Surgical Hypertension
60 SURGICAL HYPERTENSION
Thomas A. Whitehill M.D.
1. What are the surgically correctable causes of hypertension?
Show answer
Renovascular hypertension, pheochromocytoma, Cushing’s syndrome, primary hyperaldosteronism (Conn’s syndrome), coarctation of the aorta, and unilateral renal parenchymal disease. Surgical hypertension accounts for 5% of all hypertensive patients.
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Thyroid Nodules & Cancer
59 THYROID NODULES AND CANCER
Robert C. McIntyre Jr., M.D.
1. What is the prevalence of thyroid nodules and cancer?
Show answer
Thyroid nodules increase throughout life. Nodules are four times more common in females than in males, and 50% of 50-year-old women have a palpable nodule. After exposure to radiation, nodules develop at approximately 2% annually, reaching a peak at 25 years. Nodules are 10 times more frequent in glands examined by ultrasound, at surgery, or at autopsy. Fewer than 50% of thyroid nodules that appear solitary on physical examination are truly solitary.
Each year in the United States, there are approximately 15,000 new cases and 1000 deaths due to thyroid cancer. Up to 35% of thyroid glands examined at autopsy contain occult papillary cancer (< 1.0 cm).
Hyperthyroidism
58 HYPERTHYROIDISM
Robert C. McIntyre Jr., M.D.
1. What are the symptoms and signs of hyperthyroidism? Show answer
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General:
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Heat intolerance, perspiration, flushing, tremor, sleep disturbance
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Psychological:
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Nervousness, emotional lability, anxiety, aggressiveness, delusions
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Cardiovascular:
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alpitations, tachycardia, supraventricular dysrhythmias
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Respiratory:
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Breathlessness, hoarseness
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Gastrointestinal:
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Increased appetite, weight loss, increased frequency of bowel movements
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Reproductive:
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Gynecomastia, irregular menses
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Bone:
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Osteoporosis
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Other:
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Ophthalmopathy, dermopathy
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2. What causes hyperthyroidism?
Hyperparathyroidism
57 HYPERPARATHYROIDISM
Robert C. McIntyre Jr., M.D.
1. What is the prevalence of hyperparathyroidism (HPT)?
Show answer
There are approximately 100,000 new cases of HPT annually in the United States. Primary HPT occurs in 1 in 500 women and in 1 in 2000 men older than 40 years. Approximately 10% of patients with primary HPT are referred for surgery.
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Abernathy’s Surgical Secrets, Updated Edition (Book w / Student Consult)
Author / s: Harken Alden H., Abernathy Charles, Moore Ernest Eugene
Year: 2004
Pages: 473
Publishers: Elsevier Mosby; 5th Bk & Acc edition
ISBN: 0323034160
