Endocrine Tumors Flashcards
Presents with watery diarrhea, flushing, abdominal cramps, wheezing (bronchospasm/ Asthma-like) and murmur (cardiac valvular abnormalities)
± telangiectasias
If untreated complications can lead to:
skin rash, diarrhea, and memory impairement
Carcinoid Syndrome
(locations: Small intestine, Lungs, Colon)
Carcinoid cells (endocrine tumor) cause increased production of serotonin from tryptophan (required for niacin), resulting in niacin deficiency (ie, pellagra → dermatitis, diarrhea, and dementia)
Treatment for Carcinoid Syndrome
Octreotide (somatostatin analogue) for symptomatic patients
& prior to surgery/anesthesia
Surgery for liver metastases
Elevated 24-hr urinary excretion of 5-HIAA (5-hydroxyindoleacetic acid) is seen in what disorder?
Carcinoid Syndrome
(Get CT abd/pelv)
OctreoScan to detect metastases
Echo (if murmur)
Presents with episodic headache, sweating & tachycardia
HTN accompanied by unexplained Hyperglycemia.
Imaging: Adrenal mass
Pheochromacytoma
Urine or plasma metanephrine levels
Confirmatory abdominal imaging for ↑ metanephrines
Treatment for Pheochromacytoma (2)
alpha blocker before beta blocker
Phenoxybenzamine, Terazosin
Then surgical resection
In pheochromocytoma, Beta-blocker therapy in the absence of (or before) alpha-adrenergic blockade can lead to lethal hypertensive crisis due to _____.
unopposed alpha-1 stimulation
In pheochromocytoma, Beta-blocker therapy in the absence of (or before) alpha-adrenergic blockade can lead to lethal ____
hypertensive crisis
Presents with watery diarrhea, flushing, lethargy, nausea, muscle weakness/cramps
Labs show:
hypokalemia
hypercalcemia
hyperglycemia
Gastric hypochloremia
Imaging: pancreatic mass
Diagnosis?
VIPoma
a pancreatic tumor: pancreatic cells that produce vasoactive intestinal peptide (VIP).
Most patients develop VIPoma syndrome (pancreatic cholera) with watery diarrhea, muscle weakness/cramps (due to hypokalemia), and hypo- or achlorhydria (due to decreased gastric acid secretion).
Stool studies are consistent with secretory diarrhea;
a VIP level >75 pg/mL confirms diagnosis.
Treatment for VIPoma (2)
Octreotide (inhibits VIP secretion)
Tumor resection
Hypertensive crises can be triggered by palpation of the tumor on abdominal exam
Pheochromacytoma
Treat PHEochromocytoma with PHEnoxybenzamine, but remember that Alpha blockers should be given Ahead and Beta blockers Behind.
FYI
Pheochromacytomas are catecholamine-producing tumors arising from chromaffin cells of the adrenal medulla.
catecholamine-surges cause severe hypertension in patients & can be precipitated by ___ , ___, and a number of medications.
surgical procedures
induction of anesthesia
Young adult presents with:
Cerebellar & retinal hemangioblastomas
Pheochromocytoma
± Renal cell carcinoma
Diagnosis?
Von Hippel-Lindau disease
Surveillance
Eye/retinal exams
Urine metanephrines
MRI of the brain, spine & abdomen
Presents with watery diarrhea, abdominal cramps, worsening painful, pruritic rash, weight loss, and hyperglycemia
Presents with watery diarrhea, abdominal cramps, worsening painful, pruritic rash, weight loss, and hyperglycemia
± anemia
Diagnosis?
Glucagonoma
