Study your flashcards anywhere!

Download the official Cram app for free >

  • Shuffle
    Toggle On
    Toggle Off
  • Alphabetize
    Toggle On
    Toggle Off
  • Front First
    Toggle On
    Toggle Off
  • Both Sides
    Toggle On
    Toggle Off
  • Read
    Toggle On
    Toggle Off
Reading...
Front

How to study your flashcards.

Right/Left arrow keys: Navigate between flashcards.right arrow keyleft arrow key

Up/Down arrow keys: Flip the card between the front and back.down keyup key

H key: Show hint (3rd side).h key

A key: Read text to speech.a key

image

Play button

image

Play button

image

Progress

1/88

Click to flip

88 Cards in this Set

  • Front
  • Back

MCC of hyperpituitarism

Pituitary adenoma

MC type of hyperfunctioning pituitary adenoma

Prolactinomas

MC presentation of prolactinoma in males and females

Secondary amenorrhea, galactorrhra


Impotence

2nd most common type of hyperfunctioning pituitary adenoma

Somatotroph adenoma

Laboratory diagnosis of somatotroph adenoma

Failure to suppress GH production in response to an oral load of glucose


Elevated serum GH and IGF1

2 manifestations of somatotroph adenomas

Gigantism (children


Acromegaly (adult)

Cushing syndrome vs Cushing disease

Disease if pituitary is the source of ACTH


*excess ACTH causes hypercorticolism

Develops after surgical removal of adrenal glands for treatment of Cushing syndrome

Nelson syndrome

Components of MEN 1

Pituitary adenoma


HyperPTH


Pancreatic tumor

Ophtha symptoms of nonfunctioning pituitary adenoma

Bitemporal hemianopsia

Triad of pituitary apoplexy

Headache


Diplopia


Hypopituitarism

Condition of excessive urination due to an inability of the kidney to resorb water properly from the urine

Diabetes insipidus

Differentiate central DI vs nephrogenic DI

> Lack of ADH (hypothalamic disease, transection of the pituitary stalk, posterior pituitary disease)


> Collecting tubule refractory to ADH (drugs, hypokalemia, nephrocalcinosis)

Test for diabetes insipidus

Water deprivation test


*normal - inc POsm, UOsm


*CDI/NDI - inc POsm, dec UOsm


*after ADH injection - CDI: UOsm increases >50%, NDI: UOsm <50%

Treatment for DI

CDI: desmopressin


NDI: thiazide, indomethacin

MCC of SIADH

Small cell carcinoma of the lung

PE findings of SIADH

Menta status dysfunction secondary to cerebral edema


Na < 120

MCC of hypopituitarism in children

Craniopharyngioma

Mutation in craniopharyngioma

WNT signaling pathway

Hypermetabolic state caused by elevated free T3 and T4

Thyrotoxicosis

3 causes of thyrotoxicosis

Graves disease


MNG


Thyroid adenoma

Any derangement that interferes with the production of thyroid hormone

Hypothroidism

Hypothyrodism that develops in infancy/childhood

Cretinism

Hypothyroidism developing in older child or adult

Myxedema


Gull disease

PE of myxedema

Generalized fatigue


Apathy


Mental sluggishness

MCC of hypothyroidism

Hashimoto thyroiditis

Associated auto-antibodies with Hashimoto's thyroiditis

Anti-thyroglobulin


Anti-TPO

Histology of Hashimoto's thyroiditis

Hurthle cells

Associated diseases with Hashimoto's

Autoimmune disease - DMT1, SLE, MG


B cell NHL


MHL lymphoma

MCC of painful thyroid gland

Subacute thyroiditis

Subacute thyroiditis is caused by what infection

Coxsackievirus

Painless thyroiditis

Lymphocytic

Thyroditis associated with other sclerosing conditions

Reidel thyroiditis

Triad of Grave's disease

Hyperthyroidism


Axial proptosis


Pretibial myxedema/dermopathy

Auto-antibodies associated with Grave's disease

Thyroid-stimulating Ig


Thyroid growth-stimulating Ig


TSH-binding inhibitor Ig

Histologic findings of Grave's diease

Diffuse thyroid hypertrophy and hyperplasia


Infiltrative opthalmopathy - MN, GAG, adipocytes

2 phases of diffuse nontoxic goiter

Hyperplastic


Colloid involution

Distinguishes MNG from follicular CA

No capsule between the hyperplastic nodules and residual thyroid

Autonomous nodule that develops in a long-standing goiter and produce hyperthyroidism

