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@snguyn759: 这个世界充满了甜蜜的谎言。 人心如同鱼群之海。我们是鱼,无法游遍整片海洋。 the gioi nay toan nhung loi noi doi ngot ngao lòng người như biển cá . Ta là cá , không thể bơi hết đại dương #xuhuong
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Tuesday 10 March 2026 13:14:27 GMT
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thachhtott :
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2026-03-18 12:16:42
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3 Types of MEN Syndromes You MUST Know for USMLE Step 1, 2 & 3 1️⃣ MEN 1 - "3 P's" 🧬 Gene: MEN1 (tumor suppressor, chromosome 11). Autosomal dominant (AD). 📋 Triad: → Parathyroid adenoma/hyperplasia → ↑ Ca²⁺ → kidney stones, bone pain. → Pancreatic tumors → gastrinoma (Zollinger-Ellison: recurrent ulcers + diarrhea), insulinoma (hypoglycemia), VIPoma. → Pituitary tumors → prolactinoma (amenorrhea, galactorrhea, infertility). ⚠️ Can present with only ONE finding. Gastrinoma alone → still MEN 1. 💊 Tx: Parathyroidectomy. Prolactinoma → cabergoline. Surgical resection for pancreatic tumors. 2️⃣ MEN 2A — "2 P's + 1 M" 🧬 Gene: RET (proto-oncogene, receptor tyrosine kinase, chromosome 10). AD. 📋 Triad: → Medullary thyroid carcinoma (MTC) - parafollicular C cells → ↑ calcitonin. Amyloid stroma (Congo red +). → Pheochromocytoma - adrenal medulla → episodic HTN, headache, palpitations, sweating. Dx: ↑ urinary metanephrines/VMA. → Parathyroid hyperplasia → ↑ Ca²⁺ (same as MEN 1). ⚠️ Prophylactic thyroidectomy for RET carriers. Treat pheo FIRST → α-blocker before β-blocker before surgery. 3️⃣ MEN 2B - "1 P + 2 M's" 🧬 Gene: RET (same as 2A). AD. 📋 Features: → Medullary thyroid carcinoma - same as 2A, ↑ calcitonin. → Pheochromocytoma - same as 2A. → Mucosal neuromas - nodules on lips, tongue, eyelids + intestinal ganglioneuromatosis. → Marfanoid habitus - tall, long limbs. NO lens or aortic issues (unlike true Marfan). ⚠️ NO parathyroid disease - key distinction from 2A. Comment "notes" to claim early access to my 2026 USMLE Notes.#nursing #medstudent #medschool #medicalstudent #medicalschool
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