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From Flashcardlet > 12.6.2013(endocrinology) 35 > Flashcards

12.6.2013(endocrinology) 35 Flashcards

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0
Q

Parathyroid tumor common in MEN1

A

Parathyroid hyperplasia

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1
Q

Most common manifestation of MEN1

A

Hyperparathyroidism

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2
Q

Tumors associated with MEN1

A

Cutaneous leiomyoma

Pheochromocytoma

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3
Q

Metabolite of serotonin

A

5-HIAA

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4
Q

Characteristic feature of ectopic ACTH production

A

Hypokalemic/hypochloremic metabolic alkalosis

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5
Q

Ectopic ACTH production

A 
Bronchial carcinoid
SCLC
Bronchial adenoma
Medullary carcinoma
Pheochromocytoma
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6
Q

Conn syndrome is most commonly associated with

A

Cortical adenoma

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7
Q

Type of Edema in hypothyroidism

A

Pitting

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8
Q

ACTH independent Cushing

A

AIMH(ACTH Independant macronodular hyperplasia)
PPNAD(primary pigmented Nodular adrenal disease)
MCune Albright disease

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9
Q

Most common cause of primary hyperaldosteronism

A

B/L adrenal hyperplasia

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10
Q

Cafe au lait spots in mc cune Albright syndrome

A

Coast of Maine appearance(irregular)

Unilateral

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11
Q

Carney complex

A

Atrial myxoma
PPNAD
Hyperlentigenosis
Sertoli cell tumor

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12
Q

Mutation in Mc cune Albright syndrome

A

GNAS1(guanine nucleotide binding protein alpha stimulating polypeptide)

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13
Q

AIMAH

A 
Ectopic expression of receptors for 
LH
serotonin
Interleukin1
GIP
Vasopressin
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14
Q

Manifestations of conn syndrome

A 
Hypernatremia
Metabolic alkalosis
Hypokalemia:
  Polyuria
  Polydipsia
  Weakness
  Fatigue
  Muscle cramps
Hypomagnesimia 
Hyperglycaemia 
Diastolic hypertension
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15
Q

