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ABSITE > Endocrine > Flashcards

Endocrine Flashcards

1
Q

Highest sensitivity for detecting pancreatic tumors

A

Intra-operative US

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2
Q

Pancreatic exocrine function showing normal total volume and enzyme secretion but decreased bicarb

A

Chronic pancreatitis

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3
Q

Whipple’s Triad

A

Hypoglycemia symptoms
Associated low measured glucose
Relief after increase in glucose

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4
Q

Insulinoma; medical management prior to sx

A

Frequent high carb meals and diazoxide

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5
Q

Gastrinoma triangle

A

Cystic duct, junction of 2nd/3rd part of duodenum, junction neck/body pancreas

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6
Q

Main duct IPMN in head of pancreas; tx

A

Whipple

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7
Q

Galactorrhea and refractory peptic ulcer disease and hypomagnesemia; dx

A

MEN; Pancreatic tumors(most common gastrinoma), pituitary adenomas, parathyroid hyperplasia

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8
Q

Young, healthy with hypercalcemia, normal neck exam and normal PTH; next step in workup and likely dx

A

Urine calcium, Familial hypercalcemic hypocalciuria

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9
Q

Needed to confirm removal of all hyper functioning parathyroid glands

A

PTH drop of 50% compared to highest pre-excision value

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10
Q

Parathyroid carcinoma tx

A

Parathyroidectomy and en bloc hemithyroidectomy (mod rad neck if pos nodes)

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11
Q

Hyperparathyroidism, high calcium/PTH, low phosphate

A

Primary hyperparathyroidism

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12
Q

Parathyroidism, low calcium, high PTH and phosphate

A

Secondary hyperparathyroidism

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13
Q

Parathyroidism, high calcium and phosphate, VERY high PTH

A

Tertiary hyperparathyroidism

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14
Q

Very high calcium and palpable neck mass; dx

A

Parathyroid carcinoma

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15
Q

Most commonly injured nerve during thyroidectomy

A

Superior laryngeal laryngeal nerve

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16
Q

Child with MEN2A and MEN2B; tx

A

Prophylactic total thyroidectomy with bilateral central neck dissection by age 5 and age 1

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17
Q

Partial thyroidectomy for papillary thyroid Ca 0.7cm; net step

A

Thyroid hormone and surveillance US

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18
Q

Well-differentiated thyroid cancer in pregnancy; tx

A

Thyroidectomy post-partum

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19
Q

Poorly differentiated thyroid cancer in pregnancy; tx

A

Thyroidectomy in 2nd trimester

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20
Q

Absolute contraindications to radioactive iodine

A

Pregnancy and breastfeeding

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21
Q

Solitary encapsulated thyroid mass spreads through local extension and hematogenous dissemination

A

Follicular carcinoma

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22
Q

Indication for total thyroidectomy in follicular carcinoma

A

> 4cm, extra thyroidal extension, mets

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23
Q

Medullary thyroid cancer; tx

A

Total thyroidectomy with bilateral level VI LND

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24
Q

Germline mutation leading to medullary thyroid cancer in MENII

A

RET proto-oncogene

25
Q

Most common side effect of radioactive iodine

A

Hypothyroidism

26
Q

Catecholamines of adrenal medulla are derived from what

A

Tyrosine

27
Q

Enzyme Tyrosine to DOPA

A

Tyrosine hydroxylase

28
Q

Enzyme DOPA to Dopamine

A

Dopa decarboxylase

29
Q

Dopamine to NOE

A

Dopamine hydroxylase

30
Q

NE to Epi

A

PNMT

31
Q

Phenylehtanolamine-N-methyltransferase; where from

A

Adrenal medulla organ of Zuckerkandl near aortic bifurcation

32
Q

Best screening test for pheochromocytoma

A

Plasma free metanephrines

33
Q

Chemo for adrenocortical carcinomas

A

Mitotane

34
Q

Most common primary tumor to metastasize to adrenals

A

Lung

35
Q

First-line test for suspected adrenal insufficiency

A

Early morning serum cortisol

36
Q

Deficiency in 21-hydroxylase in the adrenal gland

A

Congenital adrenal hyperplasia, ambiguous genitalia and salt wasting

37
Q

Deficiency in 11beta-hydroxylase

A

CAH, less likely symptomatic than 21-hydroxylase

38
Q

Glucosylceramidase deficiency

A

Gaucher disease

39
Q

Hexosaminidase A deficiency

A

Tay-Sachs disease

40
Q

Elevated Cortisol, Low ACTH

A

Adrenocortical adenoma

41
Q

Elevated Cortisol and High ACTH; next step

A

Pituitary or ectopic source, Pituitary MRI and high-dose dexamethasone test

42
Q

Plasma aldo to renin ratio >25, muscle pain, fatigue, polyuria; dx and metabolic

A

Conn syndrome, hyperaldo, hypokalemia, hypernatremia and metabolic alkalosis

43
Q

Hypercortiolism, ACTH low and cortisol high with low dose dexamethasone test; next step

A

CT to identify adrenal source for Cushings

44
Q

Hypercortiolism, ACTH high with low dose dexamethasone test; next step and then what

A

High dose test, if suppressed Pituitary MRI, if unchanged search for ectopic source

45
Q

Pheo classic triad and rule of 10s

A

Headache, palpitations, diaphoresis
Bilateral 10%, familial 10%, extra-adrenal 10%, malignant 10%

46
Q

Most common cause of Cushing’s

A

Exogenous administration of steroids

47
Q

Most common cause of endogenous Cushing’s syndrome

A

Adrenocorticotropic hormone-secreting pituitary adenoma

48
Q

Pituitary adenoma; tx

A

Dopamine agonist (Cabergoline)

49
Q

How to distinguish between unilateral and bilateral adrenal hyperplasia

A

Adrenal venous sampling

50
Q

Functional adrenal mass; tx

A

Lap adrenalectomy

51
Q

Adrenal mass workup

A

Adrenal CT protocol
Determine if functional with BMP, Aldo, renin, serum and urine metanephrines
Adrenal vein sampling if needed to localize

52
Q

Arterial supply and venous drainage of adrenals

A

Arteries - superior(inf phrenic), middle(aorta), inferior(renal)
Right - IVC
Left - Renal vein

53
Q

Lowest risk of recurrence for tx of hyperthyroidism due to toxic adenoma or multi nodular goiter

A

Thyroid lobectomy

54
Q

Incidentaloma, HTN, Hypokalemia, increased aldo:renin, inability to suppress with sodium load; dx and initial tx

A

Conn Syndrome (prim hyperaldo), spironolactone preop

55
Q

Hypoglycemia, confusion, diaphoresis; Neuroendocrine tumor

A

Insulinoma

56
Q

Abdominal pain, diarrhea, recurrent peptic ulcer; Neuroendocrine tumor

A

Gastrinoma

57
Q

Diabetes, necrotizing migratory erythema, thrombosis; Neuroendocrine tumor

A

Glucagonoma

58
Q

Watery diarrhea, hypokalemia, hypochlorydia, NAG met acidosis; Neuroendocrine tumor

A

VIPoma

59
Q

Cholelithiasis, steatorrhea, diabetes; Neuroendocrine tumor

A

Somatistatinoma

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