Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

Endocrine 2 > Endo Imaging > Flashcards

Endo Imaging Flashcards

1
Q

What “end organs” are affected by alterations in the pituitary?

A
  • Thyroid
  • Adrenals
  • Gonads
  • Breasts
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

Give 2 examples of altered trophic hormone (TH) production

A
  1. increased levels of TH’s leads to altered target gland function
  2. increased pituitary size leads to encroachment and/or pressure causing vision changes and HA
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

List the 6 hormones produced by the anterior pituitary

A

-Growth Hormone
-Prolactin
-Adrenocorticotropic Hormone
-Thyroid Stimulating Hormone (TSH)
-Luteinizing Hormone (LH)
♂ - Leydig cells/testosterone
♀ - Ovulation/corpus luteum
-Follicle Stimulating Hormone (FSH)
♂ - Spermatogenesis
♀ - Follicle development/estrogen

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

List the 2 hormones produced by posterior pituitary

A
  • Arginine Vasopressin (ADH)

- Oxytocin

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

What is the name of the anatomical location of the pituitary gland?

A

Sella turcica

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

Causes of pituitary failure

-idiopathic

A
  • Usually infiltrative process

- Lymphoma, Hodgkin’s, Sarcoid

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

Causes of pituitary failure

-Sheehan’s syndrome

A

Postpartum Hypotension: pressures drop low enough and for long enough to infarct the pituitary
-Could affect only a portion of the pituitary

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

Causes of pituitary failure

-Pituitary Apoplexy

A
  • Infarct

- Fever: likely viral infection rather than fever itself

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

List the hormones produced by the thyroid

A
  • TSH-Controlled (from Anterior Pituitary)
  • T3 – active hormone
  • T4 – primary product
  • rT3 – not physiologically active
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

Which conditions can cause development of a goiter?

A
  • hyperthyroidism
  • hypothyroidism
  • euthyroidism
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

Symptoms of hyperthyroidism

A
  • Diaphoresis
  • Heat Intolerance
  • Cardiac Awareness (palpitations)
  • Weight Loss
  • Hair Thinning
  • Skin Hyperpigmentation
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

Physical findings of hyperthyroidism

A
  • Goiter – diffuse enlargement
  • Nodule – Hot vs. Cold
  • Tachycardia
  • Hair Thinning
  • Exophthalmos
  • -Extra-ocular muscle and retro-ocular connective tissue volume increased (uni/bilateral)
  • -Fibroblast proliferation, inflammation, and the accumulation of hydrophilic glycosaminoglycans (GAG), mostly hyaluronic acid
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

Symptoms of hypothyroidism

A
  • Fatigue &/o Lethargy
  • Weight Gain
  • Cold Intolerance
  • Paresthesias
  • Sexual Dysfunction (primarily in men)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

Physical findings of hypothyroidism

A
  • Hair Loss
  • Skin thickening
  • Can be more difficult to discern in men
  • Low Pitched Voice
  • Facial edema
  • Slow DTR (deep tendon reflex) return
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

Thyroid nodules

-cyst vs. solid

A

Proper vocabulary to use is:

  • Solid = nodule
  • Cyst = fluid-filled bump
  • Solid is more likely to be cancer
  • Evaluate posterior structures such as the parathyroids
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

What do you see on a normal Thyroid I123 or I131 Scan?

A
  • 2 lobes
  • Homogenous activity
  • Isthmus

“Marker”

  • -At the SC Notch
  • -Check for mediastinal extension
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

Your patient has I123 administered. The radiologist contacts you to state that the nodule you felt is a “cold” nodule. What does this mean?

A
  • Cold means it didn’t take up the iodine and it’s a nodule.

- The patient has an increased risk of thyroid cancer in the cold nodule.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

Etiology of “cold” thyroid nodule

A
  • ~ 90% of “lumps” are benign cysts or nodules
  • 75-90% of all nodules are “cold”
  • Most cancers are “cold” (~5-10% of cold nodules)
19
Q

Will a cold nodule or a cyst take up the iodine for I123 scan?

A

No, neither will take it up. You must FNA “cold” nodule or excise the entire lobe.

20
Q

Etiology of thyroid “hot” nodule

A
  • aka “autonomous” nodule
  • right lobe
  • low risk of cancer
21
Q

Will a hot nodule take up the iodine for I123 scan?

