Brainscape's Knowledge GenomeTM


Top Flashcards (Certified)
All Flashcards

Surgery EOR > Endocrinology > Flashcards

Endocrinology Flashcards

(79 cards)

Start Studying
1
Q

what is the incidence of adrenocortical carcinoma

A

1-2 per million people per year

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

is adrenocortical carcinoma functional or nonfunctional

A

either!

functional - Cushing syndrome

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

The majority of adrenocortical carcinomas present with a clinical syndrome of

A

hormone excess or Cushing syndrome alone or are mixed with virilization syndrome

additional sx - weight gain, weakness, and insomnia that develop quickly over 3 to 6 months

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

common findings on CT for adrenocortical carcinoma

A

mass greater than 4 cm with higher attenuation
irregular borders
calcification
invasion to surrounding structures with lymph node enlargement

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

most common sites of mets for adrenocortical carcinoma

A

liver
lungs
lymph nodes
bone

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

due to mets, what other imaging do ppl w adrenocortical carcinoma need

A

CT scan of chest
CT scan of liver
Bone scan

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

can cytology of a fine-needle aspiration distinguish between a benign adrenal mass and an adrenocortical carcinoma

A

no - It can also lead to metastasis in the needle core site

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

what is the only potentially curative tx for adrenocortical carcinoma

A

surgical resection

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

when is adjuvant mitotane recommended for adrenocortical carcinoma

A

high-grade disease
intra-operative tumor spillage
large tumors with vascular or capsular invasion

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

how long would mitotane be continued in patients with adrenocortical carcinoma

A

5 years after surgical resection for high risk
3 years after surgical resection for low risk

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

symptoms of Cushing syndrome

A

due to cortisol excess

proximal muscle weakness
weight gain
headache
oligomenorrhea
erectile dysfunction
osteoporosis
central obesity
moon facies
buffalo hump
supraclavicular fat pads
thin extremities
HTN
acanthosis nigricans
hirsutism

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

Which of the following zones of the adrenal gland is responsible for the production of catecholamines

A

adrenal medulla

produces epinephrine, norepinephrine, and dopamine

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

what does the zona glomerulosa produce

A

the outermost layer
produces mineralocorticoids like aldosterone

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

what does the zona fasciculata produce

A

middle layer
produces glucocorticoids like cortisol

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

what does the zona reticula produce

A

innermost layer
produces androgens, such as dehydroepiandrosterone and androstenedione

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

Pheochromocytoma

A

a rare neuroendocrine tumor of the adrenal medulla which causes an excess production of catecholamines like epinephrine, norepinephrine, and dopamine

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

signs and symptoms of pheochromocytoma

A

paroxysmal or sustained hypertension
headache
palpitations
diaphoresis

may have cardiac manifestations which can be life-threatening

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

lab testing for pheochromocytoma

A

plasma fractionated free metanephrines
plasma fractionated catecholamines
serum CgA
clonidine suppression testing

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

what is the most sensitive lab test for pheochromocytoma

A

plasma fractionated free metanephrines

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

if there is high suspicion of pheochromocytoma and you find that they have elevated plasma fractionated free metanephrines, what tests should you do next to help confirm

A

24-hour urine for fractionated metanephrines and creatinine

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

imaging for pheochromocytoma

A

noncontrast CT of the abdomen followed by an immediate follow-up CT with nonionic contrast using a washout protocol

Pheochromocytomas typically retain > 40% of the contrast after 15 minutes

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

what must be treated prior to surgery for pheochromocytoma

A

hypertension and tachydysrhythmias

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

what can be used to treat hypertension and tachydysrhythmias in pheochromocytoma esp prior to surgery

A

Alpha-blockers, such as phenoxybenzamin
CCB
^these are given 10-14 days prior to surgery

can be used alone or in combo

Cardioselective beta-blockers, such as metoprolol XL, should be administered for control of tachydysrhythmias only after blood pressure has been controlled - given 2-3 days prior to surgery

