Endocrine Pathology Fa

Front 1

#1 cause of Cushing's syndrome

Back 1

exogenous steroids

Front 2

ACTH level in Cushing's disease

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up

Front 3

ACTH level in ectopic ACTH

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very high

Front 4

ACTH level in adrenal adenoma

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low

Front 5

dexamethasone test in normal person

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should suppress cortisol production after a low dose

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dexamethasone test in ACTH producting pituitary tumor

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no change w/ low dose, decrease cortisol w/ high dose

Front 7

Conn's syndrome

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aldosterone secreting tumor

Front 8

symptoms of Conn's

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HTN, hypoK, met alkalosis, low renin

Front 9

secondary hyperaldosteronism

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kidney perception of low volume results in an overactive RAAS system

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causes of secondary hyperaldosteronism

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renal a stenosis, chronic renal failure, CHF, cirrhosis, nephrotic syndrome

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Addison's disease

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chronic primary adrenal insufficiency d/t adrenal atrophy or destruction

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symptoms of Addison's

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hypoTN, hyperK, acidosis, skin hyperpigmentation

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secondary adrenal insufficiency

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decreased pituitary ACTH production; no hyperpigmentation or hyperK

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Waterhouse Friderichesen Syndrome

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acute primary adrenal insufficiency d/t adrenal hemorrhage assoc w/ N. meningiditis septicemia, DIC, endotoxic show

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what do pheochromocytomas secrete?

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epi, NE, dopamine

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symptoms of pheochromocytoma

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episodic HTN; 5 Ps: pressure (BP), pain (headache), perspiration, palpitations, pallor

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urine findings in pheochromocytoma

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VMA

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what diseases is pheochromocytoma assoc w/?

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MEN 2A, 2B; neurofibromatosis

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treatment of pheochromocytoma

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α-antagonist (phenoxybenzamine), then beta blocker

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urine findings in neuroblastoma

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homovanillic acid

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what oncogene assoc w/ neuroblastoma? Tumor marker? Histo?

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N-myc, bombesin, homer wright pseudorosettes

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21 hydroxylase deficiency

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masculinization, hypoTN, hyperK+, volume depletion, salt wasting

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17 alpha hydroxylase deficiency

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external female, HTN, hypoK+

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11 beta hydroxylase deficiency

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masculinization, HTN

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most common cause of hypothyroidism

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Hashimoto's thyroiditis

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patho Hashimoto's

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autoimmune: anti microsomal + anti-thyroglobulin Abs

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what HLA type assoc w/ Hashimoto's

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DR5

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histology of Hashimoto's

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Hurtle cells, lymphocytes, germinal centers

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causes of Cretinism

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endemic when no dietary iodine, sporadic when defect in T4 or thyroid formation

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presentation of Cretinism

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pot bellied, pale, puffy faced, protruding umbillicus, protuberant tongue

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most common cause of hypothyroidism

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Hashimoto's thyroiditis

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Subacute thyroiditis

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self limited hypothyroidism following flu-like illness

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patho Hashimoto's

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autoimmune: anti microsomal + anti-thyroglobulin Abs

Front 34

what HLA type assoc w/ Hashimoto's

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DR5

Front 35

very tender thryoid

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subacute thyroidis

Front 36

labs + histo in Subacute thyroiditis

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increased ESR, granulomatous inflammation

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histology of Hashimoto's

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Hurtle cells, lymphocytes, germinal centers

Front 38

Riedel's thyroiditis

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thyroid replaced by fibrous tissue

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causes of Cretinism

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endemic when no dietary iodine, sporadic when defect in T4 or thyroid formation

Front 40

patho of Grave's

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autoimmune hypertyroid w/ TSH receptor Abs; type 2 hypersensitivity

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presentation of Cretinism

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pot bellied, pale, puffy faced, protruding umbillicus, protuberant tongue

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presentation Grave's

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ophthalmopathy, pretibial myxedema, diffuse goiter

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Subacute thyroiditis

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self limited hypothyroidism following flu-like illness

Front 44

very tender thryoid

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subacute thyroidis

Front 45

Thyrotoxicosis

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stress induced catecholamine surge --> death d/t arrhythmia

Front 46

Toxic multinodular goiter

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focal patches of hyperfunctioning follicular cells d/t mutation in TSH receptor

Front 47

labs + histo in Subacute thyroiditis

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increased ESR, granulomatous inflammation

Front 48

Riedel's thyroiditis

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thyroid replaced by fibrous tissue

Front 49

Job Basedow phenomenon

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thyrotoxicosis if pts w/ iodine deficient goiter is given iodine

Front 50

which thyroid cancer: ground glass nuclei

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papillary

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patho of Grave's

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autoimmune hypertyroid w/ TSH receptor Abs; type 2 hypersensitivity

Front 52

presentation Grave's

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ophthalmopathy, pretibial myxedema, diffuse goiter

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which thyroid cancer: psammoma bodies

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papillary

Front 54

Thyrotoxicosis

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stress induced catecholamine surge --> death d/t arrhythmia

Front 55

which thyroid cancer: RAS mutation

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follicular

Front 56

which thyroid cancer: amyloid stroma

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medullary

Front 57

Toxic multinodular goiter

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focal patches of hyperfunctioning follicular cells d/t mutation in TSH receptor

Front 58

Job Basedow phenomenon

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thyrotoxicosis if pts w/ iodine deficient goiter is given iodine

Front 59

which thyroid cancer: assco w/ Hashimoto's

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lymphoma

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which thyroid cancer: RET oncogene

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papillary

Front 61

which thyroid cancer: ground glass nuclei

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papillary

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which thyroid cancer: psammoma bodies

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papillary

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which thyroid cancer: BRAF

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papillary

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MEN 1

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parathyroid, pancreas, pituitary

