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family medicine EOR exam > endocrine > Flashcards

endocrine Flashcards

1
Q

MOA of metformin

A

decrease hepatic glucose production, sensitizes

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2
Q

what DM medication is good for post prandial lowering?

A

DPP4 inhibitors, GLP-1 agonists, glinides

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3
Q

CI to metformin

A

renal and liver failure…CHF (all cautions)

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4
Q

side effects metformin

A

GI upset, rare is lactic acidosis

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5
Q

MOA of actos (pioglitazone)

A

sensitize

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6
Q

CI of pioglitazone

A

CHF class 3-4

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7
Q

side effect pioglitazone

A

weight gain, osteoporosis, bladder cancer?

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8
Q

what drugs are best for fasting blood glucose lowering?

A

metformin, pioglitazone, SU,

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9
Q

DPP4 inhibitors

A

juanuvia (sitagliptin), tradjenta

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10
Q

DPP4 inhibitor MOA

A

increase insulin synthesis

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11
Q

GLP-1 agonists

A

byetta, bydureon (exenatide), victoza

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12
Q

MOA of GLP-1 agonists

A

activates glucagon like peptide 1 receptor which increases insulin and delays gastric emptying . Sub Q injection.

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13
Q

side effects GLP1 agonists

A

GI upset, weight loss, caution in renal failure

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14
Q

SU MOA

A

stimulates pancreas to release insulin

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15
Q

side effects of SU

A

hypoglycemia. caution in renal and liver dosing

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16
Q

glinide (prandin, repaglinide) MOA

A

stimulates pancreas to release insulin

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17
Q

hypoglycemia sxs

A

confusion, blurred vision, diplopia, anxiety, convulsions, sweating, palpitations, anxiety

18
Q

whipple’s triad

A

hx of hypoglycemia sxs, fasting BGS of 40 or less, immediate recovery with glucose

19
Q

DKA symptoms

A

polyuria, polydipsia, fatigue, N&V, mental stupor, rapid breathing, fruity odor, hypotension and tachy due to electrolyte depletion

20
Q

labs in DKA

A

plasma glucose over 350, hyperkalemia, serum ketones, hyponatremia, acidosis pH under 7.3, serum bicarb <15

21
Q

DKA TX

A

.1unit/kg IV bolus insulin then .1unit/kg/h, 1L .09% saline first hour, then IV infusion 300-400mL/h after 2 L given. NaHCO3, any other electrolyte replacement

22
Q

difference b/t DKA and hyperglycemic hyperosmolar state

A

HHS has normal blood pH, >600 serum glucose, bicarb >15, normal anion gap,

23
Q

treatment of hyperglycemic hyperosmolar state

A

fluid replacement major. insulin, KCl, phosphate if needed

24
Q

fatigue, lethargy, constipation, depression, menstrual abnormalities, cold intolerance and dry skin

A

hypothyroidism

25
Q

antithyroid peroxidase and antithyrgloblobulin antibodies

A

hashimoto’s autoimmune hypothyroidism

26
Q

anti thyroid stimulating hormone…antithyroblobulin antibodies

A

grave’s disease

27
Q

sweating, heat intolerance, weight loss, nervousness, loose stools, muscle cramps, irritability, hyperreflexia,

A

hyperthyroidism

28
Q

fever, tachycardia, vomiting, diarrhea, dehydration, weakness and muscle wasting, confusion, delirium

A

thyroid storm. usually occurs after illness, surgery, or radioactive iodine administration

29
Q

complications of hyperthyroidism

A

Afib, hypercalcemia, osteoporosis, nephrocalcinosis, decreased sperm count or libido

30
Q

subacute (deQuervain’s) thyroiditis

A

viral cause - acute painful glandular enlargement with dysphagia, low grade fever, fatigue, malaise. radiation of pain to ears is common. Tx with aspirin

31
Q

supportive (infectious) and Riedels thyroiditis

A

invasive fibrous, woody, ligenous…rare and present with fever, pain, redness and fluctuant neck mass. needs antibiotics and surgery

32
Q

weakness, abdominal pain, fever, confusion, nausea, vomiting, diarrhea, low BP, dehydration and skin pigmentation

A

Addisonian crisis

33
Q

addison’s disease treatment

A

hydrocortisone

34
Q

you suspect addisonian crisis. dx step?

A

draw serum electrolytes, cosyntropin stimulation test

35
Q

chronic adrenal insufficiency

A

weakness, fatigability, anorexia, weight loss, increased skin pigment, hypotension, small heart
Addison’s disease

36
Q

addison’s disease lab values

A

low serum cortisol and sodium, high K and Ca

37
Q

central obesity, muscle wasting, hirsutism, purple striae, osteoporosis, poor wound healing

A

cushing’s disease

38
Q

cushing’s disease dx

A

dexamethasone suppression test

39
Q

labs in cushing’s disease

A

hyperglycemia, glycosuria, hypokalemia, high serum cortisol and urinary cortisol

40
Q

tx for cushings

A

resection of pituitary adenoma or stop offending agent/exogenous cortisol

family medicine EOR exam (14 decks)

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