UWorld Flashcards
hypotension, weight loss, hypoglycemia
ACTH deficiency (seen in hypopituitarism)
fatigue, cold intolerance, slowed deep
hypothyroidism
infertility, loss of libido
hypopituitarism –> decreases in gonadotropins
etiology of hypopituitarism
pituitary causes: hemorrhage (apoplexy), ischemic infarction (sheehan syndrome),
infiltration (pituitary hypophysitis)
sheehan syndrome
ischemic infarction of the pituitary- occurs during pregnancy (peripartum hemorrhage)
most common symptom of sheehan syndrome
failure to lactate due to prolactin deficiency
usually presents with acute severe heachage, opthalmoplegia, and altered sensorium
pituitary apoplexy (hemorrhage), often as the result of an adenoma
the most common inflammatory condition of the pituitary
lymphocytic hypophysitis
what causes sheehan syndrome
high levels of estrogen during pregnancy
60 yo man had difficulty going up the stairs, dyspnea on exertion, darkening of the skin, lung mass, elevated serum cortisol levels. what is the appropriate lab to order?
high dose dexamethasone suppression test for cushing’s
high dose dexamethasone test for cushing’s involving a pituitary adenoma
ACTH and cotisol would decrease
high dose dexamathasone test for cushing’s involving a ectopic ACTH
ACTH and cortisol would be unchanged
high dose dexamethasone test for cushing’s involving adrenals and adenoma/carcinoma
ACTH/cortisol would be unchanged
man has a “cold” thyroid nodule on thyroid scan. FNA shows spindle shaped cells on amorphous background. serum calcitonin is elevated. what genetic alteration would we find?
activating mutation of the RET proto oncogene
80% of medullary thyroid carcinomas are
sporadic
20% of medullary thyroid carcinomas are
associated with MEN2B
what mutation is found in over 95% of medullary thyroid carcinomas?
germline mutations in RET
fatigue, constipation, weight gain…female patient, 45-65, diffuse enlargement of the thyroid. what would be found on fine needle aspiration?
mononuclear infiltrate, geminal centers, herthle cells, lymphocytes: hoshimoto’s thyroiditis
branching papillary structures, concentric calcifications ground glass nuclei and intranuclear grooves
papillary carcinoma, thyroid
branching papillary structures, concentric calcifications, ground class nuclei, intranuclear grooves, follicular hyperplasia and tall cells
tall cell variant of papillary thyroid carcinoma
extensive fibrosis beyond the thyroid gland, thyroid hard and fixed
Ridel’s thyroiditis
headaches, arthritic pain, erectile dysfunction, renal stones, high blood pressure, UA- glycosuria, hypercalcemia.
lactotroph-somatotroph pituitary tumor (prolactin and growth hormone secreting)
