Path/ Pathophys

Question 1

Symptoms of Hypoglycemia (<50)?

Answer 1

BLURRED vision (MC)
Shakiness 
Sweatiness
Nervousness
Hunger
Weakness
Palpitations

Question 2

Signs of Hypoglycemia?

Answer 2

Excess SNS:
Diaphoresis
Tachycardia
Systolic HTN
Tremulousness
Pallor
Confusion
Unusual behavior

Question 3

Body defenses to Hypoglycemia?

Answer 3

Decrease Insulin–> Unless Exogenous
Increase Glucagon–> Fibrosis/ amyloid inhibit
Increase Epinephrine–> Prev. epis lowers treshld
Increase Cortisol–> Prev epis
SNS symptoms–

Question 4

Alcohol and Hypoglycemia?

Answer 4

Body uses up stored Glycogen increases risk of HYPOglycemia in extended periods of drinking

Question 5

Serious complications of Hypoglycemia?

Answer 5

Seizures
Arrhythmias
Death

Question 6

Tx for Comatose pt?

Answer 6

GLUCOSE

Question 7

PNET are associated with what hereditary endocrinopahthies?

Answer 7

MEN-1 (80-100%)
von Hippel Lindau syndrome (20%)
Neurofibromatosis-1 (10%)

Question 8

Describe the histological appearance of NET?

Answer 8

Small
Monomorphic
Round "Salt & pepper" nuclei 
Scant Cytoplasm 
Nests or islands

Question 9

What are the MC sites of PNET metastasis?

Answer 9

LIVER
retropperitoneal lymph nodes
bone

Question 10

Symptoms of nonfunctioning PNET?

Answer 10

Abdominal pain (MC)
Obstructive jaundice (mc)
Anorexia 
Palpable mass
Wght loss

Question 11

Anemia + Diabetes + Necrolytic migratory erythema?

Answer 11

Glucagonoma

Question 12

Peptic ulcers + diarrhea?

Answer 12

Gastrinoma (Zollinger-Ellison syndrome)

Question 13

Diabetes + Cholelithiasis + Steatorrhea?

Answer 13

Somatostatinoma

Question 14

Watery diarrhea
Achlorhydria
Hypokaemia
Hypovolemia
Acidosis

Answer 14

VIPoma

Question 15

Zollinger-Ellison syndrome?

Answer 15

Parietal cell hyperplasia
Abdominal pain
Diarrhea
Peptic + duodenal + jujenal ulcers

Question 16

What is the first line therapy for treating Overdose beta-blockers and calcium channel blockers?

Answer 16

Glucagon

Question 17

MCC of hypercalcemia?

Answer 17

Primary HPT

Question 18

MCC of Hyper ParaThyroid?

Answer 18

Parathyroid adenoma–> MC in blacks, Asians

Question 19

Symptoms of Chronic Hypercalcemia?

Answer 19

Constipation
Urinary pain (nephrolithiasis)
Bone pain (resorptive state= ostetis fibrosa cystic)

Question 20

How can parathyroid adenoma be differentiated from parathyroid hyperplasia?

Answer 20

Adenoma= One gland (others atrophied)
Hyperplasia= Multiple glands enlarged

Question 21

How do granulomatous reactions (Sarcoidosis/TB) causes Hypercalcemia?

Answer 21

Macrophages convert Vit D–> 1,25 Vit D

Question 22

Presentation of Acute hypercalcemia?

Answer 22

Weakness
Decreased reflexes
confusion
lethargy
Seizures
Coma
Constipation--> N/V
POLYURIA 
Shorten QT+ bradycardia--> Arrhythmias

Question 23

Confusion
Decreased Mental capacity
Paraneoplastic syndrome?

Answer 23

Acute Hypercalcemia

Question 24

Asymptomatic + primary Hyperparathyroid?

Answer 24

Chronic Hypercalcemia

Question 25

What is the predominant manifestation of Acute Adrenal crisis?

