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Flashcards in Random Organ systems - endo Deck (105)
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31

Tx for SIADH?

fluid restrict; IV hypertonic saline;
Conivaptan, tolvaptan, demeclocycline

32

Tx for hypopituitarism

HRT => corticosteroids, thryoxine, sex steroids, GH

33

What 2 blood disorders can occur due to hyperthyroidism?

hypocholesterolemia => increased LDL receptor expression
hyperglycemia => gluconeogenesis & glycogenolysis

34

What are the labs associated w/ the most common cause of hyperthyroidism?

Graves disease

increased total & free T4;
decreased TSH;
hypocholesterolemia (increased LDL expression)
increased serum glucose

35

Tx for Graves disease

Beta-blockers
Thioamide (blocks peroxidase)
Radioiodine ablation

36

Patient comes w/ elevated catecholamines after birth with arrhythmia, hyperthermia, vomiting & hypovolemic shock. What is the treatment?

Thyroid storm

Give PTU, beta-blockers, steroids

37

What is the association of the most common type of hypothyroidism?

Hashimoto thyroiditis => AI destruction of thyroid gland assoc w/ HLA-DR5

38

What AI Ab are present in Hashimoto thyroiditis?

Antithyroglobulin & antimicrosomal Ab => markers that damage has occurred

39

What are the labs assoc with Hashimoto thyroiditis?

decreased T4 => controls # of TRH receptors which controls amount of TSH produced => always opposite
increased TSH

40

What type of cancer is assoc w/ hashimoto thyroiditis?

B cell lymphoma => marginal cell lymphoma

41

Young woman comes in with tender thyroid after viral infection. What is Dx & Px?

Subacute (deQuervain) Granulomatous thyroiditis

self limited transient hyperthyroidism w/ NO progression to hypothyroidism

42

young female patient presents w/ nontender, hard thyroid w/ hypothyroidism. What is Dx & what is at risk? What would be the Dx if the patient was older?

Reidel fibrosing thyroiditis => fibrosis may extend to local structures such as airway

anaplastic thyroid

43

increased I radioactive up results in what Dx? decreased?

increased in Graves or nodular goiter

decreased in adenoma & carcinoma (do FNA Bx)

44

What are the 4 types of thyroid carcinoma?

papillary, follicular, medullary, anaplastic

45

What is the MC thyroid CA? What is a major risk factor?

papillary Ca => ionizing radiation in childhood (severe acne)

46

What typically defines papillary CA of the thyroid?

nuclear features of orphan-annie eyes, psammoma bodies, nuclear grooves

47

What is oncogenes are mutated in papillary CA of thyroid?

RET & BRAF

48

Px of papillary CA after lymph node spread?

excellent

49

Tx for thyroid cancer? complications of treatment?

remove the thyroid

Hoarseness (recurrent laryngeal nerve damage);
hypocalcemia (removal of parathyroid glands);
transection of inferior thyroid artery

50

Hallmark of follicular CA of thyroid

malignant proliferation of follicles w/ invasion through the capsule

51

Why cannot FNA Bx distinguish between follicular adenoma & follicular CA?

needle insertion will only see follicular proliferation as seen in both

invasion through the capsule distinguishes them & not seen on FNA

52

How does follicular CA of thyroid spread?

hematogenously

53

What are the CA that like to spread via blood?

Renal cell CA;
follicular CA of thyroid
hepatocellular CA;
ChorioCA

54

FNA Bx done and see malignant cells in amyloid stroma

medullary CA => malignant proliferation of C cells

55

What are the Sx related to of medullary CA?

high levels of calcitonin produced by tumor lead to hypocalcemia

Calcitonin often deposits w/in tumor as amyloid

56

what are the familial cases of medullary CA of thyroid associated w/?

MEN 2A & 2B => mutations in RET oncogene

57

Mutation in RET oncogene warrants what procedure?

prophylactic thryoidectomy

58

Older person presents w/ dysphagia & respiratory compromise w/ swollen neck. what is Dx & Px?

anaplastic CA of thyroid => undifferentiated malignant tumor

Poor Px

59

What is MCC of primary hyperparathyroidism?

parathyroid adenoma => benign neoplasm

60

What are the results of primary hyperparathyroidism?

Stones, bones, groans, psych overtones
nephrolithiasis;
nephrocalcinosis;
CNS disturbances;
Constipation, PUD, acute pancreatitis;
Osteitis fibrosa cystica