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AJT CORE > CORE - Endocrine > Flashcards

CORE - Endocrine Flashcards

1
Q

Cerebriform adrenal gland(s)

A

adrenal hyperplasia

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2
Q

Salt-wasting in a boy

A

consider 21-hydroxylase deficiency CAH

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3
Q

Genital ambiguity in a girl

A

consider 21-hydroxylase deficiency CAH

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4
Q

Conn syndrome

A

increased aldosterone => hypertension, hypokalemia; most commonly due to a functional adenoma

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5
Q

Cushing syndrome

A

over-production of ACTH due to paraneoplastic syndrome, adrenal adenoma, or primary adrenal hyperplasia

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6
Q

Cushing disease

A

ACTH-secreting pituitary adenoma

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7
Q

Adrenal hemorrhage is most common on which side?

A

right

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8
Q

Nuclear medicine studies for diagnosis of pheochromocytoma

A

MIBG > octreoscan for adrenal pheo; octreoscan > MIBG for extra-adrenal pheo (paraganglioma)

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9
Q

Post-micturition syncope

A

bladder paraganglioma

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10
Q

Adrenal calcification DDx

A

old hemorrhage, ACC, myelolipoma (25%), neuroblastoma, TB, histoplasmosis, Wegener’s, melanoma mets

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11
Q

Formula for absolute washout

A

(enhanced - delayed) / (enhanced - unenhanced) * 100

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12
Q

Formula for relative washout

A

(enhanced - delayed) / (enhanced) * 100

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13
Q

Relative washout % for adrenal adenoma

A

> 40% washout

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14
Q

Absolute washout % for adrenal adenoma

A

> 60% washout

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15
Q

HU cutoff for adrenal adenoma on NECT

A

10 HU

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16
Q

Addison disease

A

adrenocortical insufficiency; autoimmune or post-infectious

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17
Q

Bilateral enlarged and calcified adrenal glands (peds)

A

Wolman disease; often fatal

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18
Q

Zuckerkandl tubercle

A

normal variant; projects from posterior aspect of lateral thyroid lobes

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19
Q

Location of recurrent laryngeal n. relative to thyroid gland

A

medial to Zuckerkandl tubercle

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20
Q

Thyroglossal duct cyst with an enhancing nodule + NEXT STEP

A

consider thyroid cancer; next step is biopsy

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21
Q

Enlarged thyroid gland DDx

A

multi-nodular goiter, Graves disease, iodine deficiency

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22
Q

TSH and T3/T4 in Graves disease

A

decreased TSH, increased T3/T4

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23
Q

Grave’s ophthalmopathy

A

order of involvement = I-M-S-L-O; painless, spares tendon insertions, increased intra-orbital fat

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24
Q

Dominant hyperechoic thyroid nodule(s)

A

Hashimoto’s thyroiditis (“white knight”)

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25
Q

Diffusely coarsened or nodular thyroid gland

A

Hashimoto’s thyroiditis

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26
Q

Delphian lymph nodes

A

adjacent to thyroid gland, level VI

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27
Q

Metastatic involvement of Delphian nodes

A

suggestive of metastatic laryngeal cancer

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28
Q

Reidel’s thyroiditis

A

assoc. with IgG-4; women 40-70 y/o; enlarged gland, fibrous replacement (T1/T2 dark)

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29
Q

Enlarged thyroid gland with low T1 and T2 signal

A

Riedel’s thyroiditis (fibrous replacement)

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30
Q

Granulmatous thyroiditis

A

a.k.a. de Quervain or subacute thyroiditis; due to viral infection, self-limited, painful; Tx is steroids

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31
Q

Lymphocytic thyroiditis

A

similar to subacute thyroiditis, except occurs post-partum and is painless

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32
Q

Most common type of thyroid cancer + 2nd most common type

A

papillary > follicular

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33
Q

Microcalcifications are most commonly assoc. with which type of thyroid cancer

A

papillary; microcalcifications may also be seen in nodal mets

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34
Q

Parathyroid adenoma imaging characteristics

A

early enhancement with delayed washout, T2 bright

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35
Q

Syndromes with increased risk of thyroid cancer

A

MEN 2 (medullary), Cowden (follicular), FAP/Gardner (papillary)

36
Q

Calcitonin-producing type of thyroid cancer

A

medullary (assoc. with MEN 2)

37
Q

Thyroid cancer types which respond poorly to I-131 therapy

A

medullary, anaplastic, Hurthle cell

38
Q

“Pancake” adrenal gland

A

congenital absence of the ipsilateral kidney

39
Q

Adrenal blood supply

A

superior suprarenal a. (from inferior phrenic a.), middle suprarenal a. (from aorta), inferior suprarenal a. (from renal a.)

40
Q

Adrenal venous drainage

A

right suprarenal v. drains to the IVC, left suprarenal v. drains to renal v. or inferior phrenic v.

