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Flashcards in Endocrine 1 Deck (46)
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1
Q

What are the 3 secreting pituitary tumors?

A

growth hormone, ACTH, prolactin

2
Q

What are diseases/indications for GH?

A

Turner syndrome, normal GH but delayed growth, intrauterine growth retardation, muscle augmentation in the elderly.

3
Q

Adverse effects of GH

A

myalgia, arthralgia, glucose intolerance, hypothyroidism

4
Q

GH excess if before epiphyseal plate closure

A

gigantism

5
Q

GH excess after epiphyseal plate close

A

acromegaly

6
Q

What are issues in acromegaly in adults?

A

glucose intolerance, cardiac enlargement, htn, renal failure, soft tissue swelling

7
Q

What are two options for treating GH excess disorders?

A

GH inhibiting hormone, GH receptor antagonist

8
Q

Indications for somatostatin agonists include

A

utility in acromegaly & carcinoid syndrome; growth limitations

9
Q

What is the main indication for GH receptor blockade?

A

non-responsive acromegaly

10
Q

Function of prolactin hormone

A

lactation, stress, sexual, fluid balance, immunologic

11
Q

typical hyperprolactinema cases in adult females:

A

amenorrhea, galactorrhea

12
Q

typical hyperprolactinema cases in adult males:

A

reduced libido, muscle mass decrease, reduced facial hair growth, ED, gynecomastia

13
Q

Most common cause of hyperprolactinemia is drug induced?

A

anti-psychotic agents

14
Q

In a psychotic patient, what drug is contraindicated?

A

dopamine agonists

15
Q

What is the best choice for hyperprolactemia?

A

cabergoline

16
Q

What are the adverse effects of dopamine agonists?

A

nausea, orthostatic hypotension. slight increased risk of HTN/CVA

17
Q

What amino acid is iodinated into T3 and T4?

A

tyrosine

18
Q

What thyroid hormone stimulates and enhances cell function in everything?

A

T3

19
Q

An excess of T3/T4 produces symptoms and signs of ____ _____ excess

A

sympathetic agonist

20
Q

In older patients, it is important to not advance levothyroxine dosage because of what?

A

it increases metabolism and oxygen requirements

21
Q

For pt >65 y/o, hypothyroidism tx is ___

A

“low and slow”

22
Q

What is the lag time for thyroid-pituitary axis?

A

6-8 wks

23
Q

What are the adverse effects of thyroxine?

A

symptoms of hyperthyroidism

24
Q

Hyperthyroidism tx (3)

A
  1. control symptoms via beta adrenergic blocker
  2. prevent thyroid storm
  3. definitive tx
25
Q

Best choice beta blocker for hyperthyroidism

A

propanolol

26
Q

This is an anti-thyroid agent that blocks the synthesis of T3/4 and needs 3-4 wks to deplete T3/4

A

Thioamides

27
Q

This anti-thyroid med is the best choice for pregnant women

A

propylthiouracil

28
Q

This anti-thyroid med prevents the reuptake of iodide.

A

Potassium perchlorate- anion inhibitor

29
Q

What can anion inhibitors cause?

A

aplastic anemia

30
Q

This anti-thyroid med suppresses the T3/4 release and has a quick onset

A

iodides

31
Q

When do you avoid iodides?

A

radioactive iodine use is likely

32
Q

What blocks T4 to T3 conversion?

A

iodinated contrast media

33
Q

This med destroys thyroid in a few weeks and is safe for > 30 but is contraindicated in pregnancy

A

Radioactive Iodine I131

34
Q

What are the symptoms of the thyroid storm?

A

high fever, tachy, d/v/d, coma

35
Q

What is the thyroid storm tx?

A
  1. hospitalize 2. propanolol 3. diltiazem 4. potassium iodide 5. PTU 6. hydrocortisone
36
Q

What are the big androgen adversities?

A

increased hematocrit - vascular thrombosis

increased libido- increased aggressiveness

37
Q

What are the indications of aromatase inhibitors?

A

breast cancer tx, breast cancer prevention, ovulation induction

38
Q

This anti-fungal blocks steroidogenesis and has a drug interaction with CYP 450 inhibitors

A

ketoconazole

39
Q

How does finasterid (propecia) work?

A

blocks T to DHT

40
Q

Indications for antiandrogen utilization

A

women: hirsutism, masculinization, PCO
men: balding, bph, prostate cancer

41
Q

How is T converted to DHT?

A

5-alpha reductase

42
Q

In BPH and male pattern baldness, medical tx are :

A

5-alpha reductase inhibitors

43
Q

Most commonly rx 5-alpha reductase inhibitors

A

finasteride, dutasteride

44
Q

Androgen caution in pregnancy

A

masculinization of a female fetus

45
Q

special caution in pregnancy regarding anti-androgens

A

incomplete masculinization of a male fetus

46
Q

Taking androgens and/or anti-androgens can produce what adverse effect in pregnancy?

A

ambigouous genitalia