Plummer syndrome

Histologic finding in thyroid adenoma

Hurthle cell adenoma

MC primary thyroid cancer in adults and children

Papillary thyroid CA

Histologic finding of papillary thyroid CA

Psammoma bodies


Orphan Annie nuclei


*groovy nuclei, nuclear pseudoinclusion, chromatin dispersed to the side

MC thyroid cancer presenting as a solitary cold nodule

Follicular thyroid CA


*dietary iodine deficiency

Thyroid CA associated with a past history of well-differentiated thyroid CA

Anaplastic thyroid CA

Thyroid neuroendocrine neoplasms derived from parafollicular cells or C cells

Medullary thyroid CA

Histologic findings in medullary thyroid CA

Amylois deposits


C-cell hyperplasia

MCC of autonomous, spontaneous overproduction of PTH

Adenoma


*primary hyperplasia


*parathyroid CA

Histology of primary hyperPTH

Water-clear cell hyperplasia

Organ involvement with primary hyperPTH

Increased osteoclasts


Osteitis fibrosis cystica


Brown tumors of hyperPTH


Nephrolithiasis

MCC of secondary hyperPTH

Renal failure

MCC of hypoPTH

Previous thyroid surgery

2 signs of tetany in hypoPTH

Chovstek - facial nerve


Trousseau - carpal spasms of forearm

Expected lab findings in pseudohypoPTH

Hypocalcemia


Hyperphosphatemia


Elevated circulating PTH

Auto-AB involved in DMT1

Anti-insulin


Anti-GAD


Anti-ICA512

Histologic finding of pancreas in DMT1

Reduction in number and size of islets


Insulitis

Histologic finding of pancreas in DMT2

Amyloid deposition within islets

MC COD in diabetes

Myocardial infarction

Pathogenesis of diabetic microangiopathy

Diffuse thickening of basement membrane

Accumulation of sorbitol in pars plicata causes

Cataracts

MC pancreatic endocrine neoplasm

Insulinoma

Components of Whipple triad

Hypoglycemia


Low plasma glucose at time of symptoms


Relief of symptoms when glucose is raised to normal

Diagnostic exam of insulinoma

Fasting hypoglycemia


Increased serum insulin


Increased C peptide

Histology of insulinoma

Giant islet cells


Amyloid deposits


Nesidioblastosis - hyperplasia of the islet

Malignant islet cell tumor that secretes gastrin

Gastrinoma


Zollinger-Ellison syndrome

Clinical presentation of Zollinger-Ellison syndrome

Peptic ulceration unresponsive to therapy


Diarrhea


Steatorrhea

MCC of hypercortisolism

Exogenous glucocorticoids

Laboratory parameter to request to differentiate pituitary/adrenal/ectopic Cushing syndrome

High dose dexamethasone (Inc in adrenal and ectopic)


Plasma ACTH (dec in adrenal, inc in ectopic)

Pituitary gland changes in Cushing syndrome

Crooke hyaline change

MC manifestion of primary hyperaldosteronism

Hypertension

Secondary hyperaldosteronism is characterized by increased levels

Plasma renin

Histologic findings in aldosterone-producing adenomas

Spironolactone bodies

AKA andrenogenital syndrome


Deficiencies of steroid biosynthetic enzyme

CAH

MC enzyme deficiency in CAH

21-hydroxylase deficiency

Clinical presentation in 21-hydroxylase deficiency

Ambiguous genitalia in female


Precocious puberty in males

Lab findings in 21-hydroxylase deficiency

INC 17-ketosteroids, hydroxyprogesterone


DEC 17-hydroxycorticoids, mineralocorticoids

Adrenal crisis in individuals with chronic adrenocortical insufficiency


*rapid withdrawal of steroids

Primary acute adrenocortical insufficiency

Massive adrenal hemorrhage in the setting of fulminant meningococcemia

Waterhouse-Friderichsen syndrome

Disorder resulting from progressive destruction of the adrenal cortex

Primary chronic adrenocortical insufficiency


Addison disease

MCC of Addison disease

Autoimmune destruction


Miliary TB


Histoplasmosis


CAH


Lung cancer metastasis

Clinical presentation of Addison disease

Progressive weakness and easy fatigability


Hyperpigmentation 2nd to POMC


Hyperkalemia, hyponatremia

Difference between secondary adrenocortical insufficiency and Addison disease

Decreased size of adrenal


No hyperpigmentation


No hyponatremia and hyperkalemia

Associated cancer syndromes in adrenocorticol neoplasm

Li Fraumeni syndrome - p53


Beckwith-Wiedemann

Neoplasm composed of chromaffin cells which synthesize and release catecholamines and peptide hormones

Pheochromocytoma

Rule of 10s in pheochromocytoma

10% extradrenal paraganglioma


Bilateral


Malignant


Not associated with HTN


Germline mutation

Histologic picture of pheochromocytoma

Potassium dichromate


Zellballen


Salt and pepper chromatin

MEN1/Wermer syndrome

PTH adenoma


Pancreatic tumor


Pituitary tumor (prolactinoma)

MEN 2A (Sipple syndrome)

Pheochromocytoma


Medullary CA


PTH hyperplasia

MEN 2B

Pheochromocytoma


Medullary carcinoma


Neuromas or ganglioneuromas