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A mass in area of sella tursica may produce
- a) bitemporal hemianopsia
- b) Elevated intracranial pressure –headache, nausea and vomiting
- c) seizures, hydrocephalus, or other cranial nervepalsies.
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Diabetes Insipidus -deficiency of ADH
1) Polyuria 2) Polydipsia 3) Dehydration and electrolyte imbalance
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Thyrotoxicosis
- a. Heat intolerance
- b. Warm sweaty skin
- c. Unintentional weight loss
- d. nervousness,emotional instability and fine tremors of hands, muscleweakness
- e. tachycardia(abnormal rapid heart rate), dyspnea(difficult breathing), palpitations; risk of cardiac arrest or cardiac failure.
- f. diarrhea
-
Myxedema
- 1) Manifestations may appear insidiously and are often subtle.
- 2) Early signs – lethargy, cold intolerance, menorrhea
- 3) Later signs
- a) CNS – slowed mentation, speech and movement
- b) Skin – cool, rough, doughy skin = myxedema!
- c) constipation
- d) Heart – decreased cardiac output, bradycardia, possibly enlarged heart and even risk of heart failure
- 4) Severe cases – may develop stupor, coma or proceed to death.
-
Cretinism
- Mental retardation (cretins)
- 3) Growth retardation
- a) Short stature
- b) Coarse facial features with protruding tongue
- c) Dry skin
- d) Delayed tooth eruption, macroglossia, scalloping at edge of tongue
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Graves
- 1) Thyrotoxicosis – most consistent feature
- 2) Bug eyes = infiltrative ophthalmopathy
- 3) Periorbital swelling and lymphocytic inflammation
- 4) Subcutaneous edema = infiltrative dermopathy,Especiallyat backs of legs
- 6) Caused by accumulation of mucopolysaccharides andlymphocytic inflammation
-
PrimaryHyperparathyroidism
- a)Moans – peptic ulcer disease, cholelithiasis,
- pancreatitis, nausea, constipation
- b) Groans – (psychic overtones) neuropsychiatric problemssuch as depression,lethargy, seizures, psychosis, even coma
- c) Stones – kidney stones and gallstones(billiary system),nephrocalcinosis
- d) Bones – osteoporosis and then osteitis fibrosa cystica
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Secondary Hyperparathyroidism
- Bones-Osteitis fibrosa cystica
- Stones – urolithiasis, if calciuria is present
-
Cushing Syndrome
- amenorrhea, mental disturbance, truncal obesity(obese around the trunk), “moon facies, HTN, muscle weakness, hirsutism(increase production
- of body hair),
-
Addison dz
Vague weakness and fatigability
- ♦ anorexia, weight loss
- ♦ Hypotension
- ♦ Hypoglycemia
- ♦ Increased pigmentation of skin and mucous membranes“bronzing of the gingiva”
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Pheochromocytoma
- 1)tumor cells prod. catecholamines
- 2) Hypertension – sustained or paroxysmal
- 3) Tachycardia
- 4) Anxiety, headaches
- 5) Diaphoresis = profuse sweating
-
Multiple EndocrineNeoplasia Syndrome Type IIB
- a. Marfanoid habitus - body that mimics marfans syndrome (tall
- and skinny, long arms)
- b. Dolichofacies(long narrow face) with fullness of the lips
-
Neuroblastoma
- 1)Protuberant abdominal mass
- 2) Fever, weight loss
- 3) Although tumor makes catecholamines, they produce no symptoms
-
Risk factors for ?
obesity
history of infertility
DMellitus
hypertension
endometrial carcinoma
-
clinical features of ?
1.Mammographic changes – micro calcifications
2.Breast lump – fixed, firm
3.Skin retraction or dimpling of skin
4.Peau d'orange skin change
5.Breast swelling, redness and tenderness
6.Palpable axillary lymph node(s) – enlarged, firm to hard, and fixed
all invasive breast cancer
-
Severe mid abdominal pain is the cardinal manifestation.
Shock
elevated serum amylase and lipase (within 12 hours)
acute pancreatitis
-
a) Polyuria -increase in the amount urine
b) Polydipsia - drink a lot due to polyuria
c) Polyphagia - hungry, cells are starving
d) Weight loss and weakness - die to the body feeding on itself
e) Ketoacidosis
DM type I
-
a) Polyuria
b) Polydipsia
c) Polyphagia
d) Obesity – the “environmental” factor!
e) Weight loss and weakness are serious and late signs
DM type II
-
Clinical:
jaundice, fetor hepaticus, hypogonadism, gynecomastia, coagulopathy, weight loss, muscle wasting, peripheral edema, increased risk of multiorgan failure
Lab
Inc. bilirubin, estrogen, ammonia
dec. coagulation factors( 2,7,9,10), glucose, albumin
hepatic failure
-
Ascites, Esophageal varices; Hemorrhoids
Caput medusae; Congestive splenomegaly
Hepatic encephalopathy -
portal hypertension
-
skip lesions
Transmuralchronic inflammation and fibrosis
1) “Rubber hose” consistency
linear ulcerations rendering a “cobblestone”
3) Fissuring with formation of fistulae
4) Crypt abscesses
d. Granulomatous inflammation – noncaseating
Crohn dz
-
Dz that contain granulomas
- TB, cat-scratch, Wegener’s,
- Temporal Artritis, sarcoidosis,
- Foreign body reactions, Crohn
-
increased acid, pepsin exposure, H. pylori, 1st part of duodenum, no malignant transformation
peptic ulcer
-
H. pylori, chronic inflammation, mucosal atrophy, intestinal metaplasia, 5x risk of gastric carcinoma
chronic gastritis
-
risk factors for?
Slowed passage of food containing carcinogens
b) Tobacco and alcohol use
c) Nitrosamines in diet
d) Vitamin and mineral deficiencies
e) Plummer-Vinson syndrome
f) Achalasia
g) chronic esophagitis
squamos cell carcinoma
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