Endocrine

Question 1

What are the signs/symptoms and pathology of Acromegaly?

Answer 1

Signs/symptoms: enlarging hands, feet and head, HTN, cardiomegaly, weight gain

Pathology: pituitary adenoma-> GH release

Question 2

What is the treatment for acromegaly?

Answer 2

Treatment: Transsphenoidal surgery, RT, bromocriptine, somatostatin analogues, GH receptor blockers

Question 3

What are the signs/sxs and path of Addison’s disease?

Answer 3

Signs/symptoms:weakness, HoTN, hyperpigmentation

Pathology: autoimmune destruction of adrenal glands -> adrenocortical insufficiency

Question 4

What is the acute and chronic treatment of Addison’s disease?

Answer 4

Acute: IV hydrocortisone or dexamethasone
Chronic: replacement w/ glucocorticoid (hydrocortisone) + mineralocorticoid (fluorocortisol)

Question 5

What are the signs/sxs and pathology of diabetes insipidus?

Answer 5

Signs/symptoms: polyuria, polydipsia
Pathology: central or nephrogenic -> relative ADH deficiency or insensitivity
Most common cause: nephrogenic type from lithium use

Question 6

What is the treatment for diabetes insipidus

Answer 6

intramuscular ADH

Question 7

Signs/sxs, pathology and treatment of prolactinoma

Answer 7

Signs/sxs: galactorrhea, amenorrhea, infertility, decreased libido

Most commonly pituitary tumor, diagnose w serum prolactin 300 or more, MRI

DDx: r/o pregnancy, hyperthyroidism, drugs

Treatment: transsphenoidal surgery, bromocriptine

Question 8

Conn’s syndrome

Answer 8

Signs/sxs: weakness (from hypoK), HTN, carb intolerance (polyuria, polydipsia)

Common cause: adrenal adenoma causing excess mineralocorticoid production

Labs: mild hyperNa, hypoK metabolic alkalosis

Tx: adenoma removal, spironolactone for hyperplasia

Question 9

Primary hyperPTH

Answer 9

signs/sxs: stones (Ca oxalate), bones (bone resporption), abdominal groans (constipation), psychic moans

Path: parathyroid adenoma

Labs: hypercalcemia, hypophosphatemia, hypocalciuria, hyperphosphaturia

Tx: removal or subtotal parathyroidectomy