Paraneoplastic syndromes (Pg. 217) - C (set default prompt)

Question 1

Paraneoplastic - Hyperpigmented velvety plaques in axilla and neck (Manif/Ass)

Answer 1

• Acanthosis Nigricans
• Gastric adenocarcinoma and other visceral malignancies (but more commonly associated with obesity and insulin resistance)

Question 2

Paraneoplastic - Sudden onset of multiple seborrheic keratoses (Manif/Ass)

Answer 2

• Sign of Leser-Trélat

- GI adenocarcinomas and other visceral malignancies

Question 3

Paraneoplastic - Hypercalcemia

Answer 3

• PTHrP –> Squamous cell carcinomas of lung, head, and neck; renal, bladder, breast, and ovarian carcinomas
• 1,25-(OH)2 vitamin D3 (calcitriol) –> Lymphoma

Question 4

Paraneoplastic - Cushing syndrome

Answer 4

Small cell lung cancer

Question 5

Paraneoplastic - Hyponatremia (SIADH)

Answer 5

Small cell lung cancer

Question 6

Paraneoplastic - Polycythemia

Answer 6

• Inc Erythropoietin

- Renal cell carcinoma, hepatocellular carcinoma, hemangioblastoma, pheochromocytoma, leiomyoma

Question 7

Paraneoplastic - Anemia with low reticulocytes (Manif/Ass)

Answer 7

• Pure red cell aplasia

- Thymoma

Question 8

Paraneoplastic - Hypogammaglobulinemia (Manif/Ass)

Answer 8

• Good syndrome

- Thymoma

Question 9

Paraneoplastic - Migratory superficial thrombophlebitis (Manif/Ass)

Answer 9

• Trousseau syndrome

- Adenocarcinomas, especially pancreatic

Question 10

Paraneoplastic - Deposition of sterile platelet thrombi on heart valves (Manif/Ass)

Answer 10

• Nonbacterial thrombotic (marantic) endocarditis

- Adenocarcinomas, especially pancreatic

Question 11

Paraneoplastic - Anti-NMDA receptor encephalitis (Manif/Ass)

Answer 11

• Psychiatric disturbance, memory deficits, seizures, dyskinesias, autonomic instability, language dysfunction
• Ovarian teratoma

Question 12

Paraneoplastic - Opsoclonus- myoclonus ataxia syndrome (Manif/Ass)

Answer 12

• “Dancing eyes, dancing feet”

- Neuroblastoma (children), small cell lung cancer (adults)

Question 13

Paraneoplastic - Paraneoplastic cerebellar degeneration (Manif/Ass)

Answer 13

• Antibodies against antigens in Purkinje cells

- Small cell lung cancer (anti-Hu), gynecologic and breast cancers (anti-Yo), and Hodgkin lymphoma (anti-Tr)

Question 14

Paraneoplastic - Paraneoplastic encephalomyelitis (Manif/Ass)

Answer 14

• Hu antigens in neurons

- Small cell lung cancer

Question 15

Paraneoplastic - Lambert-Eaton myasthenic syndrome (Manif/Ass)

Answer 15

• Antibodies against presynaptic (P/Q-type) Ca2+ channels at NMJ
• Small cell lung cancer

Question 16

Paraneoplastic - Myasthenia gravis (Manif/Ass)

Answer 16

• Antibodies against presynaptic Ach receptors at NMJ

- Thymoma