• Shuffle
    Toggle On
    Toggle Off
  • Alphabetize
    Toggle On
    Toggle Off
  • Front First
    Toggle On
    Toggle Off
  • Both Sides
    Toggle On
    Toggle Off
  • Read
    Toggle On
    Toggle Off
Reading...
Front

How to study your flashcards.

Right/Left arrow keys: Navigate between flashcards.right arrow keyleft arrow key

Up/Down arrow keys: Flip the card between the front and back.down keyup key

H key: Show hint (3rd side).h key

A key: Read text to speech.a key

image

Play button

image

Play button

image

Progress

1/129

Click to flip

129 Cards in this Set

  • Front
  • Back
Most common enzyme deficient in adrenogenital syndrome
21-hydroxylase
Adrenal hormone whose production is DECREASED in adrenogenital syndrome
Cortisol
Presenting symptom of nodule in adrenal medulla
HTN
Hyperosmolar coma: more likely type I or II diabetes
Type II
Serum test very important to do post thyroidectomy
Calcium (to check for hypoparathyroidism)
Name for an adrenal cortical adenoma secreting aldosterone
Conn syndrome
Effect of Conn syndrome on corticotropin levels
NONE. Aldosterone does not exhibit feedback on corticotropin
Only way to differentiate between follicular adenoma vs carcinoma of thyroid
Invasion or metastasis = carcinoma
Out of follicular and papillar carcinoma of thyroid, which is more likely to metastasis to lymph nodes and which to distant sites
Follicular = distant sites, Papillary = lymph nodes
Three likely metastasis site of follicular thyroid carcinoma
Bone, lung, liver
Rare, but highly aggressive thyroid cancer. Very unlikely to be confined
Anaplastic carcinoma
Thyroiditis: typically involves part of gland or whole?
Whole gland
Cancer risk increased with Hashimoto thyroiditis
non-Hodkin B-cell lymphoma
Thyroid cancer that tends to invade locally before having lymph node or distant metastasis
Medullary carcinoma
Give dx based on microscopic appearance: papillary projection in thyroid follicles lined by tall columnar epithelial cells, stromal lymphoid aggregates,
Graves disease
Give dx based on microscopic appearance: Thyroid Follicular destruction with lymphoid aggregates and Hurthle cell metaplasia
Hashimoto Thyroiditis
Give dx based on microscopic appearance: Thyroid Follicular destruction with presence of giant cells
Granulomatous thyroiditis
Thyroid cancer that can be multifocal
Medullary carcinoma
pDiabetes type with Pancreatic amyloid deposition = ?
Type 2 diabetes
Give dx based on microscopic appearance: thyroid with enlarged follicles and flattened epithelial cells
Goiter
Most patients with goiter: hypo, hyper, or euthyroid
Euthyroid
Cancer ruled out by negative low and high dose dexamethasone suppression test
Pituitary adenoma
Adrenal tumor Cushing's and Conn's disease: Effect on opposite adrenal gland?
Cushings: atrophy, Conn's: none
Type II diabetics are at risk for developing what liver complication
Nonalcoholic steatohepatitis
Mucormycosis is at increased risk when diabetics enter:
Ketoacidosis
Most common cause of primary and secondary hyperparathyroidism
Primary - parathyroid adenoma; Secondary - renal failure
Easiest way to exclude renal failure as a cause of hyperparathyroidism
Low phosphate levels. Phosphate is retained with renal failure
Infection at increased risk when type I diabetic enters ketoacidosis
Mucomycosis (Mucor Circinelloides)
Pancreas has fibrous stroma with scattered normal islets. Dx?
Chronic pancreatitis
Name for bilateral adrenocortical hemorrhage following Neisseria Meningitidis infection
Waterhouse-Friderichsen syndrome
Severe infection with this virus in immunocompromised individuls can diminish adrenal function
CMV
What is Plummer syndrome? Give its alternate name
A hyperfunctioning nodule inside a goiter. AKA toxic multinodular goiter
Affect of papillary carcinoma on thyroid function
NONE
Follicular adenoma: usually hot or cold nodules
Cold ("toxic" follicular adenoma is an exception)
Alternate name for subacute granulomatous thyroiditis
de Quarvain thyroiditis
Usual factor preceding de Quarvain thyroiditis
Viral URI
Cell types infiltrating to cause insulitis in Type I diabetes
