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First Aid Endocrine > Pathology > Flashcards

Pathology Flashcards

1
Q

1 cause of Cushing Syndrome

A

exogenous use of corticosteroids

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2
Q

Bilateral Adrenal Atrophy and decreased ACTH

A

exogenous use of corticosteroids

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3
Q

Atrophy of uninvolved Adrenal Gland and decreased ACTH

A

Primary adrenal adenoma, hyperplasia or carcinoma

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4
Q

ACTH-secreting pituitary adenoma

A

Cushing Dx

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5
Q

Paraneoplastic ACTH secretion

A

small cell lung cancer, bronchial carcinoids

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6
Q

HTN, wt gain, moon facies, truncal obesity, buffalo hump, hyperglycemia, striae, osteoporosis, amenorrhea, immune suppression

A

Cushing Syndrome

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7
Q

increase free cortisol on 24hr urinalysis

A

Cushing Syndrome

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8
Q

Low Dose Dexamethasone suppression test: adequate suppression

A

Cushing Disease

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9
Q

Low Dose Dexamethasone suppression test: No Suppression

A

ectopic ACTH secretion

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10
Q

CRH Stimulation Test: increase ACTH and Cortisol

A

Cushing Disease

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11
Q

CRH Stimulation Test: no increase in ACTH and cortisol

A

ectopic ACTH secretion

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12
Q

How Cortisol causes Immunosuppression

A

1) inhibit Phospholipase A2
2) Inhibit IL-2
3) Inhibit Histamine release

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13
Q

1 cause of Primary Hyperaldosterone

A

Aldosterone-secreting Adrenal Adenoma (Conn)

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14
Q

HTN, hypoK, Met. alkalosis, low plasma renin

A

Conn Syndrome (Primary Hyperaldosterone)

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15
Q

Cause of Secondary Hyperaldosterone

A

renal artery stenosis, CHF, cirrhosis or nephrotic syndrome

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16
Q

High Plasma Renin (overactive RAS)

A

Secondary Hyperaldosteronism

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17
Q

Tx of Secondary Hyperaldosteronism

A

Spironolactone

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18
Q

Chronic Primary Adrenal Insufficiency due to adrenal atrophy or destruction

A

Addison Disease

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19
Q

Skin Mucosal Hyperpigmentation, hyperK, acidosis, hypotension, increased ACTH

A

Aldosterone and cortisol deficiency (Addision Dx)

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20
Q

HyperK, acidosis, hypotension, decreased ACTH

A

secondary adrenal insuffieincy

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21
Q

Acute primary adrenal insuffiency due to adrenal hemorrhage associated with Niesseria meningitidis, septicemia, DIC and endotoxic shock

A

Waterhouse-Friedrichsen Syndrome

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22
Q

Most common tumor of adrenal medulla in children

A

Neuroblastoma

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23
Q

Overexpression of N-myc gene, HTN in children, distended abdomen, Bombesin (+)

A

Neuroblastoma

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24
Q

Homovanillic acid (HVA) in urine

A

Breakdown product of dopamine, associated with Neuroblastoma

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25
Q

Episodic HTN, palpitations, tachycardia and sweating

A

Pheochromocytoma

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26
Q

Rule of 10’s

A

10% malignant, 10% BL, 10% extra-adrenal (bladder wall), 10% calcify, 10% kids
Pheochromocytoma

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27
Q

Urinary VMA

A

Pheochromocytoma (breakdown product of NE and Epi)

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28
Q

Tx of Pheochromocytoma

A

Irreversible alpha-anatognist (phenoxybenzamine) and beta-blockers followed by tumor resection

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29
Q

Salt wasting (hypoNa), kyperK, hypovolemia, HYPOTENSION, clit enlargement or precocious puberty

A

Congenital Adrenal Hyperplasia, 21-hydroxylase deficiency

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30
Q

Cold intolerance, Weight gain, decreased appetite, Constipation

A

Hypothyroidism

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31
Q

Dry, cool skin, coarse, brittle hair, bradycardia, hypercholesterolemia

A

Hypothyroidism

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32
Q

Heat intolerance, weight loss, increased appetite, hyperactive

A

Hyperthyroidism

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33
Q

Diarrhea, icnreases reflexes, chest pain, palpitations, arrhythmia, warm, moist skin

A

Hyperthyroidism

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34
Q

Pretibial myxedema

A

Graves Dx (hyperthyroidism)

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35
Q

Most common cause of hypothyroidism in iodine-sufficient areas

A

Hashimoto Thyroiditis

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36
Q

Anti-thyroid peroxidase, antithyroglobulin antibodies

A

Hashimoto Thyroiditis

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37
Q

HLA-DR5

A

Hashimoto Thyroiditis

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38
Q

Hurthle cells in germinal centers of thyroid tissue

A

Hashimoto Thyroiditis

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39
Q

Hashimoto Thyroiditis increase risk to what cancer?

