Flashcards in Endocrine Deck (51)
Familial Hypocalciuric Hypercalcemia
Defective Ca2+ sensing receptor in multiple tissues
- Excessive renal Ca2+ reuptake --> mild hypercalcemia with hypocalciuria with normal/elevated PTH levels
- 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)
Empty Sella Syndrome
- Idiopathic, obese women
Atrophy or compression of pituitary
- 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
Type 1 DM Antibodies
Glutamic acid decarboxylase antibodies
Most common cause of death in DM
Nodules seen in diabetic nephron
Type 1 DM HLA
HLA-DR3 and DR4
Histology of T1DM vs. T2DM
T1DM: islet leukocytic infiltrate
T2DM: islet amyloid polypeptide deposits
Deadly infection in DKA?
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
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
Presentation of glucagonoma?
- Dermatitis (necrolytic migratory erythema)
- Diabetes (hyperglycemia)
- Declining weight
Rx: octreotide, surgery
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
Presentation of somatostatinoma?
- Diabetes/glucose intolerance, steatorrhea, gallstones due to decreased secretion of secretin, CCK, glucagon, insulin, gastrin
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
Presentation of gastrinoma?
Abdominal pain (PUD), diarrhea (malabsorption)
- Gastrin levels remain elevated after administration of secretin
Presentation of VIPoma?
Watery diarrhea, hypokalemia, achlorhydria
Pituitary adenoma, pancreatic endocrine tumor, parathyroid adenoma
- MEN1 (menin) - tumor suppressor, Chr 11
- MEDULLARY THYROID CARCINOMA (amyloid on bx, prophylactic thyroidectomy), pheochromocytoma, parathyroid hyperplasia (hypercalcemia)
- RET (RTK in cells of neural crest origin)