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STEP 1 Review > Endocrine > Flashcards

Endocrine Flashcards

1
Q

Addison disease

A

Chronic adrenal insufficiency due to disease or idiopathic. Causes hypotension, hyperkalemia, acidosis, and characteristically skin and mucosal hyperpigmentation (due to increased ACTH, which comes from POMC).

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2
Q

Neuroblastoma

A

Most common tumor of the adrenal medulla in children less than 4. Originates from neural crest cells, can occur anywhere along the sympathetic chain. Presents as an abdominal mass and abdominal distention that can cross the midline and is irregular. Associated with an overexpression of the n-myc oncogene. Bombesin positive. Can be distinguished from wilm’s tumor which is smooth and unilateral.

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3
Q

How to treat pheo?

A

Phenoxybenzamine (irreversible alpha blocker)

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4
Q

Lipids in hypothyroidism

A

Hypercholesterolemia (due to decreased LDL receptor expression)

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5
Q

Lipids and glucose in hyperthyroidism

A

Hypocholesterolemia and hyperglycemia.

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6
Q

Hashimoto’s thyroiditis

A

Associated with HLA-DR5. T-cell mediated destruction of the thyroid gland (markers include anti-thyroid peroxidase and anti-thyroglobulin antibodies).

Initial hyperthyroid phase.

Characterized by hurthle cells

Nontender thyroid that is moderately enlarged.

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7
Q

Cretinism

A

Severe fatal hypothyroidism due to maternal hypothyroidism, thyroid agenesis, thyroid dysgenesis, iodine deficiency.

Puffy faced, pale, pot-bellied, poor brain development.

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8
Q

Dequervains subacute granulomatous thyroiditis

A

After viral infection painful thyroid . Can start with hyperthyroid then proceed to hypothyroid.

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9
Q

Riedel’s Thyroiditis

A

Fibrosis of the thyroid gland. Can look a lot like anaplastic carcinoma, but instead occurs in middle aged. Can cause hypothyroidism

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10
Q

Toxic multinodular goiter

A

Focal patches of hyperfunctioning follicular cells working independently of TSH due to a mutation in the TSH receptor. Rarely malignant

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11
Q

Jod-Basedow Phenomenon

A

Thyrotoxicosis if a patient with iodine deficiency is made iodine replete!

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12
Q

Graves disease

A

Most common cause of hyperthyroidism. IgG stimulate the TSH receptors. Often presents during stress. Treat with betablockers propylthiouracil, ablation.

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13
Q

Thyroid storm

A

Stress induced catecholamine surge that is a serious complication of graves or other hyperthyroid disorders. Can cause tachyarrhythmias, agitation, delerium, diarrhea, coma. Treat with 3P’s (propylthiouracil, propranolol, and corticosteroids.

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14
Q

Complications of surgery on thyroid

A

Hoarseness (recurrent laryngeal nerve damage), hypocalcemia (due to removal of parathyroid), and transection of the inferior thyroid artery.

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15
Q

Papillary carcinoma

A

best prognosis, has psammoma bodies, and orphan annie eyes. Increased risk with RET and BRAF mutations and childhood irradiation

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16
Q

Follicular carcinoma

A

Good prognosis, invades the thyroid capsule (unlike follicular adenoma), creates follicles.

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17
Q

Medullary carcinoma

A

Tumor of parafollicular C cells. Shows up as sheets of cells in an amyloid stroma. Associated with MEN 2A and 2B.

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18
Q

MEN1

A

Parathyroid tumors, pituitary tumors, pancreatic tumors (ZE, insulinoma, VIPoma)

Kidney stones and stomach ulcers

19
Q

MEN 2A

A

Medullary carcinoma, parathyroid, pheochromocytoma

20
Q

MEN2B

A

medullary carcinoma, parathyroid, oral cavity tumors, marfanoid habitus.

21
Q

Anaplastic carcinoma

A

Older patients, invades local structures, very poor prognosis

22
Q

Lymphoma

A

Marginal zone lymphoma associated with hashimoto thyroiditis.

23
Q

Osteitis fibrosa cystica

A

Bone cysts due to hyperparathyroidism.

24
Q

Hypoparathyroidism

A

Hypocalcemia and tetany. Chvostek sign -> tapping of facial nerve contracts facial muscles. Trousseau sign, BP cuff causes carpal spasm.

25
Q

Pseudohypoparathyroidism

A

Autosomal dominant unresponsiveness of kidney to PTH.

26
Q

Treatment for prolactinoma

A

Bromocriptine or cabergoline

27
Q

Acromegaly

A

Excess GH in adults typically caused by pituitary adenoma. Can cause cardiac failure which is the most common cause of death. GH does not decrease with glucose administration.

28
Q

How to treat acromegaly?

A

Pegvisamont (growth hormone receptor antagonist), octreotide.

29
Q

What causes nephrogenic DI?

A

Hypercalcemia, LITHIUM, demeclocycline (adh antagonist).

30
Q

What causes SIADH

A

Cyclophosphamide, small cell lung cancer, pulmonary disease (like COPD), head trauma.

31
Q

Empty sella syndrome

A

Atrophy or compression of pituitary common in obese women

32
Q

Sheehan syndrome

A

Failure to lactate and hypopituitarism caused by infarct following postpartum bleeding

33
Q

Most common cause of death in diabetes?

A

MI

34
Q

Osmotic damage in diabetes

A

Sorbitol accumulation in cells without aldose reductase (lens, retina, nerves)

35
Q

Histology of type 1 DM

A

Islet leukocytic infiltrate

36
Q

Histology of type 2 DM

A

Islet amyloid polypeptide deposits

37
Q

Diabetic ketoacidosis cause

A

A stressor causes increased insulin requirement. Increased lipolysis, increased FA and protein breakdown. Fa digested to Acyl coa in mitochondria, then broken down via beta oxidation to beta hydroxybutyrate and acetoacetate.

38
Q

DKA symptoms

A

Kussmaul respirations, n/v, abdominal pain, dehydration, fruity odor. Hyperglycemia, acidosis (anion gap), hyperkalemia

39
Q

Treat DKA?

A

IV fluids, IV insulin, and K

40
Q

Insulinoma

A

Causes hypoglycemia, lethargy, syncope, diplopia

41
Q

DKA complications

A

Life-threatening mucormycosis (rhizopus), cerebral edema, cardiac arrhythmia

42
Q

Carcinoid syndrome

A

From neuroendocrine tumors in the GI tract. No problems in don’t met. If metastasis occurs past liver, then diarrhea, wheezing, fluishing, and valvular disease with 5HIAA in urina and pellagra. 1/3 metastasize, 1/3 present with 2nd malignancy, 1/3 are multiple

43
Q

ZE Syndrome

A

Gastrin secreting tumor of pancreas or duodenum. Associated with MEN 1. Present with abdominal pain or diaarhea

44
Q

MEN 2A and 2B associated with…

A

RET gene mutation

STEP 1 Review (21 decks)

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