Endo Fun Flashcards
(122 cards)
0
Q
What hormones are produced by the posterior pituitary?
A
ADH, oxytocin
1
Q
What hormones are produced by the anterior pituitary?
A
TSH, prolactin, FSH, LH, GH, ACTH
2
Q
If you think there is an excess of an hormone order what test?
A
Suppression
3
Q
If you think there is a lack or decrease of a hormone order what test?
A
Stimulation
4
Q
What stimulates synthesis of thyroid hormones and is inhibited by T3 and T4?
A
TSH
5
Q
What hormone prepares for breast feeding?
A
Prolactin
6
Q
What inhibits prolactin?
A
Dopamine
7
Q
What stimulates ovulation and sperm genesis?
A
FSH
8
Q
What inhibits FSH
A
Inhibin
9
Q
What develops the corpus leuteum, releases oocyte and produces estrogen?
A
LH
10
Q
What inhibits LH?
A
Testosterone
11
Q
What stuns bone growth and protein synthesis?
A
GH
12
Q
What inhibits GH?
A
Somatostatin
13
Q
What synthesizes secretion of adrenal cortical hormones?
A
ACTH
14
Q
What inhibits ACTH?
A
Cortisol
15
Q
What increases water resorption by kidneys?
A
ADH
16
Q
What is hyperparathyroidism?
A
Excess secretion of PTH causing increased absorption of calcium from bones, kidneys, GI
17
Q
What is the patient complaints of hyperparathyroidism?
A
Bones, stones, groans, moans.
18
Q
Primary hyperparathyroidism?
A
Middle aged woman, hyper functioning benign parathyroid adenoma 85%
19
Q
Secondary causes of hyperparathyroidism?
A
Chronic renal dz, METASTATIC dz, multiple myeloma, sarcoidosis.
20
Q
Clinical presentation of hyperparathyroidism?
A
Anorexia, N,v,constipation, fatigue, weakness, confusion. Polyuria, polydipsia, bone pain, kidney stones, abdominal pain
21
Q
Causes of hypoparathyroidism?
A
Follows thyroid surgery, autoimmune, congenital
22
Q
Acute and chronic sx of hypoparathyroidism?
A
Acute: circumoral tingling, tetany, muscle cramps, irritability
Chronic: lethargy, personality changes, blurry vision, mental retardation
23
Q
Hypoparathyroidism on physical exam.
A
Positive chvosteks sign, pos trousseaus test, prolonged QT on EKG
24
Chvosteks test?
Tap face and get facial muscle spasm, hypoparathyroidism
25
Trousseaus test.
Carpal spasm with BP cuff, hypoparathyroidism
26
Treatment for hypoparathyroidism?
Calcium, vit D if tetany then IV calcium gluconate
27
Hyperthyroid disease 2?
Thyroiditis, graves dz (+ on grave)
Decreased TSH, increased T4
28
Hypothyroid disease 2?
Thyroiditis, hashimotos
Increased TSH, decreased T4
29
MC cause of hyperthyroidism?
Graves dz, autoimmune causes 90%, increased T4 and decreases TSH
30
Hyperthyroidism on exam?
Exophthalmos, per tibial myxedema, goiter WITH bruit
31
Goiter with bruit,
Graves dz
32
MC drug causing graves dz hyperthyroidism.
Amiodarone
33
What are the signs and symptoms of graves dz?
Increase in: appetite, exertional SOB, diarrhea, fatigue, hA, heat intolerance, weight loss, irritability, nervousness, palpitations, sweating, tremor, weakness
34
Graves dz tx?
Methimazole or propythiouracil to inhibit hormone synthesis
PTU in pregnancy
Radioactive iodine
Beta blocker for sx
35
Give s/s for thyroid crisis / thyroid storm.
This is life threatening hyperthyroidism. High ver, tachycardia, vomiting, diarrhea, dehydration, delirium, congestive heart failure.
36
What causes thyroid storm?
Stress, infections, surgery or trauma
37
How can you treat thyroid storm?
Treat underlying cause. PTU, propranolol which only tx sx
| AVOID ASA
38
Most common cause of hypothyroidism?
Hashimotos, autoimmune
39
Painless goiter?
Hashimoto's thyroiditis
40
Sx of Hashimoto's thyroiditis?
Cold intolerance, decrease appetite, weight gain, constipation, depression, dry skin, fatigue, lethargy, paresthesias, muscle cramps
41
PE of Hashimoto's ?
Dry skin, thinning of lateral eyebrows, slow DTR, bradycardia, thin nails, thinning hair
42
Tx for hypothyroidism?
Synthroid, start low in elderly/CAD. Check TSH every 6 wks till euthyroid then 2/yr.
43
Describe subacute thyroiditis?
