Endo Surgery Flashcards
S/S of adrenal carcinoma
Sx related to the part of the adrenal gland where the tumor is
Constitutional sx
Palpable abdominal mass
Diagnosis of adrenal carcinoma
FNA
Hormonal evaluation
Treatment of adrenal carcinoma
Complete resection
MCC of hypercalcemia
Primary hyperparathyroidism
Etiology of primary hyperparathyroidism
Single parathyroid adenoma
S/S of primary hyperparathyroidism
Often asymptomatic
Bones, stones, groans, psychiatric overtones
Diagnosis of primary hyperparathyroidism
Elevation of PTH
24 hour urine calcium
Interpretation of 24 hour urine calcium
200-300: likely PHPT and excludes FHH
Less than 200: FHH
Management of primary hyperparathyroidism
Routine monitoring
Parathyroidectomy
Bisphosphonates
Etiology of secondary hyperparathyroidism
Chronic kidney disease
Etiology of hyperthyroidism
Autoimmune
S/S of hyperthyroidism
Anxiety
Palpitations
Heat intolerance
Weight loss
Bulging eyes
Diagnosis of hyperthyroidism
TSH and T4
Iodine uptake
Ultrasound
Treatment of hyperthyroidism
PTU or methimazole
BB for sx
Etiology of pheochromocytoma
Tumor in the adrenal medulla
S/S of pheochromocytoma
Palpitations
HA
Sweating
HTN
Diagnosis of pheochromocytoma
Plasma free metanephrines
Treatment of pheochromocytoma
Removal of tumor
Most common thyroid cancer
Papillary
Which thyroid cancer is likely to metastasize to distant sites?
Follicular
Thyroid cancer that secretes calcitonin
Medullary
Most aggressive thyroid cancer
Anaplastic
S/S of thyroid cancer
Palpable, firm, nontender thyroid nodule
Often asx
Diagnosis of thyroid cancer
US
Biopsy
Treatment of thyroid cancer
> 1 cm mass known to be cancer: total thyroidectomy
< 1 cm known to be cancer: lobectomy
< 4 cm indeterminate lesion: lobectomy
4 cm indeterminate lesion: total thyroidectomy
Diagnosis of thyroid nodule
Labs
US
RAI uptake
FNA
Cold vs. hot thyroid nodules
Cold: higher cancer risk
Hot: lower cancer risk
Indications for FNA
> 1 cm and suspicious
2 cm
Associated cervical LAN
Growth
Resting tremor
Occurs in a body part that is fully supported, relaxed, and not voluntarily activated
Action postural tremor
Occurs in an attempt to maintain a specific posture or position against the force of gravity
Action kinetic tremor
During voluntary movement
Action isometric tremor
Occurs during a muscle contraction against a rigid, stationary object
Intentional tremor
Worsens as the body part approaches its target
Treatment of essential tremor
Propranolol
Primidone
