Endocrine, Nutrition and GI Pathologies Flashcards
Gigantism vs Acromegaly
Gigantism: excess GH <18 yrs, pituitary adenoma, overgrowth of tissues in body (large hands, protruding jaw), headache, visual disturbance
Acromegaly: excess GH >growth plates closed, protruding jaw, large spatulae hands, large feet, headache, visual disturbance
Cushing’s Disease vs Syndrome
Disease: excess ACTH, from functioning pituitary adenoma, excess cortisol –> moon-face, buffalo hump, truncal obesity, HTN, purple striae, hyperpigmented sin creases, muscle wasting in extremities (recurrent infxn)
Syndrome: exogenous stroids or tumor, truncal obesity, moon face, buffalo hump, HTN, HYPERGLYCEMIA, poor wound healing, purple striae, NO HYPERPIGMENTATION
GH deficiency in children? Symptoms?
Pituitary dwarfism growth retardation (non-functioning pituitary tumor)
Ischemic necrosis of anterior pituitary lobe? Cause? S/S?
Sheehan’s syndrome
Severe postpartum hemorrhage
Amenorrhea, cessation of lactation, loss of axillary/pubic hair
Hyperprolactinemia cause and S/S
Secreting prolactin pituitary adenoma
Galactorrhea, amenorrhea, infertility
ADH deficiency from head injury, pituitary tumors, kidney disease, sarcoidosis and S/S?
Diabetes insipidus
polyuria, polydypsia, SpG urine <1.010 (despite hydration)
Hypothyroidism in adults vs infants
1o?
2o?
Reidel’s?
Myxeedema and cretinism
1o: Low T3/4 HIGH TSH, fatigue, constipation, brittle hair, slow to relax reflexes, weight gain
like in Hashimoto’s (anti-thyroglobulin Ab and goiter)
2o: low T3/4 and TSH, pituitary hypofunctioning
Reidel’s: lymphocytic fibrotic thyroid disease leading to hypothyroidism
Hyperthyroidism:
1o? Graves? Plummer’s?
2o?
1o: elevated T3/4 LOW TSH
Graves: MC, IgG ab bind to TSH receptors, exopthalmos, goiter, fine tremors of hands, nervous, diarrhea, weight los (increased appetite) HLA-B8
Plummer: toxic multinodular goiter, no exopthalmos
2o: inc T3/4 TSH - TSH secreting pituitary tumor
Hyper vs hypoparathyroidism:
Hyper: functioning parathyroid adenoma, hypercalcemia, acro-osteolysis, brown bone cysts (decomposed blood and hemosiderin)
Hypo: incidental removal of parathyroid,hypocalcemia, tetany and muscle twitching, Chvostek test + (tap facial N by ear)
Autoimmune or TB related chronic underfunctioning of adrenal cortex - S/S
Addison’s disease
low cortisol/aldosterone, hyperpigmented skin creases, bronze skin, low Na, BP but high K and ACTH
Waterhouse-Friedrichsen syndrome - cause and S/S?
acute adrenal bleeding, 2o to N. meningitidis septicemia
Shock, hemorrhagic rash
Overfunctioning of zona glomerulosa results in? Due to? S/S?
Conn’s disease
Adrenal adenoma, excess mineralocorticoids
low potassium, renin, metabolic alkalosis, high BP
Deficiency in 21-hydroxylase enzyme leads to?
Congenital adrenal hyperplasia/Adrenogenital syndrome
Excess androgen production, virilization of female infant
Neuroblastoma and oncogene
MC adrenal medulla tumor in kids, M-MYC oncogene
Diabetes Type I vs II all you can list… GO!
