Endocrine Dz Flashcards
5 years old with painless growth below hyoid bone in midline of neck. Moves with swallowing
Thyroglossal duct cyst
XY pt with hypertension, hypoK and ambiguous genitalia?
17a-hydroxylase deficiency
XY pt with HTN, hypoK. Externally female with female internal sex organs. Lacks secondary sex characteristics?
17a-hydroxylase deficiency
XX pt with fused labia. Hypotension, hyperkalemia and high renin?
21-hydroxylase deficiency
XX pt with HTN, normal K, and masculinization?
11b-hydroxylase deficiency
Pt with bad collagen IV formation, muscle weakness, amenorrhea and hyperglycemia. Causes?
Cushings exogenous steroids ACTH-tumor ectopic ACTH Cortisol producing tumor
Pt with exogenous ACTH secreting tumor. Effect on adrenals?
Hyperplasia (not hypertrophy)
Pt with increased ACTH. Given low dexamethasone - no effect. However high dose suppresses cortisol levels. Defect?
ACTH-producing pituitary adenoma
Pt with muscle weakness, metabolic alkalosis and neoplasm?
Conn’s Primary HyperALDO from adrenal adenoma
pt with chronic cough and granulomatous infection of lungs comes in with hypotension, hyperK, acidosis, and skin pigmentation – Most likely diagnosis? Differential also includes?
Addisons from adrenal destrucion from TB.
Also from Autoimmune and Mets
Signs of primary vs secondary adrenal insufficiency?
hyperpigmentation and hypoK (from increased ACTH) vs none (decreased ACTH)
Pt presents with septicimia, DIC and adrenal hemorrhage. Organism?
N. meningitis (not gonorrhae)
Pt with increased VMA in urine. Tumor?
Pre-op prep for tumor?
Pheochromocytoma. Ireversible a-antagonists to prevent HTN crisis. B-blockade to protect HR.
Pt with episodes of headaches, episodes of sweating, palpitations, and pallor?
Pheocromocytoma
Child with normal BP, and elevated homovanillic acid in urine. Suspected diagnosis? Gene?
Neuroblastoma. N-myc
Hypothyroid – effect on creatine kinase? Cholesterol?
Elevated creatine kinase. Hypercholesterol.
Hyperthyroid – effect on creatine kinase? Cholesterol?
increased glucose and decreased cholesterol
Myxedema: hypo vs hyper thyroid?
face vs legs
Pt with big but soft thyroid mass. Anterior cervical lympahdenopathy?
Hasimotos. (ant cervical pathogneumonic)
Histo shows lymphocytic infiltrate with germinal centers. Expected cells? Increased risk for?
Hurthle cells; Hasimotos. B-cell lymphoma.
Child with poor growth, mental retardation, pale, swollen face and protuberant abdomen. 2 causes?
Cretinism.
1) lack of iodine
2) any defect in T4 formation (no thyroid, no peroxidase etc)
3) materal hypothyroid
Increased TSH. Tender thyroid. Pain radiates to ears. When does it present?
Subacute thyroiditis (de Quervains). Postviral
Increased TSH. Thyroid problem with Increased ESR? Histo? Typical history?
Subacute thyroiditis (de Quervains). Granulomas
Recent flu-like illness
Increased TSH. Young female with painless goiter vs Old female with painless goiter?
riedels vs anaplastic CA
Increased TSH. Histo of thyroid mass shows fibrous tissue replacement? Cause?
Riedels. IgG4-related systemic dz
Give pt with iodine deficiency a large dose of thyroid hormone
Jod-Basedow - thyrotoxicosis
Decreased TSH. Histo shows focal patches of hot nodules.
Toxic multinodular gioter
Female pt has doughy lower leg swelling after giving birth? Mech for legs?
Grave’s. Fibroblasts activated by TSH increase GAG synthesis
Thyroid mass: psammoma bodies?
Papillary CA
Thyroid mass: childhood radiation
Papillary CA
Thyroid mass: orphan annie’s eyes cells
Papillary CA
Thyroid mass: Balls of cells with vessels and stroma
Papillary CA
Thyroid mass: see invasion through a capsule
Follicular CA
Thyroid mass: CA that spreads hematogenously?
Follicular CA
Thyroid mass: sheets of cells in amyloid stroma?
Medullary CA
Thyroid mass: hypoCa
Medullary CA
Older pt wtih Thyroid mass and granulomas?
Anaplastic CA
Thyroid mass:and dysphagia, trouble breathing
Anaplastic CA
Pt with increased increased Alk Phos, increased cAMP in urine.
Primary HyperPTH
Pt with abdominal pain, bone spaces filled with fibrous tissue. HyperCa Dz? Bone finding? What are found in urine?
Primary HyperPTH. Osteitis fibrosa cystica is bone finding. Ca-oxylate stones.
Pt with subperiosteal resorption with cystic degeneration of the skull and phalanges. Cause?
HyperPTH
Pt on dialysis. HypoCa. increased Alk Phos
Secondary hyperPTH (from renal failure)
Pt with hypocalcemia, shortened 4th and 5th digits and short stature? defect? Genetics?
Albright’s hereditary osteodystrophy. Defective Gs protein makes kindey unresponsive to PTH. Autosomal dominent
Pt with amenorrhea, galactorrhea? tx?
Prolactinoma. Bromocriptine or cabergoline
Pt with large tongue, deep voice, impaired glucose tolerance? Cause of death? Associated with?
Acromegaly. Death from heart failure. Associated with DM II,
Pt given glucose, see increased GH. Tx?
Acromegaly. (glucose should decrease GH). Octreotide (somatostatin analogue)
Tx for central DI vs Nephrogenic DI?
desmopressin vs HCT, indomethacin, amiloride
SIADH- Tx?
conivaptan, tolvaptan, demeclocyline
Pt with loss of pubic hair after giving birth?
Sheehan syndrome.
Pt unable to lactate after giving birth?
Sheehan syndrome
DMII Pt presents with neuropathy, retinopathy, and cateracts. Mech?
Sorbitol accumulation. No sorbitol dehydrogenase in these tissues
DM I vs II histo?
Islet leukocyte infiltrate vs islet amyloid deposit
DKA - K findings?
high blood K but depleted intracellular stores.
5-HIAA in urine, wheezing, and right-sided valvular dz? Deficient in what nutrient?
Metastasized carcinoid tumor. niacin deficiency,
MEN1 tumors?
Pituitary, parathyroid, pancreas (zollinger-ellison, insulinomas, VIPomas, glucagonomas)
MEN2a tumors?
Medullary thyroid, parathyroid and pheochryomocytoma
MEN2b tumors
oral ganglionneuromatosis, medullary thyroid CA, Pheochromocytoma
MEN syndromes - gene? Genetics?
ret gene. AD.
Pt with diarrhea, hypoK, achlorohydra?
VIPoma