Endocrine Flashcards Preview

Medicine Clerkship > Endocrine > Flashcards

Flashcards in Endocrine Deck (33):
1

Prolactinoma

A tumor that produces prolactin. Causes galactorrhea, loss of peripheral vision, decreased libido. Can also be caused by meds, hypothyroidism.

2

How to treat prolactinoma

Bromocriptine or surgery

3

How does hypothyroidism cause prolactinoma?

Because TRH (increased in hypothyroidism) stimulates prolactin release from anterior pituitary

4

Hormones produced by anterior pituitary

ACTH, TSH, GH, LH/FSH

5

Hormones produced by the posterior pituitary?

Oxytocin and ADH.

6

Acromegaly

Tumor producing GH. Causes gigantism in children, causes acromegaly in adults with diabetes, diastolic heart failure

7

How to diagnose acromegaly?

Look at IGF-1 level, confirm with MRI, also glucose suppression test

8

Glucose suppression test

Glucose challenge, GH should decrease. In acromegaly it doesnt.

9

How to treat acromegaly?

Octreotide or surgery.

10

Acute hypopituitarism caused by? Presentation?

Infection, infarction (sheehan's, apoplexy), surgery, radiation
Presentation: lethargy, coma, hypotension.

11

Empty sella syndrome

Pituitary is outside sella but still functions.

12

How to treat empty sella syndrome?

Do nothing

13

Chronic hypopituitarism caused by?

Autoimmune disease, deposition, cancer
Presents with decreased libido, decreased GH. Much less severe.

14

How to diagnose chronic hypopituitarism

Insulin stimulation test, with insulin, GH and epi should increase

15

SIADH

Brain lesion produces lots of ADH, water retained, very concentrated urine, decrease in serum osms.

16

How to treat SIADH

Demeclocycline, vaptans, stop taking drug, water restriction

17

Diabetes insipidus

Polydipsia, polyuria, normal BG, diagnose with water deprivation test.

18

How to treat central diabetes insipidus?

Vasopressin

19

How to treat nephrogenic diabetes insipidus?

Gentle diuresis.

20

How to conduct water dep test?

Deprive water, measure U osm. if increases, then polygenic polydipsia. Then add ADH, if U osm increases, then Central DI. If it doesn't then nephrogenic DI.

21

Symptoms of hyperthyroidism

Tachycardia, diarrhea, increased DTRs, heat intolerance, weight loss, +/- afib

22

How to diagnose hyperthyroidism

Decreased TSH, increased free T4, increased radioactive iodine uptake.

23

Graves disease

Autoimmune with antibody stimulation, diffuse growth of thyroid with diffuse radioactive iodine uptake. Exopthalmos and pretibial myxedema.

24

Thyroid storm

Shock, fever, delirium after a stress.

25

How to treat thyroid storm?

IVF + cooling blankets, PTU/Methimazole, B blocker, IV steroids.

Then surgery and iodine ablation.

26

Thyroiditis

Transient hyperthyroidism followed by hypothyroidism. Can heal or can become hashimotos.

27

Hypothyroidism

Bradycardia, constipation, decreased DTRs, cold intolerance, increased weight.

Caused by hashimotos, iatrogenic

28

Myxedema coma

Shock, cold, coma

Treat with IVF, warm blankets, T4 and T3.

29

How to work up thyroid nodules

If the patient is elderly or has radiation exposure in the past, do an FNA. Otherwise check a TSH/T4.

If TSH and T4 is normal, do an FNA, if TSH is down, do an RAIU scan.

If RAIU is positive, then resect the hot nodule.

If RAIU is negative, do a FNA.

30

Papillary carcinoma

Orphan annie eyes, psammoma bodies. Most common. Tx resect

31

Follicular carcinoma

FNA may appear normal, hematogenous spread. Treat with I2 ablation

32

Medullary carcinoma

C cells produce calcitonin. Common in MEN2A/@B.

33

Anaplastic carcinoma

Elderly, fatal