Flashcards in Random Organ systems - endo Deck (105)
Tx for SIADH?
fluid restrict; IV hypertonic saline;
Conivaptan, tolvaptan, demeclocycline
Tx for hypopituitarism
HRT => corticosteroids, thryoxine, sex steroids, GH
What 2 blood disorders can occur due to hyperthyroidism?
hypocholesterolemia => increased LDL receptor expression
hyperglycemia => gluconeogenesis & glycogenolysis
What are the labs associated w/ the most common cause of hyperthyroidism?
increased total & free T4;
hypocholesterolemia (increased LDL expression)
increased serum glucose
Tx for Graves disease
Thioamide (blocks peroxidase)
Patient comes w/ elevated catecholamines after birth with arrhythmia, hyperthermia, vomiting & hypovolemic shock. What is the treatment?
Give PTU, beta-blockers, steroids
What is the association of the most common type of hypothyroidism?
Hashimoto thyroiditis => AI destruction of thyroid gland assoc w/ HLA-DR5
What AI Ab are present in Hashimoto thyroiditis?
Antithyroglobulin & antimicrosomal Ab => markers that damage has occurred
What are the labs assoc with Hashimoto thyroiditis?
decreased T4 => controls # of TRH receptors which controls amount of TSH produced => always opposite
What type of cancer is assoc w/ hashimoto thyroiditis?
B cell lymphoma => marginal cell lymphoma
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
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
increased I radioactive up results in what Dx? decreased?
increased in Graves or nodular goiter
decreased in adenoma & carcinoma (do FNA Bx)
What are the 4 types of thyroid carcinoma?
papillary, follicular, medullary, anaplastic
What is the MC thyroid CA? What is a major risk factor?
papillary Ca => ionizing radiation in childhood (severe acne)
What typically defines papillary CA of the thyroid?
nuclear features of orphan-annie eyes, psammoma bodies, nuclear grooves
What is oncogenes are mutated in papillary CA of thyroid?
RET & BRAF
Px of papillary CA after lymph node spread?
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
Hallmark of follicular CA of thyroid
malignant proliferation of follicles w/ invasion through the capsule
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
How does follicular CA of thyroid spread?
What are the CA that like to spread via blood?
Renal cell CA;
follicular CA of thyroid
FNA Bx done and see malignant cells in amyloid stroma
medullary CA => malignant proliferation of C cells
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
what are the familial cases of medullary CA of thyroid associated w/?
MEN 2A & 2B => mutations in RET oncogene
Mutation in RET oncogene warrants what procedure?
Older person presents w/ dysphagia & respiratory compromise w/ swollen neck. what is Dx & Px?
anaplastic CA of thyroid => undifferentiated malignant tumor
What is MCC of primary hyperparathyroidism?
parathyroid adenoma => benign neoplasm