Goljan 22-4 Endocrine

Front 1

Pheochromocytoma
epidemiology ?

Back 1

majority benign, unilateral, arise in adrenal medulla

Front 2

Associations of Pheochromocytoma ?

Back 2

neurofibromatosis, MEN IIa/IIb; von Hippel-Lindau disease

Front 3

Pheochromocytoma

unique findings?

Back 3

palpitations, paroxysmal hypertension, anxiety, drenching sweats, headache
orthostatic hypotension, chest pain, ileus

Front 4

Pheochromocytoma

Diagnosis test?

Back 4

plasma free metanephrines is best screen

Front 5

Pheochromocytoma

urine tests?

Back 5

24- hour collection for metanephrine (best test), VMA

Front 6

Pheochromocytoma

lab findings?

Back 6

hyperglycemia, neutrophilic leukocytosis

Front 7

Neuroblastoma

malignant tumor = ?

Back 7

postganglionic sympathetic neurons

Front 8

Neuroblastoma

occurs most often to?

Back 8

childhood tumor and cause of hypertension

Front 9

Opsoclonus-myoclonus syndrome = ?

Back 9

paraneoplastic syndrome; myoclonic jerk; chaotic eye movements

Front 10

Neuroblastoma:
"small tumor" shows ______ under electron microscopy

Back 10

neurosecretory granules

Front 11

Neuroblastoma

clinical findings?

Back 11

child with abdominal mass + hypertension

Front 12

Insulinoma

lab findings?

Back 12

↑ serum insulin
↑ C-peptide

Front 13

Insulinoma
if patient injecting excess insulin:
lab findings?

Back 13

↑ serum insulin
↓ C-peptide

Front 14

DM (Diabetes Mellitus) is the most common cause of what conditions?

Back 14

blindness, peripheral neuropathy, chronic renal failure, below -knee amputation

Front 15

Maturity onset diabetes of the young (MODY) = ?

Back 15

AD (Autosomal dominant) inheritance; not obese; impaired glucose-induced secretion of insulin

Front 16

Metabolic syndrome in DM?

Back 16

insulin resistance exacerbated by obesity

Front 17

insulin resistance syndrome a
associations?

Back 17

acanthosis nigricans; Alzheimer;s disease

Front 18

Hyperinsulinemia

clinical and lab findings?

Back 18

↑ VLDL (very low-density lipoprotein), hypertension, CAD (Coronary artery disease)
↓ HDL-CL (high-density lipoprotein cholesterol)

Front 19

what prevents complications in diabetes?

Back 19

good glycemic control

Front 20

NEG (Nonenzymatic glycosylation) = ?

Back 20

Hb(↷A1c), hyaline, arteriolosclerosis, glomerulopathy

Front 21

Aldose reductase = ?

Back 21

converts glucose to sorbitol; osmotic damage

Front 22

Osmotic damage = ?

Back 22

cataracts, peripheral, neuropathy, retinopathy

Front 23

Diabetic microangiopathy = ?

Back 23

diabetic glomerular disease

Front 24

what is the most common complication of diabetes?

Back 24

Insulin-induced hypoglycemia

Front 25

DKA (Diabetic ketoacidosis)
is a complication of which type of DM?

Back 25

type 1 DM

Front 26

what is the most important mechanism of hyperglycemia in diabetic ketoacidosis?

Back 26

Gluconeogenesis

Front 27

Ketoacids are synthesized from ?

Back 27

synthesized from acetyl CoA derived from β-oxidation of fatty acids

Front 28

Hypertriglyceridemia

mechanism?

Back 28

↓ capillary lipoprotein lipase activity;
↓ hydrolysis of chylomicrons and VLDL (very low-density lipoprotein)

Front 29

DKA (diabetic ketoacidosis) electrolytes

lab findings?

Back 29

↓ serum sodium, bicarbonate (metabolic acidosis);
↑ serum potassium, anion gap

Front 30

Hyperomolar nonketotic coma is a complication of which type of DM?

Back 30

type 2 DM

Front 31

Hb(↷A1c) is a marker of ?

Back 31

long term glycemic control

Front 32

IGT (Impaired glucose tolerance ) = ?

Back 32

prediabetic state; insulin resistance

Front 33

GDM (Gestational diabetes) = ?

Back 33

anti-insulin effect of HPL (human placental lactogen), cortisol and progesterone

Front 34

Macrosomia (newborn risk) :

an increase of insulin causes?

Back 34

↑ in adipose and muscle

Front 35

Respiratory distress syndrome (RDS)

an increase of insulin causes?

Back 35

inhibits fetal surfactant

Front 36

Neonatal hypoglycemia

an increase of insulin causes?

Back 36

drives glucose into hypoglycemic range; give newborn glucose at birth

Front 37

Type I polyglandular syndrome

clinical findings?

Back 37

Addison's disease, primary hypoparathyroidism, mucocutaneous candidiasis

Front 38

Type II polyglandular syndrome

clinical findings?

Back 38

Addison's disease, Hashimoto's thyroiditis, type 1 diabetes

Front 39

What are the two subdivisions of Hypoglycemia?

Back 39

fed state and fasting state

Front 40

Fed state hypoglycemia:
reactive hypoglycemia

most common cause?

Back 40

excess insulin; adrenergic symptoms

Front 41

Fasting hypoglycemia

causes?

Back 41

alcohol excess; insulinoma; cirrhosis

Front 42

Alcohol excess :

what happens to glycogen stores? gluconeogenesis?

Back 42

↓ glycogen stores
↓gluconeogenesis (pyruvate converted to lactate)

Front 43

Fasting hypoglycemia in children

look for signs of ___?

Back 43

look for inborn errors of metabolism

Front 44

Neuroglycopenia

symptoms?

Back 44

dizziness, mental status changes, motor disturbances

Front 45

Diagnosis for fasting hypoglycemia?

Back 45

prolonged fast; satisfy Whipple's triad