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Endocrine Diagnostic Tests
Condition Problem Test Acromegaly ↑ GH Serum IGF-1 Glucose suppression test Prolactinoma ↑ Prolactin Serum prolactin DI ↓ ADH Water deprivation DDAVP stimulation SIADH ↑ ADH Urine Osm/Na Cushing Syndrome ↑ Cortisol 24h Urine cortisol 1 mg Dexa ACTH 8 mg Dexa Addison ↓ Cortisol 8AM Cortisol Cosyntropin Conn’s...
Read moreMetabolic Syndrome
WEIGHHT (3 out of 5) Waist ↑ → >40 inch Impaired Glucose → >100 Hypertension → >130/85 HDL ↓ → <40 TG ↑ → >150
Read moreCongenital Adrenal Hyperplasia
Congenital Adrenal Hyperplasia Etiology Inherited defect in steroid synthesis 21-hydroxylase (>90%) 11β-hydroxylase 17α-hydroxylase Presentation Most common → Hypotensive child with severe electrolyte abnormalities Deficiency 21-hydroxylase 11β-hydroxylase 17α-hydroxylase Aldosterone ↓ ↓ ⬆︎ Cortisol ↓ ↓ ↓ Sex hormones ↑ ↑ ↓ 17-OH progesterone ⬆︎ — — 11-deoxycorticosterone (11-DOC) — ⬆︎...
Read moreThyroid Cancer
Thyroid Nodule Etiology Palpable in 5% of women and 1% of men 95% benign Radiation to neck Presentation Benign Adenoma Colloid nodule Cyst Malignant Papillary Radiation to neck Papillary cell tumor Branching papillae Lymphadenopathy Orphan Annie nuclei Psammoma bodies Positive prognosis Lymphatic spread Follicular Follicular cell tumor Hematologic spread...
Read moreMultiple Endocrine Neoplasia (MEN Syndromes)
Syndrome MEN 1 (3P) MEN 2A MEN 2B Tumors Pituitary Functioning or NOT Parathyroid ↑Ca Pancreas Zollinger Ellison Insulinoma VIPoma Parathyroid ↑Ca Thyroid (Medullary) Calcitonin → ↓Ca Pheo Neuronal Tumors Intestinal ganglioma Thyroid (Medullary) Calcitonin → ↓Ca Pheo Notes MEN gene Ret oncogene Ret oncogene Marfanoid habitus
Read moreDiabetes
Etiology Type 1 DM Insulin deficient Childhood onset HLA-DR3, HLA-DR4 Insulin dependent from beginning Not related to obesity Type 2 DM Insulin resistant Adult onset Related to obesity Presentation Polyurea Polyphagia (Type 1>2) Polydipsia ↓ Wound healing DKA (Type 1>2) Diagnosis 2x FBS >125 (two separate occasions) 1x Glucose >200...
Read moreAdrenal Disorders
Hypercortisolism Etiology ↑ ACTH Pituitary source → Cushing Disease (70%) Ectopic source → Cushing Syndrome Small cell lung cancer, Carcinoid (10%) Unknown (5%) Adrenal source (15%) Presentation Fat redistribution Moon face Truncal obesity (↑ abdominal fat) Buffalo hump Thin extremities Skin Striae Easy bruising ↓ Wound healing Thin skin Osteoporosis...
Read moreCalcium Disorders
Hypercalcemia Etiology Primary hyperpara Cancer Vit D intoxication Granulomatous disease (Sarcoidosis) Thiazide diuretics Hyperthyroidism Bone metastasis Multiple myeloma Presentation Stones → Nephrolithiasis Bones → Osteoporosis Groans Constipation Abdominal pain Moans Confusion Stupor Lethargy Short QT Syndrome Hypertension Diabetes insipidus Renal failure Treatment Ca >14 or Symptomatic → Saline at high volume...
Read moreThyroid Disorders
Hypothyroidism Etiology Hashimoto Thyroiditis Autoimmune Thyroid burnout Subacute Thyroiditis Postpartum Thyroiditis Postviral Thyroiditis Secondary Hypothyroidism Pituitary compromise Congenital Hypothyroidism FTT Hypotonia Umbilical hernia Prolonged jundice Generalized thyroid hormone resistance Iatrogenic → After surgery ↓ Iodine intake Lithium Amiodarone Presentation Bradycardia Constipation ↑Weight Fatigue, Lethargy, Coma ↓DTR Cold intolerance Hypothermia...
Read morePituitary Disorders
Panhypopituitarism Etiology Tumors Metastasis Adenoma Rathke cleft cyst Meningioma Craniopharyngioma Lymphoma Conditions Hemochromatosis Sarcoidosis Histiocytosis X Trauma Radiation Syndromes Sheehan Kallmann ↓LH/FSH Anosmia Renal agenesis (50%) Infection Fungi TB Parasites Autoimmune Lymphocytic penetration Presentation Hypothyroidism Hypoadrenalism ↓ Prolactin Men → Normal, Extreme ↑ can cause ED Women → No lactation...
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