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ABSITE > Endocrine, Head & Neck > Flashcards

Endocrine, Head & Neck Flashcards

1
Q

Management of septal hematoma

A

Early I&D (otherwise there can be fibrosis and necrosis of septal cartilage)

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2
Q

Cushing disease

A

ACTH-secreting pituitary adenoma

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3
Q

Diagnosis of gastrinoma

A

Serum gastrin >1000 or
Paradoxical increase in gastrin with secretin administration

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4
Q

Symptoms of glucagonoma

A

Anemia, diabetes, stomatitis, dermatitis, weight loss

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5
Q

Diagnosis of glucagonoma

A

Fasting serum glucagon >500-1000

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6
Q

Insulinoma symptoms

A

Anxiety, dizziness, confusion, personality changes, seizures (sx worse in the morning)

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7
Q

Diagnosis of insulinoma

A

72hr observed fast

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8
Q

Location of insulinoma

A

Evenly distributed throughout pancreas

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9
Q

Somatostatinoma symptoms

A

Steatorrhea, diabetes, hypochlorhydria, cholelithiasis

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10
Q

Somatostatinoma diagnosis

A

Fasting plasma somatostatin >100

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11
Q

VIPoma diagnosis

A

Serum VIP level 250-500

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12
Q

What cancers are Peutz-Jeghers at risk for

A

Pancreatic, breast

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13
Q

S-100 tumor marker - associated with?

A

Melanoma, neurofibroma, schwannoma

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14
Q

Vimentin tumor marker - associated with?

A

Melanoma, colon, esophageal, gastric

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15
Q

KRAS tumor marker - associated with?

A

Melanoma, colon

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16
Q

HER2 tumor marker - associated with?

A

Breast, ovarian, lung, gastric, oral cancers

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17
Q

Management incidentaloma - when to resect?

A

When >6cm (consider if 4-6cm)

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18
Q

Chemoprevention for patients with FAP after TAC + ileorectal anastomosis

A

Sulindac

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19
Q

VHL screening for which cancers

A

CNS and retinal hemangioblastomas, RCC, and pheochromocytomas

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20
Q

Most common location for undifferentiated spindle cell tumor

A

Proximal tibia and distal metaphysis of femur

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21
Q

Histology of undifferentiated spindle cell tumor

A

Fibroblasts in whirling patterns with multinucleated giant cells, inflammatory cells, and foamy mononuclear giant cells

22
Q

Management of spindle cell tumors

A

Neoadjuvant chemo -> surgery with wide margins

23
Q

Histology of pleomorphic adenoma (salivary gland tumor)

A

Stromal tissue with groups of epithelial and myoepithelial cells

24
Q

Most common mutation in PDAC

A

KRAS

25
Q

Only thyroid cancer that metastasizes hematogenously

A

Follicular

26
Q

Management of follicular thyroid cancer

A

Partial thyroidectomy
Total thyroidectomy only done if: radioactive iodine therapy is planned, nodule is >4cm, extrathyroidal invasion, or mets

27
Q

Pathology of papillary thyroid cancer

A

Intranuclear inclusion bodies (Orphan annie eyes), Psammoma bodies

28
Q

Follow-up for medullary thyroid cancer after resection

A

CEA & calcitonin q3-6mo
[Neck US if any suspicion of recurrence]

29
Q

MEN1 syndrome

A

Pituitary adenomas
Hyperparathyroidism
PNETs

30
Q

MEN2A

A

Medullary thyroid cancer
Hyperparathyroidism
Pheochromocytoma

31
Q

MEN2B

A

Medullary thyroid cancer
Pheochromocytoma
Mucosal neuromas
Marfanoid habitus

32
Q

MEN4 syndrome

A

Hyperparathyroidism
Pituitary tumors
Neuroendocrine tumors
Uterine, testicular, colonic tumors

33
Q

Gene mutation in MEN4 syndrome

A

CDKN1B

34
Q

Maxillary torus

A

Benign osteoblastic tumor arising from the hard palate

35
Q

What to give if hypertensive episode occurs intraop with pheochromocytoma

A

Nicardipine or nitroprusside (titratable agents)

36
Q

What if you get Hurthle cells on thyroid FNA?

A

Non-diagnostic -> patient should get a diagnostic thyroid lobectomy

37
Q

Gastrinoma triangle borders

A

CBD, neck of pancreas, and 3rd portion of duodenum

38
Q

Most common location of an ectopic superior parathyroid gland

A

Tracheoesophageal groove

39
Q

Boundaries of a central neck dissection

A

Hyoid bone (superior)
Innominate artery (inferior)
Carotid arteries (lateral)

40
Q

Most common location for Ewing sarcoma

A

Pelvis (onion skin appearance)

41
Q

What is the hypothesized reason for resistance to radiation therapy?

A

Tumor hypoxia and low levels of oxygen free radicals

42
Q

When to FNA a thyroid nodule

A

> 1cm
Hypoechoic
Solid
Irregular margins
Any calcifications
Taller-than-wider shape

43
Q

Bethesda criteria for thyroid cytopathology: I

A

Nondiagnostic
Repeat FNA in 4-6wks

44
Q

Bethesda criteria for thyroid cytopathology: II

A

Benign
Observation with repeat US in 1-2yrs

45
Q

Bethesda criteria for thyroid cytopathology: III

A

Atypia/follicular lesion of unknown significance
Molecular testing or surgery

46
Q

Bethesda criteria for thyroid cytopathology: IV

A

Follicular neoplasm
Molecular testing or surgery

47
Q

Bethesda criteria for thyroid cytopathology: V

A

Suspicious for malignancy
Surgery

48
Q

Bethesda criteria for thyroid cytopathology: VI

A

Malignant
Surgery

49
Q

Calcium-to-creatinine clearance ratio >0.02 with hypercalcemia

A

Primary hyperparathyroidism

50
Q

Calcium-to-creatinine clearance ratio <0.01 with hypercalcemia

A

FHH

51
Q

Monitoring for nonfunctioning adrenal tumor

A

Imaging in 6, 12, and 24 mo
Annual hormone testing for 4yrs
(If growth more than 1cm/yr or hormonal secretion: resect)

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