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which thyroid cancer: RAS mutation

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follicular

Front 66

which thyroid cancer: amyloid stroma

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medullary

Front 67

MEN 2A

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medullary thyroid, parathyroid, phenochromoctoma

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which thyroid cancer: assco w/ Hashimoto's

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lymphoma

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MEN 2B

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medullary, mucosal tumors, pheochromocytoma

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which thyroid cancer: RET oncogene

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papillary

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ret gene assoc w/ which MEN

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2A, 2B

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inheritance of MEN syndromes

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AD

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which thyroid cancer: BRAF

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papillary

Front 74

MEN 1

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parathyroid, pancreas, pituitary

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MEN 2A

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medullary thyroid, parathyroid, phenochromoctoma

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MEN 2B

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medullary, mucosal tumors, pheochromocytoma

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ret gene assoc w/ which MEN

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2A, 2B

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inheritance of MEN syndromes

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AD

Front 79

primary hyperPTH

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adenoma of parathyroid gland

Front 80

labs in primary hyperPTH

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hyperCa2+, hypoP, alk phos, cAMP in urine

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presentation of primary hyperPTh

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stones, bones, groans, psychic moans

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secondary hyperPTH

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hyperplasia d/t decreased gut Ca2+ absorption and increased P

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labs in secondary hyperPTH

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hypoCa2+, hyperP, alk phos

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tertiary hyperPTH

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refractory hyperPTH from chronic renal disease

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causes of hypoPTH

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accidental surgical excision, autoimmune, DiGeorge

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primary hyperPTH

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adenoma of parathyroid gland

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Chvostek's sign

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tap facial nerve --> contract facial muscles

Front 88

labs in primary hyperPTH

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hyperCa2+, hypoP, alk phos, cAMP in urine

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Trousseau's sign

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occlude brachial artery w/ BP cuff --> carpal spasm

Front 90

presentation of primary hyperPTh

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stones, bones, groans, psychic moans

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pseudohypoPTH

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Albright's hereditary osteodystrophy: AD kidney unresponsive to PTH

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secondary hyperPTH

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hyperplasia d/t decreased gut Ca2+ absorption and increased P

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findings in Albright's hereditary osteodystrophy

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hypoCa2, shortened 4th/5th digits, short stature

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labs in secondary hyperPTH

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hypoCa2+, hyperP, alk phos

Front 95

bitemporal hemianopsia assoc w/?

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prolactinoma

Front 96

tertiary hyperPTH

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refractory hyperPTH from chronic renal disease

Front 97

how to diagnose excess GH?

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increased serum IGF-1

Front 98

causes of hypoPTH

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accidental surgical excision, autoimmune, DiGeorge

Front 99

treatment of pituitary adenoma

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resect + octreotide

Front 100

Chvostek's sign

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tap facial nerve --> contract facial muscles

Front 101

treatment of central DI

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intranasal desmopressin

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Trousseau's sign

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occlude brachial artery w/ BP cuff --> carpal spasm

Front 103

treatment of nephrogenic DI

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HCTZ, indomethacin, amiloride

Front 104

pseudohypoPTH

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Albright's hereditary osteodystrophy: AD kidney unresponsive to PTH

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causes of central DI

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pituitary tumor, trauma, surgery, histiocytosis X

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findings in Albright's hereditary osteodystrophy

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hypoCa2, shortened 4th/5th digits, short stature

Front 107

causes of nephrogenic DI

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hereditary, lithium, demeclocycline, secondary to hyperCa2+

Front 108

bitemporal hemianopsia assoc w/?

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prolactinoma

Front 109

3 findings in SIADH

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excess water retention, hypoNa+, urine osmolarity > serum osmolarity

Front 110

how to diagnose excess GH?

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increased serum IGF-1

Front 111

how does body respond to SIADH?

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decrease aldosterone --> hyponatremia

Front 112

treatment of pituitary adenoma

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resect + octreotide

Front 113

histology of type 1 vs type 2 diabetes

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1: leukocyte infiltrate; 2: amyloid deposition

Front 114

treatment of central DI

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intranasal desmopressin

Front 115

labs in DKA

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hyperglycemia, anion gap met acid, hyperK+ but depleted intracellular K

Front 116

treatment of nephrogenic DI

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HCTZ, indomethacin, amiloride

Front 117

DKA treatment

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fluids, insulin, K+

Front 118

causes of central DI

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pituitary tumor, trauma, surgery, histiocytosis X

Front 119

symptoms of carcinoid

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diarrhea, flushing, wheezing, R side valve disease

Front 120

causes of nephrogenic DI

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hereditary, lithium, demeclocycline, secondary to hyperCa2+

Front 121

labs in carcinoid syndrome

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urine 5-HIAA

Front 122

3 findings in SIADH

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excess water retention, hypoNa+, urine osmolarity > serum osmolarity

Front 123

treatment of carcinoid syndrome

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octreotide

Front 124

how does body respond to SIADH?

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decrease aldosterone --> hyponatremia

Front 125

Zollinger Ellison syndrome

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gastrin secreting tumor of pancreas or duodenum

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histology of type 1 vs type 2 diabetes

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1: leukocyte infiltrate; 2: amyloid deposition

Front 127

labs in DKA

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hyperglycemia, anion gap met acid, hyperK+ but depleted intracellular K

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DKA treatment

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fluids, insulin, K+

Front 129

symptoms of carcinoid

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diarrhea, flushing, wheezing, R side valve disease

Front 130

labs in carcinoid syndrome

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urine 5-HIAA

Front 131

treatment of carcinoid syndrome

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octreotide

Front 132

Zollinger Ellison syndrome

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gastrin secreting tumor of pancreas or duodenum