Hyperparathyroidisim_____hypercalcemia,hypophosphotemia,hypercalciuria,PTH,DEXA,99mTC,thyroid
ultrasonography, & treated by parathyroidectomy,(iv fluids,loop diuretics,iv bisphophonates for acute
hypercalcemia),oral po4_ _ binders(ca++ salts,sevelamers hydrochloride,lanthanum carbonate)in renal
insufficiency,cinacalcet for lowering serum PTH( calcimimetic)
Hypercalcemia_____stones,bones,moans,groans,psychiatric overtones
Hypopituitarisim_____pituitary lesions(tumors,cysts),surgery,radiation,sheehan's
syndrome,apoplexy,infilterative disorders,infections,8AM cortisole level,freeT4,testosterone
level,estradiol level,insulin like growth factor level
****
****
Gigantism_____in children,raised GH level,benign pituatary GH secreting adenoma,enlargement of
the(frontal bossing and wide spread teeth),large hands,large feets,large tongue,coarsening of facial
features,skin's tags,carpal tunnel syndrome,obstructive sleep apnea,type 2 DM, heart's
diseases(diastolic dysfunction),hypertension,colon cancer,arthritis,bitemporal hemianospia(compression
of optic disc by pituatary adenoma),glucose intolerance,diabetes,cardiomyopathy,IG F1 level raised,MRI
for a sellar lesion,external beam radiation,treated with octreotide(somastatin analouge),pigvisomant(GH
receptor antagonist)
Hyperprolactenemia_____prolactinoma,pituatary stalk
compression(craniopharyngioma),meningioma,non secreting pituatary tumors,drugs(dopamine
antagonists),renal failure,cirrhosis, raised prolactin level,decreased GnRH level,low LH,low
FSH,infertility,galectonorrhea,amenorrhea,bitemporal hemianospia,treated by Dopamine
agonists(cabergoline,bromocriptine),surgical resection
GIT
Gastroesophageal reflux disease____beart burnafter meal worsening with reclining and improving with
antacid,sour taste in mouth,morning hoarseness,chest pain mimecking CAD, unexplained cough,
investigated by EGD,biopsy,24hrs ph monitering with impedance,barrium swallow,esophageal
manometry,treated by weight loss,elevation of bed's head,avoiding (alchohol,chocolates, coffee),use of
antacids,H2 receptors antagonists(cimetidine),PPI(omeprazole),Nissen fundoplication
*****appendicitis______
Upper gi
bleeding_____hematemesis(coffeegroundemesis),hematochezia,hypovolumia,
(tachycardia,lightheadedness,hypotension),ng tube,gastric lavage,endoscopy for diagnosis,treated with
iv fluid ,packed rbc transfusion
Lower gi
bleeding____hematochezia>melana,nglavage,anoscopy,sigmoidoscopy,colonoscopy,arteriography,explo
ratory laparotomy,treated with iv fluid blood transfusion,endoscopic therapy(epinephrine
injectiin,cauterization,clio placement),intra arterial vasopressin infusion,embolization,surgery
Indirect inguinal hernia____abdominal contents herniation through both external and internal
rings,lateral to inferior epigastric vesseles,most common ,from congenital patent processes vagianlis
Femoral hernia_____herniation below inguinal ligamwnt through femoral canal,below and lateral to the
pubic tubercle,increased intra abdominal pressures,weakened pelvic floor,in womem more common