FA endocrine Pathology p254-257
Terms
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- 10's for pheochromocytoma:
-
10s:
malignant
bilateral
extraadrenal
calcify
kids
familial - 5 P's for pheochromocytoma
-
pain, pallor, palpitations
perspirations
pressure - tx for pheo
-
phenoxybenzamine
phentolamine - MEN I
- pancreas, pituitary, parathyroid
- MEN II
-
med ca of thyroid
pheo
parathyroid - Men III
-
med ca of thyroid
pheo
oral and intestinal ganglioneuromatosis (mucosal neuromas) - cold intolerance, hypoactivity, wt gain, fatigue, lethargy, dec appetite, constipation, weakness, dec reflexes, myxedema, dry, cool skin, and coarse, brittle hair
- hypothyroidism
- heat intolerance, hyperactivity, wt loss, chest pain and chest palps, arrhythmias, diarrhea, inc reflexes, warm, moist skin, and fair hair
- hyperthyroidism
- proptosis, EOM swelling, pretibial myxedema, diffuse goiter
- Graves' disease
- thyroid replaced by fibrous tissue
- Riedel's thyroiditis
- Autoimmune d/o --> hypothyroidism. Lymphocytic infiltrate with germinal centers
- Hashimoto's thyroiditis
- Antimicrosomal Abs and antithyroglobulin Abs
- Hashimoto's thyroiditis
- self-limited hypothyroidism following a flulike illness
- subacute thyroiditis (de Quervain's)
- Is the thyroid tender in subacute thyroiditis?
- yes (nontender in Hashimoto's thyroiditis)
- List the 4 kinds of thyroid cancer in order of most prevalence:
-
pap ca
follicular ca
medullary ca
anaplastic/undiff - "ground-glass" nuclei, psammoma bodies
- pap ca of thyroid
- from C cells; produces calcitonin, sheets of cells in amyloid stroma
- med ca
- causes of cretinism
-
lack of dietary iodine
defect in T4 formation
Dev. failure of thyroid formation - pot-bellied, pale, puffy-faced child with protruding umbilicus and protuberant tongue
- cretinism
- large tongue with deep furrows, deep voice, large hands and feet, coarse facial features, impaired glucose tolerance
- acromegaly
- inc GH in children
- gigantism
- tx for acromegaly
- octreotide
- findings in 1^ hyperparathyroidism
-
bones, stones, groans, moans
Osteitis fibrosa cystica
Renal stone
constipation
psych - confused state - most likely cause of 1^ and 2^ hyperparathyroidism
-
1^: adenoma
2^: dec Ca due to CRF - bone lesions due to 2^ hyperpara b/c of renal disease
- renal osteodystrophy
- 2 signs of hypoparathyroidism
-
Chvostek's sign - tap facial nerve --> contraction of facial mm
Trousseau's sign - occlusion of brachial artery with BP cuff leads to carpopedal spasm - hypocalcemia, shortened 4th/5th digits, short stature
- pseudohypoparathyroidism (aka Albright's hereditary osteodystrophy) (kidney unresponsive to PTH)
- Causes of hypercalcemia
-
CH(2)IMPANZEES
Ca ingestion
Hyperparathyroidism, hyperthyroidism
Iatrogenic (thiazides)
Multiple myeloma
Paget's disease
addison's disease
neoplasms
Zollinger-Ellison syndrome
Excess Vit D
Excess Vit A
Sarcoidosis - small vessel manifestations of DM
- retinopathy, glaucoma, nephropathy
- tests for DM
- fasting serum glucose, glucose tolerance test, HbA1c
- kussmaul respirations (rapid/deep breathing), hyperthermia, n/v, abd pain, dementia, dehydration, fruity breath odor
- DKA (Breathe easy...)
- tx for DKA
- fluids, insulin, and K+; glucose if necessary to prevent hypoglycemia
- complications of DKA
- mucormycosis, Rhizopus, cerebral edema, arrhythmias, heart failure
- causes of DI
-
lack of ADH (central DI)
lack of renal response to ADH (nephrogenic DI) - tx for central DI
- desmopressin (ddavp)
- tx for nephrogenic DI (3 possible)
- thiazides, indomethacin, amiloride
- diarrhea, cutaneous flushing, asthmatic wheezing, right-sided valvular disease
- carcinoid syndrome
- most common tumor of appendix
- carcinoid tumor
- carcinoid syndrome has inc ___ in urine
- 5 HIAA
- Carcinoid syndrome not seen if tumor is limited to ___
- GI tract (first pass metabolism in liver)
- carcinoid tumors secrete high levels of ___ and are gneerally found in the ___
- 5-HT; small bowel
- carcinoid tumors are derived from ___
- neuroendocrine cells of GI tract
- rule of 1/3 for carcinoid syndrome
-
1/3 metastasize
1/3 present with 2nd malignancy
1/3 multiple - tx for carcinoid syndrome
- octreotide
- gastrin secreting tumor of pancreas or duodenum; causes recurrent ulcers
- Zollinger-Ellison syndrome