1. 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.
  2. Diabetes Insipidus -deficiency of ADH
    1) Polyuria 2) Polydipsia 3) Dehydration and electrolyte imbalance
  3. 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
  4. 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.
  5. 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
  6. 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
  7. 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
  8. Secondary Hyperparathyroidism
    • Bones-Osteitis fibrosa cystica
    • Stones – urolithiasis, if calciuria is present
  9. Cushing Syndrome
    • amenorrhea, mental disturbance, truncal obesity(obese around the trunk), “moon facies, HTN, muscle weakness, hirsutism(increase production
    • of body hair),
  10. Addison dz
    Vague weakness and fatigability

    • ♦ anorexia, weight loss
    • ♦ Hypotension
    • ♦ Hypoglycemia
    • ♦ Increased pigmentation of skin and mucous membranes“bronzing of the gingiva”
  11. Pheochromocytoma
    • 1)tumor cells prod. catecholamines
    • 2) Hypertension – sustained or paroxysmal
    • 3) Tachycardia
    • 4) Anxiety, headaches
    • 5) Diaphoresis = profuse sweating
  12. 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
  13. Neuroblastoma
    • 1)Protuberant abdominal mass
    • 2) Fever, weight loss
    • 3) Although tumor makes catecholamines, they produce no symptoms
  14. Risk factors for ?
    history of infertility
    endometrial carcinoma
  15. 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
  16. Severe mid abdominal pain is the cardinal manifestation.
    elevated serum amylase and lipase (within 12 hours)
    acute pancreatitis
  17. 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
  18. a) Polyuria
    b) Polydipsia
    c) Polyphagia
    d) Obesity – the “environmental” factor!
    e) Weight loss and weakness are serious and late signs
    DM type II
  19. Clinical:
    jaundice, fetor hepaticus, hypogonadism, gynecomastia, coagulopathy, weight loss, muscle wasting, peripheral edema, increased risk of multiorgan failure

    Inc. bilirubin, estrogen, ammonia
    dec. coagulation factors( 2,7,9,10), glucose, albumin
    hepatic failure
  20. Ascites, Esophageal varices; Hemorrhoids
    Caput medusae; Congestive splenomegaly
    Hepatic encephalopathy -
    portal hypertension
  21. 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
  22. Dz that contain granulomas
    • TB, cat-scratch, Wegener’s,
    • Temporal Artritis, sarcoidosis,
    • Foreign body reactions, Crohn
  23. increased acid, pepsin exposure, H. pylori, 1st part of duodenum, no malignant transformation
    peptic ulcer
  24. H. pylori, chronic inflammation, mucosal atrophy, intestinal metaplasia, 5x risk of gastric carcinoma
    chronic gastritis
  25. 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
Card Set
S/S of dz for endocrine