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Surgery EOR > Endocrinology (Alice) > Flashcards

Endocrinology (Alice) 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
Q

complications of hyperparathyroidism

A

osteoporosis
renal calculi
bone pain
GI
dpn/psychosis

stones, bones, groans, psychiatric moans

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26
Q

hallmark finding of hyperparathyroidism

A

serum Ca > 10.5

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27
Q

3 ways in which increased PTH secretion raises blood Ca

A

breaks down bone
increased absorption from GIT
increased absorption from kidneys

results in: increased serum and urinary Ca, osteoporosis, renal calculi

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28
Q

urine findings associated w. hyperparathyroidism

A

hyperphosphaturia
hypercalciuria

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29
Q

tx for hyperparathyroidism

A

primary: parathyroidectomy (subtotal vs total)

secondary: vit D, Ca supplementation
severe secondary: IVF, furosemide, calcitonin, bisphosphonates

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30
Q

tx for hyperthyroidism

A

methimazole
PTU

pregnant, first trimester: PTU

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31
Q

sx of thyroid storm

A

fever
weakness
muscle wasting
extreme restlessness
emotional swings
confusion/psychosis
n/v
diarrhea
hepatomegaly/mild jaundice
shock

32
Q

tx for hyperthyroidism in the acute setting

A

bb

33
Q

major rf for thyroid ca

A

childhood irradiation to the head/neck

34
Q

order of dx for thyroid nodules (4)

A
  1. palpable nodule
  2. confirm by US
  3. RAIU scan
  4. FNA
35
Q

characteristics of malignant thyroid nodules (6)

A

microcalcifications
hypoechogenicity
solid nodule
irregular margins
chaotic intranodular vasculature
nodule that is more tall than wide

36
Q

RAIU scans: findings of cancerous vs non-cancerous

A

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
Q

on RAIU, cancerous nodules are _, and non-cancerous lesions are _

A

cancerous: cold
non-cancerous: hot

38
Q

tx for thyroid nodules

A

benign: f/u in 6 months
malignant/suspicious: thyroidectomy
unsatisfactory specimen: FNA in 1-4 weeks

39
Q

3 nonthyroidal neck masses

A

-inflammatory lesions: abscess/lymphadenitis
-congenital lesions: thyroglossal duct, branchial cleft cyst
-malignant lesions: lymphoma, metastases, squamous cell carcinoma

40
Q

gs test for thyroid nodule

A

FNA

41
Q

what tx for thyroid nodules is diagnostic and therapeutic

A

thyroid suppression:
administer TSH -> suppresses TSH secretion -> up to 1/2 of benign nodules disappear

42
Q

4 rf for thyroid carcinoma

A

neck radiation
fam hx of thyroid ca or MENII
young age
female

43
Q

5 characteristics of a cancerous thyroid nodule

A

single nodule
cold nodule
increased calcitonin
LAD
hard, immobile nodule

44
Q

4 sx of thyroid carcinoma

A

voice change
dysphagia
neck discomfort
rapid enlargement

45
Q

mcc of thyroid enlargement

A

multinodular goiter

46
Q

3 indications for surgery w. multinodular goiter

A

cosmetic deformity
compressive sx
can not r.o ca

47
Q

what is plummer’s dz

A

toxic multinodular goiter

48
Q

catecholamine secreting adrenal tumor, which secretes NE and epi autonomously

A

pheochromocytoma

49
Q

5 sx of a pheo

A

5 p’s
pressure (htn)
pain (HA)
perspiration
palpitations/tachy
pallor

50
Q

what conditions are associated w. pheo’s (3)

A

neurofibromatosis type 1
MEN 2A/2B
von hippel-lindau dz

51
Q

dx for a pheo

A
  1. 24 hr urine screen for catecholamine metabolites (metanephrine/vanillylmandelic acid)
  2. MRI vs CT abdomen
52
Q

tx for a pheo

A
  1. preop nonselective alpha blockade x 7-14 days: phenoxybenzamine vs phentolamine
  2. bb
53
Q

what happens if you treat a pheo w. a bb before an alpha blockade

A

unopposed alpha constriction -> life threatening htn

54
Q

where are pheo’s found

A

adrenal medulla and sympathetic ganglion

55
Q

mc sx of a pheo

A

htn

56
Q

2 lab findings of a pheo (other than catecholamine metabolites)

A

hyperglycemia
polycythemia

57
Q

what must you rule out in a pt w. a pheo

A

MEN II

almost all cases are bilat

58
Q

mc type of thyroid carcinoma

A

papillary

59
Q

thyroid nodules must be > _ cm in order to be palpated

A

1

60
Q

mc type of benign thyroid nodule

A

thyroid adenoma

61
Q

2 lab findings of a nonfunctional thyroid nodule

A

normal vs high TSH
normal T4

62
Q

indication to bx a thyroid nodule

A

> 1 cm

63
Q

tx for cancerous thyroid nodules always includes (2)

A

complete vs partial thyroidectomy
chemo

64
Q

indication for xrt w. a cancerous thyroid nodule

A

anaplastic thyroid ca

65
Q

5 types of thyroid carcinoma: mc -> lc

A

papillary
follicular
medullary
huerthle cell
anaplastic/undifferentiated

66
Q

what 2 oncogenes are associated w. thyroid carcinoma

A

Ras
RET

67
Q

histologic findings of papillary carcinoma

A

psammoma bodies

68
Q

2 types of adrenal masses

A

functional
nonfunctional

69
Q

mc type of adrenal mass

A

nonfunctional adenoma

70
Q

3 types of functional adrenal tumors

A

pheochromocytoma
aldosteronoma
cortisol-producing adenoma

71
Q

3 features of adrenal cortical cancer (acc)

A

mixed cortisol
aldosterone hypersecretion
heterogenous/large tumors (>4 cm)

72
Q

lab work up for acc (4)

A

-plasma or urine fractionated metanephrines (r/o pheo)
-serum K+/aldosterone/renin
-24 hr urinary free cortisol or dex suppression
-DHEA-S

73
Q

CT findings of acc (7)

A

> 4 cm
calcifications
irregular shape
central necrosis
high attenuation
enhanced w. contrast
delayed contrast washout

74
Q

CT findings of adrenal adenoma (3)

A

low attenuation
rapid contrast washout
smooth borders

75
Q

indications for adrenalectomy

A

e.o hormone production
suspicious for acc

76
Q

what type of adrenalectomy is NOT recommended for ACC

A

laparoscopic

high rate of recurrence due to positive/close margins

77
Q

tx for metastatic nonfunctioning adrenal tumors

A

chemo
xrt

Surgery EOR (17 decks)

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