endocrine and kidney diseases - piemonti

Surgical removal of the entire thyroid gland.

Surgical removal of one lobe (half) of the thyroid gland, often including the isthmus.

Surgical removal of the isthmus (rarely performed).

Surgical removal of lymph nodes in the neck, categorized as central or lateral.

An enlargement of the thyroid gland, which can involve single or multiple nodules.

Minimally Invasive Video-Assisted Thyroidectomy; a less invasive surgery using a small incision and camera.

Monitoring of laryngeal nerves during surgery to ensure they are not damaged.

A common condition with varied causes needing investigation of TSH levels.

A test performed when ultrasounds show suspicious nodule characteristics. A sample with a needle of cells is taken.

Dominant thyroid type in young women; slow-growing with lymphatic spread. Good prognosis.

A less common, differentiated form that tends to give distant metastases; poorer prognosis than papillary carcinoma.

Cancer of the parafollicular cells; linked to MEN syndromes; identified by calcitonin levels.

A rare, aggressive thyroid cancer with poor prognosis and infiltration.

Major arteries supplying the thyroid.

Nerve responsible for vocal cord movement; damage can cause vocal cord palsy.

Doctor that discovered iodine is contained in thyroxine and levo-thyroxine in 1934

Disease affecting the thyroid gland, characterized by the presence of nodules.

Initial patient assessment involving gathering information about their history and symptoms.

A procedure to collect cells from a thyroid nodule for examination, guided by ultrasound.

A classification system for thyroid FNA results, used to assess malignancy risk.

A surgical biopsy involves the removal of a suspicious mass or lump.

Solid, hypoechoic nodule with irregular margins, calcifications, and increased intramodular vascularization.

A benign nodule that does not contain cysts, or liquid, and is solid.

A diagnostic imaging technique using a radioactive tracer to assess the metabolic activity of thyroid nodules.

Surgical removal of a thyroid lobe while trying to maintain normal hormone production. Useful in benign cases.

Structures around the thyroid.

Glands responsible for maintaining calcium levels; avoid damaging during thyroid surgery.

A technique assessing thyroid nodules that combines ultrasound with Doppler flow analysis.

A condition of overactive parathyroid glands leading to excess calcium in the blood.

Monitoring PTH levels during surgery to confirm successful removal of parathyroid adenoma.

Heterogenous neoplasms affecting various organs, originating from cells of the neural crest.

Initial step in diagnosis, involving detailed questioning about symptoms, medical history, and medications.

Begins with inspection, followed by auscultation, percussion, and palpation.

Elevated levels may indicate acute inflammation; liver function tests, and C-reactive protein levels are taken.

The appendix is sent to the pathology lab to check for inflammation, acute appendicitis with invasion of neutrophils, white blood cells or perforations.

Symptoms consistent with hypoglycemia, low plasma glucose, and symptom relief after glucose elevation.

Due to the mass effect by lumen obstruction.

Tumors that occur through acquired mutations during a lifetime.

Tumors caused by germline mutations inherited from parents.

Affects pancreas, parathyroid, and pituitary glands.

Allows for detailed assessment of nodule characteristics, vascularity, and involvement of pancreatic ducts.

Tend to have calcifications in the cyst, are rarely found in IPMNs (intraductal papillary mucinous neoplasms) or mucinous cystadenomas.

Quantifies the extensiveness of the tumor by measuring the tumor size, lymph nodes involvement and metastases.

Evaluate for liver metastases, the most common site for NETs.

Detects somatostatin receptors, useful for well-differentiated tumors.

Tumors that originate from cells of the neural crest which are found throughout the body.

Includes inspection, auscultation, percussion, and palpation to assess abdominal complaints.

Sign indicating acute appendicitis involving palpation of the left lower quadrant of a patient's abdomen, which causes pain in the right lower quadrant.

Looking for the appearance of the appendix, thickened walls, fluid, and peri-appendicular inflammation.

A common surgical procedure to remove the appendix, often performed with general anesthesia for appendicitis.

Finding tumors unexpectedly during tests or procedures for other conditions.

Resulting from secreting hormones, leading to specific clinical syndromes.

A syndrome characterized by gastritis and non-responsiveness to PPIs due to excessive gastrin production.

Obstructive jaundice is possible, but it's rare since NETs are usually encapsulated.

Localized, indolent, small, and asymptomatic and are becoming more prevalent due to increased detection.

Used to quantify the extensiveness of the tumor. It involves measuring the tumor size, lymph node involvement, and metastases.

Being able or not to operate on the patient.

Used for liver metastases evaluation.

Very little clinical value since it is not sensitive, because patients can have high levels but no tumor is present.

Consists in a combination of finding circulating mRNAs of tumor cells and perform a PCR of these to expand the number of copies of these RNAs and then use some deep learning strategies that can help out in giving a score.

Removal of lymph nodes around arterial stations of the stomach during gastric tumor resection.

Parameter to decide between surgery and endoscopy for gastric NET type I.

Treatment depends on size and location; surgical resection if periampullary or endoscopic if not.

Endoscopic or extra-endoscopic surveillance for tumors less than 2 cm.

The primary difference between gastric and duodenal resection's invasiveness.

Parameter used to decide between surgery and surveillance for pancreatic tumors.

Jaundice or dilation of pancreatic duct; surgery is the only solution.

Considering a patient's psychological well-being when opting for surveillance.

Considered when determining the need for surgery or surveillance.

Main factor for deciding the type of pancreatic surgery.

Procedure with pancreatic head, duodenum, gall bladder, bile duct resection.

Procedure removing body and tail of pancreas, plus the spleen.

Spleen removal due to lymph node dissemination in neuroendocrine tumors.

Type of pancreatic surgery done for multifocal malignant NETs.

Leaking pancreatic juice from pancreatic anastomosis after surgery.

Elevated pancreatic enzymes in drain fluids after surgery.

Surgical procedures aimed at reducing endocrine insufficiency.

Carving out a small tumor only when it's far from pancreatic duct.

Performed in well capsulated cases, or tumor won't be resected.

Radical resection, removing small bowel segment containing tumor and its lymph nodes.

Active surveillance suggested for asymptomatic PanNETs smaller than 2 cm.

Aims to reduce the risk of diabetes and endocrine insufficiency by sparing parenchyma.

Used as first line treatments; can inhibit tumor growth.

Peptides linked with radiation, internalize into tumor to kill tumor cells

Taking out of the bulk of the disease, despite you cannot reach radicality.

Most NETS are metastatic when they present.

The pancreatic body with the jejunum or with the stomach

Artery vascularizing the small bowel; follow to remove lymph nodes.

Surgical procedure to remove a damaged or non-functioning organ and replace it with a healthy one from a deceased or living donor.

Transplantation from one human to another.

Transplantation from animals to humans.

Developed vascular anastomosis techniques, crucial for organ transplantation.

First kidney transplant to a human (though unsuccessful) in 1933.

Donation is allowed unless the individual has expressed a negative will. If the will is unknown, relatives are consulted.

Death confirmed by neurological criteria: persistent coma, absent brainstem reflexes, and inability to breathe independently.

Death confirmed by cardiorespiratory criteria following planned withdrawal of support.

Warm ischemia is higher, increasing the risk of organ damage.

The superior vena cava is cut, halting circulation, and perfusion with cold solution begins.

A major problem globally, with varying incidence across countries, impacting costs, quality of life and survival.

Monitoring glomerular filtration rate and albuminuria to classify risk levels: green (low), yellow/orange (intermediate), red (high).

Performing a kidney transplant before ESRD offers better patient outcomes than transplanting during dialysis.

Increases survival years, reduces cardiovascular events, improves quality of life, and is cost-effective compared to dialysis.

Patients with CKD G4-G5 should be considered for transplant, after nephrologist referral 6-12 months before dialysis.

Multiple myeloma, amyloidosis, severe liver/cardiac/pulmonary disease, and central neurodegenerative diseases.

Routine screening is needed per local guidelines to mitigate risk during immunosuppression.

Living donor kidneys have superior graft survival due to younger age and reduced ischemia.

Time between chilling and blood supply restoration; shorter in living donors, impacting graft function.

It must be non-invasive, and uses laparoscopic or robotic techniques for reduced pain and better recovery.

Preserving blood flow by ligating renal artery and vein at their ends, maintaining vessels for anastomosis.

Expanded criteria donors are used due to organ shortage, including older individuals or those with renal dysfunction.

Long incision shaped like a hockey stick, with extraperitoneal placement in the iliac fossa, often on the right side.

The renal vein is anastomosed to the external iliac vein, while the renal artery is connected to the external iliac artery.

Transplanting two kidneys into one patient due to poor quality, using same vessels to boost recovery.

