Day 3 - Endo2 Quiz Flashcards Preview

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Flashcards in Day 3 - Endo2 Quiz Deck (11):

Elevated bp, palpitations, HA, perspiration, & urinary VMA - effect of beta blockers?

Elevate bp; Need to give Alpha blocker first (Pheochromocytoma)


Lactotroph v. Somatotroph adenoma

Lactotroph (prolactin): Prolactin-secreting, Pituitary adenoma; Somatotroph (somatotropin): GH-secretin, pituitary adenoma; 50% prolactin 20% GH pituitary adenomas


High PTH w/ Decreased serum Ca, increased serum phosphate

Renal failure w/ Vit D def (PTH raised due to low calcium 2/2 vit D def; kidneys not function well, so phosphate not trashed, instead increased)


DHEA/DHEA-S/Tesoterone; Which more specific for adrenal tumor/secretion in women?

DHEA-Sulfate; Testosterone & DHEA made by both adrenals & ovary in women


HIgh specificity test for dx primary aldosteronism

High aldostosterone: renin ratio; more specific than high sodium or metabolic alkalosis


Next step mgt hyperprolactinemia not due to drug use

MRI brain (pituitary adenoma); TSH


Next step mgt absent pituitary on MRI

Empty sella syndrome; No sx - reassure that residual pituitary tissue acting normally; If sx - id deficient hormones & tx


2 most common causes of Cushing syndrome; Test(s) help distinguish between 2

(1) Exogenous steroid use - low serum cortisol, no suppression regardless of dexamethasone dose (2) Pituitary adenoma, causes Cushing disease - no suppression w/ low dose dexamethasone but suppression with high dexamethasone; Dexamethasone for ACTH suppression test


Drugs causing hyperprolactinemia

Phenethiazines, Antipsychotics (Risperidone, Haloperidone), Methyldopa, Verapamil


Compare/Contrast Alk Phos, PTH, serum Ca, & serum phosphate levels: (1) Paget disease (2) Osteomalacia or Rickets (3) Renal failure (4) Osteopetrosis or Osteoporosis (5) Primary hyperparathyroid (6) Hypoparathyroidism (7) Pseudohyperparathyroidism

(1) Elevated Alk Phos (2) Vit D def: low serum Ca, elev PTH, low phosphate, Alk Phos norm or elev (3) Vit D def (but non-fx kidneys): low Ca, high PTH, high P, Alk Phos normal or high (4) All normal (5) High PTH, high Ca, low phosphate, Alk Phos usually high (6) Low PTH, low Ca, high phosphate, unchanged Alk Phos (7) PTH elevated BUT low Ca & high phoshate


Indications for surgical parathyroidectomy

Any of following: (1) Sx (2) Serum Ca > 1 mg/dL above upper limit of norm (3) 24 hr urinary calcium > 400 mg (4) Cr clearance reduced by 30% (5) Bone mineral density T-score

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