Flashcards in Endo (Step up son) Deck (26):
What illness have been associated with the onset of type I diabetes?
Is it possible for someone to become hypoglycemic after eating?
Yes...reactive hypoglycemia can happen postsurgery or can be idiopathic
Eat more carbs and more, smaller meals
A person is fucking hammered and has hypoglycemia. Why?
Alcohol inhibition of gluconeogenesis
When would total T4 be elevated, but free T4 be normal? When would total T4 be low, but free T4 be normal?
Increased TBG levels...pregnancy, oral contraceptives, etc
Decreased TBG levels...nephrotic syndrome and androgen use
TRH secretion is stimulated by stress. What can happen if a person with hyperthyroidism gets stressed?
Thyroid storm...severe diaphoresis, vomiting, diarrhea, tachycardia, fever, and mental status changes*
What medications can be used to treat thyroid storm?
IV sodium iodine (inhibits thyroid hormone release)
Hydrocortisone (inhibits T4 --> T3)
Surgery if necessary
A new mom comes in concerned about a swelling on her neck. It's painless. Scan shows low uptake and a biopsy shows inflammation. What should be done?
Beta-blockers if having symptoms...should self resolve
What is found with Graves' disease?
Most common cause of hyperthyroidism
What is found with Hashimoto thyroiditis?
Most common cause of hypothryoidism
A male aged 20-60 has a "cold", solid thyroid nodule. Benign or malignant?
Increased risk of malignancy
A medicated bipolar patient becomes hypothyroid. What is one possible reason?
Chronic lithium use
Patient comes in concerned about a lump on her neck. FNA shows cleared out cells and psammoma bodies. What is it? What is the prognosis?
Papillary thyroid carcinoma (Orphan Annie tumor)
Good prognosis...follicular variant has slightly worse prognosis
A patient presents Chvostek and Trousseau signs...a nodule is seen on thyroid US. What is most likely?
Medullary Thyroid Carcinoma (parafollicular C cells --> calcitonin)
Seen with MENIIa and MENIIb
Worse in older patients
A patient noticed a neck lump not too long ago and now they sound hoarse. What is a concern?
Anaplastic Thyroid Carcinoma...very aggressive...poor prognosis
Patient has hypocalcemia, but normal/high PTH. What could be going on?
Albright hereditary osteodystrophy...bone doesn't respond to PTH
What drugs block dopamine synthesis? Why does it matter for endo?
Phenothiazines (anti-psychotic), risperidone, haloperidol, methyldopa, verapamil
Can cause prolactinoma
What is treatment for a prolactinoma?
Dopamine agonist (cabergoline, bromocriptine, pergolide)
Surgery/radiation in refractory cases
How is acromegaly treated?
What is the first pituitary hormone to be decreased with hypopituitarism?
GH, then FSH/LH, then TSH, then prolactin, then ACTH/MSH
A patient comes in with a buffalo hump and moon facies with a broken hip. What caused the broken hip?
Avascular necrosis due to cushing syndrome
What causes excess aldosteronism?
Unilateral adrenal adenoma (Conn syndrome)
Increased renin-angiotensin activity d/t perceived low BP
An 18yo girl comes in concerned about not having menarche yet. She is hypertensive and labs show low K+ and high Na+. What is likely diagnosis?
causes ambiguous genitals in males
A 10yo boy comes in and he looks like he is 20yo and is found to be hypotensive with low Na+ and high K+. What is likely going on? What can be used for treatment?
21-alpha-hydroxylase (most common congenital adrenal hyperplasia)
causes ambiguous genitals in females
A 10yo boy comes in and he looks like he is 20yo and is found to be hypertensive. What does he have? What special lab should be ordered?
Order deoxycorticosterone level...it'll be high (it's causing the HTN)
Why are the adrenals enlarged with Congenital Adrenal Hyperplasia (CAH)?
Decreased cortisol --> increased ACTH --> over stimulated adrenals