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24 Cards in this Set
- Front
- Back
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Hashimoto's Thyroiditis
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hyperthyroid early in course.
Antimicrosomal and antiithyroglobulin anitbodies. Associated with HLA-DR5 and Hurthle cells on histology. |
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Cretinism
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cretin means Christlike
fetal hypothyroidism. endemic goiter is prevalent (lack of dietary iodine) caused by defect in T4 formation or developmental failure in thyroid formation. pot-bellied, pale, puffy-faced child with protruding umbilicus and protuberant tongue. |
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Subacute Thyroiditis
(de Quervain's) |
-self-limited hypothyroidism
-flu like illness -elevated ESR, jaw pain. -granulomatous inflammation. -hyperthyroid early in course. -lymphocytic subacute thyroiditis is painless |
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Riedel's Thyroiditis
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thyroid replaced by fibrous tissure (hypothyroid).
fixed, hard (rock like) and painless goiter |
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Graves' Disease
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autoimmune hyperthyroidism with thyroid-stimulating/TSH receptor antibodies.
pretibial myxedema, diffuse goiter presents during stress stress induced catecholamine surge leasding to death by arrhythemia. |
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Toxic Mulitnodular Goiter
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focal pathces of hyperfunctioning follicular cells working independently of TSH due to mutation in TSH receptor. Release of T3 and T4 Nodules.
thyrotoxicosis if patient with iodine deficeincy goiter is made iodine replete. |
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Thyroid Cancer
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1. most common, excellent prognosis, "ground glass" nuclei, psammomma bodies, rish with childhood irradiation.
2. good prognosis, uniform follicles 3. parafollicular "C cells"; produces calcitonin, sheets of cells 4. older patients; very poor prognosis 5. associated with Hashimoto's thyroiditis |
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Hypercalcemia
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-caused by calcium infenstion
-hyperparathyroid -hyperthyroid -iatrogenic (thiazides) -multiple myeloma -paget's disease -addison's disease -neoplasms -zollinger-ellison syndrome -excess vitamin d -excess vitamin a -sarcoidosis |
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Hyperparathyroidism
(Primary) |
usually an adenoma
-hypercalcemia -hypercalciuria (renal stones) -hypophosphatemia -PTH -alkaline phophatase -cAMP in urine |
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Hyperparathyroidism
(Secondary) |
2* hyperplasia due to gut Ca2 absorption and phosphorus
chronic renal disease hypocalcemia hyperphosphatemia PTH |
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Pituitary Adenoma
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most commonly prolactinoma
-amenorrhea -galactorrhea -low libido -infertility can impinge on optic chiasm -->bitemporal hemianopia |
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Sheehan's Syndrome
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-postpartum hypopituitarism
-enlargement of anterior pituitary (lactotrophs) during pregnancy withouth blood supply leads to infarction of the pituitarty gland following severe bleeding and hypoperfusion during delivery. May Cause: -fatigue -anorexia -poor lactation -loss pubic and axillary hair |
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Diabetes Insispidus
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intense thirst and polyuria together with an inability to concentrate urine.
-lack of ADH -urine specific gravity < 1.006; serum osmolality > 290mOsm/L |
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central DI
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pituitary tumor, trauma surgery, histiocytosis X) or to a lack of renal response to ADH
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Nephrogenic DI
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hereditary or 2* to hypercalceima, lithium, demeclocycline (ADH antagonist)
-water deprevationtest-urine osmolality doesn't |
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SIADH
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syndrome of inappropriate antidiuretic hormone secretion:
1.excessive water retention 2.hyponatremia 3.urine osmolarity >serum osmolarity very low serum sodium levels can lead to seizures Causes include 1. ectopic ADH(small cell lung cancer) 2.CNS disorders/head trauma 3.pulmonary disease 4.drugs |
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Diabetes Mellitus
Acute Manifestations |
-polydipsia
-polyuria -polyphagia -weight loss -DKA -unopposed secretion of GH and epindephrine (exacerbathing hyperglycemia) |
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Diabetes Mellitus
Chronic Manifestations |
Nonenzymatic glycosylation:
1. small vessel disease, retinopathy, glaucoma, nephropathy 2.large vessel athersoclerosis, CAD, peripheral cascular occluisve disease adn gangrene, cerebrovascular disease Osmotic damage: 1.neuropathy (motor, sensory, and autonomic degeneration) 2.cataracts (sorbitol accumulation) |
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Diabetic Ketoacidosis
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-important comlications of type I diabetes
-due to insulin requirements from stress -excess fat breakdown and ketogenesis from free fatty acids -made into ketone bodies -kussmaul respirtations -psychosis/delirium -dehydration -fruity breath odor -hyperglycemia -H+ -blood ketone levels -hyperkalemia |
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Carcinoid Syndrome
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-rare syndrome caused by carcinoid tumors
-especially metastatic small bowel tumors -secrete high levels of serotonin (5-HT) -not seen in tumors limited to GI tract -recurrent diarrhea, cutaneous, flushing, asthmatic wheezing, right sided valvular disease Rule of 1/3's: 1/3 metastasize 1/3 present with 2nd malignancy 1/3 multiple derived from neuroendocrine cells of GI tract |
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Zollinger-Ellison Syndrome
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gastrin-secreting tumor of pancreas or duodenum
causes recurrent ulcers associated with MEN type I |
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Mulitple Endocrine Neoplasias
MEN I (Wermer's Syndrome) |
-parathyroid tumors
-pituitary tumors (prolactin or GH) -Pancreatic endocrine tumors - Zollinger-Ellison -Insulinomas -VIPomas -presents with kidney stones and stomach ulcers 3P's (pancreas, pituitary, parathyroid) |
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MEN 2A
(Sipple's syndrome) |
-medullary thyroid carcinoma (secretes calcitonin)
-pheochromocytoma -parathyroid tumors 2 P's (pheochromocytoma and parathyroid) |
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MEN 2B
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-medullary thyroid carcinoma (secretes calcitonin)
-pheochromocytoma -oral/intestinal ganglioneurmomatosis (associated with marganoid habitus) 1P (pheochromocytoma) all MEN syndromes have autosomal-dominant inheritance |
