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Emma Endocrine > Random - Mostly Review Slides > Flashcards

Random - Mostly Review Slides Flashcards

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1
Q

MEN1

A
  • pituitary adenoma
  • parathyroid adenoma
  • pancreatic tumors (ZE, insulinoma, glucagonoma, VIPoma)
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2
Q

MEN2 A

A
  • medullary thyroid CA
  • parathyroid hyperplasia
  • pheochromocytoma
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3
Q

MEN2 B

A
  • medullary thyroid CA
  • mucosal neuromas, marfanoid appearance
  • pheochromocytoma
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4
Q
  • trabecular architecture

- uniform cells with round to ovoid. nuclei and finely stippled chromatin

A

NET

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5
Q

hematogenous mets

A

follicular CA

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6
Q

follicular CA dx

A

need gross specimen to see capsule invasion

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7
Q

“cold” FNA

A

nonfunctional thyroid growth

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8
Q

“hot” FNA

A

autonomous thyroid protein production

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9
Q

psamomma bodies

A

papillary CA

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10
Q

nuclear grooves

A

papillary CA

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11
Q

orphan Annie eyes

A

papillary CA

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12
Q

complex branching structure

A

papillary CA

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13
Q

calcitonin producing thyroid malignancy

A

medullary CA

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14
Q

malignant cells surr by amyloid stroma

A

medullary CA

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15
Q

hypOCa thyroid malignancy

A

medullary CA

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16
Q

invades local structures

thyroid malig

A

anaplastic CA

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17
Q

anapestic CA age

A

elderly >60

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18
Q

oxyphil cells
voluminous pink granular cytoplasm
prominent nucleoli

A

Hurthle cells

thyroid adenoma/CA/Hashimoto’s Thyroiditis

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19
Q

ratio of plasma aldosterone to plasma renin > __ is suggestive of primary hypERaldosteronism

A

> 20

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20
Q

confirmatory testing of Conn syndrome

A

Elevated aldosterone levels following salt loading

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21
Q

11-B hydroxylase deficiency

A 
inc androgens
no salt wasting
no hypERK+ 
(still some Aldo prod)
dec cortisol
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22
Q

21-B hydroxylase deficiency

A 
inc androgens
salt wasting
hypOvolemia
hypERK+
dec cortisol
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23
Q

17a-hydroxylase deficiency

A

inc mineralocorticoids
dec androgens
dec cortisol

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24
Q

nests of cells
“zellballen”
sep by blood vessels

A

pheo or paraganglioma

most likely to metastasize!

