Term
Diseases of the adrenal cortex?
Disease of the adrenal medulla gland? |
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Definition
Cusings and addisons
Pheochromocytoma |
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Term
| Historyically addisonse most commonly occured as a result of ? |
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Definition
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Term
What lab results would you expect with addisons?
K
Na
Glucose
Cortisol
ACTH |
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Definition
High potassium & BUN
Low sodium & glucose
Low cortisol level
Elevated serum ACTH |
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Term
| What tests would you order if you suspect addisons? |
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Definition
Serum electrolytes
BUN & Creatinine
Serum glucose
Serum cortisol and serum ACTH
ACTH stimulation test
Chest x-ray
PPD (TB skin test) |
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Term
| With the diagnosis of addisons, you should consult ______ |
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Definition
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Term
| Treatment for acute adrenal crisis? |
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Definition
Start glucocorticoids and mineralocorticoids immediately
Hydrocortisone, dexamethasone (solucortef IV)
Refer to hospital for management |
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Term
| A patient with addison's disease should keep an emergency kit with? |
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Definition
syring, needle with 4mg of dexamethasone.
Medic alert ID |
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Term
| What is the cause of Cushing's disease? |
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Definition
| excessive secretion of adrenocorticotopin hormone (ACTH) by a pituitary tumor, usually an adenoma. |
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Term
Red cheeks
Buffalo Hump
Moon face
Slow wound healing
What disease? |
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Definition
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Term
Hyperglycemia
Hypertension
Changes in physical appearance
What disease? |
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Definition
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Term
Hyperglycemia
Hypertension
Changes in physical appearance
What disease? |
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Definition
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Term
Purple striae, ecchymoses
what disease? |
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Definition
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Term
Thin hair, acne, bronze skin
what disease? |
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Definition
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Term
| What tests would you order if you suspect cushing's? |
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Definition
Creatinine
24 hr urine for cortisol
ACTH suppression test |
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Term
| What results would you expect with cushing's? |
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Definition
| Elevated serum corisol or exretion of urine free cortisol |
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Term
| Tumor that forms in the center of the adrenal gland (gland located above the kidney) that causes it to make too much adrenaline. |
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Definition
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Term
| Pheochromocytomas can cause: S?S? |
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Definition
| Pheochromocytomas are usually benign (noncancerous) but can cause high blood pressure, pounding headaches, heart palpitations, flushing of the face, nausea, and vomiting. |
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Term
| What is the test used to diagnose pheochromocytoma? |
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Definition
| 24 hr urine sample to measure VMA (vanillylmadelic acid) which measures catecholamines. |
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Term
6) Increased Serum Glucose
7) Nausea, Vomiting
8) Tremors, Weakness, Anxiety
9) Flushing
10)Tachypnea
what disease? |
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Definition
|
|
Term
1) Key Symptom is hypertension:
Sustained Hypertension – 1/3 of pts
Paroxysmal Hypertension-2/3 of pts
2) Orthostatic Hypotension
3) Tachycardia
(Cardiac Stimulation, palpitations)
4) Headaches
Severe
5) Sweating
heat intolerance,
sweating,
fever,
weight loss
What disease? |
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Definition
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Term
| What is the treatment for pheochromocytoma? |
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Definition
| laparoscopic adrenalextomy to remove tumor. |
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Term
| Hyperpigmentation, which is evident in nearly all patients with _______ |
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Definition
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Term
Lassitude
Fatigue that is worsened by exertion and improved with bed rest
Weakness that is generalized, not limited to particular muscle groups
Anorexia
Weight loss
what disease? |
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Definition
|
|
Term
What type of thyroid carcinoma?
enlarging, painful mass associated with hoarseness, dysphonia, dysphagia or dyspnea (more apt to be advanced at time of diagnosis). |
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Definition
| anaplastic thyroid carcinoma |
|
|
Term
What type of thyroid carcinoma?
causes flushing and persistent diarrhea. |
|
Definition
| medullary thyroid carcinoma |
|
|
Term
What type of thyroid carcinoma?
usually presents as a rapidly enlarging, painful mass arising out of a multinodular or diffuse goiter affected by autoimmune thyroiditis |
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Definition
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|
Term
| __________is high in most metastatic papillary and follicular tumors, making this a useful marker for recurrent or metastatic disease. |
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Definition
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Term
| How is thyroid cancer diagnosed? |
|
Definition
Fine-needle aspiration biopsy– this is usually done first and, if positive, significantly reduces the need for more elaborate and expensive testing
Ultrasonography– this may be required for guidance of the fine needle biopsy if the nodule is difficult to feel
Thyroid scan – this can be done to see if the mass is capable of concentrating radioiodine, particularly in those patients with low TSH levels |
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Term
| What is the initial management of a thyroid nodule? |
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Definition
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Term
A fixed painless, painless thyroid mass accompanied by hoarseness and dysphagia should raise the suspicion of?
1. autonomously functioning adenoma
2. Graves disease
3. Hashimoto disease
4. Thyroid malignancy |
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Definition
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|
Term
| Most cost effective method of distinguishing malignant from benign thyroid nodules preoperatively? |
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Definition
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Term
| When should TSH be reassessed after changing levothyroxine dosage? |
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Definition
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Term
| As part of an evaluation of a 3cm round mobile thyroid mass, you obtain an US that reveals a fluid filled structure. Most likely diagnosis? |
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Definition
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Term
| Hyperreflexia with a characteristic quick out quick back action at the patellar reflex? |
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Definition
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Term
| Delayed relaxation phase of the deep tendon reflex =? |
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Definition
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Term
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Definition
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Term
| Chilling easily, cold intolerance with? |
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Definition
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Term
| Obesity seems to ______ osteoporosis risk. |
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Definition
|
|
Term
| Most common ethnic group at risk for osteoporosis? |
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Definition
| small framed asian and european |
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|
Term
| Risk factors for osteoporosis? |
|
Definition
ERIC, CTH
Estrogen deficiency
RA
Inactivity
Cushings
Thyrotoxicosis
Corticosteroids
Heparin |
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Term
| Most common sites of injury with osteoporosis? |
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Definition
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Term
| WHy should plain radiographic films be avoided with screening or eval of osteoporosis? |
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Definition
| because the disease cannot be detected until 40-50% of bone mass is lost |
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Term
| What is the most accepted method for measuring bone mineral density? |
|
Definition
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Term
| What are the recommendations for screening for osteoporosis? |
|
Definition
Women > 65 and older.
< 65 if with risk factor.
Men 50-70 with one or more risk factors |
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|
Term
| What is the initial treatment for osteoporosis? |
|
Definition
-wt bearing exercise
-quit smoking
-<2 etoH drinks per day
-> 1200 mg calcium and 800 Vit D per day
-Caclium citrate is better than carbonate because of better absorption |
|
|
Term
| Inhibit bone resorption by osteoclasts |
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Definition
|
|
Term
| What are the 3 main bisphosphonates? |
|
Definition
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|
Term
Which osteoporosis medication?
Inability to stand or sit upright for 60 minutes after administering. |
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Definition
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|
Term
Which osteoporosis med?
Can't stand or situpright for 30 minutes
Take with full glass of water |
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Definition
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