T-cells
Thyroid cancer with RET mutation
Papillary and medullary carcinomas
Amyloid stroma is a common feature of what thyroid tumor
Medullary carcinoma
Most medullary carcinomas (80%) are sporadic, name two other times they are seen
MEN IIA or IIB
Alternate name for MEN Type I
Wermer syndrome
Neck irradiation predisposes to what thyroid cancer?
Papillary carcinoma
MHC Class II alleles seen with type 1 diabetes
HLA-DR3 and DR4
Most likely dx for solitary cold nodule in younger person
Cancer, most likely follicular adenoma
Enzyme causing converstion of glucose to sorbitol
Aldose reductase
Mechanism of increased atherosclerosis in diabetics
Glycosylation of vascular walls
MEN syndrome with the "three P's." Name them
MEN type I. Pancreas, Pituitary, Parathyroid
Most likely causative organism of Waterhouse-Friderichsen syndrome
Neisseria Meningiditis
Give dx based on microscopic appearance: thyoid with nests of cell in congo red-positive hyaline stroma
Medullary carcinoma
Product of C cells (aka parafollicular)
Calcitonin
HLA-DR3 and HLA-DR4 are seen with?
Type 1 diabetes
Mechanism of neuropathy in diabetics
Sorbitol accumulation causes osmolar damage
Hereditary tendency of graves disease:
Fairly high (50% twin concordance)
Frequency of exopthalmos in graves disease
Only 40%
Cell type in medullary carcnioma of the thyroid
C cells (aka parafollicular cells)
Condition with antithyroid peroxidase antibodies
BOTH Hashimoto and Graves, though higher tighter in Hashimoto
If a unilateral adrenal cortical adenoma is present, but the opposite gland is NOT atrophied, what do you know?
It's either nonfunctional or secretes aldosterone, NOT cortisol
Alternate name for primary chronic adrenocortical insufficiency
Addison disease
Most common cause of Addison disease (assume NOT a TB-rich country)
Autoimmune adrenalitis
Co-morbidity common with autoimmune adrenalitis
Other autoimmune diseases in 50% of cases, often endocrine
Two most common mutations in parathyroid tumors
#1: Cyclin D1, #2: MEN1
GNAS1 mutations are common in what endocrine tumor?
Somatotroph Pituitary adenoma
VHL mutation can be seen in what endocrine tumor?
Pheochromocytoma
Describe Zollinger-Ellison syndrome
One or more islet cell adenomas that secrete gastrin; produces intractable PUD
Symptoms of vasoactive intestinal polypepite tumor (VIPomas)
Marked diarrhea, hypokalemia, achlorhydria (low HCl in gastric secretions)
Pancreatic tumor that can secrete several various hormones
Islet cell tumor
Strong sign that PUD may be cause by Zollinger-Ellison
Disease is intractable - H2 blockers will not heal the ulcers
Most common Thyroid malignancy
Papillary
Occurance rate of metastasis TO the thyroid
Rare
Invasion pattern of parathyroid carcinoma
Usually Local invasion only
Thyroid cancer with cervical node metastasis. Likely Dx?
Papillary carcinoma
Usual age, location of craniopharyngioma
Child or young adult, suprasellar region
Embryologic origin of craniopharyngioma
Remnant of Rathke pouch
Microscopic appearance of craniopharyngioma
Squamous elements + debris containing cholesterol crystals (primitive tooth structures)
Likely dx for high prolactin + hypernatremia
Craniopharyngioma
Ways to segregate high prolactin caused by craniopharyngioma versus prolactinoma
Craniopharyngioma: suprasellar, destructive of surrounding structures, hypernatremia. These do NOT occur with prolactinoma
Symptoms (other than galactorrhea) seen with prolactinoma
Decreased libido, amenorrhea, infertility
Easiest way to segregate pancreatic adenocarcinoma versus islet cell tumor
Adenocarcinoma does not secrete hormones
Fatty replacement of pancreas. Dx?
Cystic fibrosis
Pseudocysts in the pancreas are a complication of?
Pancreatitis
Usual serum calcium levels in hyperparathyroidism secondary to renal failure
Normal (kidney failure tends to increase PO4/decrease Ca, so PTH balances out)
Most common location of neuroblastoma
Retroperitoneum - Adrenal glands or nearby ganglia
Endocrine product of neuroblastoma, urine test used
Catecholamine precursors, homovanillic acid (HVA)
