Endocrine Cpx, Dx Flashcards
What is the presentation of Pheochromocytoma?
- high blood pressure unresponsive to therapy
- headaches, palpitations, and sweating
What labs should you order if you suspect pheochromocytoma?
24 hour Urine metanephrines and VMA (will be elevated)
VMA is a metabolite of epinephrine
What is a Pheochromocytoma?
catecholamine secreting adrenal tumor which secretes norepinephrine and epinephrine autonomously and intermittently, causing hypertension, palpitations, headaches, excessive sweating
What disease is Pheochromocytoma associated with?
Neurofibromatosis Type 1
What are the 5 Ps of Pheochromocytoma?
Pressure (↑ BP)
Pain (headache)
Perspiration
Palpitations (tachycardia)
Pallor
What is the most common visual complain in patients with a pituitary adenoma?
Diminished temporal vision or bitemporal hemianopsia
Patient will present as → a 31-year-old woman who complains of irregular, infrequent menstrual periods. On further questioning, she complains of headaches, fatigue, and breast discharge. She takes ibuprofen only occasionally. The serum prolactin level is 380 μg per L.
What dz?
Pituitary Adenoma
What is the diagnostic test of choice for Pituitary Adenoma?
MRI: look for sellar lesions/tumors
What labs should you order for pituitary adenoma?
Endocrine studies: Prolactin, GH, ACTH, TSH, FSH, LH
1st line Tx for Pituitary Adenoma
Cabergoline or Bromocrpitine (dopamine agonists)
Dopamine inhibits prolactin
Tx of pituitary adenoma if active or compressive
trannsphenoidal surgery
Best diagnostic test for pt w/suspected pheochromocytoma who is at high risk?
Plasma fractionated metanephrines
Best diagnostic test for pt w/suspected pheochromocytoma who is at low risk?
24-hour urine fractionated metanephrines and catecholamines
What will Thyroid Carcinoma Labs show?
normal thyroid function, cold nodule
Dx for thyroid carcinoma?
initial: US
confirmation: FNA
What is the most common type of thyroid carcinoma?
Papillary (popular)
What is the most aggressive type of thyroid carcinoma?
anaplastic
What is associated with psammoma bodies on FNA?
Papillary thyroid cancer
Colicky abdominal pain, distention, and emesis
What is the dz?
small bowel obstruction
What will PE show for small bowel obstruction?
high pitched bowel sounds
What is the diagnostic test of choice for small bowel obstruction?
abdominal radiograph:
dilated bowels
air fluid levels in step ladder pattern
stack of coins or string pearls sign
