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120 Cards in this Set
- Front
- Back
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exceptions to suppression tests hyperfxning d/o
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PRLoma, pit Cushing's syndrome
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tumros altering hypothalamic fxn 4
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pit adenoma, craniopharyngioma, midline hamartoma, Langerhans histiocytosis
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infl d/o altering hypothalamic fxn 2
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sarcoidosis, meningitis
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most common cause precocious puberty in boys
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midline hamartoma
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paralysis of upward gaze (setting sun sign)
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pineal gland tumor
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majority pineal gland tumors are
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germ cell tumors
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common patho of pineal gland
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dystrophic calcification
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most common cause hypopituitarism in adult
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nonfunctioning adenoma
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MEN 1
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pit adenoma, parathyroid high, panc tumor (usu ZE)
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most common cause hypopituitarism in child
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craniopharyngioma
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ant pit develop from
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Rathke's pouch
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sudden cessation lactation
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Sheehan postpartum necrosis
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pit paoplexy is
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hemorrhage into preexisting adenoma
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autoimmune destruction of hypophysis during/after preg
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lymphocytic hypophysitis
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patho of empty sella syndrome
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subarachnoid space extend into sella -> inc CSF pressure compress gland
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stim test for GH 2
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arg, sleep
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most common pit tumor
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PRLoma
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PRLoma Sx in women
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galactorrhea, 2o amenorrhea
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PRLoma Sx in men
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impotence (loss libido), HA
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Dx for acromegaly
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compare to old photo
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most common cause of death in acromegaly
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cardiomyopathy
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anabolics fx on TBG
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dec
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estogen fx on TBG
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inc
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mass at base of tongue
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lingual thyroid
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cystic midline mass
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thyroglossal duct cyst
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branchial cleft cyst located in
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anterolateral neck
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most common cause of painful thyroid
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subacute granulomatous thyroiditis
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Hashimoto's thyroiditis is which type HSR
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type 2 & 4 HSR
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reidel's thyroidits is
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fibrous tissue replacement of gland & surrounding tissue
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painless postpartum thyroiditis
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subacute -> progress to hypothyroidism
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brain req what for maturation
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thyroxine
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cretinism most often caused by
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maternal hypothyroidism before fetal thyroid developed
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diastolic v. systolic HTN in thyroid d/o
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hypothyroidism: DHTN; hyperthyroidism: SHTN
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GAG in thyroid d/o
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myxedema in both hypo & hyperthryroidism
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exophthalmos
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Graves' dz
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pretibial myxedema
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Graves' dz
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acropachy
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Graves' dz
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grave's dz in elderly 3
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apathetic: afib, CHF, muscle weakness
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Plummer's dz is
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toxic multinodular goiter
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patho euthyroid sick syndrome
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block in conversion T4->T3 so become rT3 instead
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most common benign tumor of thyroid
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follicular adenoma
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most common endocrine CA
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papillary carcinoma
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psammoma bodies in thyroid
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papillary carcinoma
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MEN 2a
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medullary carcinoma, Hyper PTH, pheochromocytoma
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MEN 2b
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medullary carcinoma, mucosal neuroma, pheochromocytoma
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tumor marker medullary carcinoma
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calcitonin (tumor or C cells)
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calcitonin in medullary carcinoma converted to
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amyloid
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gene assoc w/ medullary carcinoma
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RET oncogene
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thyroid CA rapidly fatal
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anaplastic thyroid CA
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mech for alkalosis causing hypocalcemia
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alkalosis -> more COO- on albumin -> bind more Ca -> dec free Ca
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superior parathyroids derive from
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4th pharyngeal pouches
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inferior parathyroids derive from
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3rd pharyngeal pouches
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2 Sx of tetany
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caropedal spasm; Chvostek's sign
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most common cause hypocalcemia in hosp
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hypomagnesemia
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most common cause hypocalcemia
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chronic renal failure
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salt & pepper skull
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1o hyperPTH
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1o hyperPTH mnemonic
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stones, bones, groans, moans
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most common cause hypophosphatemia
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renal failure
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DiGeorge syndrome is failed descent of
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3rd & 4th pharyngeal pouches
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primary hyperPTH assoc w/ which MEN?