Answer 25

``` SHOCK anorexia N/V abdominal pain fever confusion ```

Question 26

Manifestations of Chronic Adrenal insufficiency?

Answer 26

``` Hypoglycemia fatigue Weakness Hypotension+ salt craving Hyperpigmentation Hyponatremia + HYPERkalemia Loss of libido and genital hair (females) ```

Question 27

Stress is mediated by what acutely and chronically?

Answer 27

``` Acute= catecholamines Chronic= corticosteroids ```

Question 28

Hypertension and Hypokalemia?

Answer 28

Adrenal cortical tumor secreting ALDOSTERONE | Conn syndrome

Question 29

Signs: Episodic headache, sweating , tachycardia Symptom: HTN are associated with what Genetics?

Answer 29

Pheochromocytoma= MEN-2

Question 30

What are the major risk factors for atherosclerosis?

Answer 30

Age Sex SHODDY

Question 31

``` Symptoms: Stones Moans Groans Bones? ```

Answer 31

Hypercalcemia

Question 32

``` Symptoms: Polyuria Polydipsia Polyphagia Fatigue Wgt loss? ```

Answer 32

Hyperglycemia

Question 33

``` Symptoms: Fatigue Weakness Nausea parathesias confusion? ```

Answer 33

Hyperkalemia

Question 34

``` Symptoms: Lethargy Confusion Irritability Seizures Coma? ```

Answer 34

Hypernatremia + Hyponatremia

Question 35

``` Symptoms: Parasthesias (tingling or numbness) Muscle cramps irritability depression? ```

Answer 35

Hypocalcemia

Question 36

``` Symptoms: Shakiness sweatiness nervousness hunger weakness? ```

Answer 36

Hypoglycemia

Question 37

``` Symptoms: Fatigue weakness constipation irritability myalgias? ```

Answer 37

Hypokalemia

Question 38

``` Dx: Hypoglycemia Anorexia, wgt loss, N/V weakness hypotension hyperkalemia Metabolic acidosis decreased pubic/ axillary hair in females Hyper-pigmentation? ```

Answer 38

Addison's disease--> Primary adrenal insufficiency

Question 39

What is elevated in Addison's disease and whats the treatment?

Answer 39

ACTH elevated--> NO cortisol -feedback inhibition | Tx; replace GC + MC

Question 40

``` Dx: Hyoerglycemia Muscle wasting Central obesity Osteoporosis Striae Menstrual disorders Hypertension? ```

Answer 40

Cushing's syndrome (LOW ACTH)--> Primary Adrenal hyperplasia

Question 41

What is the Cushing's disease? /

Answer 41

Elevated ACTH due to tumor causing same symptoms as Cushing syndrome

Question 42

Dx: Hypertension Hypokalemia Metabolic alkalosis?

Answer 42

Conn's syndrome--> Aldo secreting tumor ** LOW RENIN

Question 43

What is the treatment for Cushing syndrome?

Answer 43

Ketoconazole | Metyrapone

Question 44

``` Dx: Masculinization in females Early accelerated linear growth Early Pubic/ axillary hair Hyperkalemia Hypoglycemia weakness metabolic alkalosis Hyperpigmenation? ```

Answer 44

21 beta hydroxylase deficiency Excess androgens Deficient GC + MC

Question 45

Dx: No pubic hair female Low cortisol High Aldosterone?

Answer 45

17 alpha hydroxylase deficiency

Question 46

Painless Goiter Peripheral edema Headache & joint ache Anovulation?

Answer 46

Hashimoto Thyroiditis--> Anti Thyroid antibodies

Question 47

``` Hyper-excitability Wght Loss Sweating Diarrhea Extreme fatigue Hand tremors Dry eyes / corneal ulcerations? ```

Answer 47

Graves Disease--> Thyroid stimulating Antibodies

Question 48

Round Islets vs. Trabecular Islets in pancrease?

Answer 48

Round--> Beta cells | Trabecular--> PP cells