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EOR - Surgery > Endocrinology > Flashcards

Endocrinology Flashcards

1
Q

3 causes of resting tremor

A

parkinson’s
wilson’s
severe essential tremor

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2
Q

5 types of postural/action tremor

A

physiologic
drugs/toxins
essential tremor
writing tremor
parkinson’s

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3
Q

tremor w. peripheral neuropathy

A

charcot-marie-tooth

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4
Q

6 causes of intention tremor

A

MS
trauma
vascular dz
wilson’s dz
hepatocerebral degeneration
drugs/toxins

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5
Q

how much fatigue is normal post op

A

6-12 weeks

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6
Q

t/f: even “nonsedating” antihistamines have a 15% sedation rate

A

t!

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7
Q

7 endocrine causes of fatigue

A

hypothyroid
DM
pituitary insufficiency
hypercalcemia
adrenal insufficiency
chronic renal failure
hepatic failure

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8
Q

short PR interval and a delta wave on EKG

A

wolf parkinson white syndrome

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9
Q

htn
diaphoresis
palpitations

A

pheochromocytoma

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10
Q

irritability, diaphoresis, weakness, tremulousness, palpitations

A

insulinoma

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11
Q

muscle cramps, constipation, flattened/inverted T waves, U waves

A

hypokalemia

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12
Q

muscle weaknessm, hyperreflexia, prolonged QT/PR, wide QRS, vtach, torsades

A

hypomagnesemia

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13
Q

SOB
palpitations
systolic murmur w. midsystolic ejection click

A

MVP

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14
Q

heat intolerance/cold intolerance make you think of

A

heat: hyperthyroidism
cold: hypothyroidism

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15
Q

3 eye signs associated w. hyperthyroidism

A

stare
lid lag
exophthalmos

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16
Q

what is spared in a thyroidectomy (2)

A

parathyroid glands
recurrent laryngeal n

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17
Q

indication for complete total thyroidectomy (vs subtotal)

A

graves w. ophthalmopathy

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18
Q

decreased ACTH production causes _,
which leads to what symptoms (3)

A

hypocorticolism:
-fatigue
-slow return to health after minor illness
-orthostatic hypotn

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19
Q

excess parathyroid hormone causes excess blood levels of

A

calcium

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20
Q

what level of hypercalcemia is mc asymptomatic

A

< 12

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21
Q

sx of hypercalcemia

A

n/v
LOA
weak
fatigue
constipation
confusion
lethargy
cardiac arrhythmia
coma

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22
Q

pathway of hyperparathyroidism

A
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23
Q

causes of hyperparathyroidism: primary vs secondary

A

primary: parathyroid adenoma secreting PTH
secondary: 2/2 to hypocalcemia, vit D deficiency, CKD

