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USMLE STEP 2 CK RETAKE > Endicrinology > Flashcards

Endicrinology Flashcards

(53 cards)

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1
Q

Prolactinoma Presentation

A

Female- Amenorrhea, Galctorrhea, Microadenoma

Male-Decreased libido, Macroadenoma visual field changes

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2
Q

Pralctinoma Dx

A

Medications
TSH
Prolactin
MRI to find tumor

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3
Q

Prolactinoma Treatment

A

Dopamine Agonists

Carbegoline>Bromocriptine

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4
Q

Acromegaly Presenation

A 
kids-gigantism 
Adults-Hands, Feet, Face]visceral organs
diabetes, Diastolic HF 
Dx: ILGF-1
Glucose Supression Test 
Tx: Surgery 
Octreotide
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5
Q

Hypopituitarism Acute Causes

A

Infection, Infarction, Iatrogenic

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6
Q

Hypopituitarism Acute Presentation

A 
Cortisol-Hypotensive, Tachycardia
TSH-Lethargy, Coma 
Dx: Cortisol
T4
Tx: Replace hormones
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7
Q

Diabetes Insipidus Presentation

A

Polydipsia, Polyuria, Normal glucose, no glucose in the urine
Dx: H2O Deprivation test
Tx: PP- stop drinking water
Central- DDAVP
Nephrogenic-Gentle Diuresis, HCTZ, Amiloride

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8
Q

H20 Deprivation Results

A

increase uOSM=PP
Give ADH-uOSM and it corrects means central
Give ADH with no change means nephrogenic

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9
Q

SIADH Presentation

A 
Pt: Hyponatremia 
Dx: U/A-
uNa increased 
increase uOsm
sOsm decreased 
Tx: Water Restriction 
Demeclocycline
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10
Q

Hyperthyroidism Presentation

A

Tachycardia, Diarrhea, Heat intolerance, increased DTR, Weight loss, A-Fib
Dx: TSH decreased
Free T4 increased
Tx: Surgery
Radioactive iodine ablation for everything else

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11
Q

Hypothyroidism Presentation

A 
Bradycardia 
Constipation
decreased DTR 
Weight gain 
Dx: TSH increased 
T4 Decreased 
RAIU
Tx: Levothyroxine
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12
Q

Treatment for thyroid storm

A
  1. Propanolol
  2. PTU/methimazole
  3. Steroids
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13
Q

Thyroid Nodule history risk of cancer

A

Hx of radiation to the head and neck
H/O of cancer or cancer in the family
Hoarseness
Age, <20, >60

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14
Q

Thyroid nodule Physical exam for risk of cancer

A

Fixed, Firm, Hard, Non-tender Lymph nodes
U/S: Solid, Hypoechoic, Size >2cm
Microcalcifications, irregular borders

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15
Q

Thyroid nodule <1 cm

A

Repeat U/S in 6-12 months

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16
Q

Thyroid Nodule >1 cm

A

FNA

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17
Q

FNA findings thyroid

A

CA- Resection
Not CA- Repeat U/S 6-12 months
Inconclusive-repeat FNA

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18
Q

Paipillary CA description

A

Most common
Orphan Annie Nuclei
Ts: Resection

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19
Q

Follicular CA description

A

FNA shows normal thyroid
hematogenous spread
Tx: Radioactive iodine ablation

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20
Q

Medullary CA description

A

C-cells, Calcitonin
Associated with MEN 2A 2B
RET oncogene and pheochromocytoma

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21
Q

Anaplastic CA description

A

affects the elderly

Locally invasive usually fatal

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22
Q

Cushing Syndrome Presentation

Study These Flashcards
A

HTN, Diabetes, Obesity,

Acne (Moon Facies), Truncal obesity, Buffalo Hump, Purple Striae

23
Q

Cushing Sydrome Diagnostic tests

Study These Flashcards
A

Low dose dexamethasone suppression-if cushings should fail to suppress cortisol THEN
check ACTH level
if low then do high dose dexa suppression

24
Q

Cushing Syndrome ACTH normal

Study These Flashcards
A

primary adrenal tumor

MRI Resection

25
Cushing Syndrome ACTH elevated
ACTH dependent THEN High dose dexamethasone Fails-Ectopic tumor Suppressed-Cushing disease from pituitary tumor -resection
26
if you get the low dose dexamethsone test what other tests should you get?
24 hour urine cortisol or late night salivary cortisol you need two tests to says cushing syndrome
27
Addisons disease Acute Presentation
Nausea, Vomiting, Hypotension, Coma - At deaths door
28
Addisons disease Chronic presentation
Orthostatic, Hyperpigmentation, decreased Na and increased potassium
29
Addisons disease Diagnostic tests
1. Early AM cortisol 2. Cosyntropin Stimulation (Give ACTH)
30
Consyntropin Stim Test increases Cortisol, Addisons disease
Anterior Pituitary problem MRI Replace Cortisol
31
Cosyntropin Stim Test No change in cortisol, addisons
Adrenal Gland CT/MRI Cortisol & Fludrocortisone
32
Conn Syndrome Presentation
HTN, Hypokalemia | secondary hypertension-to 3 or more medications
33
Conn Syndrome aldosterone:renin=>30 Aldosterone increased Renin Decreased
Conns do salt suppression test doesnt suppress perfomr MRI perform adrenal vein sampling
34
Conn syndrome Increased aldosterone Increased Renin Ratio <10
Renal vascular disease FMD-Stent AS-no stent
35
Pheochromocytoma Presentation
Paroxysmal pain-HA Pressure-HTN Palpitations-HTN Perspiration
36
Pheochromocytoma diagnostic tests
Plasma free catecholamines 24 hr urine metanephrines, VMA CT/MRI Abd Adrenal vein sampling
37
Pheochromocytoma Treatment
first Alpha blockade then Beta blockade Then resect
38
Diabetes screening Random BG
one time plus symptoms | >200
39
Diabetes screening Fasting BG
two times >125=DM 100-125=pre diabetes <100= normal
40
Diabetes screening HbA1c
>6.5=DM 5.7-6.5=Pred diabetes <5.7=Normal
41
Contraindications for metformin
CKD, CHF, Liver disease
42
Biguanides-Metformin AE
Diarrhea
43
Sulfonylureas-glipizides/glyburide AE
Hypoglycemia
44
TZD-glitazone AE
CHF, weight gain
45
DDP4i-gliptins
Weight neutral
46
glp1-utides
weight loss
47
a-glucosidase-acarbose
diarrhea, flatulence
48
SGLT2i-gliflozins
euglycemia, DKA
49
hypoglycemia in non-diabetic
check C-peptide | decreased=injecting-factitous
50
increased C-peptide in non-diabetic, hypoglycemia
``` secretagogue screen positive-ingesting negative-insulinoma 72 hr fast CT/MRI/Abd ```
51
Diabetic with hypoglycemia Treatment
Awake-PO Glucose | Come- IV D50
52
DKA presentation
``` too much sugar Diabetes, Coma, Ketones, Acidosis Dx: BG>300-500 U/A-Ketones ABG:Acidosis BMP: GAP,K ```
53
DKA Treatment
Glucose: 10u IV insulin GAP: NS/LR BMP -When BG normalizes gap is open give D5 1/2 normal Potassium: check potassium is >4 before insulin and replace when is low

USMLE STEP 2 CK RETAKE (15 decks)

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