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COMAT - Surgery > Endocrine > Flashcards

Endocrine Flashcards

1
Q

What level of TSH is considered low-risk for concerning thyroid nodules?

A

LOW TSH

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2
Q

If a patient has LOW TSH, what scan should then be done to assess for a thyroid nodule?

A

Radioactive Iodine uptake

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3
Q

Treatment for a Hot thyroid nodule?

A

Resect

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4
Q

Treatment for a Cold thyroid nodule?

A

Fine Needle Aspiration to assess for malignancy!

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5
Q

What level of TSH is considered High-risk for thyroid nodules?

A

HIGH TSH

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6
Q

If a patient has HIGH TSH, what test should be done to assess for a thyroid nodule?

A

Ultrasound

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7
Q

If a thyroid nodule is larger than 1 cm, what should be done?

A

Fine Needle Aspiration to assess for malignancy

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8
Q

What 2 types of thyroid nodules are the most concerning for malignancy?

A

Cold nodules
Large nodules

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9
Q

What 2 types of thyroid nodules are the most concerning for malignancy?

A

Cold nodules
Large nodules

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10
Q

A Gastrinoma secretes Gastrin which causes?

A

Parietal cells to secrete lots of acid

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11
Q

What is the sign that someone may have a Gastrinoma?

A

Peptic Ulcer Disease that fails to improve

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12
Q

What 2 diagnostic images can diagnose a Gastrinoma?

A

Somatostatin Receptor Scintigraphy
CT scan

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13
Q

How will a patient with an Insulinoma present?

A

Hypoglycemia even when fasting
– sweating, syncope, tachycardia

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14
Q

What 2 things will be HIGH with an Insulinoma?

A

Insulin
C-PEPTIDE!! (endogenous insulin)

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15
Q

What should you screen for if someone is presenting similar to an Insulinoma?

A

Sulfonylureas – taking these cause excess insulin secretion

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16
Q

Levels of PTH, Calcium and Phosphate with Primary Hyperparathyroidism?

A

HIGH PTH and Calcium
LOW Phosphate

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17
Q

What specific scan detects Primary Hyperparathyroidism?

A

Sestamibi scan

18
Q

What is a potential transient post-op complication following resection of Primary Hyperparathyroidism and why?

A

LOW Calcium
– The parathyroid glands left behind intially under-function because the over-functioning one is gone

19
Q

What metabolic changes will be present with Primary Hyperaldosteronism?

A

HTN
LOW K+
LOW Renin

20
Q

What metabolic changes will be present with Renal Artery Stenosis?

A

HTN
LOW K+
HIGH Renin

21
Q

What test should be done to ensure correct lateralization of primary hyperaldosteronism/pheochromocytoma?

A

Adrenal vein sampling

22
Q

How is Renal A. Stenosis diagnosed?

A

US doppler or CTA

23
Q

How is Primary Hyperaldosteronism diagnosed?

A

CT/MRI

24
Q

What do Pheochromocytomas produce? In what fashion?

A

Catecholamines in a pulsatile fashion

25
Q

What are the symptoms of a Pheochromocytoma?

A

5 P’s
- Paroxysms of symptoms
- Pressure is up (BP)
- Pain (headache)
- Palpitations
- Perspire

26
Q

What are the symptoms of a Pheochromocytoma?

A

5 P’s
- Paroxysms of symptoms
- Pressure is up (BP)
- Pain (headache)
- Palpitations
- Perspire

27
Q

What is often diagnostic of a Pheochromocytoma?

A

Urinary VMA and Metanephrines over 24 hours

28
Q

What is the unique treatment for a Pheochromocytoma?

A
  1. Alpha blocker first
  2. Beta blocker second
  3. Resecetion
29
Q

What are the signs of Cushing’s? What is elevated?

A

HIGH Cortisol
= Buffalo hump, moon facies, abdominal striae and truncal obesity

30
Q

If Cushing’s is suspected, what test should be done first?

A

LOW-dose dexamethasone cortisol suppression test

31
Q

If someone has Cushing’s Syndrome is present, what is the result of the Low-dose dexamethasone suppression test?

A

Fails to suppress cortisol

32
Q

Following the LOW-dose dexamethasone suppression test, what should be measured?

A

ACTH

33
Q

If ACTH is LOW, that means what?

A

ACTH independent elevated cortisol

34
Q

If the ACTH is HIGH, that means what?

A

ACTH dependent elevated cortisol

35
Q

With a Primary Adrenal Tumor, what will be the level of ACTH?

A

LOW

36
Q

If ACTH is HIGH, what test should then be done?

A

HIGH-dose dexamethasone suppression test

37
Q

With the HIGH-dose dexamethasone suppression test, if cortisol fails to suppress, what is the diagnosis?

A

Ectopic tumor secreting ACTH

38
Q

With the HIGH-dose dexamethasone suppression test, if cortisol is suppressed, where is the tumor?

A

Pituitary tumor

39
Q

Cushing’s Disease vs. Cushing’s Syndrome

A

Disease = pituitary tumor
Syndrome = signs of excess cortisol

40
Q

Treatment for a Pheochromocytoma?

A
  1. Alpha blocker
  2. Beta blocker
  3. Resection

COMAT - Surgery (13 decks)

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