Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

Surgery > Endocrinology > Flashcards

Endocrinology Flashcards

1
Q

The majority of patients with _________ are asymptomatic. Recurrent nephrolithiasis may be one of the presentations.

A

Hyperparathyroidism

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

Measurement of parathyroid levels would be the initial laboratory test for the evaluation of _______.

A

Hypercalcemia

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

_______ is the recommended treatment for overactive thyroid tissue in patients without risk for subsequent thyroid cancer, leukemia, or other malignancies.

A

Radioactive iodine

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

What is the best initial step for the examination of a palpable thyroid nodule?

A

Ultrasound is the best initial step for evaluation of a palpable thyroid nodule. Microcalcifications, hypoechogenicity, a solid nodule, irregular nodule margins, chaotic intranodular vasculature, and a nodule that is more tall than wide are poor prognostic indicators. The combination of fine needle aspiration and radioisotope scanning of a solitary thyroid nodule provides the best diagnostic yield. Because cold nodules may be cancerous, they are generally referred for surgical removal.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

While awaiting operative removal of pheochromocytoma, which of the following classes of medications are used for control of hypertension?

A

Alpha-adrenergic blockers are used preoperatively to control hypertension in a patient with pheochromocytoma that occurs from unopposed alpha stimulation when the tumor is manipulated.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

2 key RFs for thyroid nodules are:

A
  1. Extremes of age (very young, >60)

2. History of head/neck irradiation

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

Most thyroid nodules found in _____ are benign. Most thyroid nodules found in _____ and _____ are malignant.

A

Women- benign (follicular adenoma or cysts)

Men and children- malignant

  • Only 10% are malignant
  • *Papillary cancer most common in women
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

What are the S&S of thyroid nodules?

A
  1. Most are ASYMPTOMATIC

2. Compressive sx- trouble swallowing, neck/jaw/ear pain, hoarseness

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

PE findgins for thyroid nodules include:

A
  1. Malignant- rapid growth, fixed in place, no movement with swallowing
  2. Benign- varies

Thyroid function tests- most patients are euthyroid

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

What is the best initial test to evaluate a thyroid nodule?

A

FNA with biopsy

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

What is the most common type of thyroid nodule?

A

Follicular adenoma (50-60%)- >90% of nodules are benign

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

When do you decide to do a radioactive iodine uptake scan?

A
  • Usually performed if FNA is indeterminate

- Cold nodules (no/low iodine uptake) are highly suspicious for malignancy!!

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

____ is used to obtain a specimen during a FNA. It also helps the provider monitor a suspicious nodule or to see if a nodule is growing or shrinking.

A

High resolution US

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

How are thyroid nodules treated and managed?

A
  1. Surgery- if thyroid cancer is suspected or if an indeterminate FNA with a cold thyroid scan
  2. Observation- usually every 6-12 months with US
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

Papillary and follicular cancers are well differentiated with a _____ (better/worse) prognosis. Anaplastic is poorly differentiated with a (good/poor) prognosis.

A

Better; poor

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

_____ is the most common type of thyroid cancer.

A

Papillary

  • RF- radiation exposure
  • *MC in young females
  • **Treatment- total or subtotal thyroidectomy (can be coupled with radioiodine therapy)
17
Q

_____ thyroid cancer is associated with iodine deficiency. It is more aggressive than papillary but also slow growing.

A

Follicular

  • Distant METS common (lung, brain, bone, liver, skin)
  • *Excellent prognosis, same treatment options as papillary ca
18
Q

______ is the most aggressive form of thyroid cancer and is MC in men > 65y.

A

Anaplastic

  • Local and distant METS
  • *May invade trachea
  • **Poor prognosis- most don’t live 1y after dx
  • ***Treatment- resection, chemotherapy, palliative tracheostomy in 20% to maintain airway
19
Q

_______ exhibits an excess of PTH production.

A

Primary Hyperparathyroidism

  • MC type!!
  • *Parathyroid adenoma is MC cause
  • **Occurs in 20% of patients taking lithium
20
Q

_______ exhibits an excess of PTH due to hypocalcemia or Vitamin D deficiency.

A

Secondary Hyperparathyroidism

21
Q

_____ is the MC cause of secondary hyperparathyroidism

A

Chronic kidney failure (kidneys convert Vitamin D to its usable form)

*Also severe calcium and vitamin D deficiency

22
Q

Clinical manifestations of hyperparathyroidism include:

A

Signs of HYPERcalcemia and decreased DTRs

23
Q

Triad of Hyperparathyroidism is:

A
  1. Hypercalcemia
  2. Intact PTH
  3. Decreased phosphate
24
Q

What would you find on a bone scan of a patient with hyperparathyroidism?

A

Osteopenia

*May have a parathyroid adenoma

25
Q

How is hyperparathyroidism treated?

A
  1. Surgery- parathyroidectomy

2. Vit D/Ca2+ supplementation if secondary. Treat hypercalcemia if symptomatic with IV fluids and Lasix

26
Q

Adrenal cancer’s age distribution

A

Bimodal- peaks before 5y and in the 4th & 5th decades of life

Women > Men

27
Q

Pathophysiology of Adrenal Cancer….

A

Rare, often aggressive tumors that may be functional and cause Cushing’s Syndrome and/or virilization or nonfunctional and present as an abdominal mass or an incidental finding

28
Q

Glucocorticoid excess may lead to:

A

Weight gain, weakness, insomnia, usually develops rapidly (over 3-6mos)

29
Q

How is adrenal cancer diagnosed?

A

CT initially- larger size, irregular borders, calcifications, invasion of surrounding structures or lymph node enlargement

  • MRI
  • FNA CANNOT distinguish between a benign adrenal mass and an adrenal carcinoma. It can distinguish between an adrenal tumor and a metastatic tumor
30
Q

How is adrenal cancer treated?

A

Surgery- complete resection (hormonal assessment to be performed first)

+/- chemo

31
Q

What is Pheochromocytoma?

A

CATECHOLAMINE-SECRETING RENAL/ADRENAL TUMOR

*Secretes norepinephrine and epinephrine autonomously and intermittently (triggers include surgery, stress, exercise, pregnancy, meds- TCA, opiates, Metoclopramide, glucagon, histamine)

**90% are benign!

32
Q

What are the S&S of pheochromocytoma?

A

HTN most consistent finding!

PHE–> Palpitations, HA, Excessive sweating

33
Q

How is pheochromocytoma diagnosed?

A
  1. Increase in 24hr urinary catecholamines including metabolites (increase in metanephrine and vanillylmandelic acid)
  2. MRI or CT can visualize the tumor
  3. Labs–> hyperglycemia and hypokalemia
34
Q

Treatment of pheochromocytoma involves:

A

Complete adrenalectomy:

  • Preoperative nonselective A-BLOCKADE: PHENOXYBENZAMINE PHENTOLAMINE x 7-14 days followed by beta blockers to control HTN
  • DO NOT initiate therapy with beta blockade to prevent unopposed a-constriction during catecholamine release triggered by surgery or spontaneously, which could lead to life-threatening HTN

Surgery (11 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions