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Internal medicine > Endo > Flashcards

Endo Flashcards

1
Q

Common Signs and symptoms of hyperthyroidism

A

1)Heat intolerance
2)Tachycardia and palpitations
3)Heat intolerance
4)Weight loss
5)Miscarriage
6)Nervousness and irritability
7)Poor sleep
8)Shakiness and myopathy:hand tremors
9)Diarrhoea
10)Shorter or lighter menstrual periods(oligomenorrhea)

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2
Q

Atypical signs and symptoms of hyperthyroidism

A

Atrial fibrillation in elderly
Single nodule mass in elderly(toxic adenoma)
Apathy
Steatorrhea(malabsorption syndrome)
Acute psychotic Attack:violence and anger
Young onset osteoporosis

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3
Q

Endocrinology causes of osteoporosis

A
  1. Hyperthyroidism
  2. Cushing’s syndrome
  3. Hypogonadism
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4
Q

Signs of thyrotoxic periodic paralysis

A

-Suddenly unable to move eg getting up from toilet
-More common in Asians
-Together with typical hyperthyroidism signs(?)

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5
Q

Causes of orbital swelling

A

Hyperthyroid
Angioedema in allergic run
Raynaud’s disease

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6
Q

Difference in texture of Graves and Hashimotos

A

Graves thyroid tends to be soft, Hashimoto will be firm

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7
Q

Indications for PTU use over carbimazole

A

1) 1st and 2nd trimester of pregnancy
2) Thyrotoxic storm(because of inhibition of peripheral conversion of t3 to t4

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8
Q

Indications for thyroidectomy

A

4Cs
Cancer
Compression
Cosmetics
Complications

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9
Q

Risk of thyroidectomy

A

1) Vocal cord palsy and stridor
2) post operative hypocalcemia
3) Early onset dementia if not compliant to medications,because of complete removal of thyroid

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10
Q

Signs of thyrotoxic/thyroid storm

A

Young,high fever,tachycardia and goitre

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11
Q

What is the renal threshold level for glucose?

A

about 160–180 mg/dL (8.9-10 mmol/L), the proximal tubule becomes overwhelmed and begins to excrete glucose in the urine. This point is called the renal threshold for glucose (RTG).

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12
Q

6Is of DKA and HHS

A

Insulin: Undiagnosed or noncompliant
Infection: UTI, pneumonia etc
Inflammation: cholecystitis, pancreatitis etc
Infarction: AMI,stroke etc
Intoxication: Alcohol,toxins
Iatrogenic: drugs,surgery

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13
Q

Mx of DKA acronym

A

SPIDER

Saline
Potassium
Insulin
Dextrose
Electrolyte abnormalities+ Eat nothing
Reason(underlying)

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14
Q

Sx of DKA

A

Polyuria(due to glucosuria)
Dehydration
N/V
Abdominal pain
Kussmaul breathing
Sweet breath(acetate)

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15
Q

In thyroid PE carotid bruit,thyroid acropachy and oncolysis is specific for?

A

Graves

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16
Q

Causes of Addison disease(primary adrenal insufficency)

A
  1. Ischemic injury and necrosis due to shock(Waterhouse Friderichsen syndrome)
  2. DIVC
  3. Trauma(blunt or postoperative)
  4. R
    enal mass causing hemorrhage
    . Short course of corticosteroids
  5. Autoimmune causes
  6. Infectious causes eg TB, CMV
  7. Infiltrative causes( amyloidosis, Hemochromatosis)
  8. VTEs
  9. Vitamin B5 deficiency
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17
Q

Management of DKA

A

SPIDER

  1. IV fluids,saline or hartmanns
  2. Balance electrolytes especially K
  3. IV insulin infusion
  4. Treat underlying cause
  5. Avoid complications
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18
Q

Types of diabetes insipidus

A

CDI: Central
NDI: Nephrogenic

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19
Q

Antihypertensive contraindicated in pheochromocytoma

A

Beta blocker: releases peripheral adrenaline at B2, may cause hypertensive crisis

USE alpha blocker: phenoxybenzamine

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20
Q

Mx of pheochromocytoma

A

Pharmacological: Alpha blocker phenoxybenzamine

Surgical: Adrenalectomy

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21
Q

Condition that is most specific for Pretibial Myxedema

A

Graves disease, esp TrAb positive

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22
Q

Gold standard test for acromegaly

A

Growth hormone suppression test with 75g OGTT and 30mins serial HGH measurements

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23
Q

Causes of tiredness in acromegaly patient

A
  1. DM
  2. Anemia
  3. OSA
  4. Panhypopituitarism
24
Q

Management of acromegaly

A

Dopamine agonists eg bromocriptine

Surgical: Trans sphenoidal surgery

25
Q

Script for acromegaly mx

A

“Acromegaly is a complex condition which will require involvement of the patient, endocrinologist and neurosurgeon

Patient education should be first followed by referral to neurosurgeon

But it is difficult to completely treat so subsequent pharmacotherapy(3 drugs) and radiotherapy will be required

Complications such as orthopedic,endocrine, CVS and GI will have to be managed”

26
Q

Drug for pheochromocytoma

A

PHEnoxybenzamine for PHEochromocytoma

27
Q

Signs suggestive of myxedema coma in comatose patient

A

Bradycardia and hypothermia(not commonly seen in other causes of collapse)

28
Q
A
29
Q

SEs of metformin

A

Lactic acidosis

30
Q

SEs of SGLT2

A
  1. Euglycemic KA
  2. Hypotension
31
Q

SE of pioglitazone

A

Fluid overload

32
Q

Mx of severe Hypoglycemia

A

D50 IV 40ml stat
IM glucagon 1mg if no IV access

33
Q

Mx of mild hypoglycemia

A

15g oral dextrose

34
Q

When to suspect secondary HTN

A

1) Young HTN
2) Treatment resistant HTN(despite 3 anti hypertensives)
3) Features of swcondary etiologies

35
Q

Drug of choice for pheochromocytoma

A

Alpha blocker

NOT beta, will cause pheochromocytoma crisis

36
Q

Mx of acute addisonian crisis

A

1) 100mg bolus IV hydrocortisone then 200mg infusion
2) 1l crystalloids
3) Treat precipitant

37
Q

Test for suspected Addisons disease

A

Random serum cortisol and ACTH

38
Q

What is the short synacthen test for

A

Synthetic ACTH to test for adrenal response in producing cortisol

39
Q

Cause of Hyperpigmentation in Addisons disease

A

High ACTH activates melanocytes in skin

40
Q

Amount of time after giving PTU/carbimazole to give Lugols Iodine in thyroid storm

A

1hr

41
Q

MOA of teriperatide

A

PTH analogue. PTH in pulses instead of being chronically high has an Anabolic effect

42
Q

Min Creatinine Clearance for bisphosphonates

A

30

43
Q

Causes of central diabetes insipidus

A
  1. Pituitary tumor
  2. Neurosurgical intervention
  3. Sheehan and RT?
44
Q

Causes of nephrogenic diabetes insipidus

A

1) Uncontrolled hyperglycemia
2) Drugs eg lithium
3) Electrolytes eg HyperCa, hypoK
4) Renal disease eg ADPKD
5) inherited(rare)

45
Q

4 stages of hypertensive retinopathy

A
  1. Silver wiring
  2. AV nipping
  3. Cotton wool spots, dot and blot hemorrhages
  4. Papilloedema
46
Q

Cause of metabolic acidosis with hypoK

A

Renal Tubular Acidosis

Hyperglycemic emergency?

47
Q

Cause of hypertension with hypokalemia

A
  1. Conn’s syndrome
  2. Cushing syndrome
  3. Pheochromocytoma
  4. Hyperthyroidism
48
Q

Causes of metabolic alkalosis

A
  1. Conn’s syndrome
  2. Cushing syndrome
  3. Liddle syndrome
49
Q

Doses for HyperK mx

A

Calcium gluconate: 10ml 10% over 10mins
Iv insulin 10units
20ml D50

50
Q

magic number for Calcium and Vit D intake

A

1000mg of Ca and 1000U of vit D

51
Q

When is slow bolus calcium gluconate diluted in 100ml and infused over 1hr

A

Post thyroidectomy

52
Q

Syndromes a/w pheochromocytoma

A
  1. MEN 2A/2B
  2. Neurocutaneous syndromes
    - NF1
    - Sturge Weber
    - Tuberous Sclerosis
    - Von Hippel Lindau
53
Q

GFR cutoff for bisphosphonate use for osteoporosis

A

30ml/min/1.73m^2

54
Q

Which endocrinopathies are adrenal vein sampling useful for

A

Only for hyperaldosteronism

-No role in Cushings or pheochromocytoma

55
Q

Bone vs Liver ALP is heat sensitive

A

ALP from bone pathologies is heat sensitive( BONE BURNS)

56
Q
A

Internal medicine (15 decks)

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