Aldosterone renin ratio

A

750
Or
450pmol/ml(aldosterone alone)

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16
Q

Antenatal bartter syndrome

A

Hyper prostaglandin E syndrome

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17
Q

Antenatal bartter

A

Dehydration
Metabolic alkalosis
Polyhydramnios

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18
Q

Diff btw bartter and chronic vomiting

A

Urinary Cl- levels are increased in bartter

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19
Q

Facies in bartter

A

Triangular
Protruding ears
Large eyes with strabismus
Drooping mouth

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20
Q

Enzymes elevated in barterr

A

Aldosterone
Renin
Prostaglandin E

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21
Q

Histology in bartter

A

Hyperplasia of JGA

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22
Q

Rx of bartter

A

Indomethacin

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23
Q

Renin and aldosterone levels in Gitelman

A

Normal

PGE2 level is also normal

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24
Presentation of Gitelman
Growth failure | Dehydration don't occur
25
Serum cortisol,normal level
3-5microg/dl
26
Serum ACTH in Addison
>200pg/ml
27
Calcium levels in Addison
Hypercalcemia
28
Pigmentation in Addison disease
``` Palmar creases ORAL MUCOSA,GUMS,CONJUNCTIVA pressure areas(knuckles,knees,elbows,nail beds) Areola scars ```
29
Hyperosmolar coma is common in
Type 2DM
30
Mode of transmission of MODY
Autosomal dominant
31
Genetic syndromes associated with DM
``` Prader willi Laurence moon biedel Turner Klinefelter Down Huntington chorea Friederich ataxia Myotonic dystrophy Porphyria Wolfram ```
32
MODY that respond to SUR
MODY 2 and 3
33
Defect in MODY 1,3,5
Hepatocyte nuclear transcription factor 4alpha(1) HNF 1alpha(3) HNF 1 beta(5)
34
MODY 4
Mutation in IPF1(insulin promotor factor 1)
35
Homozygous mutation of IPF1
Pancreatic agenesis
36
Endocrine disorders causing DM
``` Acromegaly Cushing Aldosterone excess Glucagonoma Pheochromocytoma Somatostatinoma Hyperthyroidism ```
37
Adverse effects of thiazelidenidiones
``` Macular Edema Peripheral Edema Fractures Obesity CHF ```
38
HbA1C measurement is unreliable in
Hemolytic Anemia Hemoglobinopathies Uraemia
39
Glucose challenge test
50g of glucose given and plasma glucose measured after 1 hour >140,do OGTT
40
Insulin as initial therapy in DM2
FBG 250-300 or | Symptomatic from hyperglycaemia
41
Monotherapy in DM1
FBG>200-250
42
Reduction in Na+ concentration in hyperglycaemia
Every 100mg% rise in blood glucose will reduce Na+ by 3 mEq/L
43
Prominent feature of hyperosmolar nonketotic coma
Prerenal azotemia
44
Ketoacidosis with hypoglycaemia
Alcoholic ketoacidosis
45
Rx of alcoholic ketoacidosis
Glucose
46
Glucose lowering effect of which class of drugs takes weeks
Biguanides | Thiazelidenidiones
47
Microvascular complications of diabetes
Nephropathy Retinopathy Neuropathy
48
Microalbuminuria
``` 30-300mg/d Overt proteinuria(>300mg/d) ```
49
Glucose challenge test
O Sullivan test
50
OGTT in pregnant women
100g glucose | 3hours test
51
Alternative to HbA1C
Glycated albumin
52
Drug causing DKA
Cocaine
53
Glucose levels in DKA
250-600
54
Electrolytes in DKA
``` Sodium N Potassium N to increased Magnesium N Chloride N PHOSPHATE IS REDUCED creatinine is slightly increased ```
55
Osmolality in DKA
300-320 It's >350 in nonketotic coma
56
Macrovascular complications of DM
PVD CAD CVA
57
Most common form of diabetic neuropathy
Distal symmetric sensory polyneuropathy
58
Drugs used in Rx of painful diabetic neuropathy
``` Amitryptiline Nortryptiline Desipramine NSAID gabapentin Other agents: Phenytoin Carbamazepine Mexilitine Capsaicin cream ```
59
Microalbuminuria is seen in which stage of diabetic nephropathy
Stage 3
60
Endstage renal disease is stage ________ nephropathy
v
61
Features of stage I of diabetic nephropathy
Increased GFR | Increased in renal size and plasma flow
62
Findings in stage 2 diabetic nephropathy
Thickening in glomerular capillary basement membrane
63
Complications that can be halted by pancreatic transplantation
Neuropathy | Nephropathy(stage 3)
64
Complications that cannot be reversed by pancreatic transplantation
Retinopathy | PVD
65
False positive microalbuminuria
``` UTI Fever menstruation Pregnancy CHF Exercise ```
66
Most common pattern of glomerular involvement in diabetic nephropathy
Diffuse glomerulosclerosis
67
Capsular drop
Eosinophilic thickening of parietal layer of bowman capsule
68
Fibrin caps
Eosinophilic material in wall of peripheral capillary of lobule
69
Pathognomonic lesion of diabetic nephropathy
Kimmelstein Wilson lesion
70
Pathogeneic factors in foot ulcers in DM
``` Neuropathy(trophic changes) PVD autonomic neuropathy(altered superficial blood flow,anhidrosis) Altered foot biomechanics(disordered proprioception and sensorimotor neuropathy) ```
