ENDO Flashcards
Mediastinal Anterior Compartments
4Ts
Thymoma
Terrible lymphoma
Thyroid neoplasm (ectopic, goiter)
Teratoma, seminoma, nonseminoma
Mediastinal Middle Compartments
CVELL
Cystic masses (bronchogenic, pericardial)
Vascular masses
Esophageal tumors
Lymphoma
Lymphadenopathy (sarcoidosis and lung cancer)
Mediastinal Posterior Compartments
Lymphoma
Metastasis spinal masses, Meningocele
Neurogenic tumor (schwanomma, neurofibroma)
Vitamin D function
Bone: Ca and Phosphate insertion
Kidney: inc Ca and Phosphate resorption
Blood: inc Ca and Phos levels
PTH function
Bone: inc Ca and Phosphate release
Kidney: inc Ca resorption, dec Phosphate resorption
Blood: inc Ca levels and dec Phosphate levels
Calcitonin function
Bone: dec Ca and Phosphate release
Kidney: inc Ca and Phosphate excretion
Blood: dec Ca and Phosphate levels
Insulin dependent glucose transporter/s
Glut4: adipose tissue and striated muscle
Insulin independent glucose transporters
BRICKLIPS
Brain - GLUT1, GLUT3
RBCs - GLUT1
Intestines - GLUT2, GLUT5, SGLT1/SGLT2
Cornea - GLUT1
Kidney - GLUT2, SGLT1/SGLT2
Liver - GLUT2
Islet beta cells - GLUT2
Placenta - GLUT1, GLUT3
Spermatocytes - GLUT5
Cortisol function
A BIG FIB
Appetite INC
Blood pressure INC
Insulin resistance INC
Gluconeogenesis, lipolysis and proteolysis INC
Fibroblast activity DEC
Inflammatory and immune response DEC
Bone formation DEC (dec osteoblast activity)
Treatment for Acromegaly
COP
Cabergoline (dopamine agonist)
Octreotide
Pegvisomant (GH receptor antagonist)
Hashimoto Thyroiditis lab results
(+) antimicrosomal/antithyroid peroxidase antibody
(+) antithyroglobulin antibody
(+) Hurtle cells
HLADR3
Subacute granulomatous thyroiditis/De quervain findings
Very tender thyroid
Preceeded by viral infection
Activation of cytotoxic T cells
Blood flow decreased on UTZ
Dec TSH, radioiodine uptake
Inc T3 T4, thyroglobulin
Reidel’s thyroiditis findings
Hard, nontender, woody, fixed thyroid
IgG4-related disease
Fibrosis may extend to trachea and esophagus
Congenital Hypothyroidism/cretinism
6Ps
Pale
Poor brain development
Puffy faced
Protuberant tongue
Protuberant umbilicus
Pot bellied
Treatment for thyroid storm
4Ps
PTU
Propanolol
Potassium iodide
Prednisolone
Pseudohypothyroidism features
Maternally transmitted mutations (imprinted GNAS gene)
Autosomal dominant
Inactivation of adenylate cyclase
End organ resistance (kidney and bone) to PTH
INC PTH and Phosphate
DEC Calcium
Pseudopseudohypoparathyrodism features
No end organ resistance
Normal PTH, Ca and Phosphate
Paternally transmitted
Autosomal dominant
Pseudohypothyrodism PE findings
DR SSS
Developmental delay
Round face
Shortened 4th/5th digit
Short stature
Subcutaneous calcifications
Cushing Syndrome Findings
OOH BAM CUSHINGS
Osteoporosis
Obesity
Hirsutism
Buffalo hump
Amenorrhea
Moon facies
Cholesterol INC
Urinary free cortisol INC
Skin changes (thinning, striae, acanthosis nigricans)
Hypertension
Immunosupression
Neoplasm as cause
Growth restriction in children
Sugar in blood INC
Electrolyte imbalance seen in Primary Adrenal Insufficiency
Low CASE
Cortisol
Aldosterone
Sodium
Epinephrine
high PAN
Potassium
ADH/vasopressin
Norepinephrine
Neuroendocrine cells share a common biologic function through
Amine Precursor Uptake Decarboxylase (APUD)
Neuroblastoma lab findings
Amplification of N-myc gene
(+) HVA and VMA in urine
Homer-Wright rosettes in biopsy
(+) bombesin and NSE
Electrolyte imbalance in Hyperaldosteronism
INC Sodium and bicarbonate
DEC Potassium and H+
Metabolic alkalosis
Pheochormocytoma rule of 10s
10% maligant
10% bilateral
10% extraadrenal (bladder wall, organ of Zuckerkandl)
10% calcify
10% kids
