Pathology: MEN and Pacreas Tumors

Question 1

Patient in coma, what to give them?

Answer 1

Glucose

Question 2

What are the signs of hypoglycemia?

Answer 2

confusion, rapid heart beat, sweating, tremor, visual disturbance, confusion

Question 3

MEN 1?

Answer 3

PPP

Question 4

MEN 2a?

Answer 4

TPP

Question 5

MEN2b?

Answer 5

TPMM

Question 6

Patient comes in with abdominal pain, weight loss, jaundice. Complains of double vision and shakey hands. Then passes out. Ddx?

Answer 6

Insulinoma

• Autonomic failure
• EtOH
• Insulin therapy

Question 7

Most common metastasis of pancreas cancer?

Answer 7

Liver>Retroperitoneal lymph node>Bone

Question 8

What are thresholds for Insulin, glucagon/Epi/NE/cortisol, and hypoglycemic symptoms?

Answer 8

80,70, 50

Question 9

What is seen in histology of insulinomas?

Answer 9

“salt and pepper” chromatin
Sheets and islands of oval cells
Amyloid deposition

Question 10

What can you treat insulinomas with?

Answer 10

Octreotide, sunitinib (mtor inh)

Question 11

What is another pancreatic cancer other than insulinoma?

Answer 11

Gastoma

Question 12

Patient comes in with GI ulcer and diarrhea, hypoglycemic.

Answer 12

Gastrinoma

Question 13

What syndrome does gastrinoma lead to?

Answer 13

Zollinger-Elliston: GI ulcers

Question 14

Patient comes in with rash on butt cheecks, anemia, swollen tongue, and newly onset diabetes. Dx?

Answer 14

Glucagonoma: increase Gluc, decrease insulin

Question 15

What can be given to recussitate comatose patients?

Answer 15

Glucagon and glucose

Question 16

Patient comes in with huge gallstones, smelly greasy diarrhea, and new diabetes mellitus. Dx?

Answer 16

Somatostatinoma of delta cells

Question 17

Patient comes in with watery diarhea, hypoKALEMIA, achlorhydria, hypovolemia, acidosis. Dx?

Answer 17

VIPoma

Question 18

What are the modifiable risk factors for atherosclerosis?

Answer 18

SHODDY: smoking, HTN, Obesity, Diabetes, Dyslipidemia

Question 19

Stones, Moans, Groans, Bones

Answer 19

Hypercalcemia

Question 20

Polyuria, polydipsia, polyphagia, fatigue, weight loss

Answer 20

Hyperglycemia

Question 21

Fatigue, weakness, nausea, parathesia, confusion

Answer 21

Hyperkalemia

Question 22

Lethargy, confusion, irritability, seizures, coma

Answer 22

Hypernatremia and HYPOnatremia

Question 23

Parathesias, muscle cramps, irritability, depression

Answer 23

Hypocalcemia

Question 24

Shakiness, sweatiness, nervousness, hunger, weakness

Answer 24

Hypoglycemia

Question 25

Fatigue, weakness, constipation, irritability, myalgia

Answer 25

Hypokalemia

Question 26

Monotonous round to oval cells with stippled chromatin pattern, minimal mitoses, arranged in nests, cords, strands, glands, sheets

Answer 26

Neuroendocrine tumors

Question 27

What is characteristic of PT adenoma?

Answer 27

Low fat content

Question 28

Primum non nocere

Answer 28

First, do no harm