71
Life threatening infectious complications of DM
Malignant otitis externa Emphysematous pyelonephritis Rhinocerebral mucormycosis
72
Intensive diabetes management necessary in
Pregnancy | Microvascular complications
73
Metabolic syndrome
Abdominal obesity Insulin resistance Hypertension Dyslipidemia
74
Tumors associated with hypoglycaemia
``` Insulinoma Soft tissue sarcoma Fibrosarcoma Mesothelioma Rhabdomyosarcoma Liposarcoma Hepatoma Adrenocortical tumor Melanoma Carcinoid Leukemia/lymphoma Teratoma ```
75
Hypoglycaemia in adrenocortical tumor
Overproduction of IGF2
76
Autoimmune hypoglycemias
Insulin antibodies | Insulin receptor antibodies
77
Presentation of insulin antibody hypoglycemia
Postprandial late onset hypoglycemia
78
Postprandial hypoglycemia
Postgastrectomy | Noninsulinoma pancreatogenous hypoglycemia
79
Nesidoblastosis and noninsulinoma postprandial hypoglycemia
Similar islet cell pattern but in nesidonlastosis fasting hypoglycemia is seen
80
Rx of nesidoblastosis
Diazoxide Thiazide Somatostatin Subtotal pancreatectomy
81
Drugs causing hyperprolactinemia
``` Antipsychotics Metoclopramide Methyl DOPA Opioids reserpine Imipramine(amitryptyline,amoxapine) CCB(verapamil) Cimetidine,ranitidine SRI(fluoxetine) MRI CerVical Spine ```
82
Physiologic hypersecretion of prolactin
Sleep Stress Chest wall stimulation
83
Systemic disorders causing increased prolactin secretion
``` CRF Cirrhosis Hypothyroidism Epileptic seizures Pseudocyesis ```
84
Sx in macroadenoma
If after dopamine agonist therapy Tumor size increases/remains same Persistent increase in prolactin level
85
TRH causes GH secretion in
Acromegaly
86
Features of Prolactinoma MRI showing macroadenoma Serum prolactin levels<200microgram/L
Stalk compression Macroadenoma secreting prolactin(>200)
87
Causes of pitutary apoplexy
``` Per existing pitutary adenoma Pregnancy Postpartum Diabetes Hypertension Sickle cell Anemia Acute shock Trauma Carotid angiography Radiation to pitutary tumor Artificial respiration Bleeding/clotting disorder Anticoagulant therapy ```
88
Causes of polyuria with increased urine osmolality
``` Solute/osmotic diuresis Glucose Mannitol Urea(high protein diet) Resolving ATN Medullary cystic disease Diuretics ```
89
Drugs causing SIADH
``` Chlorpropamide Carbamazepine Cyclophosphamide Vincristine Nicotine Antidepressants(TCA,SRI,MAO) Phenothiazines Oxytocin ```
90
Neurological causes of SIADH
``` GBS MS delirium tremens ALS peripheral neuropathy Psychosis Hydrocephalus Cavernous sinus thrombosis Stroke Head trauma ```
91
Neoplasms causing SIADH
``` Bronchial adenoma Carcinoid Ca lung Thymoma Ewing Mesothelioma Gangliocytoma Ca duodenum Ca pancreas Ca ovary Ca bladder Ca ureter ``` BCC MET
92
Infectious causes of SIADH
``` Pneumonia Lung abscess Brain abscess TB lung,brain Aspergilloma(cavity) HIV meningoencephalitis ```
93
Metabolic causes of SIADH
AIP asthma Pneumothorax Positive pressure ventilation
94
Congenital defects associated with SIADH
``` Midline defects(cleft lip,palate) Agenesis of Carpus callosum ```
95
Causes of Euvolemic hyponatremia
``` Hypothyroidism Cortisol insufficiency SIADH Reset osmostat Other causes of increased ADH ```
96
Drugs causing diabetes insipidus
``` Li Demeclocycline AmphotericinB Aminoglycosides Cisplatin Rifampicin Foscarnet Methoxy flurane ``` AA CRF
97
Causes of psychogenic polydipsia
Schizhophrenia | OCD
98
Causes of psychogenic polydipsia
``` MS Head trauma tuberculous meningitis Sarcoidosis Li Carbamazepine ``` MTS
99
Metabolic causes of nephrogenic diabetes insipidus
Hypercalcemia Hypercalciuria Hypokalemia
100
Causes of nephrogenic DI
``` Pregnancy Neurosarcoid Sarcoma Sickle cell disease ATN Amyloidosis ``` N Acetyl ASSP
101
Infectious cause of central DI
Toxoplasma Viral encephalitis Chronic meningitis
102
Primary DI in pregnancy is due to
Vasopressinase
103
Inflammatory causes of central DI
Lymphocytic infundibuloneurohypophysitis Wegener Scleroderma SLE SWELS
104
Toxins causing central DI
Snake venom | Tetrodotoxin
105
Neoplasms causing central DI
``` Meningioma Pitutary adenoma Dysgerminoma Craniopharyngioma Ca lung,breast Leukemia,lymphoma ```
106
Granulomas causing central DI
Sarcoidosis Histiocytosis Xanthoma disseminatum
107
Vascular causes of central DI
Sheehan syndrome Aortocoronary bypass ICA aneurysm Hypoxia encephalopathy
108
Polyuria
>3L/day
109
Pseudohyponatremia
``` Normal plasma osmolality Hyperlipidemia Hyperproteinemia Post TURP Increased plasma osmolality Mannitol Hyperglycaemia ```
110
Urine osmolality in DI
<300mosm/L
111
U/P ratio after water deprivation
>2 in psychogenic polydipsia | < 2 in diabetes insipidus
112
Indication for water deprivation test
Hypotonic polyuria | With plasma osmolality btw 275-295

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