Path/ Pathophys Flashcards
Symptoms of Hypoglycemia (<50)?
BLURRED vision (MC) Shakiness Sweatiness Nervousness Hunger Weakness Palpitations
Signs of Hypoglycemia?
Excess SNS: Diaphoresis Tachycardia Systolic HTN Tremulousness Pallor Confusion Unusual behavior
Body defenses to Hypoglycemia?
Decrease Insulin–> Unless Exogenous
Increase Glucagon–> Fibrosis/ amyloid inhibit
Increase Epinephrine–> Prev. epis lowers treshld
Increase Cortisol–> Prev epis
SNS symptoms–
Alcohol and Hypoglycemia?
Body uses up stored Glycogen increases risk of HYPOglycemia in extended periods of drinking
Serious complications of Hypoglycemia?
Seizures
Arrhythmias
Death
Tx for Comatose pt?
GLUCOSE
PNET are associated with what hereditary endocrinopahthies?
MEN-1 (80-100%)
von Hippel Lindau syndrome (20%)
Neurofibromatosis-1 (10%)
Describe the histological appearance of NET?
Small Monomorphic Round "Salt & pepper" nuclei Scant Cytoplasm Nests or islands
What are the MC sites of PNET metastasis?
LIVER
retropperitoneal lymph nodes
bone
Symptoms of nonfunctioning PNET?
Abdominal pain (MC) Obstructive jaundice (mc) Anorexia Palpable mass Wght loss
Anemia + Diabetes + Necrolytic migratory erythema?
Glucagonoma
Peptic ulcers + diarrhea?
Gastrinoma (Zollinger-Ellison syndrome)
Diabetes + Cholelithiasis + Steatorrhea?
Somatostatinoma
Watery diarrhea Achlorhydria Hypokaemia Hypovolemia Acidosis
VIPoma
Zollinger-Ellison syndrome?
Parietal cell hyperplasia
Abdominal pain
Diarrhea
Peptic + duodenal + jujenal ulcers
What is the first line therapy for treating Overdose beta-blockers and calcium channel blockers?
Glucagon
MCC of hypercalcemia?
Primary HPT
MCC of Hyper ParaThyroid?
Parathyroid adenoma–> MC in blacks, Asians
Symptoms of Chronic Hypercalcemia?
Constipation Urinary pain (nephrolithiasis) Bone pain (resorptive state= ostetis fibrosa cystic)
How can parathyroid adenoma be differentiated from parathyroid hyperplasia?
Adenoma= One gland (others atrophied) Hyperplasia= Multiple glands enlarged
How do granulomatous reactions (Sarcoidosis/TB) causes Hypercalcemia?
Macrophages convert Vit D–> 1,25 Vit D
Presentation of Acute hypercalcemia?
Weakness Decreased reflexes confusion lethargy Seizures Coma Constipation--> N/V POLYURIA Shorten QT+ bradycardia--> Arrhythmias
Confusion
Decreased Mental capacity
Paraneoplastic syndrome?
Acute Hypercalcemia
Asymptomatic + primary Hyperparathyroid?
Chronic Hypercalcemia
What is the predominant manifestation of Acute Adrenal crisis?
SHOCK anorexia N/V abdominal pain fever confusion
Manifestations of Chronic Adrenal insufficiency?
Hypoglycemia fatigue Weakness Hypotension+ salt craving Hyperpigmentation Hyponatremia + HYPERkalemia Loss of libido and genital hair (females)
Stress is mediated by what acutely and chronically?
Acute= catecholamines Chronic= corticosteroids
Hypertension and Hypokalemia?
Adrenal cortical tumor secreting ALDOSTERONE
Conn syndrome
Signs: Episodic headache, sweating , tachycardia
Symptom: HTN are associated with what Genetics?
Pheochromocytoma= MEN-2
What are the major risk factors for atherosclerosis?
Age
Sex
SHODDY
Symptoms: Stones Moans Groans Bones?
Hypercalcemia
Symptoms: Polyuria Polydipsia Polyphagia Fatigue Wgt loss?
Hyperglycemia
Symptoms: Fatigue Weakness Nausea parathesias confusion?
Hyperkalemia
Symptoms: Lethargy Confusion Irritability Seizures Coma?
Hypernatremia + Hyponatremia
Symptoms: Parasthesias (tingling or numbness) Muscle cramps irritability depression?
Hypocalcemia
Symptoms: Shakiness sweatiness nervousness hunger weakness?
Hypoglycemia
Symptoms: Fatigue weakness constipation irritability myalgias?
Hypokalemia
Dx: Hypoglycemia Anorexia, wgt loss, N/V weakness hypotension hyperkalemia Metabolic acidosis decreased pubic/ axillary hair in females Hyper-pigmentation?
Addison’s disease–> Primary adrenal insufficiency
What is elevated in Addison’s disease and whats the treatment?
ACTH elevated–> NO cortisol -feedback inhibition
Tx; replace GC + MC
Dx: Hyoerglycemia Muscle wasting Central obesity Osteoporosis Striae Menstrual disorders Hypertension?
Cushing’s syndrome (LOW ACTH)–> Primary Adrenal hyperplasia
What is the Cushing’s disease? /
Elevated ACTH due to tumor causing same symptoms as Cushing syndrome
Dx:
Hypertension
Hypokalemia
Metabolic alkalosis?
Conn’s syndrome–> Aldo secreting tumor
** LOW RENIN
What is the treatment for Cushing syndrome?
Ketoconazole
Metyrapone
Dx: Masculinization in females Early accelerated linear growth Early Pubic/ axillary hair Hyperkalemia Hypoglycemia weakness metabolic alkalosis Hyperpigmenation?
21 beta hydroxylase deficiency
Excess androgens
Deficient GC + MC
Dx:
No pubic hair female
Low cortisol
High Aldosterone?
17 alpha hydroxylase deficiency
Painless Goiter
Peripheral edema
Headache & joint ache
Anovulation?
Hashimoto Thyroiditis–> Anti Thyroid antibodies
Hyper-excitability Wght Loss Sweating Diarrhea Extreme fatigue Hand tremors Dry eyes / corneal ulcerations?
Graves Disease–> Thyroid stimulating Antibodies
Round Islets vs. Trabecular Islets in pancrease?
Round–> Beta cells
Trabecular–> PP cells