A

non-Hodgkin Lymphoma

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40
Q

Cretinism

A

congenital hypothyroidism due to maternal hypothyroidisim, thyroid agenesis or dysgenesis, iodine deficiency

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41
Q

Pot-bellied, Pale, Puffy faced child with protruding Umbilicus, protuberant tongue and poor brain development

A

Cretinism (congenital hypothyroidism)

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42
Q

Self-limited hypothyroidsim following a flu-like illness

A

Subacute thyroiditis (de Quervain)

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43
Q

granulomatous inflammation of thyroid, hypothyroidism

A

Subacute thyroiditis (de Quervain)

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44
Q

tender thyroid, hypothyroidism

A

Subacute thyroiditis (de Quervain)

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45
Q

Thyroid replaced by fibrous tissue

A

Riedel Thyroiditis

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46
Q

hard, painless goiter

A

Riedel Thyroiditis

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47
Q

Mimicks anaplastic carcinoma

A

Riedel Thyroiditis

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48
Q

Hyperfunctioning follicular cells working independently of TSH due to mutation in TSH receptor

A

Toxic multinodular goiter (hyperthyroidism)

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49
Q

Jod-Basedow Phenomenon

A

thyrotoxicosis if a patient with iodine deficiency goiter is made iodine replete (Toxic multinodular goiter)

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50
Q

retro-orbital fibroblasts

A

Proptosis, extraocular muscle swelling - Graves Dx for hyperthyroidism

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51
Q

Scalloping of colloid thyroid

A

Grave’s Dx (hyperthyroidism)

52
Q

Tx of Graves

A

Thioamide (block peroxidase), Radioiodine ablation, Beta-blockers

53
Q

Autoantibodies (IgG) that stimulate TSH-R

A

Grave’s Dx (hyperthyroidism)

54
Q

Stress-induces catecholamine surge seen as serious complicatino of Graves Disease

A

Thyroid Storm

55
Q

agitation, delirium, fever, diarrhea, coma, increase ALP from increase bones turnover and tachycardia

A

Thyroid Storm

56
Q

Tx of Thyroid Storm

A

Propranolol, Propyluracil, Prednisolone

57
Q

Benign proliferation of thyroid follicles surrounded by a fibrous capsule

A

Follicular adenoma

58
Q

4 Carcinomas that spread through the blood

A

Renal carcinoma - Renal Vein
Hepatocellular carcinoma - hepatic vein
Follicular carcinoma
Choriocarcinoma

59
Q

Complications of Thyroid resection

A

Hoarseness - recurrent laryngeal
hypocalcemia - PTH removal
transectino of inferior thyroid artery

60
Q

Orphan Annie Eyes

A

Papillary carcinoma of Thyroid (most common)

61
Q

RET and BRAF mutations, childhood irradiation

A

Papillary carcinoma of Thyroid

62
Q

Psammoma bodies, nuclear grooves, spreads to cervical nodes but excellent prognosis

A

Papillary carcinoma of Thyroid

63
Q

Cancer from parafollicular C cells

A

medullary carcinoma of thyroid

64
Q

Hypocalcemia, sheets of amyloid stroma associated wtih MEN2A and 2B

A

medullary carcinoma of thyroid

65
Q

“Stones, bones, groans, and psychiatric overtones”

A

Primary HyperPTH

66
Q

cystic bone spaces filled with brown fibrous tissue

A

Osteitis fibrosis cystica

67
Q

Constipation, weakness, kidney stones, acute pancreatitis, depression

A

Primary HyperPTH

68
Q

Bone lesions due to Secondary or tertiary HyperPTH

A

Renal Osteodystrophy

69
Q

Causes of secondary hyperPTH

A

chronic renal disease, hypovitaminosis D, Hypocalcemia, hyperphosphatemia

70
Q

Tetany

A

Hypocalcemia

71
Q

Chvostek Sign

A

Tapping facial nerve (cheek) causes contraction of facial mucles, seen in hypoPTH, hypocalcemia

72
Q

Trousseau Sign

A

Occlude Brachial Artery by BP cuff and get carpal spasm, seen in hypoPTH and hypocalcemia

73
Q

Albright hereditary osteodystrophy

A

pseudohypoparathyroidism, autosomal dominant unresponsiveness of kidney to PTH

74
Q

Hypocalcemia, shortened 4th/5thh digits, short stature

A

pseudohypoparathyroidism, Albright hereditary osteodystrophy

75
Q

Mass effect

A

nonfunctional tumor, bitemporal hemianopsia hypopituitarism and HA

76
Q

microadenoma

77
Q

macroadenoma

78
Q

Tx of prolactinoma

A

dopamine agonist Bromocriptine or Cabergoline

79
Q

Large Tongue, deep voice, large hands and feet, coarse facial features, insulin resistance

