Reviewer #6 Flashcards
A condition characterized by enlarged tissues, muscle weakness, hypertrophied joints, osteoporosis of the spine, and joint pain.
Common symptoms include erectile dysfunction in men and amenorrhea, increased facial hair, and deepened voices in women.
Acromegaly
What diagnostic tools are used for Acromegaly?
Skull radiograph, MRI, CT, bone radiographs, radioimmunoassay, glucose tolerance test.
These tests reveal pituitary enlargement and increased plasma levels of GH.
What is the treatment method for Acromegaly?
Hypophysectomy, radiation therapy, and Bromocriptine Mesylate.
Bromocriptine inhibits the release of GH.
It is characterized by fluid retention and dilutional hyponatremia.
SIADH
What are the key features of SIADH?
- Fluid retention
- Serum hypoosmolality
- Dilutional hyponatremia
- Concentrated urine
- Normal renal function
What are the initial symptoms of SIADH?
Thirst, dyspnea on exertion, and fatigue.
Severe symptoms include muscle twitching, vomiting, and seizures.
What diagnostic criteria indicate SIADH?
Serum sodium less than 134 mEq/L, serum osmolality less than 280 mOsm/kg, urine specific gravity greater than 1.025.
A low serum osmolality compared to urine osmolality indicates inappropriate excretion of concentrated urine.
What is the treatment for mild SIADH?
Fluid restriction of 800 to 1000 mL/day.
In acute settings, restrict total fluid intake to no more than 1000 mL/day.
A condition characterized by polydipsia and polyuria, with large urine output and low urine specific gravity.
Serum osmolality is usually elevated due to hypernatremia.
Diabetes Insipidous
What diagnostic test is used to identify central DI?
Water deprivation test.
It differentiates between central and nephrogenic DI.
What are common treatments for central DI?
Fluid and hormone therapy, Desmopressin (DDAVP), and monitoring of serum glucose levels.
DDAVP can be administered orally, IV, subcutaneously, or as a nasal spray.
A condition of hyperactivity of the thyroid gland with increased synthesis and release of thyroid hormones.
Thyrotoxicosis is the clinical syndrome resulting from excess thyroid hormone.
Hyperthyroidism
What are the clinical manifestations of Hyperthyroidism?
- Increased metabolism
- Nervousness
- Weight loss
- Goiter
- Ophthalmopathy
An enlarged thyroid gland that may result in either hyperthyroidism or hypothyroidism.
Nontoxic goiters are not due to malignancy or inflammation.
Goiter
What laboratory findings confirm Hyperthyroidism?
Decreased TSH levels and elevated free thyroxine (free T4) levels.
RAIU test differentiates Graves’ disease from other forms of thyroiditis.
What is the primary treatment goal for Hyperthyroidism?
To block the adverse effects of excessive thyroid hormone and prevent complications.
Treatment includes antithyroid drugs, iodine, and β-adrenergic blockers.
A deficiency of thyroid hormone that causes a general slowing of the metabolic rate.
Iodine deficiency is the most common cause worldwide.
Hypothyroidism
What are common symptoms of Hypothyroidism?
- Anemia
- Bruising easily
- Increased serum cholesterol
- Myxedema
- Systemic effects of slowing body processes
What are the manifestations of Hyperparathyroidism?
- Hypercalcemia
- Muscle weakness
- Loss of appetite
- Constipation
- Osteoporosis
What serious complications can arise from Hyperparathyroidism?
- Renal failure
- Pancreatitis
- Cardiac changes
- Fractures
What is hyperparathyroidism primarily associated with?
Hypercalcemia
Hypercalcemia leads to various manifestations including muscle weakness and emotional disorders.
List common manifestations of hyperparathyroidism.
- Muscle weakness
- Loss of appetite
- Constipation
- Fatigue
- Emotional disorders
- Shortened attention span
- Osteoporosis
- Fractures
- Kidney stones (nephrolithiasis)
What serious complications can arise from hyperparathyroidism?
- Renal failure
- Pancreatitis
- Cardiac changes
- Long bone, rib, and vertebral fractures
What is the role of bisphosphonates in treating hyperparathyroidism?
They inhibit osteoclastic bone mineral resorption, normalizing serum calcium levels and improving bone mineral density.
Which agents increase the sensitivity of the calcium receptor on the parathyroid gland?
Calcimimetic agents (e.g., cinacalcet [Sensipar])
What are the clinical features of acute hypoparathyroidism?
- Tetany
- Tingling of the lips
- Stiffness in extremities
- Painful tonic spasms
- Lethargy
- Anxiety
- Personality changes
What emergency treatment is required for tetany after surgery?
Administration of IV calcium
Calcium chloride, Calcium gluconate, or calcium gluceptate can be used.
What is the primary cause of pheochromocytoma?
A tumor in the adrenal medulla affecting the chromaffin cells.
What are the classic manifestations of pheochromocytoma?
- Severe, episodic hypertension
- Severe, pounding headache
- Tachycardia with palpitations
- Profuse sweating
- Unexplained abdominal or chest pain
What is the simplest and most reliable diagnostic test for pheochromocytoma?
Measurement of urinary fractionated metanephrines and fractionated catecholamines.
What is Cushing Syndrome caused by?
Chronic exposure to excess corticosteroids, particularly glucocorticoids.
List common physical changes associated with Cushing Syndrome.
- Moon face
- Reddened skin
- Hirsutism
- Weight gain
- Buffalo hump
- Supraclavicular fat pad
- Purple striae
- Bruising
What is the first indication of Cushing syndrome?
- Centripetal (truncal) obesity
- Moon face
- Purplish red striae
- Hirsutism in women
- Menstrual disorders in women
- Hypertension
- Unexplained hypokalemia
What is the standard treatment for Cushing syndrome caused by a pituitary adenoma?
Surgical removal of the pituitary tumor using the transsphenoidal approach.
What should be monitored in patients undergoing treatment for Cushing syndrome?
- Vital signs
- Daily weight
- Glucose levels
- Signs of infection
What is the main cause of Addison’s Disease?
Hypofunction of the adrenal cortex.
What are the primary features of Addison’s Disease?
- Progressive weakness
- Fatigue
- Weight loss
- Anorexia
What triggers an Addisonian crisis?
- Stress
- Sudden withdrawal of corticosteroid therapy
- Adrenal surgery
- Sudden pituitary gland destruction
What is the mainstay treatment for adrenocortical insufficiency?
Hormone therapy, primarily hydrocortisone.
What dietary changes are recommended for patients with Addison’s Disease?
Increased salt needs to be added to the diet.
What are the signs of corticosteroid deficiency that patients with Addison’s Disease should recognize?
Signs and symptoms of Cushing syndrome.
