USMLE 2 Endo Quick Notes

Type Io Pituitary tumors
o Primary hyperPTH (90%)
o Pancreatic/GI tumors (gastrinoma)
Type 2A
o Medullary thyroid cancer (MTC)
o Pheochromocytoma
o Parathyroid hyperplasia
Type 2Bo MTC
o Pheochromocytoma
o Mucosal neuromas
o marfanoid habitus

Multiple endocrine neoplasia classification

▪ MEN1 pancreatic tumors:
gastrinoma, insulinoma, glucagonoma, VIPoma
o gastrinoma causes recurrent peptic ulcers
▪ Diabetes Mellitus
➢ DM screening: sustained BP > 135/80 mmHg
▪ OGTT is preferred to screen glucose intolerance & DM Type II
▪ Dx: Type II DM
➢ 2 hr OGTT ≥ 200 mg/dL
o fasting blood glucose > 126
o HbA1c ≥ 6.5%
o random plasma glucose ≥ 200
➢ weight loss = most effective lifestyle intervention
to reduce BP
• DASH diet is the next most effective approach in prevent & treat HTN especially non-obese; then exercise, dietary sodium, alcohol intake
• smoking causes a transient rise in BP
▪ early-onset HTN, progressive renal insufficiency,
gross hematuria, flank pain, B/L abdominal masses
▪ central obesity, facial plethora, proximal weakness, abdominal striae, ecchymosis: Cushing’s
▪ headaches, palpitations, diaphoresis a/w
paroxysmal BP elevations: pheochromocytoma
o urinary vanillylmandelic acid, & metanephrines
▪ high serum & low urine osmolality due to inadequate ADH response is most likely due to
lithium-induced nephrogenic DI
▪ Lithium induces ADH resistance, resulting in
acute-onset nocturia, polyuria, & polydipsia
▪ hypovolemic hypernatremia
▪ Rx: discontinue lithium; salt restriction & diuretics (amiloride: K+ sparing diuretic)
▪ Rx: hemodialysis for lithium level ˃ 4 mEq/L or
˃ 2.5 mEq/L + signs of toxicity or renal disease