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45 Cards in this Set
- Front
- Back
Pheochromocytoma
epidemiology ? |
majority benign, unilateral, arise in adrenal medulla
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Associations of Pheochromocytoma ?
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neurofibromatosis, MEN IIa/IIb; von Hippel-Lindau disease
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Pheochromocytoma
unique findings? |
palpitations, paroxysmal hypertension, anxiety, drenching sweats, headache
orthostatic hypotension, chest pain, ileus |
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Pheochromocytoma
Diagnosis test? |
plasma free metanephrines is best screen
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Pheochromocytoma
urine tests? |
24- hour collection for metanephrine (best test), VMA
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Pheochromocytoma
lab findings? |
hyperglycemia, neutrophilic leukocytosis
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Neuroblastoma
malignant tumor = ? |
postganglionic sympathetic neurons
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Neuroblastoma
occurs most often to? |
childhood tumor and cause of hypertension
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Opsoclonus-myoclonus syndrome = ?
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paraneoplastic syndrome; myoclonic jerk; chaotic eye movements
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Neuroblastoma:
"small tumor" shows ______ under electron microscopy |
neurosecretory granules
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Neuroblastoma
clinical findings? |
child with abdominal mass + hypertension
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Insulinoma
lab findings? |
↑ serum insulin
↑ C-peptide |
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Insulinoma
if patient injecting excess insulin: lab findings? |
↑ serum insulin
↓ C-peptide |
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DM (Diabetes Mellitus) is the most common cause of what conditions?
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blindness, peripheral neuropathy, chronic renal failure, below -knee amputation
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Maturity onset diabetes of the young (MODY) = ?
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AD (Autosomal dominant) inheritance; not obese; impaired glucose-induced secretion of insulin
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Metabolic syndrome in DM?
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insulin resistance exacerbated by obesity
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insulin resistance syndrome a
associations? |
acanthosis nigricans; Alzheimer;s disease
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Hyperinsulinemia
clinical and lab findings? |
↑ VLDL (very low-density lipoprotein), hypertension, CAD (Coronary artery disease)
↓ HDL-CL (high-density lipoprotein cholesterol) |
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what prevents complications in diabetes?
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good glycemic control
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NEG (Nonenzymatic glycosylation) = ?
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Hb(↷A1c), hyaline, arteriolosclerosis, glomerulopathy
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Aldose reductase = ?
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converts glucose to sorbitol; osmotic damage
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Osmotic damage = ?
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cataracts, peripheral, neuropathy, retinopathy
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Diabetic microangiopathy = ?
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diabetic glomerular disease
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what is the most common complication of diabetes?
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Insulin-induced hypoglycemia
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DKA (Diabetic ketoacidosis)
is a complication of which type of DM? |
type 1 DM
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what is the most important mechanism of hyperglycemia in diabetic ketoacidosis?
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Gluconeogenesis
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Ketoacids are synthesized from ?
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synthesized from acetyl CoA derived from β-oxidation of fatty acids
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Hypertriglyceridemia
mechanism? |
↓ capillary lipoprotein lipase activity;
↓ hydrolysis of chylomicrons and VLDL (very low-density lipoprotein) |
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DKA (diabetic ketoacidosis) electrolytes
lab findings? |
↓ serum sodium, bicarbonate (metabolic acidosis);
↑ serum potassium, anion gap |
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Hyperomolar nonketotic coma is a complication of which type of DM?
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type 2 DM
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Hb(↷A1c) is a marker of ?
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long term glycemic control
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IGT (Impaired glucose tolerance ) = ?
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prediabetic state; insulin resistance
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GDM (Gestational diabetes) = ?
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anti-insulin effect of HPL (human placental lactogen), cortisol and progesterone
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Macrosomia (newborn risk) :
an increase of insulin causes? |
↑ in adipose and muscle
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Respiratory distress syndrome (RDS)
an increase of insulin causes? |
inhibits fetal surfactant
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Neonatal hypoglycemia
an increase of insulin causes? |
drives glucose into hypoglycemic range; give newborn glucose at birth
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Type I polyglandular syndrome
clinical findings? |
Addison's disease, primary hypoparathyroidism, mucocutaneous candidiasis
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Type II polyglandular syndrome
clinical findings? |
Addison's disease, Hashimoto's thyroiditis, type 1 diabetes
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What are the two subdivisions of Hypoglycemia?
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fed state and fasting state
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Fed state hypoglycemia:
reactive hypoglycemia most common cause? |
excess insulin; adrenergic symptoms
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Fasting hypoglycemia
causes? |
alcohol excess; insulinoma; cirrhosis
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Alcohol excess :
what happens to glycogen stores? gluconeogenesis? |
↓ glycogen stores
↓gluconeogenesis (pyruvate converted to lactate) |
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Fasting hypoglycemia in children
look for signs of ___? |
look for inborn errors of metabolism
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Neuroglycopenia
symptoms? |
dizziness, mental status changes, motor disturbances
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Diagnosis for fasting hypoglycemia?
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prolonged fast; satisfy Whipple's triad
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