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Flashcards in Endocrine Deck (51)
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31

Familial Hypocalciuric Hypercalcemia

Defective Ca2+ sensing receptor in multiple tissues
- Excessive renal Ca2+ reuptake --> mild hypercalcemia with hypocalciuria with normal/elevated PTH levels

32

Sheehan Syndrome
- Postpartum failure to lactate, absent menstruation, cold intolerance, loss of pubic hair

- Ischemic infarct of pituitary following postpartum bleeding (pituitary is much larger during pregnancy but there is no increase in blood flow --> increased susceptibility to hypoperfusion)

33

Empty Sella Syndrome
- Idiopathic, obese women

Atrophy or compression of pituitary

34

Pituitary Apoplexy
- Sudden onset severe HA, visual impairment (bitemporal hemianopia, diplopia due to CN III palsy), features of hypopituitarism

- Sudden hemorrhage of pituitary gland --> compresses normal tissue
- Often in presence of existing pituitary adenoma

35

Type 1 DM Antibodies

Glutamic acid decarboxylase antibodies

36

Most common cause of death in DM

MI

37

Nodules seen in diabetic nephron

Kimmelstiel-Wilson Nodules

38

Type 1 DM HLA

HLA-DR3 and DR4

39

Histology of T1DM vs. T2DM

T1DM: islet leukocytic infiltrate
T2DM: islet amyloid polypeptide deposits

40

Deadly infection in DKA?

Mucormycosis (Thizopus)

41

Treatment for DKA?

- IV fluids --> sugar in urine is diuretic (dehydrated)
- IV insulin
- K+ --> lost lots of K+ in urine (even though labs show hyper K+, plus insulin drives K+ into cells)
- Glucose if necessary

42

Hyperosmolar Hyperglycemia Nonketotic Syndrome
- Thirst, polyuria, lethargy, focal neuro defects (seizures), can progress to coma and death
- elderly T2 diabetic w/ limited ability to drink

- Profound hyperglycemia-induced dehydration (osmotic diuresis)
- Labs: hyperglycemia, increased serum osmolarity, no acidosis, no ketones
- Rx: aggressive IV fluids, insulin therapy

43

Presentation of glucagonoma?

- Dermatitis (necrolytic migratory erythema)
- Diabetes (hyperglycemia)
- DVT
- Declining weight
- Depression
Rx: octreotide, surgery

44

Presentation of insulinoma?

- Whipple triad: hypoglycemia, sx of hypoglycemia (lethargy, syncope, diplopia), and resolution of sx after normalization of glucose levels
- Labs: decreased blood glucose, increased C-peptide
- MEN1 syndrome

45

Presentation of somatostatinoma?

- Diabetes/glucose intolerance, steatorrhea, gallstones due to decreased secretion of secretin, CCK, glucagon, insulin, gastrin

46

Presentation of carcinoid syndrome?

- Recurrent diarrhea, cutaneous flushing, asthmatic wheezing, R-sided valvular heart DZ, pellagra (niacin deficiency), 5-HIAA in urine
- Only seen if tumor has spread out of GI tract
- ROSETTES
- Serotonin

47

Presentation of gastrinoma?

Abdominal pain (PUD), diarrhea (malabsorption)
- Gastrin levels remain elevated after administration of secretin
- MEN1

48

Presentation of VIPoma?

Watery diarrhea, hypokalemia, achlorhydria

49

MEN1

Pituitary adenoma, pancreatic endocrine tumor, parathyroid adenoma
- MEN1 (menin) - tumor suppressor, Chr 11

50

MEN2A

- MEDULLARY THYROID CARCINOMA (amyloid on bx, prophylactic thyroidectomy), pheochromocytoma, parathyroid hyperplasia (hypercalcemia)
- RET (RTK in cells of neural crest origin)

51

MEN2B

Medullary thyroid cancer, pheochromocytoma, MUCOSAL NEUROMAS, MARFINOID HABITUS
- RET (oncogene)