41
Q

Adrenal zones

A

glomerulosa (aldosterone), fasciculata (cortisol), reticularis (androgens), medulla (catecholamines)

42
Q

Triple stripe appearance of adrenal gland

A

normal in infants; hypoechoic cortex - hyperechoic medulla - hypoechoic cortex

43
Q

Most common cause of excess cortisol

A

Cushing disease (pituitary adenoma)

44
Q

Malignancy assoc. with increased ACTH production

A

small cell lung cancer

45
Q

Clinical symptoms of Cushing disease/syndrome

A

moon facies, buffalo hump, central obesity, striae, thin skin

46
Q

Causes of neonatal adrenal hemorrhage

A

breech birth or fetal distress (“stress”), congenital syphillis

47
Q

Adrenal lesion equivocal for hemorrhage vs. neuroblastoma - NEXT STEP

A

short-term US follow-up (hemorrhage will get smaller)

48
Q

Waterhouse-Friderichsen syndrome

A

post-hemorrhagic adrenal failure in the setting of N. meningitidis

49
Q

Neuroblastoma typically arises from the adrenal cortex or medulla?

A

medulla

50
Q

Pheochromocytoma imaging characteristics

A

T2 bright, heterogeneous enhancement

51
Q

Pheochromocytoma assoc. syndromes

A

VHL, MEN 2 > NF1, tuberous sclerosis, Sturge-Weber, Carney triad

52
Q

Carney triad

A

extra-adrenal pheochromocytoma (paraganglioma), pulmonary chondromas, GIST

53
Q

Carney complex

A

cardiac myxomas, skin lesions; considered an MEN syndrome

54
Q

Rule of 10’s

A

for pheochromocytoma; 10% extra-adrenal, 10% bilateral, 10% malignant, 10% in children, 10% familial, 10% not assoc. with hypertension, 10% contain calcification

55
Q

Myelolipoma associations

A

Cushing’s, CAH, Conn’s

56
Q

Most common mets to adrenal gland

A

breast, lung, melanoma; same as spleen

57
Q

Adrenal lesion with signal loss on out-of-phase

A

adenoma; may be functional or non-functional

58
Q

MEN 1

A

parathyroid hyperplasia, pituitary adenoma, pancreatic islet cell tumors

59
Q

MEN 2a

A

medullary thyroid cancer, pheochromocytoma, parathyroid hyperplasia

60
Q

MEN 2b

A

medullary thyroid cancer, pheochromocytoma, neuromas (mucosal or ganglioneuromas), marfanoid habitus

61
Q

Flushing, diarrhea, pain, right heart failure, bronchospasm

A

carcinoid syndrome (liver mets)

62
Q

Most common location for carcinoid

A

appendix > ileum

63
Q

Collision tumor

A

mets to adrenal gland with a pre-existing adenoma (classically)

64
Q

Suspicious features of thyroid nodules

A

solid, calcifications (esp. microcalcifications)

65
Q

Thyroid nodule with comet tail artifact

A

colloid nodule

66
Q

Most common location of ectopic thyroid tissue

A

lingual thyroid

67
Q

Most common location for a thyroglossal duct cust

A

infrahyoid (per Radiopaedia)

68
Q

RAIU % for Grave’s and multi-nodular goiter

A

> 70% for Graves, >40% for multi-nodular goiter

69
Q

Risk assoc. with Hashimoto’s thyroiditis

A

increased risk of primary thyroid lymphoma

70
Q

Antibodies assoc. with Hashimoto’s thyroiditis

A

anti-TPO, anti-thyroglobulin

71
Q

Hyperthyroid => hypothyroid => euthyroid

A

subacute thyroiditis

72
Q

Acute suppurative thyroiditis

A

bacterial infection of thyroid, may develop into an abscess

73
Q

Cause of acute suppurative thyroiditis (peds)

A

may start in a 4th branchial cleft anomaly

74
Q

Thyroid cancer type that mets hematogenously

A

follicular

75
Q

Thyroid cancer type assoc. with prior radiation

A

anaplastic; seen in elderly patients

76
Q

Papillary thyroid cancer mets

A

often cystic with microcalcifications

77
Q

Origin of parathyroid glands

A

superior glands from 4th branchial pouch, inferior glands from 3rd branchial pouch

78
Q

Most common cause of hyperparathyroidism

A

parathyroid adenoma

79
Q

Typical age for ganglioneuroma

A

> 10 y/o

80
Q

Laboratory test for pheochromocytoma

A

urine metanephrines/catecholamines (NE, Epi)

81
Q

Lipid-poor adenoma

A

may be >10 HU on NECT and not demonstrate signal loss on out-of-phase MR

82
Q

Indeterminant adrenal lesion after advanced imaging (CT/MR)

A

biopsy is indicated

83
Q

Most common type of adrenal cyst

A

endothelial (lymphatic or angiomatous origin)

84
Q

Adrenal cyst with peripheral calcification

A

pseudocyst (result of prior hemorrhage)

85
Q

Most common location for an intra-abdominal paraganglioma

A

organ of Zuckerkandl (aortic bifurcation)

86
Q

Adrenal cortical carcinoma - functional or non-functional?

A

may be either; functional ACC may produce excess aldosterone, cortisol, or androgens

87
Q

Causes of adrenal hemorrhage (adult)

A

trauma, anticoagulation; may be bilateral; may cause hypotension

AJT CORE (12 decks)

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