Episodic hyperadrenergic symptoms of Pheochromocytoma
5 Ps
Pain - headache
Pressure - inc BP
Perspiration
Pallor
Palpitations
Pheochormocytoma lab findings
(+) HVA and VMA in urine and plasma
(+) chromogranin, synaptophysin, NSE
Treatment for Pheochromocytoma
Phenoxybenzamine (irreversible alpha antagonist) then beta blockers prior to tumor resection
Whipple triad in Insulinoma
- low blood glucose
- Symptoms of hypoglycemia (eg, lethargy, syncope, diplopia)
- resolution of symptoms after normalization of plasma glucose levels. S
Glucagonoma presentation
6Ds
Dermatitis (necrolytic migratory erythema)
Diabetes (hyperglycemia)
DVT
Declining weight
Depression
Diarrhea
Somatostatinoma presentation
Diabetes/glucose intolerance
Achlorydia
Gallstones
Steatorrhea
Carcinoid syndrome presentation
WaRDEN
Wheezing
Right-sided valvular heartdisease (eg, tricuspid regurgitation, pulmonic stenosis)
Diarrhea
Episodic flushing
Niacin deciency (pellagra)
Carcinoid tumor lab findings
INC urinary 5-HIAA
Histology: prominent rosettes
(+) chromogranin A , synaptophysin
Rule of thirds in Carcinoid tumors
1/3 metastisize
1/3 present with 2nd malignancy
1/3 multiple
Drug that causes Liver: DEC glucose production
Adipose tissue & Skeletal muscle: INC insulin sensitivity
- Biguanides - metformin
- Thiozolidinediones - pioGLITAZONE rosiglitazone
Drug that causes Kidney: DEC glucose reabsorption
SGLT2 inhibitors
- CanagliFLOZIN
- Dapagliflozin
- Empagliflozin
Drug that causes Intestine: DEC glucose absorption
alpha-glucosidase inhibitors
1.Acarbose
2. Miglitol
Drug that causes
Pancreas (alpha cells): DEC glucagon release
Stomach: DEC gastric emptying
- GLP1 analog - exeniTIDE, liraglutide
- DPP4 inhibitors - linagLIPTIN, sitagliptin
- amylin analogs - prAMLINtide
Drug that causes Pancreas (beta cells): INC insulin secretion
- Sulfonylureas - chlorpropAMIDE, tolbutamide
- meglitinides - nateGLINIDE, repaglinide
- GLP1 analog - exeniTIDE, liraglutide
- DPP4 inhibitors - linagLIPTIN, sitagliptin
Weight gain DM drugs
SIT
Sulfonylurea - 1st gen: chlorpropaMIDE, tolbutamide, 2nd gen: glipizIDE, glyburide
Insulin
Thiazolidinediones - pioGLITAZONE, rosiglitazone
Weight loss DM drugs
MSG
Metformin
SGLT2 - CanaGLIFLOZIN, dapagliflozin, empagliflozin
GLP 1 receptor antagonist - exenaTIDE, liraglutide
Weight neutral DM drugs
DPP4 inhibitors
“DiPaPataba”
Side effect of Metformin
Lactic acidosis
Vitamin B12 deficiency
DM drug with an increase in risk of fractures
Pioglitazone
Rosiglitazone
DM drug that may cause pancreatitis
GLP-1 analogs - Exenatide, liraglutide, semaglutide
DM drug that may cause respiratory infections such as nasopharyngitis and urinary infections
DPP-4 inhibitors - Linagliptin, saxagliptin, sitagliptin
Side effects of SGLT2 inhibitors
Glucosuria
UTIs
vulvovaginal candidiasis
dehydration
Orthostatic hypotension
Benefits of SGLT2 inhibitors
- Reduce BP by intravascular volume reduction
- Lower mortality for HF by DECreasing preload and afterload
- Slow progression of DM nephropathy
Thyroid drug associated with ANCA (+) vasculitis
PTU
Thyroid drug associated with aplasia cutis
Methimazole
Desmopressin is clincally used in:
Central DI
von Willebrand disease
sleep enuresis
hemophilia A
Somatostatin/octreotide is clinically used in:
Carcinoid syndrome
Acromegaly
Gastrinoma
Glucagonoma
esophageal varices
Mutations of Papillary Thyroid Carcinoma
RET/APC rearrangement
BRAF mutation
Mutations of Follicular carcinoma
RAS mutation
PAX8-PPAR-Y translocation
Mutations of Medullary Thyroid Carcinoma
RET mutation
Mutation of Undifferentiated/Anaplastic Carcinoma
TP53 mutation
Mutation of Pseudohypoparathyroidism type 1A
maternally transmitted
Imprinting GNAS gene
