Endocrine

Question 0

Thyroid biopsy shows follicular cancer – management?

Answer 0

#Total thyroidectomy so
# radioactive iodine

Question 1

Thyroid nodule in euthyroid patients – work up?

Answer 1

1. FNA
#if Malignant/indeterminant, thyroid lobectomy 
# Further surgery determined by histologic diagnosis

Question 2

High calcium found on blood test – suspected diagnosis? work up?

Answer 2

Hyperparathyroidism;

1. Repeat calcium, phosphorus test, rule out bone metastasis
2. PTH determination
3. Option of sestamibi scan
4. Removal is curative

Question 3

Signs of Cushing’s disease?

Answer 3

#Buffalo hump
#Supraclavicular fat pads
#Obesity with abdominal stria
#Facial changes

Question 4

Complications of Cushing’s disease?

Answer 4

#Osteoporosis
#Diabetes
#Hypertension
#Mental stability

Question 5

Work up of Cushing’s disease?

Answer 5

1. Overnight low dose dexamethasone suppression test
2. If no suppression, 24 hour urine free cortisol
3. If elevated, high-dose suppression test

Question 6

The goal of high-dose dexamethasone suppression test in Cushing’s work up?

Answer 6

separates pituitary microadenoma from adrenal adenoma/Paraneoplastic syndrome

Question 7

Patient with suspected as Zollinger-Ellison. Test if gastrin level is equivocal?

If gastrin/secretin test are suggestive?

If metastatic disease?

Answer 7

Secretin

CT scan with contrast

Omeprazole

Question 8

Differential diagnosis for insulinoma?

Answer 8

#Reactive hypoglycemia
#exogenous insulin

Question 9

Nesidioblastosis? Management ?

Answer 9

Hypersecretion of insulin in the newborn, requiring 95% pancreatctomy

Question 10

Glucagonoma complications?

Answer 10

Migratory necrolytic dermatitis

In patients with mild diabetes; anemia, glossitis, stomatitis

Question 11

Glucagonoma – diagnosed by? Curative treatment?

Treatment for patients with metastatic, inoperable disease?

Answer 11

CT scan; resection

Somatostatin and streptozocin