I: insulin dependent, beta cell destruction, Ab to beta cells of pancreas, weight loss, Diabetic Ketoacoidosis, children, teens, HLA-DR34
II: non-insulin dependent, insulin receptor insensitivtiy, insulin levels elevated, obese adults, fm hx, polyuria, polydypsia, polyphagia, hyperosmolar non-ketotic coma (dehydration), advanced glycated end products, narrowing of small/med sized vessels, damage vasa vasora and nervosa, premature cataracts and retinopathy related to acc of sorbitol
Mature Onset Diabetes in the Young
Non-insulin dependent, no islet cell ab, not obese, <25
Gestational diabetes
3-10% all pregnancies, resolves w/end of pregnancy, 50% develop T2DM w/in 15 yrs
Carcinoid syndrome what cells? S/S?
Neuroendocrine in gut
recurrent diarrhea, cutaneous flushing, bronchial wheezing
(1/3 mets, 1/3 multiple)
Insulinoma. Relieved by?
Pancreatic beta-islet cell tumor
Hypoglycemia relieved by food
Gastrinoma cause, S/S?
excess gastrin from GI tumor
Recurrent peptic ulcer disease (Zollinger-Ellison syndrome)
Part of MEN type I
MEN Type 1
2a? 2b?
1: Wermer’s syndrome, pituitary adenoma, parathyroid adenoma, pancreas adenoma
2a: Sipple’s syndrome: medullary thyroid cancer, pheochromocytoma, parathyroid hyperplasia
2b: Marfanoid ft, medullary thyroid CA, mucosal neuromas, pheochromocytoma
Failure of lower esophageal sphincter to relax; loss of ganglion cells (myenteric plexus)
Achalasia - mainly dysphagia for liquids
Hiatal hernia
stomach into chest through diaphragm
Dilated V in lower esophagus (portal HTN)
Esophageal varices
GERD
chronic inflammation of lower esophagus due to acid regurgitation
Premalignant metaplastic change of lower esophagus due to GERD
Barrett’s esophagus
Mallory-Weiss Syndrome
linear tear in lower esophagus due to protracted vomiting and retching
Peptic ulcer disease
Gastric vs Duodenal ulcer
H. Pylori (lesser curvature, duodenum)
Inc pain w/meals for gastric
Dec pain w/meals for duodenal
Projectile vomiting in young male infants (<6 wks)
Congenital pyloric stenosis (hypertrophic pyloric sphincter)
Atrophic Gastritis
H. Pylori infxn; predisposition to pernicious anemia and stomach cancer
H. pylori infection with high nitrosamines in diet (smoked meats) causes? S/S?
Gastric carcinoma - MC lesser curvature
unexplained weight loss, Troisier’s sign (met lymph node in L supraclavicular fossa AKA Virchow’s node)
Non-caseous granulomas, cobblestone terminal ileum, skip lesions, fistula
Crohn’s disease (regional ileitis)
Meckel’s diverticulum
Remnant of vitelline duct; 2” long 2’ proximal to iliocecal valve, 2% people 2x MC in males, gastric or pancreatic tisue
Whipple’s disease/Tropical sprue:
Trophermya whipplei (Gram+ rod) infxn cause statorrhea and arthritis
Periumbilical pain to RLQ pain w/tenderness @McBurney’s point
Appendicitis (inflammation following blockage of lumen by fecalith)
Diverticulosis vs Diverticulitis
Osis: condition of numerous outpouching of large bowel-older ppl
Itis: inflammation for diverticulum in bowel; MC in older males, LLQ pain and blood in stool (elderly)
Telescoping of proximal part of bowel into distal segment
S/S
Intussusception
Ab pain and intestinal obstruction in child
Congenital aganglionosis of descending colon is?
S/S
Hirschsprung’s disease
chronic constipation, distended abdomen in child
Ulcerative colitis
Chronic ulcerative inflammation confined to rectum, bloody diarrhea, toxic megacolon, increased risk colon cancer
Twisting of bowel on itself; MC sigmoid
S/S
Volvulus
intestinal obstruction, ab pain
Oral pigmentation + multiple intestinal polyps
Peutz-Jegher syndrome
IBS
spastic colon (unknown cause); associated with interstitial cystitis Ab pain relieved by defecation w/diarrhea and/or constipation
Hepatitis A B C E
inflammation of liver caused by viral infections, alcohol, drugs
A: fecal/oral transmission; water borne infxn
B: IV drugs, STI; chronic carrier state
C: MC cuase of post-transfusion hep
E: fecal/oral transmission; water born infxn
Chronic passive venous congestion of liver is? Seen with what pathology?