A

Acromegaly

80
Q

Most common cause of death in Gigantism

A

Cardiac Failure

81
Q

increased serum IGF-1, failure to suppress GH following oral glucose tolerance test

A

Acromegaly

82
Q

Tx of Acromegaly

A

Octreotide (somatostatin analog) or Pegvisomant (GH-R antagonist) or pituitary resection

83
Q

Intense thirst and polyuria with inability to concentrate urine due to lack of ADH

A

Diabetes Insipidus

84
Q

Decreased ADH, No change with water restriction, do get change with desmopressin

A

Central DI

85
Q

normal or increased ADH, no change with water restriction test, no response to DDAVP

A

Nephrogenic DI

86
Q

Tx of Nephrogenic DI

A

HCTZ, indomethacin, amiloride, hydration

87
Q

Tx of Central DI

A

DDAVP, hydration

88
Q

Secondary to hypercalcemia and lithium and demeclocycline

A

Nephrogenic DI

89
Q

Hyponatremia with continued urinary sodium excretion

90
Q

excessive water retention

91
Q

Correct SIADH slowly to prevent

A

Central Pontine Myelinolysis

92
Q

Causes of SIADH

A

ectopic ADH like small cell lung cancer, CNA disorders/head trauma, pulmonary disease and cyclophosphamide

93
Q

Tx of SIADH

A

fluid restriction, IV hypertonic saline, conivaptan, tolvaptan and demeclocycline (blocks ADH)

94
Q

Ischemic infarct of pituitary following postpartum bleeding; failure to lactate

A

Sheehan Syndrome

95
Q

Pituitary Apoplexy

A

bleeding into pituitary

96
Q

Empty sella syndrome

A

atrophy or compression of pituitary, often idiopathic or obese women

97
Q

Kimmelstiel-Wilson syndrome

A

Diabetic nephropathy (kidney disease) from chronic diabetes

98
Q

Diabetic Osmotic Damage of certain cells

A

Schwann Cells - peripheral neuropathy
Pericytes of Retina BV - blindness
Lens - cataracts
All caused by increased glucose, aldose reductase turns into sorbitol

99
Q

Autoimmune destruction of beta cella

A

Type IV HS, Type I diabetes mellitus

100
Q

HLA-DR3 and 4

A

Type I diabetes mellitus

101
Q

Islet leukocytic infiltrate

102
Q

Islet amyloid polypeptide deposits

A

Type II DM

103
Q

Ketoacidosis

A

More likely in Type I DM

104
Q

Glucose Intolerance

105
Q

rapid/deep breathing, delirium, dehydration, fruity breath

106
Q

> 300mg/dL sugar, hyperK, acidosis

107
Q

Mucormycosis (Rhizopus), Cerebral edema, HF

A

DKA complications

108
Q

tx of DKA

A

IV fluids, insulin, and potassium

109
Q

Lethargy, Syncope, Diplopia

A

Whipple Triad of episodic CNS symptoms from insulinoma (Hypoglycemia)

110
Q

Random Glucose >200mg/dL

A

DM Type II

111
Q

Glucose Tolerance test >200mg/dL 2hr after glucose load

A

DM Type II

112
Q

Fasting Glucose >126mg/dL

A

DM Type II

113
Q

Glucose >500mg/dL, hypotension and coma, no ketones

A

Hyperosmolar Non-Ketotic Coma, associated with Type II DM

114
Q

Achlorhydria, Cholelithiasis and Steatorrhea

A

Somatostatinoma

115
Q

Watery diarrhea, hypoK, anchlorhydria

116
Q

High levels of 5-HT, recurrent diarrhea, cutaneous flushing, asthmatic wheezing and right sided valvular disease

A

Carcinoid Syndrome

117
Q

Increased 5-HIAA in urine

A

Carcinoid Syndrome

118
Q

Tx of Carcinoid Syndrome

A

resection of Octreotide (somatostatin analog)

119
Q

Most common malignancy in the small intestine

A

Carcinoid Syndrome

120
Q

Recurrent ulcers in distal duodenum and jejunum

A

ZE-syndrome

121
Q

Pituitary, parathyroid, and Pancreas Tumors

A

MEN1 - Wermer Syndrome

122
Q

Commonly present with kidney stones and stomach ulcers

A

MEN1 - Wermer Syndrome

123
Q

Medullary thyroid carcinoma, Pheochromocytoma, parathyroid hyperplasia

A

MEN2A (Sipple Syndrome)

124
Q

Medullary thyroid carcinoma, Pheochromocytoma, Oral/intestinal ganglioneuromatosis (mucosal neuromas),

125
Q

Associated with Marfanoid Habitus

126
Q

ret gene mutation

A

MEN2A and 2B

127
Q

Drunk Drive Thru

First Aid Endocrine (4 decks)

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