Woman in 40's with acute painful glandular enlargement with dysphagia. Gland is hard and tender.
Tx with ASA for pain and inflammation and BBlocker for thyroid sx.
44
Describe suppurative thyroiditis.
Rare, caused by pyogenic bacteria. Very painful tender, red, asymmetric swelling go thyroid. Tx. Abx and surgical drainage.
45
Patient presents to clinic with a painless single hard mass on thyroid, dysphagia and hoarseness
Thyroid cancer.
46
Thyroid cancer is liked to what other disease?
MEN IIa and IIb
47
Adrenal gland outer most layer?
Zona glumerulosa produces aldosterone, controlled by renin
48
Adrenal middle layer?
Zona fasiculate producing cortisol and controlled by ACTH
49
Adrenal innermost layer?
Zona reticularis producing DEHA controlled by androgen stim factor
50
Lab test to checkm for adrenal hypo function?
ACTH stimulation test
51
Lab test to check for adrenal hyper function?
Dexamethasone suppression test
52
What is Cushing syndrome and its causes?
Too much cortisol! From excess steroid use, pituitary hypothalamus dys, adenoma, adrenal neoplasia
53
What does Cushing syndrome present with?
Apple obesity, buffalo hump, thin skin, acne, hirsutism, amenorrhea, fatigue, proximal muscle meekness, pigmented striae, HTN.
54
What Is the #1 test for Cushing syndrome?
Increase free cortisol in urine over 125/24 hrs
55
Tx for Cushing syndrome?
Transphenoidal resection and replacement therapy if tumor. Radiation therapy. Meds not OK alone:ketoconazole, metyrapone
56
What is Addison's disease?
Primary corticoadrenal insufficiency.
57
MC cause of Addison's dz?
Autoimmune inflammation of the adrenal cortex, TB infection, trauma, mets
58
Patient presents to clinic with weakness, easy fatigue ability, ortho static hypotension, anorexia, n,v, diarrhea, wt loss, hyper pigmentation?
Addison's disease
59
Screening test for Addison's disease?
Plasma cortisol 30-60 min after cosyntropin IM or IV
60
If screening lab for Addison's produces high ACTH?
Primary dz
61
If screening lab for Addison's produces low ACTH?
Secondary dz
62
Treatment for Addison's dz?
Oral cortisone and mineral cortocoid. IV if crisis.
63
What is a pheochromocytoma?
Rare tumor rising for the chromaffin cells of sympathetic nervous system. Can cause HTN.
64
Presentation of pheochromocytoma?
HA, sweating, palpitations, anxiety, tremor, abdominal pain, HTN.
65
What labs should you order if you suspect pheochromocytoma?
Urine catecholamines, plasma catecholamines, MRI/CT for adrenal tumor
66
Treatment for pheochromocytoma?!
Treatment is surgery BUT remember to give alpha blocker FiRST before beta blocker or blood pressure will rise more
67
What is insufficientroduction of thyroid hormone at birth?
Congenital hypothyroidism or creatinism
68
Signs and symptoms of congenital hypothyroidism?
Sluggish, constipation, large tongue, umbilical hernia, hypothermia, bradycardia, enlarged fontanelle, jaundice, scaly dry skin, brittle hair, inability to feed.
69
How do children present with Cushing syndrome.
Growth arrest, obesity, precocious puberty, easy bruising, and difficulty standing for a crouch.
70
What is the leading cause of death in diabetes?
Myocardial infarction
71
Cause of primary hyperthyroidism?
Thyroid making too much hormone
72
Cause of secondary hyperthyroidism?
Pituitary making too much TSH
73
A patient presents with amenorrhea and galactorrhea in the absence of pregnancy?
Pituitary adenoma
74
Number one treatment of pituitary adenoma?
Dopamine agonist, carbegoline or bromocriptine
75
Nerve damaged during thyroidectomy causing hoarseness.
Recurrent laryngeal nerve
76
Risk of pituitary surgery?
Diabetes insipidus. Treat with desmopressin
77
Hungry bone syndrome.
When hyperthyroidism is corrected surgically the patient needs extra calcium because the damaged bone be absorbs it quickly.
78
What do most pituitary adenomas secrete?
Prolactin
79
How dose primary hyper aldosteronism present.
HTN, polyuria, polydipsia, muscle weakness, fatigue, NO edema.
80
Treatment for primary hyper aldosteronism?
Spironolactone (blocks aldosterone) and surgery of tumor.
81
What is acromegaly?
Excess GH from anterior pituitary. Usually fo
| Rom an GH secreting pituitary macro adenoma.
82
Clinical presentation of increase on glove and hat size, space between teeth, DM, kidney stones, HA?
Acromegaly
83
Screening test for acromegaly?
