Flashcards in Other Endocrine Deck (12):
Test for pheochromocytoma?
If positive, next step?
Elevated urinary catecholamines, metanephrine, vanillylmandelic acid
1. Locate tumor
#if difficult to locate, octreotide scan
#Last resort, metaiodobenzylguanidine (MIBG scan)
2. Alpha blockade 10 to 14 days before surgery
3. Transabdominal expiration and tumor resection
Patient complains of sudden onset of swollen, tender thyroid gland – likely diagnosis? Effect on thyroid hormone? Associated finding? Histologic finding? Management?
Hyperthyroid from sudden release due to injury
Giant cell granulomas around degenerating thyroid follicles
Analgesics and aspirin
When do you do surgery for acute thyroid inflammation?
Acute superlative thyroiditis (bacterial infection)
Streptococcus, Staphylococcus, Pseudomonas, tuberculosis, aspergillosis, actinomycosis, syphilis
Antibiotics and drainage
Hashimoto's – histologic findings?
Lymphocytic and plasma cell invasion into thyroid tissue
Patient m with history of parathyroidectomy presents with intractable ulcers – suspected diagnosis? Establish diagnosis with?
Gastrinoma (Zollinger-Ellison syndrome)
Elevated unstimulated serum gastrin level or positive calcium/secretin stimulation test
Difference in treatment between sporadic gastrinoma and MEN gastrinoma?
MEN – Multifocal an dcan metastasize. Appropriate therapy is Debated
Sporadic – disease limited. Resect
Operative strategy for gastrinoma?
#Endoscopy and ultrasound for location
# surgical enucleation
#If mass involves large pancreatic duct, Whipple
Strategy for unoperable metastasized gastrinoma?
Streptozocin as chemotherapeutic agent
#Fasting hypoglycemia (under 60)
#relief with glucose
Surgical management of insulinoma? If inoperable?
#Endoscopy an ultrasound for location
#if involves large pancreatic duct, Whipple
Diazoxide (inhibitor of insulin release)
Patient with medullary carcinoma of the thyroid is found to be MEN-2 positive. Management of thyroid carcinoma?
Total thyroidectomy and removal of lymph nodes in central compartment of neck