paraneoplastic syndromes

Question 1

ACTH → cushing syndrome
ADH → SIADH: ↓ serum osmolality, hyponatremia (seizures)
lambert-eaton syndrome

Answer 1

small cell lung cancer

Question 2

ADH → SIADH

Answer 2

intracranial neoplasm

Question 3

tumor secretes ↑ PTHrP → humoral hypercalcemia of malignancy

Answer 3

squamous cell lung cancer
head/neck squamous cell cancer
renal cell carcinoma
breast cancer

Question 4

muscle weakness
tumors induces production of Abs against presynaptic Ca channels in NMJ → no NT release
test: isometric muscle ctx (against your resistance) allows Ca to build up → remove resistance→weakness/reflexes IMPROVES with use (vs myasthenia gravis - WORSENS with use)

Answer 4

lambert-eaton syndrome

Question 5

tumors secretes local osteolytic factors → lytic bone lesions + hypercalcemia
back pain
anemia
renal failure

Answer 5

multiple myeloma (not paraneoplastic)

Question 6

secrete active vitamin D (1,25 OH D3, calcitriol) →↑ hypercalcemia

Answer 6

Hodgkin and some non-Hodgkin lymphoma

Question 7

secrete EPO → polycythemia

Answer 7

Potentially Really High Hematocrit
Pheochromocytoma
Renal cell carcinoma
Hepatocellular carcinoma
Hemangioblastoma
**Uterine fibroids (leiomyoma: heavy bleding but NOT ANEMIC)

Question 8

common causes of hypercalcemia

Answer 8

#1 1° hyperparathyroidism
#2 malignancy

Question 9

lytic bone mets can cause

Answer 9

hypercalcemia