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Flashcards in Endo (Step up son) Deck (26):
1

What illness have been associated with the onset of type I diabetes?

Rubella
Coxsackie
Mumps

2

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

3

A person is fucking hammered and has hypoglycemia. Why?

Alcohol inhibition of gluconeogenesis

4

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

5

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*

6

What medications can be used to treat thyroid storm?

Beta-blockers
Thionamides
IV sodium iodine (inhibits thyroid hormone release)
Hydrocortisone (inhibits T4 --> T3)
Surgery if necessary

7

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

8

What is found with Graves' disease?

TSI antibodies

Most common cause of hyperthyroidism

9

What is found with Hashimoto thyroiditis?

Anti-TPO

Most common cause of hypothryoidism

10

A male aged 20-60 has a "cold", solid thyroid nodule. Benign or malignant?

Increased risk of malignancy

11

A medicated bipolar patient becomes hypothyroid. What is one possible reason?

Chronic lithium use

12

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

13

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

14

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

15

Patient has hypocalcemia, but normal/high PTH. What could be going on?

Albright hereditary osteodystrophy...bone doesn't respond to PTH

16

What drugs block dopamine synthesis? Why does it matter for endo?

Phenothiazines (anti-psychotic), risperidone, haloperidol, methyldopa, verapamil

Can cause prolactinoma

17

What is treatment for a prolactinoma?

Dopamine agonist (cabergoline, bromocriptine, pergolide)
Surgery/radiation in refractory cases

18

How is acromegaly treated?

Dopamine agonist
Octreotide
Surgery

19

What is the first pituitary hormone to be decreased with hypopituitarism?

GH, then FSH/LH, then TSH, then prolactin, then ACTH/MSH

20

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

21

What causes excess aldosteronism?

Unilateral adrenal adenoma (Conn syndrome)
Increased renin-angiotensin activity d/t perceived low BP

22

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?

17-alpha-hydroxylase deficiency

causes ambiguous genitals in males

23

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

Fludrocortisone

24

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?

11-beta-hydroxylase deficiency

Order deoxycorticosterone level...it'll be high (it's causing the HTN)

25

Why are the adrenals enlarged with Congenital Adrenal Hyperplasia (CAH)?

Decreased cortisol --> increased ACTH --> over stimulated adrenals

26

A baby has prolonged jaundice and large fontanelles. What is a concern? What should be checked?

Cretinism...caused by iodide deficiency or hereditary disorder of thyroid hormone synthesis

Check thyroid studies...can result in physical and mental retardation