Endo Case Studies 2

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  1. Symptoms:
    -bone pain
    -GI disturbances
    • Primary Hyperparathyroidism
    • cause: PTH adenoma
    • test: hypercalcemia, increased PTH levels, increased alkaline phosphate, decreased phosphate, bone biopsy to reveal brown tumors, parathyroid biopsy to reveal polygonal cheif cells and larger oxyphil cells
    • treatment: surgical removal
  2. Symptoms:
    -diffuse osteoclastic bone disease
    -metastatic calcification in soft tissues
    -generalized bone pain
    -associated with renal failure
    • 2o Hyperparathyroidism
    • cause: associated with chronic renal failure
    • test: hypocalcemia, increased PTH, increased alkaline phosphatase, increased phosphate
    • treatment: calcium, vitamin D, phosphate binders; surgical removal of the abnormal glands if disorder is severe
  3. Symptoms:
    -hyperthyroidism symptoms (incl heat intolerance)
    -thickened edematous nodules on lower extremeties
    • Graves Disease
    • cause: autoimmune; formation of thyroid-stimulating immunoglobulin and thyroid growth immunoglobulin
    • test: thyroid function tests
    • treatment: radioactive iodine, antithyroid drugs, thyroidectomy, beta-blockers to control tachycardia
  4. Symptoms:
    -galactorrhea (milky discharge)
    -infertility in women
    -impotence in men
    -amenhorrhea (missed periods)
    *negative pregnancy test
    • Prolactinoma
    • cause: pituitary lactotroph adenoma
    • test: decreased LH and FSH, increased PRL, MRI of brain
    • treatment: dopamine agonist (bromocriptine or cabergoline), surgery or radiation to remove adenoma
  5. Symptoms:
    -hypothyroidism during infancy
    -short stature
    -mental retardation
    -large tongue
    -distended abdomen
    • Cretinism
    • cause: iodine deficiency, deformity of thyroid, deficiency of enzymes that synthesize thyroid hormones
    • test: thyroid funtion tests
    • treatment: synthetic levothyroxine
  6. Symptoms:
    -hypothyroidism in adults
    -thickening of facial features
    -dry/pale skin
    -periorbital edema
    • Myxedema
    • cause: idiopathic, iodine deficiency, surgical or radiation destruction of the thyrod
    • test: thyroid function test
    • treatment: synthetic levothyroxine
  7. Symptoms:
    -nodule or mass in neck
    -swollen lymph nodes
    -previous radiation therapy
    • Carcinoma of the Thyroid
    • cause: previous radiation, predisposition to thyroid carcinoma
    • test: check thyroid and TSH levels, radioactive thyroid scan, fine needle biopsy of nodule/mass and lymph nodes
    • treatment: thyroidectomy, radioactive iodine treatment
  8. Symptoms:
    -related to pulmonary (lung) disorders
    • Syndrome of Inappropriate ADH (SIADH)
    • cause: ectopic ADH producing small-cell bronchogenic carcinoma, other pulmonary disorders
    • test: hyponatremia, decreased osmolality, increased urine osmolality
    • treatment: fluid restriction, demeclocyclne, hypertonic saline if hyponatremia is severe
  9. Symptoms:
    -delayed deep tendon reflexes
    -puffy face
    • Hashimoto Thyroiditis
    • cause: autoimmune
    • tests: autoantibodies against thyroglobulin, thyroid peroxidase, TSH receptors, and/or iodine receptors
    • treatment: synthetic levothyroxine
  10. Symptoms:
    -prolonged QT interval
    -Trousseau sign (carpal spasms)
    -Chvostek sign (facial muscle twitch)
    • Hypoparathyroidism
    • cause: surgical removal of parathyroid glands, radioactive idodine therapy, idiopathic autoimmune
    • tests: hypocalcemia, decreased PTH, increased serum phosphate,
    • treatment: calcium and vitamin D supplements
  11. Symptoms:
    -history of goiters
    -usually euthyroid (thyroid normal)
    -several lumps
    -can possibly present with hyperthyroidism if toxic
    • Multinodular Goiter
    • cause: usually from long-standing simple goiters
    • tests: thyroid hormone and TSH lvls, ultrasound of thyroid and fine needle biopsy to rule out carcinoma (toxic LH producing)
    • treatment: synthetic levothyroxine if euthyroid
  12. Symptoms:
    -neurological exam unremarkable
    • Nephrogenic Diabetes Insipidus
    • cause: defective ADH receptor in the kidney
    • tests: increased serum osmolality, hypernatremia (fluid deprivation test)
    • treatment: thiazide diuretic and low-sodium diet
  13. Symptoms:
    -neurological exam remarkable (previous trauma, meningitis)
    • Central Diabetes Insipidus
    • cause: deficiency of ADH secretion
    • tests: increased serum osmolality, hypernatremia (fluid deprivation test)
    • treatment: synthetic vasopressin
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Endo Case Studies 2
2012-02-10 10:02:18

endo exam 2 case studies
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