, low LDL, and bradycardia
- Central obesity, elevated triglycerides, low HDL, hypertension, and elevated fasting glucose (Correct answer)
- Peripheral edema, hyponatremia, and elevated TSH
- High LDL, normal triglycerides, normal blood pressure, and low BMI
Correct answer: Central obesity, elevated triglycerides, low HDL, hypertension, and elevated fasting glucose
Metabolic syndrome requires at least 3 of 5 criteria: large waist circumference, high triglycerides, low HDL, hypertension, and elevated fasting glucose.
Question 5: Which adrenal hormone, when chronically elevated, directly increases appetite and promotes visceral fat deposition?
- Aldosterone
- DHEA
- Cortisol (Correct answer)
- Epinephrine
Correct answer: Cortisol
Cortisol stimulates appetite (especially for calorie-dense foods) and drives preferential fat storage in visceral depots.
Question 6: A patient with acromegaly (excess GH in adulthood) may paradoxically have which metabolic complication that promotes weight-related disease?
- Severe hypoglycemia due to GH stimulating insulin
- Insulin resistance and secondary diabetes mellitus (Correct answer)
- Central hypothyroidism from pituitary compression
- Hypoaldosteronism causing salt wasting
Correct answer: Insulin resistance and secondary diabetes mellitus
Chronic GH excess induces insulin resistance, leading to secondary diabetes mellitus and associated metabolic complications.
Question 7: Hypothalamic obesity, a rare but severe form of obesity, results from damage to which hypothalamic nucleus?
- Suprachiasmatic nucleus
- Ventromedial hypothalamus (satiety center) (Correct answer)
- Anterior hypothalamic nucleus
- Mammillary bodies
Correct answer: Ventromedial hypothalamus (satiety center)
Damage to the ventromedial hypothalamus destroys the satiety center, causing uncontrolled hunger, hyperinsulinemia, and rapid weight gain.
Endocrine Weight Loss Endocrine Pathology 3
Which of the following is a characteristic lab finding in a patient with primary hypothyroidism causing weight gain?