Nutmeg liver
CHF
Rare cause of childhood hepatoencephalopathy caused by use of aspirin in kids w/some febrile illnesses-chickenpox and influenza
Reye’s syndrome
Hepatocellular carcinoma/malignant hepatoma
liver cancer associated w/Hep B/C and raised a-fetoprotein, aflatoxins
Painful hepatomegaly, anorexia, fatigue, weight loss
Cholecystitis? In who/ Cause?
inflammation of GB
Fair, fat, fertile, flatulent females >40 w/RUQ pain
95% caused by gallstone (cholelithiasis) cholesterol, pigment or mixed stones (70-80% asymptomatic)
Pancreatitis? Causes? S/S?
inflammation of pancreas
Alcohol, gallstones, trauma, steroids, mumps, hypercalcemia
Swollen pancreas, leaky pancreatic enzymes into ab cav, severe ab pain, Cullen’s sign (blue around umbilicus) or Grey Turner sign (around flank), epigastric pain radiates to back, nausea, vomiting
Pancreatic cancer
malignancy from pancreatic ducts (adenocarcinoma)
Painless jaundice, clay-coloured stool, weight loss, severe itching
Calorie vs protein deficiency
Marasmus - wasting, calories
Kwashiorkor - red hair, flaky-paint dermatitis, ascities, protein
B1 (thiamine deficiency)
Beriberi: (Wet, Dry)
Wernicke-Korsakoff syndrome
Beriberi: in alcoholics, dietary B1 deficiency, anorexia, bulimia, hyperemesis gravidarum
Dry: peripheral neuropathy, Wet: heart failure, swollen ankles and tachycardia
WKS: confusion, confabulation, coma in chronic alcoholics
B2 (niacin) deficiency
Pellagra: diarrhea, dermatitis (Casal’s necklace), Dementia, Death
B9 (folic acid) deficiency
Neural tube defects, megaloblastic anemia (fatigue, beefy red tongue)
B12 (cobalamin) deficiency
Pernicious anemia (lack of IF from parietal cells) (macrocytic, normochromic)
Diet or poor absorption (disease in terminal ileum)
Spinal cord degeneration, fatigue, ataxia, upper motor neuron signs, urinary/fecal incontinence
Vit C Deficiency
Inability to hydroxylate proline/lysine in collagen - weakens capillaries –> scurvy (tissue hemorrhage, bleeding swollen gums, loose teeth, poor wound healing, impaired bone formation in kids
Vit A Deficiency
Nyctalopia (night blind), xerophthalmia, keratomalacia (soft cornea)
Vit D deficiency (kids vs adults)
Rickets: soft bones, bowed legs, rachitis rosary (swollen costochondral junctions), pectus carinatum (pigeon chest)
Osteomalacia: looer’s zones (pseudofx)
Vit E deficiency:
Hemolytic anemia (low RBC cound and Hb, fatigue)
Vit K deficiency
Hemorrhagic disease of newborns (abnormal bleed from umbilicus)
Prevented w/Vit K shot
Hemochromatosis
can be autosomal recessive or acquired (diet)
Arthritis, bronze skin, cirrhosis, DM, Erection problems (testicular failure)
Wilson’s disease/Hepatolenticular disease
Excessive copper absorption (Chromosome 13 gene mutation)
Lack ceruloplasmin - excess deposition in brain, liver, eyes –> asterixis (flapping tremor of extended wrist), basal ganglia degeneration, cirrhosis, corneal deposits (Kayser-Fleisher rings), dementia
