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Flashcards in Other Endocrine Deck (12):
0

Test for pheochromocytoma?

If positive, next step?

Elevated urinary catecholamines, metanephrine, vanillylmandelic acid

1. Locate tumor
#T2-weighted MRI.
#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

1

Patient complains of sudden onset of swollen, tender thyroid gland – likely diagnosis? Effect on thyroid hormone? Associated finding? Histologic finding? Management?

DeQuervain's thyroiditis

Hyperthyroid from sudden release due to injury

Elevated ESR

Giant cell granulomas around degenerating thyroid follicles

Analgesics and aspirin

2

When do you do surgery for acute thyroid inflammation?

Etiologies?

Management?

Acute superlative thyroiditis (bacterial infection)

Streptococcus, Staphylococcus, Pseudomonas, tuberculosis, aspergillosis, actinomycosis, syphilis

Antibiotics and drainage

3

Hashimoto's – histologic findings?

When surgery?

Lymphocytic and plasma cell invasion into thyroid tissue

Compressive symptoms

4

Patient m with history of parathyroidectomy presents with intractable ulcers – suspected diagnosis? Establish diagnosis with?

Associated with?

Gastrinoma (Zollinger-Ellison syndrome)

Elevated unstimulated serum gastrin level or positive calcium/secretin stimulation test

MEN-1

5

Difference in treatment between sporadic gastrinoma and MEN gastrinoma?

MEN – Multifocal an dcan metastasize. Appropriate therapy is Debated

Sporadic – disease limited. Resect

6

Operative strategy for gastrinoma?

#Endoscopy and ultrasound for location
# surgical enucleation
#If mass involves large pancreatic duct, Whipple

7

Strategy for unoperable metastasized gastrinoma?

Streptozocin as chemotherapeutic agent

8

Whipple Triad?

#Fasting hypoglycemia (under 60)
#Symptomatic hypoglycemia
#relief with glucose

9

Surgical management of insulinoma? If inoperable?

#Endoscopy an ultrasound for location
#Resection
#if involves large pancreatic duct, Whipple

Diazoxide (inhibitor of insulin release)

10

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

11

Patient with incidental adrenal mass – when to remove?

5 cm or more