Increase in insulin like GF and confirm with oral glucose suppression test and MRI
84
Describe familial short stature.
Growth curves at or below 5% by age 2, healthy and normal PE, normal bone age and puberty.
85
Describe constitutional delay of growth.
At or below 5%, delay in puberty! skeletal imaturation, likely to be expected height
86
What is achondroplasia?
Dwarfism, short limbs, long torso, big head, prominent brow, delayed milestones (motor), normal intelligence, bowing of legs, frequent ear infections
87
What is diabetes insipidus and the causes?
Decrease of ADH. Central: decreased production of vasopressin from post pituitary from tumor, surgery, basal skull fx
Nephrogenic: decreased renal response to vasopressin from chronic renal dz
88
Sx are polyuria, polydipsia, polyphagia?
Diabetes insipidus
89
Treatment of DI?
Central: desmopressin
Nephrogenic: thiazides , monitor sodium levels
90
What are some causes of hyperprolactinemia?
Exercise, pregnancy, suckling, seizure, Meds, pituitary adenoma
91
Clinical presentation in men/women with hyperprolactinemia?
Men: ED, gynecomastia, decreased libido
Women: oligomenorrhea, amenorrhea, galactorrhea, infertility
92
If prolactin over 100 think?
Pituitary adenoma
93
Treatment for hyperprolactinemia?
Stop Meds. Surgery and dopamine agonists (bromocriptine.)
94
Meds than can cause hyperprolactinemia?
Risperidone and SSRI
95
What is hypopitutiarism?
Partial or complete loss of anterior pituitary
96
Causes of hypoputiaryism?
Pituitary adenoma, infarction of the pituitary, inflammatory dx, vascular dz (Sheehan postpartum necrosis)
97
What is DM type 1?
Cause by insulin deficient, autoimmune dz, little or no endogenous insulin
98
What are the sx of DM type 1?
Polyuria, polydipsia, polyphagia, blurry vision, fatigue, eight loss
99
Positive labs for DM?
Fasting glucose over 126 and random glucose over 200.
100
Treatment measure for DM type I?
Cholesterol less than 300 per day, less protein, less saturated fat, less sodium
101
What is diabetic ketoacidosis?
Ketones as a result from fat metabolism. From infection, inadequate insulin tx, MI, trauma
102
Patient present to clinic with abdominal pain, N, V, decreased appetite, thirst tachycardia, fruity Oder to breath.....?
DKA
103
What is the treatment for DKA?
Regular insulin. IV fluids. Treat potassium is less than 5.5. Tx underlying cause.
104
Describe what happens in DM type II.
Tissues are resistant to insulin, there is NO deficiency.
105
Lab results confirming DMt2?
Fasting glucose over 126, random glucose over 200, elevated HA1C.
106
Treatment for DM type 2?
Metformin: decreases hepatic glucose production, decreases body weight, improves lipids. Hold if oral contrast.
Sulfonylureas: glyburide and glipizide
107
Monitoring parameters for DM type 2?
HA1C less than 7%, microalbumin, BP target 130/85, lifestyle modification
108
Complications of diabetes?
Cataracts, retinopathy, glaucoma, diabetic neuropathy in stocking glove pattern, gastropsresis, impotence
109
What is the honeymoon period in DM?
Ketoacidosis followed by a sx free period , no tx required
110
Describe the somogyi effect.
Hypoglycemic at night and body's response overshoots leading to hyperglycemia in the morning
111
What is the dawn phenomena?
Early morning rise in glucose requiring increased amounts of insulin to maintain balance
112
If rise in early morning blood sugar check the 3 am glucose and if.... Increased?
Dawn phenomonon and increase pm insulin dose
113
If early morning blood sugar is increased check 3 am glucose... If it is decreased.....
Somogyi effect and decrease pm insulin.
114
What are the signs and symptoms of hypoglycemia?
Sweating, palpitations, hunger, tremor, weakness, lightheaded ness, headache, confusion
115
Hypoglycemia is a glucose below what? And what is the treatment?
55, dextrose
116
High LDL increases the risk of?
Atherosclerotic dz, less than 100 is optimal
117
High HDL is associated with?
Decreased fish of atherosclerotic dz, 40-60
118
Increased triglycerides is associated with?
Increased risk of atherosclerotic dz in women and diabetics, keep under 125
119
Hyperlinked is on exam?
Xanthomas, lipemic blood sample, abdominal pain, Hepatomegaly,
120
Metabolic syndrome clinical features?
```
Must have 3:
Abdominal obesity men >40 in women > 35 in
Triglycerides over 150
HDL m<50
BP greater than 130/85
Fasting glucose over 110
```
121
Treatment for metabolic syndrome?
Reduce underlying cause
