Endocrine Flashcards
Refractory HTN and muscle cramping with elevated Aldo: renin level > 30. Whats the dx? what are the biochemical abnormalities?
Primary Hyperaldosteronism
Hypernatremia
Hypoklamia
34 F with thyroid nodule found by PCP, no LAD. FNA with Hurthle cells. Mgmt?
Partial thyroidectomy as it could be cancer
s/p renal transplant with bone pain, renal stones, weight gain. what is the cause?
Tertiary hyperparathyroidism (causing hypercalemia) long standing secondary hyperparathyroidism leading to hyperplasia of the parathyroid glands
incidental adrenal mass w/u
H and P!!
Is it functional or malignant?
R/o phew, hypercortism, hyperaldosteronism
Type of thyroid cancer that requires central compartment dissection?
MTC > 1cm or <1cm bilobar dz requires central neck dissection regardless of the clinical node usstat
45 F with refractory hyperthyroidism gets a cellulitis and goes to ER with tachycardia, fever, diaphoresis and confusion. whats the dx? and tx?
Thyroid storm; dexamethason
63 M withincidental neck mass with no risk factors. whats the most likley dx and how to confirm?
Lingual thyroid
Radioiodine uptake scan
what characterizes Conn syndrome? and how does thew treatment w unilateral v b/l dz change?
refractory HTN< with hyperaldosteronism, low renin, low potassium
Bilateral» unilateral
Bilateral tx medical mgmt
Unilateral is lap adrenalectomy
What is the vasculature of the adrenal gland and what is the most important step during dissection?
Artery = branches of the inferior phrenic artery, aorta and renal artery
Each gland drains into single drain.
the RIGHT adrenal vein enters directly into IVC directly – this is a CRITiCAL STEP in dissection
Tests for adrenal incidentaloma
Dex suppression test, 24 hour urine collection for catecholamines, metanephrines and VMA
MC place for hiding parathyroid gland?
thyrothymic ligament
FNA of asx thyroid nodule shows follicular neoplasm. what is the mgmt?
thyroid lobectomy?
s/p total thyroid after the patient can’t elevate her pitch of phonation. what nerve?
EXTERNAL branch of the superior laryngeal nerve
bc the external branch innervates the cricothyroid muscle
25 F with fam h/o VH: and presence of multiple cerebellar hemangioblastomas. What next in management?
24 hour VMA and metanephrines bc VHL pts shouod be screened for CNS and retinal hemangioma, RCC and pheos
Primary cancer that mets to the adrenal gland
Lung
situation where emergent trach is presrred over cricothyroidotomy
unvaccinated child with acute epiglottis because the cricothyroid ligament in kids <5 is very small making it difficult
s/p modified radical mastectomy with difficulty arm extension and internal rotation, What structured injured?
Thoracodorsal nerve
presence of of LEFT non-RLN indicates what other anomalies?
- Right Aortic ARch
- Lef tSubclavian comes off a weird place on the arch
- aligamentum arteriosum displaced to the right
RIGHT non RLN association
Arteria lusoria abherrent right subclavian artery where the R SCA originates from DESCENDING aorta
Inceidental adrenaloma with > 4cm irregular mass w peripheral enhacement with central necrosis, next step?
Total adrenalectomy as high chance that it’s cancer.
Must r/o pheo because
33 F total thyrod for 2.3 cm mass. final path with Papillary and 1 node. whats next?
routine follow up and possible RAI
70 F with 5 cm cyctic mass i nthe tail. what are the next diagnostic steps?
- MRI/MRCP or CT pancreas to characterize lesion
- If the mass is > 1.5 cm, main duct is dilated, or theres a solif component,
EUS-FNA
Diarrhea, flushing, CT with tail of panc mass. NE tumor suspected. Common features?
VIPoma
watery diarrhea, hypokalemia, hypochlrhydria
left recurrent laryngeal ___ toinferior thyroid artery
POSTERIOR
nerve most likley to be injured in thyroidectomy?
external branch of superior laryngeal nerve