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

what do pheochromocytomas consist of

A

chromaffin cells

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
treatment for pheochromocytomas
complete adrenalectomy - usually performed laparoscopically
26
what is the most common clinical (lab) presentation of hyperparathyroidism
hypercalcemia
27
Classical presentations of hyperparathyroidism
bone disease nephrolithiasis weakness fatigue neurobehavioral sx like depression or psychosis
28
how do you diagnose hyperparathyroidism
If an elevated serum calcium concentration is found on routine testing, confirmation by repeat lab draw is the first step If an elevated level is found on repeat lab draw, the next step in evaluation is a serum parathyroid hormone
29
what is considered diagnostic for primary hyperparathyroidism
Elevated serum calcium and elevated serum parathyroid hormone
30
tx for sx hyperparathyroidism
parathyroidectomy
31
tx for asx hyperparathyroidism
surgery - if serum calcium concentration of 1.0 mg/dL or more above the upper limit of normal, bone density of hip, lumbar spine, or distal radius greater than 2.5 standard deviations below normal, previous asx vertebral fx, glomerular filtration rate (GFR) less than 60 mL/min, 24-hour urine calcium greater than 400 mg/day, nephrolithiasis on imaging, age < 50
32
what is the MC cause of primary hyperparathyroidism
parathyroid adenoma
33
what are the most common causes of hypoparathyroidism
post neck surgery (thyroidectomy, parathyroidectomy) or autoimmune destruction of the parathyroid gland
34
what other electrolyte abnormality can cause hypoparathyroidism
hypomagnesemia
35
signs and sx of hypoparathyroidism
tingling around the perioral area paresthesias and muscle cramping of the hands and feet (carpopedal spasm) tetany laryngospasm seizures hyperactive DTR Chvostek sign (facial twitching that is induced by tapping the facial nerve on the same side) Trousseau sign (spasm in the hands after inflating a blood pressure cuff above the systolic pressure)
36
triad for diagnosis of hypoparathyroidism
hypocalcemia low PTH increased phosphate
37
what will EKG show for hypoparathyroidism
prolonged QT interval (increased risk of arrhythmia)
38
tx for hypoparathyroidism - acute vs non-acute
acute - IV calcium gluconate plus oral calcitriol (activated vitamin D) non-acute - calcium (500 mg to 2,000 mg two to four times daily) and vitamin D
39
normal range for calcium
8.5-10 mg/dL
40
when is a thyroid nodule more likely to be benign
if the nodule is painful or tender to touch and if it is soft, smooth, and mobile upon palpation
41
how are thyroid nodules evaluated
thyroid scintigraphy (radionuclide scanning) - describes nodule as hot, warm, cold, depending on its uptake of the radioactive isotope
42
Hot thyroid nodules
Hot nodules take up more of the radioactive isotope than surrounding thyroid tissue and are indicative of autonomously functioning nodules, such as toxic adenomas or toxic multinodular goiters, and are rarely found to be malignant
43
Warm thyroid nodules
Warm nodules indicate normal thyroid function
44
Cold thyroid nodules
cold nodules indicate low functional or nonfunctional thyroid tissue. Cold nodules will have a decreased uptake of radioactive isotope compared to surrounding thyroid tissue on scintigraphy
45
what thyroid nodules carry the highest risk of malignancy
cold nodules
46
how to fully evaluate thyroid nodules
if there is a lower than normal TSH finding --> scintigraphy next If the serum TSH is high or normal --> thyroid ultrasound A fine-needle aspiration should be performed if there is any suspicion for malignancy on ultrasound
47
what do follicular cells secrete
thyroxine (or T4) and triiodothyronine (T3)
48
what do parafollicular cells secrete
thyrocalcitonin
49
Sonographic features of thyroid nodules suspicious for malignancy
microcalcifications irregular borders hyper echoic areas increased vascularity
50
what are the 4 main types of thyroid carcinoma
anaplastic follicular medullary papillary
51
what are thyroid hormone levels commonly like in thyroid carcinoma
normal TSH and T4 levels
52
The most common type of thyroid cancer
papillary thyroid cancer
53
what is the least aggressive thyroid cancer
papillary thyroid cancer
54
The greatest risk factor for papillary thyroid cancer is
head or neck radiation exposure as a child
55
what is a tumor marker for papillary thyroid cancer and follicular thyroid cancer
Thyroglobulin
56
second most common thyroid cancer
follicular thyroid cancer
57
what is follicular thyroid cancer associated with
iodine deficiency
58
what thyroid cancer is associated with MEN2
medullary thyroid cancer
59
what is used to monitor for residual disease after treatment or for recurrence of medullary thyroid cancer
calcitonin levels
60
what is the most aggressive type of thyroid cancer
anaplastic thyroid cancer
61
The most common cause of primary hypothyroidism in the United States
Hashimoto
62
what is the MC cause of primary hypothyroidism in the world
iodine deficiency
63
subclinical hypothyroidism
A normal T4 level and high TSH level
64
what antibody is positive in majority of people with Hashimoto
thyroid peroxidase antibody
65
how often should TSH be tested after starting levothyroxine
every 6 weeks
66
what can be used in addition to levothyroxine for hypothyroidism
Some patients may have impaired conversion of T4 to T3 and may benefit from liothyronine
67
The most common cause of hyperthyroidism
Grave's disease - an autoimmune disease that affects TSH receptors by stimulating or blocking antibodies to the thyrotropin receptor
68
T3 toxicosis
T4 is normal and T3 is elevated --> more favorable prognosis
69
what antibodies may be present in grave's disease
Thyroid-stimulating immunoglobulin antibodies - most sensitive peroxidase antibodies antithyroglobulin antibodies
70
what can be used to treat cardiac sx in hyperthyroidism
beta blockers
71
contraindication of Radioactive iodine ablation
pregnancy
72
Diabetes insipidus (DI) is characterized by
excretion of a large volume of dilute urine through the kidneys
73
Central DI
decreased secretion of antidiuretic hormone (ADH)
74
nephrogenic DI
decreased sensitivity to ADH in the kidneys, leading to decreased urine concentration
75
sx of DI
polyuria, polydipsia, and nocturia
76
Water deprivation followed by administration of vasopressin (ADH) to differentiate btwn nephrogenic and central DI
central DI: the ADH administered will act on the kidneys to concentrate the urine, leading to an increased urinary osmolality nephrogenic DI: the urine osmolality will remain unchanged because the kidneys are already insensitive to ADH
77
drug of choice for central DI
desmopressin (ADH analog)
78
drugs of choice for nephrogenic DI
Nonsteroidal anti-inflammatory drugs, such as indomethacin, and thiazide diuretics
79

Surgery EOR (7 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2025 Bold Learning Solutions. Terms and Conditions