Endocrine Path/pharm

Front 1

MCC of Cushing's syndrome

Back 1

exogenous (iatrogen) steroid use (decreased ACTH)

Front 2

Cushing's disease

Back 2

70% of endogenous causes; due to ACTH secretion from pituitary adenoma (increased ACTH)

Front 3

ectopic ACTH as cause of Cushing's

Back 3

15%; nonpituitary tissue making ACTH ex. small cell lung cancer, bronchial carcinoids (increased ACTH)

Front 4

adrenal cause of Cushing's

Back 4

15%; adenoma, carcinoma, nodular adrenal hyperplasia (decreased ACTH)

Front 5

dexamethasone suppression test - healthy person

Back 5

decreased cortisol level after low dose

Front 6

dexamethosone suppression test - ACTH producing pituitary tumor (Cushing's disease)

Back 6

increased cortisol after low dose; decreased cortisol after high dose

Front 7

dexamethosone suppression test - ectopic ACTH producing tumor

Back 7

increased cortisol after both low and high doses

Front 8

dexamethasone suppression test - cortisol-producing tumor

Back 8

increased cortisol after low and high dose

Front 9

clinical findings in Cushing's syndrome

Back 9

HTN, weight gain, moon facies, truncal obesity, buffalo hump, hyperglycemia, skin changes, osteoporosis, amenorrhea, immune suppression

Front 10

primary hyperaldosteronism (Conn's syndrome)

Back 10

unilateral/bilateral aldosterone-secreting tumor

Front 11

findings in Conn's syndrome

Back 11

hypertension (Na+ and H20 retention), hypokalemia, metabolic alkalosis (H+, K+ secretion), low plasma renin

Front 12

treatment of Conn's syndrome

Back 12

(1) surgery to remove tumor (2) spirinolactone - K+ sparing diuretic that is an aldosterone antagonist

Front 13

secondary hyperaldosteronism

Back 13

kidney perception of low IV volume results in overactive renin-angiotensin system; associated with high plasma renin

Front 14

causes of secondary hyperaldosteronism

Back 14

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

Front 15

Addison's disease

Back 15

chronic primary adrenal insufficiency due to adrenal atrophy or destruction by disease resulting in deficiency of aldosterone and cortisol

Front 16

findings in Addison's disease

Back 16

hypotension, hyperkalemia, metabolic acidosis, skin hyperpigmentation, adrenal atrophy of all 3 layers

Front 17

secondary adrenal insufficiency

Back 17

decreased pituitary ACTH production which has no skin hyperpigmentation and no hyperkalemia

Front 18

waterhouse-friedrichson syndrome

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acute primary adrenal insufficiency due to adrenal hemorrhage

Front 19

causes of waterhouse friedrichson syndrome

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Neisseria meningitidis, DIC, endotoxic shock

Front 20

MC tumor of adrenal medulla in adults

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pheochromocytoma

Front 21

which cells does a pheochromocytoma arise from?

Back 21

chromaffin cells (neural crest)

Front 22

findings in pheochromocytoma

Back 22

(1) episodic HTN - due to E, NE and DA release (2) urinary VMA elevated (3) plasma catecholamines elevated

Front 23

pheochromocytomas are associated with..

Back 23

neurofibromatosis, MEN types 2a and 2b

Front 24

rule of 10s (pheochromocytoma)

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10% malignant, 10% bilateral, 10% extraadrenal, 10% calcify, 10% kids, 10% familial

Front 25

pheochromocytoma symptoms

Back 25

episodic: Pressure (BP), Pain (headache), Perspiration, Palpitations (tachycardia), Pallor

Front 26

breakdown productions of DA (1), NE (2) and E (3)

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(1) DA - HVA (2) NE - VMA (3) E - metanephrine

Front 27

MC tumor of adrenal medulla in children

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neuroblastoma

Front 28

neuroblastoma

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can occur anywhere along sympathetic chain, elevated HVA in urine, overexpression of N-myc oncogene associated with rapid tumor progression

Front 29

signs/symptoms of hypothyroidism

Back 29

cold intolerance, weight gain (decreased appetite), lethargy/fatigue, constipation, decreased reflexes, myxedema, dry cool skin, bradycardia, dyspnea on exertion

Front 30

signs/symptoms of hyperthermia

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heat intolerance, weight loss, increased appetite, hyperactivity, diarrhea, increased reflexes, pretibial myxedema, warm moist skin, fine hair, chest pain, palpitations, arrhythmias

Front 31

lab findings in hypothyroidism

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increased TSH, decreased total T4, free T4, T3 uptake

Front 32

lab findings in hyperthyroidism

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decreased TSH, increased total T4, freeT4 and T3 uptake

Front 33

MCC of hypothyroidism

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Hashimoto's thyroiditis

Front 34

Hashimoto's thyroiditis

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autoimmune disorder; antimicrosomal and antithyroglobulin ab's with association to HLA-DR5

Front 35

histology in Hashimoto's

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Hurthle cells, lymphocytic infiltrate with germinal centres

Front 36

findings in Hashimoto's

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moderately enlarged, nontender thyroid

Front 37

Cretinism

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severe fetal hypothyroidism

Front 38

endemic Cretinism

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endemic goiter is prevalent ex. lack of dietary iodine

Front 39

sporadic cretinism

Back 39

defect in T4 formation or developmental failure in thyroid function

Front 40

findings in Cretinism

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pot bellied, pale, puffy-faced child with protruding umbilicus and protuberant tongue; mental retardation

Front 41

subacute thyroiditis (de Quervain's)

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self-limited hypothyroidism following a flu-like illness; may initially be hyperthyroid

Front 42

histology of subacute thyroiditis

Back 42

granulomatous inflammation

Front 43

findings in subacute thyroiditis

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increased ESR, jaw pain, early inflammation, very tender thyroid

Front 44

Reidel's thyroiditis

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thyroid replaced by fibrous tissue (hypothyroid)

Front 45

findings in Riedel's thyroiditis

Back 45

fixed, hard (rock-like) and painless goiter

Front 46

Grave's disease

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type II HS, autoimmune hyperthyroidism with thyroid stimulating/TSH receptor antibodies

Front 47

signs/symptoms of Grave's disease

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ophthalmopathy - proptosis, EOM swelling; pretibial myxedema, diffuse goiter; often presents during stress

Front 48

thyrotoxicosis

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stress-induced catecholamine surge leading to death by arrhythmia; serious complication of Grave's disease

Front 49

toxic multinodular goiter

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focal patches of hyperfunctioning follicular cells working independently of TSH due to mutation of TSH receptor; increased release of T3/T4

Front 50

Jod-Basedow phenomenon

Back 50

thyrotoxicosis if a patient with iodine deficiency goiter is made iodine replete