TTR Flashcards
medullary carcinoma of the breast presentation
(histologic subtype of invasiv ductal carcinoma)
histo: large, high grade cells, lymphocytic infiltrate
gross: well circumscribed mass; can mimic fibroadenoma on mammography
higher incidence in BRCA1 patients
most important prognostic factor affecting the course of breast cancer
involvement of axillary lymph nodes
If there is no spread to axillary nodes, the 10-year survival rate is almost 80%
risk factors for male breast cancer
age(70+)
1st degree relative w/BC
BRCA2 mutations
exposure to ionizing radiation
exogenous estrogen
infertility
obesity
conn syndrome
primary hyperaldosteronism
commonly an fxnl adrenal adenoma in glomerulosa of adrenal cortex
differentiate metastases in papillary vs follicular thyroid carcinoma
papillary - more likely to involve lymph nodes
follicular - more likely to metastatsistze to distant sites(bone, lung, liver)
how do you differentiate these origins of cushings?
pituitary
adrenal
ectopic
pituitary adenoma - suppressed by dexamethasone
adrenal tumor - unilateral enlargement of adrenals
ectopic ACTH - bilateral adrenal enlargement; not suppressed by dexamethasone
how is phosphate used to differentiate between primary and secondary hyperparathyroidism
phosphate is LOW in primary hyperparathyroidism due to excess PTH
phosphate is HIGH in secondary(renal failure) due to retention/broken kidneys
HLAs associated with DM type 1
HLA DR3, DR4
extensive fibrosis and fatty replacement of the pancreas is seen in what disease?
cystic fibrosis
amyloid deposition islet cells of pancreas is seen in what disease
type II DM
how do craniopharyngiomas cause galactorrhea and hypernatremia?
stalk-effect: reduces dopamine inhibition of prolactin – causes galactorrhea
Hypernatremia results from diabetes insipidus caused by lack of ADH – dilute urine
glucokinase vs hexokinase
both are used to trap glucose by creating G6P
glucokinase acts as a glucose sensor in the pancreas
- has a lower affinity for glucose than hexokinase
- is not inhibited by its product G6P
- defective in MODY2(mild hyperglcyemia since threshold for insulin release increases)
hexokinase is found in all tissue and works to trap glucose in tissues
- higher affinity for glucose
- IS inhibited by G6P
HVA is increased in what childhood tumor?
neuroblastoma
what do you screen for in an adult with a suspected pheochromocytoma
urinary free catecholamines, metanephrine, VMA
empty sella syndrome presentation
obese woman
hyperprolactinemia due to stalk effect - galactorrhea, infertility
the compression of the anterior pituitary by the arachnoid herniation(cause of empty sella) usually does not cause hypopituitary(would have to destory 70%)