Color, fibrosis, adipose tissue, firmness, atrophy, hemorrhagic signs, and vascular anomalies.

Insulin therapy, delayed nephropathy, obesity, donor pancreas quality, and alternative treatments.

Equality of access, maximum benefit, priority for sensitized patients, and allocation to islet transplantation.

Malignancy, active infections, extrarenal complications, obesity, substance abuse, and psychiatric disorders.

Patients with stage 3-5 CKD with type 1 diabetes should be considered for SPK transplant.

Genetic susceptibility and environmental triggers that disrupt immune tolerance, leading to a breakdown in self-tolerance and autoimmunity.

Circulating markers, such as autoantibodies, that recognize antigens expressed on beta cells, indicating an immune response.

The time when autoantibodies appear in the natural history of T1D, typically within the first two to three years of life.

The percentage range of beta cell mass reduction that leads to the clinical appearance of T1D.

A period where the disease is present with antibodies attacking beta cells, but without clinical symptoms or modified glucose levels.

Testing pre-symptomatic individuals for autoantibodies to identify and potentially intervene in early stages of T1D.

Stage with presence of two or more autoantibodies, but normal glucose levels.

Stage with autoimmunity and dysregulation of glucose levels, defining pre-diabetes.

Stage with autoimmunity, clear hyperglycemia, and symptomatic patient.

The relevant factor in T1D progression that, when considered, turns the disease into a "movie."

Genes associated with HLA strongly linked to the risk of developing autoimmunity against beta cells in type 1 diabetes.

Genes such as HLA that confer protection against the development of type one diabetes.

Beyond HLA, this gene affecting insulin production is correlated with the susceptibility of type one diabetes.

Environmental factors that contribute to autoimmunity against beta cells in T1D.

An organ that supports the immune system that can potentially trigger the autoimmunity associated with T1D.

The hypothesis questioning if beta cell destruction is self-initiated or externally caused.

A gluten-related disease which is frequently associated with T1D due to common genetic factors or cause-effect relationships.

An organ where defects may impair T regulatory cell development, increasing autoimmunity risk, and related to the genetic HLA risk associated with T1D.

The appearance of one antibody signals potential T cell recognition and killing of beta cells; shifting to a second antibody increases the risk of developing diabetes.

Process in which the body has a leakage of antigens in the environment after the killing of sites so that the antibodies can recognise

A condition where the body's cells become resistant to insulin, requiring higher concentrations to achieve the same biological effect.

Type 2 diabetes is mainly caused by insulin resistance, rather than a lack of insulin.

Reduced responsiveness to insulin primarily in the liver.

Reduced responsiveness to insulin mainly in muscles and adipose tissue.

Inflammatory mediators released from adipose tissue, increased proportionally with the amount of adipose tissue a patient has.

Cellular damage induced by high concentrations of free fatty acids, making beta cells less responsive to glucose.

The ability of gut hormones to boost insulin release, amplifying glucose's stimulus.

Refers to the damage of small blood vessels caused by elevated glucose levels, affecting organs such as kidneys, retina, and nerves.

Related to damage in large vessels such as carotids and coronary arteries that can lead to cardiovascular risks.

Condition derived from severe dehydration in which there is a high level of glucose in the blood.

The production of ketone bodies due to the ketogenesis related to lipid digestion.

Is an indicator that one can have DKA.

Hyperosmolar Hyperglycemic State. Seen in Type II DM patients. Characterized by relative insulin deficit.

Inadequate insulin production, insulin resistance, or non-adherence to therapy can cause this.

Infections, pneumonia, myocardial infarction, and pancreatitis may increase insulin needs.

High blood glucose levels resulting from decreased insulin sensitivity and increased hepatic glucose production.

↑ Gluconeogenesis & Glycogenolysis

↓ECF volume and ↑ ECF osmolarity, typically with hypernatremia.

Delirium, lethargy, seizures, stupor, coma

Increased thirst as the body attempts to compensate for fluid loss.

Increased hunger due to hypothalamic cells sensing low intracellular glucose.

Large volume urine output due to glucose in kidney filtrate causing osmotic diuresis.

↓renal perfusion,↓ GFR + Renal Failure (pre-renal cause)

Decreased extracellular fluid causes cells to shrink.

A condition resulting from water loss exceeding intake

Loss of potassium (K+) via osmotic diuresis.

Catabolic hormones (Glucagon, Epinephrine, Cortisol, GH)