Hormone which causes can hyperpigmentation in Cushing's
ACTH (or it's precursors)
Inheritance pattern of MODY
Autosomal dominant
Mutation in MODY2
Inactivation mutation in glucokinase
Mutation in MODY3
Hepatocyte nuclear factor alpha-1
Worse hyperglycemia: MODY3 or MODY2
MODY3
Reason for hyperglycemia in MODY
Reduced insulin secreition in response to glucose
Newborn with retroperitoneal mass + HTN. Likely Dx?
Neuroblastoma
Three things than can be screened in urine for pheochromocytoma
Free catecholamines, metanephrine, vanillylmandelic acid (VMA)
Reason secondary hyperparathyroidism occurs in ADPKD
Kidney funciton down --> PO4 up, Vit D down --> Calcium down --> PTH up
Appearance of nuclei in papillary carcinoma of thyroid
Clear
Mutations seen in 30% of papillary thyroid carcinomas; What family are these genes in?
RET or NTRK1; Receptor tyrosine kinases
What is Sheehan syndrome? Why does it occur?
Postpartum pituitary necrosis. Pituitary enlarges during pregnancy, but blood supply does not. Blood loss during childbirth causes infarction
More at risk for Sheehan syndrome: anterior or posterior pituatary?
Anterior
Anatomical abnormality in empty sella
Arachnoid herniates through diaphragma sella
Most frequent presentation symptom of empty sella
Hyperprolactinemia
What is the "stalk section" effect?
Seen with empty sella: herniation cuts off prolactin inhibition, but other anterior pituitary functions are normal
Typical patient for empty sella
Obese woman
If patient has Cushing's syndrome plus feminization, where is the tumor probably located?
Adrenal cortex
Location of organ of Zuckerkandl and tumor that arises from it
Aortic bifurcation; Pheochromocytoma
Mutation seen in "toxic" follicular adenoma
Activation of TSH receptor pathway
Thyroid cancer with PAX8-PPAR gamma fusion gene
Follicular carcinoma
Mutation in AIRE gene causes:
Autoimmune polyendocrinopahty
Name a recently discovered type I diabetes polymorphism
CTLA4
Enzyme deficient in salt-wasting form of adrenogenital syndrome
21-hydroxylase
Name a recently discovered type II diabetes polymorphism
TCF7L2
Most common cause of SIADH
Paraneoplastic, most often small cell carcinoma of the lung
Most common pineal tumor in children and adults
Children - pineoblastoma, Adults - pineocytoma
Location of adrenal gland
Sella turcica
Organ located between left and right thalamic pulvinar regions, inferior to copus callosum and superior to collicular plate
Pineal gland
Relative amount of islets left when Type 1 DM becomes clinically evident
Pretty much none
Necrolytic migrating erythema (a skin rash) is found with what endocrine tumor?
Glucagonoma
Hormone production reduced in 17 alpha hydroxylase deficiency
Cortisol and DHEA
Hormone production reduced in 21 hydroxylase deficiency
Aldosterone and cortisol
Hormone production reduced in 11 hydroxylase deficiency
Aldosterone and cortisol
How to differentiate between 21 vs 11 hydroxylase deficiency
Glucocorticoid activity. Neither can make cortisol, but with 11 hydroxylase deficiency, some glucocorticoid active intermediates are produced
Alternate names for MEN IIA and IIB
IIA - Sipple syndrome; IIB - Williams syndrome
How to differentiate between MEN 2A versus 2B
2B does not have hyperparathyroidism, instead has neuromas/ganglioneuromas at multiple sites and Marfanoid appearance
MEN with Marfanoid appearance
MEN 2B
Neoplasm present in nearly all MEN 2A and 2B
Thyroid medullary carcinoma
Lesions in MEN IIA
Thyroid medullary carcinoma, pheochromocytoma (40-50%) parathyroid hyperplasia/adenoma (10-20%)
Oncogene mutated in MEN 2A and B
RET
Bilateral pheochromocytomas means?
It's familial (check MEN II)
What causes granulomatous destruction of the adrenals?
TB
How to differentiate between toxic multinodular goiter versus toxic follicular adenoma
Look at the rest of the gland. Will be enlarged with goiter, atrophied with adenoma
Initial thyroid enlargement and hyperfunction followed by progressive atrophy. Dx?
Hashimoto Thyroiditis
Cause of permanent neonatal diabetes
Gain of function mutation in ATP-sensitive potassium channels