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24
Q

mcc of secondary hyperparathyroidism

A

CKD

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25
complications of hyperparathyroidism
osteoporosis renal calculi bone pain GI dpn/psychosis **stones, bones, groans, psychiatric moans**
26
hallmark finding of hyperparathyroidism
serum Ca > 10.5
27
3 ways in which increased PTH secretion raises blood Ca
breaks down bone increased absorption from GIT increased absorption from kidneys **results in: increased serum and urinary Ca, osteoporosis, renal calculi**
28
urine findings associated w. hyperparathyroidism
hyperphosphaturia hypercalciuria
29
tx for hyperparathyroidism
primary: parathyroidectomy (subtotal vs total) secondary: vit D, Ca supplementation severe secondary: IVF, furosemide, calcitonin, bisphosphonates
30
tx for hyperthyroidism
methimazole PTU pregnant, first trimester: PTU
31
sx of thyroid storm
fever weakness muscle wasting extreme restlessness emotional swings confusion/psychosis n/v diarrhea hepatomegaly/mild jaundice shock
32
tx for hyperthyroidism in the acute setting
bb
33
major rf for thyroid ca
childhood irradiation to the head/neck
34
order of dx for thyroid nodules (4)
1. palpable nodule 2. confirm by US 3. RAIU scan 4. FNA
35
characteristics of malignant thyroid nodules (6)
microcalcifications hypoechogenicity solid nodule irregular margins chaotic intranodular vasculature nodule that is more tall than wide
36
RAIU scans: findings of cancerous vs non-cancerous
**cancerous:** lesion does not make hormone -> does **not** take up iodine -> **cold nodule** **non-cancerous:** lesion does make hormone -> **does** take up iodine -> **hot nodule**
37
on RAIU, cancerous nodules are _, and non-cancerous lesions are _
cancerous: cold non-cancerous: hot
38
tx for thyroid nodules
benign: f/u in 6 months malignant/suspicious: thyroidectomy unsatisfactory specimen: FNA in 1-4 weeks
39
3 nonthyroidal neck masses
-inflammatory lesions: abscess/lymphadenitis -congenital lesions: thyroglossal duct, branchial cleft cyst -malignant lesions: lymphoma, metastases, squamous cell carcinoma
40
gs test for thyroid nodule
FNA
41
what tx for thyroid nodules is diagnostic and therapeutic
thyroid suppression: administer TSH -> suppresses TSH secretion -> up to 1/2 of benign nodules disappear
42
4 rf for thyroid carcinoma
neck radiation fam hx of thyroid ca or MENII young age female
43
5 characteristics of a cancerous thyroid nodule
single nodule cold nodule increased calcitonin LAD hard, immobile nodule
44
4 sx of thyroid carcinoma
voice change dysphagia neck discomfort rapid enlargement
45
mcc of thyroid enlargement
multinodular goiter
46
3 indications for surgery w. multinodular goiter
cosmetic deformity compressive sx can not r.o ca
47
what is plummer's dz
toxic multinodular goiter
48
catecholamine secreting adrenal tumor, which secretes NE and epi autonomously
pheochromocytoma
49
5 sx of a pheo
**5 p's** pressure (htn) pain (HA) perspiration palpitations/tachy pallor
50
what conditions are associated w. pheo's (3)
neurofibromatosis type 1 MEN 2A/2B von hippel-lindau dz
51
dx for a pheo
1. 24 hr urine screen for catecholamine metabolites (metanephrine/vanillylmandelic acid) 2. MRI vs CT abdomen
52
tx for a pheo
1. preop nonselective alpha blockade x 7-14 days: phenoxybenzamine vs phentolamine 2. bb
53
what happens if you treat a pheo w. a bb before an alpha blockade
unopposed alpha constriction -> life threatening htn
54
where are pheo's found
adrenal medulla and sympathetic ganglion
55
mc sx of a pheo
htn
56
2 lab findings of a pheo (other than catecholamine metabolites)
hyperglycemia polycythemia
57
what must you rule out in a pt w. a pheo
MEN II *almost all cases are bilat*
58
mc type of thyroid carcinoma
papillary
59
thyroid nodules must be > _ cm in order to be palpated
1
60
mc type of benign thyroid nodule
thyroid adenoma
61
2 lab findings of a nonfunctional thyroid nodule
normal vs high TSH normal T4
62
indication to bx a thyroid nodule
> 1 cm
63
tx for cancerous thyroid nodules always includes (2)
complete vs partial thyroidectomy chemo
64
indication for xrt w. a cancerous thyroid nodule
anaplastic thyroid ca
65
5 types of thyroid carcinoma: mc -> lc
papillary follicular medullary huerthle cell anaplastic/undifferentiated
66
what 2 oncogenes are associated w. thyroid carcinoma
Ras RET
67
histologic findings of papillary carcinoma
psammoma bodies
68
2 types of adrenal masses
functional nonfunctional
69
mc type of adrenal mass
nonfunctional adenoma
70
3 types of functional adrenal tumors
pheochromocytoma aldosteronoma cortisol-producing adenoma
71
3 features of adrenal cortical cancer (acc)
mixed cortisol aldosterone hypersecretion heterogenous/large tumors (>4 cm)
72
lab work up for acc (4)
-plasma or urine fractionated metanephrines (r/o pheo) -serum K+/aldosterone/renin -24 hr urinary free cortisol or dex suppression -DHEA-S
73
CT findings of acc (7)
**> 4 cm** **calcifications** **irregular shape** central necrosis high attenuation enhanced w. contrast delayed contrast washout
74
CT findings of adrenal adenoma (3)
low attenuation rapid contrast washout smooth borders
75
indications for adrenalectomy
e.o hormone production suspicious for acc
76
what type of adrenalectomy is NOT recommended for ACC
laparoscopic *high rate of recurrence due to positive/close margins*
77
tx for metastatic nonfunctioning adrenal tumors
chemo xrt

EOR - Surgery (13 decks)

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