Pathology VIII Flashcards
What causes the fruity breath odor of DKA?
Exhaled acetone (p.303)
What lab findings point to a diagnosis of DKA?
Hyperglycemia, Increased H+, decreased bicarb, anion gap metabolic acdosis, increased blood ketone levels, leukocytosis, hyperkalemia (but depleted intracellular K+) (p.303)
Name five potential complications of DKA.
Life threatening mucormycosis, Rhizopus infection, cerebral edema, cardiac arrythmias, heart failure (p.303)
How is DKA treated?
IV fluids, IV insulin, and Potassium (to replete intracellular stores). Give glucose if necessary to prevent hypoglycemia (p.303)
What is carcinoid syndrome?
Rare syndrome caused by carcinoid tumors (p.304)
Which type of tumor most commonly causes carcinoid syndrome?
Metastaic small bowel tumors (p.304)
From what cells are carcinoid tumors derived?
Neuroendocrine cells (p.304)
What is secreted from carcinoid symdrome small bowel tumors?
High levels of serotonin (p.304)
When is carcinoid syndrome detected in patients with small bowel tumors?
When tumor metastasises to liver; not seen if tumor is limited to GI tract (serotonin undergoes first pass metabolism in the liver) (p.304)
What symptoms are caused by carcinoid syndrome?
Recurrent diarrhea, cutaneous flushing, asthmatic wheezing, right sided valvular disease (p.304)
What lab findings are characteristic of carcinoid syndrome?
Increased 5-HIAA in urine; niacin deficiency (p.304)
How is carcinoid syndrome treated?
Somatostatin analogues (e.g. octreotide) (p.304)
What type of drug is octreotide?
A somatostatin analogue (p.304)
What is the rule of 1/3s as it pertains to carcinoid tumors?
1/3 metastasize, 1/3 present with second malignancy, 1/3 are multiple tumors (p.304)
What is the most common tumor of the appendix?
Carcinoid tumor (p.304)
What is Zollinger- Ellison syndrome?
Gastrin secreting tumor of the pancreas or duodenum (p.304)
What pathologic changes to the stomach occur with Zollinger Ellison syndrome?
Rugal thickening of the stomach with acid hypersecretion; causes recurrent ulcers (p.304)
What conditon is associated with Zollinger Ellison syndrome?
MEN Type I (p.304)
What are five characteristic findings in MEN I (Wermer’s syndrome)?
Parathyroid tumors, pituitary tumors (prolactin or GH), pancreatic endocrine tumors (Zollinger-Ellison syndrome, insulinomas, VIPomas, glucagonomas), Kidney stones, stomach ulcers (Findings include ‘3 Ps’) (p.304)
What are four types of pancreatic endocrine tumors?
Zollinger-Ellison syndrome, insulinomas, VIPomas, glucagonomas (very rare) (p.304)
What are three characteristic findings in MEN 2A (Sipple’s syndrome)?
Medullary thyroid carcinoma, pheocromocytoma, parathyroid tumors (findings include ‘2 Ps’) (p.304)
What is secreted by medullary thyroid carcinomas seen in MEN 2A and MEN 2B?
Calcitonin (p.304)
What are three characteristic findings in MEN 2B?
Medullary thyroid carcinoma, pheocromocytoma, oral/intestinal ganglioneuromatosis (findings include ‘1 P’) (p.304)
What is the principle difference in findings in MEN 2A vs MEN2B?
MEN 2A- parathyroid tumors; MEN 2B- oral/intestinal ganglioneuromatosis (p.304)
What is associated with oral/intestinal ganglioneuromatosis?
Marfanoid habitus (p.304)
How are all MEN syndromes inherited?
Autosomal dominant inheritance (p.304)
What gene mutation is associated with MEN types 2A and 2B?
Ret gene mutation (p.304)
