General surgery: Endocrinology Flashcards
Short PR interval and delta wave on EKG?
Wolff-Parkinson-White syndrome
HTN, diaphoresis(episodic), and palpitations?
Pheochromocytoma
Irritability, diaphoresis, weakness, tremulousness, palpitations
insulinoma
muscle cramps, constipation, flattened/inverted T waves, U waves
Hypokalemia
Muscle weakness, hyperreflexia, prolonged QT, PR and Wide QRD, Tach, tornadoes de pointes?
Hypomagnesemia
mild shortness of breath, palpitations and systolic murmur with mid-systolic ejection click?
MVP
How can you dx palpitations?
history, ECG, echo, exercise testing -> identify and treat abnormal ECG
This disease can have weight loss, increased appetite, heat intolerance, fatigue.
Eye sign: stare, lid lag, exophthalmos
Hyperthyroidism (thyrotoxicosis)
What surgery is generally indicated for Graves ophthalmopathy?
Complete total thyroidectomy
Elevated TSH and decreased free T4
Hypothyroidism
Low or absent TSH and elevated T3 T4
Hyperthyroidism
Patient will present as → a 62-year-old female complaining of joint pain, polyuria, polydipsia, and generalized fatigue. The patient reports a history of recurrent kidney stones and depression. Radiographs show osteopenia and subperiosteal resorption on the phalanges (Bones, stones, abdominal groans and psychic moans)
Hyperparathyroidism
What rises in hyperparathyroidism?
Calcium levels in blood
Whats the cause of primary hyperparathyroidism
Increased PTH usually by the PTH secreting parathyroid adenoma
Whats the cause of secondary hyperparathyroidism?
Increased PTH by physiologic response to hypocalcemia or vitamin D deficiency. Chronic kidney disease is the most common cause of secondary hyperparathyroidism.
What is the preferred tx of hyperthyroidism during pregnancy?
PTU
Most common cause of hyperthyroidism?
Graves disease
what is the tx for hyperthyroidism?
methimazole or PTU (first trimester pregnancy)
What antibodies are made with Graves dz?
Anti-thyrotropin antibodies
What medication can be given to treat the cardiac sx of Graves’ dz?
B-Blockers. (most often atenolol)
What is a dangerous complication of a thyroidectomy?
injury to the recurrent laryngeal nerve
What is a cold nodule in a Thyroid uptake scan?
A cancerous lesion because it does not make hormone and will not take up iodine
What is a hot nodule in a Thyroid uptake scan?
A non cancerous lesion because it does make hormone and will take up iodine.
How do you treat a thyroid nodule?
tx based on US guided fine needle aspiration.
If malignant or suspicious: thyroidectomy
If benign: f/u 6 months
What is pheochromocytoma?
Its a catecholamine secreting adrenal tumor which secretes norepinephrine and epinephrine
What dz is associated with Neurofibromatosis type 1, MEN 2A/2B and Von Hippel-Lindau disease?
Pheochromocytoma
What are the sx of pheochromocytoma?
Sx are episodic: 5 P’s
Pressure (↑ BP)
Pain (headache)
Perspiration
Palpitations (tachycardia)
Pallor
How do you dx pheochromocytoma?
24 hour catecholamines
MRI ot CT to visualize catecholamine secreting tumor
Preoperative therapy for pheochromocytoma?
nonselective a-blockade: phenoxybenzamine or phentolamine x 7-14 days followed by beta blockers to control HTN.
What is the most common risk factor for thyroid carcinoma?
radiation exposure
What is the most common type of thyroid cancer?
Papillary carcinoma (papillary is popular)
