Endocrine Flashcards

1
Q

What is should be suspected if a patient is found to have elevated Calcitonin and mucosal neuromas?

A

MEN2B

    • Medullary Carcinoma
    • Pheochromocytoma
    • Marfan’s-like Syndrome
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2
Q

If a patient is found to have excessive Gastrin levels and hypercalcemia, what might you be suspicious of/

A

MEN1

    • Parathyroid Carcinoma – Elevated PTH
    • Pancreatic Tumor (Gastrinoma 95%)
    • Pitutary Adenoma (Prolactinoma)
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3
Q

If a patient is found to have a pheochromocytoma and elevated calcitonin, what might need evaluation?

A

Need to evaluate for Parathyroid Tumor

    • MEN2A
  • Medullary Carcinoma
  • Pheochromocytoma
  • Parathyroid Tumor
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4
Q

If a male presents with infertility and is very tall on exam, but smaller than average testicles, might might be diagnostic?

A

Elevated FSH

    • Klinefelter’s Syndrome
    • Testicles no longer work in producing androgens and there is a high Estrogen:Androgen ratio producing gynocomastia
    • reduced spermatogenesis
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5
Q

What should be used to reduce LH and FSH secretion from the hypothalamus/pituitary?

A

Leuprolide — constant, to inhibit GnRH, thus reducing LH/FSH

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6
Q

What pharmacologic agents reduces the conversion of Testosterone to DHT for BPH?

A

Finasteride

— blocks 5-alpha reductase in prostate

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7
Q

What agent can be used to block androgen receptors?

A

Flutamide — however due to negative feedback can cause increased LH/FSH to overcome inhibition, so need to use Leuprolide as well.

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8
Q

Why would someone with pituitary adenoma secreting ACTH (ectopic too) cause amenorrhea in a female?

A

ACTH – induces increased cortisol production in the adrenal fasciculata (hyperplasia), but if untreated with continued ACTH adrenal reticularis will become hyperplastic secreting androgens – inhibiting LH/FSH.

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9
Q

If you give a patient a dose of Metyrapone what are you testing?

A

Metyrapone - inhibits 11-B-hydroxylase in adrenal cortisol synthesis, which SHOULD cause an INCREASE in ACTH production (surge) to produce more cortisol.
– Testing Hypothalamic-Pituitary Axis
If no increase, then failure in hypothalamus to detect a decrease in cortisol

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10
Q

What is a distinct finding of Klinefielters?

A

Elevated FSH

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11
Q

If you find a patient to have elevated Acid Phosphatase, what might be occuring within the patient?

A

Increased osteoclast bone reabsorption

Alk Phosphatase is usually used by osteoblasts to lay down osteoid

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12
Q

What is the cause of proptosis in hyperthyroidism?

A

From infiltration of T-cells which induce a localized inflammatory reaction/cytokine release causing swelling and pushing out of the eyes.

    • can lead to dysfunction of extraoccular muscles as well
  • *Treat with Prednisone**
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13
Q

What is defective in a Her-2 positive breast cancer?

A

ERB-B2 gene defect – Tyrosine Kinase Receptor

Her-2/Neu gene

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14
Q

Thyroid Disease – Germinal Centers

A

Hoshimato Thyroiditis

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15
Q

What type of thyroid histolgoy causes PAINFUL thyroid?

A

DeQuervian Thyroiditis

– Mixed Cell Infiltration with Giant Cells

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16
Q

What are the differentials when there is extensive fibrosis the thyroid into surrounding tissue?

A

Riedel’s Thyroiditis – usually younger

Anaplastic Thyroiditis – high mortality and older people

17
Q

What pathology of the thryoid will have cells with empty nuclei and psammona bodies?

A

Papillary Thyroid Cancer

    • Orphan Annie Eyes
    • Psammona Bodies
18
Q

What is a common side effect of Anti-thryoid medications?

A

Agranulocytosis

    • Methimazole — tetrogenic
    • Propylthiourical – heptatoxicity