Endo 2

Question 1

Psammoma bodies, intranuclear vacuoles, multi centric, LN Meét, from prior rads vs capsular/vasc invasion, lung/bone mets (LN Mets less common)

Answer 1

Papillary adenoca vs follicular ca

Question 2

ONCOCYTIC THYROID CELLS w/ eos gran cyto, altered mito, cellular/inflam stress or 75% = Hurthe cells that can benign (no invasion) or carcinoma (capsular/vasc invasion)

Answer 2

Hurthe cell ca

Question 3

PARAFOLLICULAR “C” CELLS -> high calcitonin, AMYLOID/DENSE CALCIFICATIONS, CERVICAL NODE METS COMMON vs BILATERAL, AUTOSOMAL DỎM, MEN IIA (hyperPTH, pheo) & IIB (neurofibromatosis, pheo, Marfan) vs fixed, move to adjacent structures, rapid growth x/ small cell variant lymphoma; BRAF+ -> -nib, RAS+ -> palliative care

Answer 3

Medullary ca vs fam medullary ca vs anaplastic ca

Question 4

How to dx thyroid nodules? Tx?

Answer 4

US -> cystic, solid, mixed; FNA = best preop; Lobectomy, thyroidectomy. Surg, RAIU but nml thyroid tissue must be gone, thyroid suppression w/ exogenous TH but inc osteoporosis, external beam only for aggressive papillary or lymphoma, chemo w/ tyr kinase inhibitors for RAI-refractory mets dz

Question 5

How to tx DM foot ulcer? How do they originate? How to tx otitis externa and how does it originate?

Answer 5

Ceph for gram pos, augmentin for gram neg (clinda if PCN allergy), doxycycline for MRSA. No coverage for PSEUDOMONAS. From periph aa dz. IV FLQ, Pseudomonas

Question 6

Biggest complication of DKA & its sxs? Tx?

Answer 6

Cerebral edema -> Cushing triad: Brady, HTN, irreg breathing; HA, vision, memory loss. Mannitol

Question 7

Genes vs sxs vs dx vs tx of PTH adenoma in 1o hyperPTH

Answer 7

MEN1/2A vs hypercalcemia sxs vs 24h urine Ca high or nml, high Ca/low PO4, US/TC99/4D CT vs surg, meds if no surg

Question 8

Causes of isolated hyperCa vs isolated hypoPTH vs congenPTH

Answer 8

PTH rP malig, granulomatous, immobile/spinal injury vs autoimmune vs diGeorge

Question 9

Need 3 of 5 to dx metabolic syndrome. What are they?

Answer 9

Abd obese -> waist circumference >40in men/ >35in women; TG >/= 150 or drug tx for TG; HDL >40 men/>50 women; bp >/=135/85 or drug tx; fasting glu >/=100 or drug tx for glu

Question 10

Indic of PTHectomy

Answer 10

Acute w/ life threatening hyperCa, serum Ca>1 above nml limit, 24h urine Ca >400, <50yo, dec BMD/T score <-2.5, complications of hyperPTH

Question 11

Describe 2 vs 3o hyperPTH. PseudohypoPTH vs pseudopseudohypoPTH

Answer 11

D/t lack vịt D absorption, phenobarbital, phenytoin, cholestyramine, laxatives -> type 1/2 rickets (auto rec); high PTH, low to nml Ca/P; tx underlying cause vs low Ca -> uremic PTH -> prolonged can become autonomous and 3o hyperPTH; renal osteodystrophy, bone erosions, osteomalacia; tx metab d/o or surg if life threatening. High PTH & P, low Ca -> short vs nml everything -> short