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25
paraganglioma
via sympathetic ganglia | catecholamine secreting
26
mut of succinate dehydrogenase
paraganglioma
27
homer-wright rosettes
neuroblastoma -origin: neural crest cells -type of small round blue cell tumor of children -poorly differentiated -release catecholamine metabolites (asymptomatic) ^Neuroblastoma=Normotensive -acellular central areas of the rosettes contain rudimentary axons (“neuropil”)
28
neck pain
subacute thyroiditis
29
dec urinary Ca
familial benign hypOcalciuric hypERCa
30
primary hypERaldosterone dx
inc aldo:RAAS Na loa --> still high aldo image adrenal v. sample
31
very high BP hypOK+ metabolic alkalosis
primary hypERaldosteronism --> adrenal adenoma, bilateral adrenal hyperplasia or rarely adrenal carcinoma
32
main functions of cortisol
1. maintains BP (a1 sensitivity to NE/EPI) 2. suppresses immune system (sequesters immune cells) 3. inc gluconeogenesis, inhibit peripheral uptake of glucose 4. enhanced effects of glucagon, epi (inc insulin resistance) 5. active of lipolysis in adipocytes (inc free FAs, inc total CHL, inc triglycerides) 6. muscle atrophy/skin thinning,bruising,striae/bone (inhibits osteoblasts)
33
cortisol activates a ____ receptor
nuclear hormone receptor
34
insulin --> ... --> downstream signaling
1. insulin binds and activates tyrosine kinase domains of receptor 2. tyrosine phosphorylation (autophos) 3. receptor binds substrates (IRS 1, IRS 2) 4. downstream signaling --> PIK3 (glycogen form, FA synth, inc GLUT4) RAS/MAPK (cell growth/ gene express)
35
acromegaly, ketosis?
no, gen sufficient insulin
36
dx of acromegaly
serum IGF-1 | oral glucose test (should suppress GH w/i 2 hr in nml subj
37
succinate dehydrogenase
paraganglioma
38
Graves does not show lymphocytic/destructive histo and instead is a ____ process
hyperplastic
39
acidophil adenoma
prolactin, GH
40
basophil adenoma
ACTH, FSH/LH
41
pituitary adenoma may be confused w/
craniopharyngioma (both cause bitemporal hemianopsia) - suprasellar - bimodal (child and 6th decade) - inc prolactin if stalk disruption
42
Clear lipid-containing cells Low Nuclear/cytoplasm ratio Rare or absent normal mitoses
adrenal cortical ademona
43
homogenous yellow (lipid-rich)
adrenal cortical adenoma
44
differences on gross inspection between functional adenomas (prod glucocorticoids/mineral) and non-functional incidentalomas
none, look same gross/micro
45
adrenal cortical adenoma | unilateral or bilateral
unilateral w/ atrophy of contralateral cortex due to suppression of ACTH secretion
46
adrenal hyperplasia in ACTH-dep Cushing's | unilateral or bilateral
bilateral | diffusely thickened cortex w/ streaks/patches of yellow, lipid-containing cells and brown lipid-depleted cells
47
compact, lipid-depleted cells high N/C ratio atypical mitoses
adrenal cortical CA
48
specific assay to complete when dx pheo
Calcitonin assay could be used to screen for C-cell hyperplasia in MEN2A (pheo assoc w/ medullary thyroid CA)
49
Sites of origin of adrenal metastases
Lung, breast, GIT, thyroid, kidney
50
neuroblastoma
no circulating catecholamines causing sx (just metabolites) rosettes, small blue cell tumor rudimentary axons in center = neuropil young child
51
ganglioneuroma prognosis
benign, mature neurons
52
homogenous rubbery cut surface
ganglioneuroma
53
scalloped
...colloid --> Graves
54
fibrosis is present in graves or hashimotos?
hashimotos
55
focal mushroom
low risk, minimally invasive follicular thyroid CA
56
green birefringence under polarized light
amyloid --> medullary thyroid CA
57
chromogranin
medullary thyroid CA +other neuroendocrine substances
58
parathyroids show inc ___ with age
stromal fat
59
parathyroid adenoma
no fat | classic: compressed rim of parathyroid at periphery (some fat)
60
normal fasting BS
<100
61
diabetes fasting BS
>126
62
pre-diabetes A1c
5.7-6.4
63
subacute thyroiditis iodine uptake
low
64
toxic adenoma iodine uptake
high
65
toxic multinodular goiter iodine uptake
high
66
exogenous hypERthyroidism iodine uptake
low
67
Use of methimazole in thyroiditis?
none, hormone is pre-formed
68
dx test of choice for non-toxic thyroid nodules
FNA
69
complications of acromegaly
- carpal tunnel syndrome - obstructive sleep apnea - hypERhidrosis (xs sweating) - stroke (COD)
70
comm causes of inc prolactin
``` Prolactinoma Hypothyroidism Anti-dopaminergic drugs, mostly antipsychotics Renal disease Liver disease Non-secreting pituitary tumor Herpes Zoster ```
71
Herpes Zoster
inc prolactin
72
comm causes of HTN and hypOK+
Primary hyperaldosteronism Ectopic Cushing’s syndrome Glycyrrhizic  acid from licorice, herbal preps Liddle’s syndrome Primary hypertension with diuretic use Adrenal carcinoma 11 OHase deficiency (CAH)
73
comm causes of primary adrenal insufficiency
Autoimmune (polyglandular failure) Tuberculosis Sarcoidosis, amyloidosis, hemochromatosis Hemorrhage (meningococcemia, anticoagulants, trauma) Fungal infections Metastatic neoplasia/infiltration Congenital adrenal hyperplasia
74
metyrapone test
blocks last step in synthesis of cortisol looks at pituitary reserve of ACTH (not initially done)
75
cortrosyn
truncated ACTH, use for dynamic testing with adrenal insufficiency STIMULATION test if cortisol doesn't inc upon stim with cotrosyn --> adrenal gland may be atrophied due to long-standing hypOpituitarism
76
Non-PTH Causes of Hypercalcemia
``` Malignancy Granulomatous disease Vitamin D intoxication Vitamin A intoxication Calcium antacids (milk alkali) Pheochromocytoma Addison’s disease Thyrotoxicosis Paget’s disease of bone Immobilization ```
77
T/F cortisol can lead to adrenal hypERplasia
F (neg feedback)
78
insulin works thru which type of receptor
tyrosine kinase
79
vitamin D deficiency may predispose to
type II DM
80
gold standard for eval pituitary adrenal reserve
insulin tolerance test | nml response to hypoglycemia due to insulin --> rise in GH and cortisol
81
glucocorticoid effects on bone mass
dec bone mass --> osteoporosis, fractures
82
Follicular variant of papillary thyroid CA acts like
classic papillary thyroid CA
83
hyperplasia w/I follicle BM
C-cell hyperplasia (familial medullary thyroid CA)

Emma Endocrine (4 decks)

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