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MEN 1, MEN 2a
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most common cause 1o hyperPTH
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benign adenoma
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knuckle-knuckle-dimple-dimple sign
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pseudohypoparathyroidism
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1o hyperPTH Sx 5
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stones, PUD, acute pancreatitis, constipation, pseudogout, diastolic HTN, band keratopathy
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best initial screen for 1o HPTH
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intact serum PTH
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mech for insulin therapy causing hypophosphatemia
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inc glucose uptake req phosphorylation
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most common cause hypophosphatemia in hosp
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alkalosis -> activate PFK -> inc glucose phosphorylation
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vit D-resistant ricklets genetics
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XD
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hypophosphatemia is norm in
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child (drive Ca into bone)
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most common cause acute adrenocortical insufficiency
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abrupt w/d of steroids
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patho Waterhouse-Friderichsen syndrome
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N. meningitidis -> sepsis -> DIC -> b/l adrenal hemorrhage
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most common cause Addison's in US
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autoimmune
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most common cause Addison's in developing countries
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miliary TB
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stim test for ACTH
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metyrapone test
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results of metyrapone test in Addisons
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inc ACTH but no inc in 11-deoxycortisol
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electrolyte findings in Addison's
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hyponatremia, hyperkalemia, met acidosis
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fasting hypoglycemia, eosinophilia, lymphocytosis, neutropenia
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Addison's
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first step in NB with ambigous genitalia
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determine genetic sex
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21-OH def fx on 17KS, 17OH, 17HP, mineralocorticoids
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inc: 17KS, 17OH; dec: 17HP, mineralocorticoids
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11-OH def fx on 17KS, 17OH, 17HP, mineralocorticoids
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inc in all
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17-OH def fx on 17KS, 17OH, 17HP, mineralocorticoids
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dec: 17KS, 17OH, 17HP; inc mineralocorticoids
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most common cause Cushing syndrome
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steroid therapy
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order of ACTH in Cushing etiologies
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adrenal < pituitary < ectopic
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mech of purple abdominal striae
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cortisol weakens collagen -> rupture blood vessels
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first step in Dx Cushing
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urine cortisol
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hyperglycemia, hypokalemia, metabolic alkalosis
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Cushing
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Nelson's syndrome is
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b/l adrenalectomy -> enlargement pit adenoma
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HTN, hypernatremia, hypokalemia, met alkalosis
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1o hyperaldosteronism
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patho of 2o aldosteronism
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compensation for low cardiac output
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pheochromocytoma assoc w/ 4
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NF 1; MEN 2a; MEN 2b; vHL
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DDx essential HTN & pheochromocytoma 4
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palpitations, drenching sweats, anxiety, paroxysmal burst in DHTN
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best screen pheochromocytoma
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inc plasma free metanephrines
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childhood tumor causing HTN
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Neuroblastoma
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opsoclonus-myoclonus syndrome 3
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paraneoplastic syndrome, myoclonic jerks of extremities, chaotic eye movemetns
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Homer-Wright rosettes
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neuroblastoma w/ small cell tumor
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5 type of panc tumors
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glucagonoma, insulinoma, SMSToma, VIPoma, gastrinoma
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most common cause blindness
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DM
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most common cause peripheral neuropathy
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DM
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most common cause CRF
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DM
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most common cause below-knee amputation
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DM
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MODY genetics
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AD
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epi for MODY
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pt <25, not obese
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T1DM HLA assoc
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HLA-DR3, HLA-DR4
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3 patho processes of DM
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nonenzymatic glycosylation, osmotic damage, microangiopathy
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nonenzymatic glycosylation responsible for 2
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hyaline arteriolosclerosis, glomerulopathy
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osmotic damage of aldose reductase responsible for 3
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cataracts, peripheral neuropathy, retinopathy
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diabetic microangiopathy responsible for 2
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inc type IV collagen synth; glomerulopathy
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mech of hyperglycemia in DKA
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gluconeogenesis
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mech for KB in DKA
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lipolysis
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mech for hyperTGemia in DKA
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dec cap LPL in blood
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DKA is which type of pH disturbance
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inc AG met acidosis
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mech of prerenal azotemia in DKA
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volume depletion
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patho of gestational DM
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anti-insulin fx of HPL, cortisol, progesterone
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NB risks w/ gestational DM 4
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macrosmia, RDS, NT defects, hypoglycemia
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post-preg Tx of gestational DM
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regulate glucose b/c more prone to DM
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type 1 polyglandular syndrome genetics
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auto R
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findings of type 1 polyglandular syndrome 3
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addison's, 1o hypoPTH, mucocutaneous candidiasis
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type 2 polyglandular syndrome genetics 2
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auto D; HLA-DR3, DR4
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findings of type 2 polyglandular syndrome 3
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addison's, Hashimoto's, T1DM
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most common cause reactive hypoglycemia
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xs insulin
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ketotic hypoglycemia in childhood 5
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MSUD, galactosemia, hereditary fructose intolerance, von Gierke's, carnithine def
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