Treatment is medically initially, but the preferred treatment is surgical. ... ACTH secreting tumors, pituitary operation, irradiation, head trauma. ...
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University of Virginia Clinical Clerkship in Surgery
Peter I. Ellman M.D.
Toxic thyroid adenoma
Follicular adenoma (most common adenoma)
Hürthle cell adenoma
Hürthle Cell CA
Metastatic Carcinoma to the Throid Gland.DDX of thyroid nodule
PTH calcium (normal renal function)
poor renal functioncalcium, PO4 PTH
Hyperplastic parathyroids from chronic stimulation continue post renal transplant
Vit D or A intoxication
Familial hypocalcuric hypocalcemia
Neonatal severe hyperparathyroidism.Discuss ddx of a paitent with hypercalcemia.
On initial evaluation hyperparathyroidism.
Markedly elevated CA
Hx of life threatening hypercalcemia (??)
Reduced Cr CL.
Markedly elevated 24hr U Ca
Substantially reduced bone mass
Following asymptomatic pt
Pt becomes symptomatic
Ca 1-1.6 mg/100 ml above normal
Decline in bone mass
Neuro or psych problems
Pt desire to fix.Surgical indications for asymptomatic hyperparathyroidism
Describe the clinical features of Cushing’s syndrome and discuss how lesions in the pituitary, adrenal cortex and extraadrenal sites are distinguished diagnostically.
How lesions in the pituitary, adrenal cortex and extraadrenal sites are distinguished diagnostically-CONTPlasma ACTH levels can be helpful in determining