A

Yes, but reduced overall I123 update d/t suppressed TSH

22
Q

Dx of hot nodule

A

FNA vs. surgical excision

23
Q

Tx of hot nodule

A

I131 “burns” out nodule or multinodular goiter

24
Q

Parathyroid adenoma is usually a disease of…

A

overactivity (i.e. increased PTH)

25
Q

Sx of parathyroid adenoma

A
  • Bone pain: Osteopenia on X-rays of hands & clavicles

- Weakness; Anorexia; Wt. Loss; Fatigue; Confusion/ Ψ

26
Q

Tx of parathyroid adenoma

A
  • Surgical excision

- Medical: K-Phos and/or Neutra-Phos

27
Q

Dx of parathyroid adenoma

A

increased PTH d/t increased Ca++ and decreased PO–3

28
Q

Parathyroid adenoma epidemiology

A

-~ 85% are single adenomas & benign
-< 1% are malignant
-Familial versions
-Multiple Endocrine Neoplasia (MEN) of various types
(Red flags if any GI cancers present in family history: pancreatic, stomach, etc.)

29
Q

Diagnostic tests for parathyroid adenoma

A
  • U/S of occasional benefit
  • 10% are ectopic
  • Scintiscans: thallium-201 for parathyroids (uptake in thyroid & parathyroid); 99mTc sestamibi/CT scan pre-op
  • digital subtraction technology
  • may be “embedded” in thyroid
  • “transplant” to SCM MM or forearm former surg. tx
  • PTH assay intra-operatively
30
Q

Describe normal adrenals on CT

A
  • Bilobed
  • Surrounded by fat - aid to identification
  • R: above upper pole R kidney
  • L: anterior to upper pole L kidney
31
Q

Adrenals

-functioning tumors

A

Diagnosed clinically

  • Cushing’s
  • Addison’s
  • Pheochromocytoma

-Abnormal serum or urine studies

32
Q

What are the benefits of CT for adrenals?

A
  • Best for routine evaluation

- Consistently shows size/shape

33
Q

What are the benefits of U/S & MRI for adrenals?

A
  • U/S used initially
  • Displays retroperitoneum
  • Shows relationship of mass to adjacent organs: when origin of mass in question (renal vs. adrenal origin)
34
Q

Describe adrenal tumors

A
  • Generally > 2 cm.
  • CT delineates tumor well
  • MRI an option
  • 10% are bilateral
35
Q

Aldosterone in the adrenals

A

-Production in outer zone of gland

Mineralocorticoid:

  • Na + resorbed
  • K + excreted
36
Q

Describe Conn’s tumor

A
  • unilateral adrenal aldosteronoma
  • < 1 cm
  • can be difficult to “image” with CT scan
37
Q

Cortisol in the adrenals

A
  • Produced in inner zone
  • Counters insulin effect
  • Modulates inflammation
38
Q

Primary adrenal INsufficiency

-Acute

A
  • Acute –> Adrenal Crisis
  • S/P surgery or stress
  • decreased Na+ & Glc.; increased K+; decreased BP
  • Tx: IV hydrocortisone
39
Q

Primary adrenal INsufficiency

-Chronic

A
  • Addison’s disease*
  • decreased Na+ and increased K+; decreased BP
  • increased Pigment; Weakness
  • Non-responsive to Cosyntropin (~Artificial ACTH)
40
Q

Adrenals

-Cortisol overproduction

A

increased ACTH –> increased Cortisol –> Cushing’s

  • No response to dexamethasone suppression test
  • 90% Pituitary
  • 10% Adrenal Hyperplasia
  • Central obesity; muscle wasting
  • increased Glc; decreased K+
  • Bruising and Striae
  • Dorsal Fat Pad
41
Q

What is the best diagnostic method for pheochromocytoma?

-CT vs. MRI

A
  • *CT – best for routine evaluation
  • Consistently shows size/shape

MRI:

  • Displays retroperitoneum in any plane
  • Shows relationship to adjacent organs –> benefit if origin in question (renal vs. adrenal)
42
Q

Describe diagnosis of adrenal tumors that are > 2cm

A
  • CT delineates tumor well
  • MRI an option
  • 10% are bilateral
43
Q

Sx of pheochromocytoma

A
  • HA, diaphoresis, nausea, wt. loss, heat intolerance (sounds like HYPERthyroidism)
  • C-V – palpitations, HTN
  • Ψ – anxiety, tremor
  • TSH & T4 normal
44
Q

What is MIBG in adrenal metastasis?

A

MIBG = meta-iodo-benzyl guanidine

  • –Concentrated in pheochromocytomas
  • –Delineates mets or multiple tumors

Endocrine 2 (15 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions