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STEP 1 > Endocrine Pathology > Flashcards

Endocrine Pathology Flashcards

1
Q

Euvolemic hyponatremia with urinary NA+ secretion

Urine osmolality> Blood osmolality

A

SIADH

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2
Q

What happens to Aldosterone and ANP in SIADH

A

Low Aldosterone
High ANP

SIADH increases blood volume which causes the atrial to secrete ANP to lower blood volume and lowers aldosterone secretion which would also increase blood volume.

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3
Q

Rapid correction of SIADH induced hyponatremia can cause

A

Osmotic Demyelination Syndrome

locked in

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4
Q

SIADH can be caused by what malignancy

A

SMALL cell lung Carcinoma

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5
Q

What drugs can caused SIADH

A

Carbamazepine
Cyclophosphamide
SSRIs

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6
Q

How to treat SIADH

A 
Fluid restriction is 1st line
Salt Tablets
ADH antagonist (–Vaptans & Demeclocycline)
IV fluids (slowly and if emergent)
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7
Q

What drug causes Nephrogenic DI

high ADH, high blood osmolality, low urine osmolality

A

Lithium

Demeclocycline

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8
Q

A patient with LOW Blood osmolality and LOW urine osmolality probably has

A

Polygenic Polydipsia

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9
Q

Desmopressin elevates urine osmolality after water deprivation test.

A

Central Diabetes Insipidus

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10
Q

Desmopressin minimally increases urine osmolality even after water deprivation test

A

Nephrogenic Diabetes Insipidus

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11
Q

Pituitary tumor, Sheehan syndrome, Blunt head trauma, surgery, encephalopathy can all cause

A

Central Diabetes Insipidus

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12
Q

Ischemic infarct of the pituitary following postpartum bleeding due to hypoperfusion of hypertrophied gland

A

Sheehan syndrome

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13
Q

Presents with failure to lactate post-partum, cold intolerance, ammenorhea

A

Sheehan syndrome

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14
Q

Frontal bossing, large hands and feet, coarse facial features, deep furrows, thick jaw, insulin resistance, +/- lowered labido

A

Acromegaly

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15
Q

Acromegaly increases the risk of _____ cancer

A

Colorectal polyps & cancer

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16
Q

Acromegaly is diagnosed via elevated ____ levels following oral glucose tolerance test

A

IGF-1

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17
Q

Acromegaly is treated with

A

Ocretotide (somatostatin analog)

Pegvisomant (GH receptor anatagonist)

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18
Q

DiGeorge syndrome presents with __ PTH & ___ Phosphate

A

Low PTH

High Ph

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19
Q

Multiple Myeloma presents with ___ Calcium & __ Phosphate

A

High (both)

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20
Q

Elevated Alkphosphate indicates

A

high bone turnover

functioning PTH

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21
Q 
How does Chronic Kidney Disease affect levels of:
\_\_\_ Alkphosphate 
\_\_\_ Calcium
\_\_\_ Calciferol (inactive VIt. D)
\_\_\_ pH
A

High (thus PTH is working)
Low
Low (PTH is working, kidneys must be & letting Ca go)
high (PTH and pH always go in the same direction)

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22
Q

High PTH
Low Calcium
*MOST COMMON

A

CKD

Vit. D inactive/deficient (Chron’s, CF, malabsoprtion)

23
Q

Low PTH

High Calcium

A

Cancer

Excess active Vit.D

24
Q

Low PTH

Low Calcium

A 
Primary Hypoparathyroidism
(accidentally removed in surgery or autoimmune dest)
25
Q

High PTH

High Calcium

A

Primary Hyperparathyroidism

Hyperplasia, adenoma/carcinoma

26
Q

presents with episodic hypertension

200>180

A

Pheochromacytoma

27
Q

Treatments of Pheochromacytoma
FIRST __blocker
then
__ blocker

A

alpha (phenoxybenzamine)
beta

Phenoxybenzamine for Pheochroma
A before B

28
Q

Pheochromacytoma can be caused by what 3 mutations

A

VHL
NF-1
MEN2a/b

29
Q

Explain why and alpha blocker needs to be used before a beta blocker in pheochromacytoma?

A

To prevent HYPERTENSIVE CRISIS

Alpha blocker stops Vasoconstriction

Beta blockers slow down HR (which would cause vasoconstriction thus HTN)

30
Q

Most common adrenal tumor in children

A

Neuroblastoma (neural crest cell origin)

31
Q

abdominal mass
irrregular
firm
crosses midline

A

Neuroblastoma (neural crest cell origin)

32
Q

abdominal mass
smooth
firm
does NOT cross midline (Unilateral)

A

WIlm’s Tumor (Kidney tubular cells)

33
Q

Normotensive baby with an abdominal mass and

jerking limbs, plus non-rhythmic eye movements

A

Neuroblastoma (neural crest cell origin)

34
Q

Bombesin +
NSE+
N-myc amplification
Homer Wright- rosettes (small blue round cells in a circle with a pink center)

A

Neuroblastoma (neural crest cell origin)

*mass may compress spine = DUMBELLS

35
Q 
Dermatitis (Necrolytic)
Diabetes (Hyperglycemia/weight loss)
DVT
Diarrhea
Depression
A

Glucagonoma

*give octreotide

36
Q

Insulinoma is associated with what endocrine disorder

A

MEN1

*so is Zollinger-Elison

37
Q

Intestinal ulcers (doudenum/jejunum)
Peptic Ulcer Disease
diarrhea/steatorrhea
Hypertrophies Rugae

A

Zollinger-Elison

*give octreotide + PPi

38
Q

Asthma/wheezing
Diarrhea/ Dermatitis/ Dementia
Cutaneous Flushing
Murmur (right heart)

A

Carcinoid syndrome

39
Q

+ Urine 5HIAA

A

Carcinoid syndrome

40
Q

If a carcinoid tumor is located in the GI tract it will be asymptomatic why?

A

5HT will go to liver via portal circulation and be inactivated

*becomes symptomatic is tumor spreads to the liver

41
Q

Chromogranin A +
Synpatophysin +
Granular Rosettes

A

Carcinoid syndrome

42
Q 
Classic Triad:
Hyperpigmentation
Hyperkalemia
Hypotensive (syncope etc.)
Low aldosterone
A

Primary adrenal Insufficiency

43
Q

List 2 causes of chronic Primary adrenal Insufficiency

A 
autoimmune destruction (in western world)
TB (in developing countries)
44
Q

Pituitary apoplexy
Sheehan syndrome
Pituitary tumor can precipitate secondary

A

adrenal insufficiency

45
Q

No hyperpigmentation
Normal ACTH levels
No hyperkalemia
normal aldosterone (RAAS okay)

A

secondary adrenal insufficiency

46
Q

The most common cause of adrenal insufficiency is due to

A

abrupt withdrawl of glucocorticoid (iatrogenic)

*taper patient off of medication

47
Q

Sugar and salt cravings can be suggestive of

A

Adrenal Insufficiency

48
Q

Adrenal crisis can precipitate

A 
hypotensive shock
(no aldosterone or cortisol to retain water and vasoconstrict)
49
Q

Hypotension
Seizures (+/-)
Altered mental status
Hypotensive shock

A

Adrenal crisis

50
Q

Elevated ACTH = __ adrenal insufficiency

A

Primary

* low 11-doxycortisol clinches the diagnosis

51
Q

Low ACTH = __ adrenal insufficiency

A

secondary/tertiary (glucocorticoid withdrawl)

52
Q

The most common cause of cushing syndrome is due to

A 
Iatrogenic (Prednisone)
Pituitary adenoma (Organic cause)
53
Q

Cushing syndrome can be precipitated by what malignancy

A

SMALL cell lung cancer

STEP 1 (88 decks)

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