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Flashcards in Endocrine Deck (73)
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31

Autoantibodies and HLA type in hashimoto thyroiditis

anti-thyroid peroxidase, antimicrosomal, antithyroglobulin
HLA-DR5 associated

32

Tender vs non-tender thyroid in hypothyroidism

Nontender: hashimoto, Riedel thyroiditis
Tender: subacute thyroiditis

33

Congenital hypothyroidism presentation

pot-belly
pale
puffy face
protruding umbilicus
protuberant tongue
poor brain development

34

subacute thyroiditis

self-limited
hyperthyroid progressing to hypothyroid
granulomatous inflammation
very tender thyroid

35

Riedel thyroiditis

thryoid replaced by fibrous tissue
IgG4-related systemic disease
fixed, hard, painless goiter

36

Presentation of Graves disease

hyperthyroidism, exophtalmos, pretibial myxedema

37

toxic multinodular goiter

focal patches of hyperfunctioning follicular cells due to TSH receptor mutation. Hot nodules rarely malignant

38

Thyroid storm

Stress induced catecholamine surge due to thyrotoxicosis. Agitation, delirium, fever, diarrhea, coma, tachyarrhythmia.

Treatment: beta blocker, propylthiouracil, corticosteroids

39

Thyroid cancers: papillary, follicular, medullary, anaplastic, lymphoma

Papillary carcinoma: Most common and excellent prognosis. Empty-appearing nuclei with central clearing. Psammoma bodies with nuclear grooves.

Follicular carcinoma: Good prognosis. Distinguished from follicular adenoma by invasion of the capsule.

Medullary carcinoma: C-cell drived. Produces calcitonin. Associated with MEN2A and 2B

Anaplastic carcinoma: seen in older patients. Very poor prognosis

Lymphoma: associated with hashimoto

40

Symptoms of hypoparathyroidism

Hypocalcemia and tetany.

Chvostek sign: tap facial nerve and see contraction of facial muscles

Trousseau sign: occlude brachial artery with BP cuff and see carpal spasm

41

Pseudohypoparathyroidism

AD condition in which kidney unresponsive to PTH. Causes hypocalcemia, shortened 4th/5th digits, short stature

42

Familial hypocalciuric hypercalcemia

Defective Ca++ receptor on parathyroid cells so PTH not suppressed. High calcium with normal to high PTH.

43

Presentation of acromegaly

Large tongue with deep furrows
Deep voice
Large hands and feet
Coarse facial features
Insulin resistance
Risk of colorectal polyps and cancer

44

Sheehan syndrome

Ischemic infarct of pituitary following postpartum bleeding leading to hypopituitarism. Presents with failure to lactate, absent menstruation, cold intolerance.

45

Empty sella syndrome

Atrophy or compression of pituitary leading to hypopit. Common in obese women

46

Pituiary apoplexy

Sudden hemorrhage of pituitary leading to hypopit

47

Diabetic complications of osmotic damage

Sorbitol accumulates in organs with aldolase reductase is what causes the damage. Neuropathy and cataracts.

48

Diabetic complications due to small vessel disease

Diffuse thickening of BM. Retinopathy, glaucoma, neuropathy, nephropathy.

49

Type I diabetes: HLA association

HLA-DR3 and HLA-DR4

50

Zollinger-Ellison syndrome

Gastrin-secreting tumor in pancreas or duodenum. Acid hypersecreting reulting in ulcers.

presentation: abdominal pain and diarrhea

Diagnosis: Pos secretin stim tes (gastrin stays high after giving secretin which should suppress it

Associated with MEN 1

51

MEN1

Parathyroid tumors, pituitary tumors, pancreatic endocrine tumors (zollinger-ellison syndrome, insulinomas, VIPomas, glucagonomas)

52

MEN2A

Parathyroid hyperplasia, pheochromocytoma, medullary carcinoma, marfanoid habitus, RET mutation

53

MEN2B

Pheochromocytoma, Medullar thyroid carcinoma, oral/intestinal ganglioneuromatosis, marfanoid habitus, RET mutation

54

Names of insulins

Rapid acting: aspart, glulisine, lispro

Short acting: regular insulin

Intermediate acting: NPO

Long acting: glargine, detemir

55

Metformin

MOA: unkown, decreases gluconeogenesis, increases glycolysis, increases peripheral glucose uptake (insulin sensitizer)

Use: Oral for type 2 DM. Modest weight loss.

ADRs: lactic acidosis (contraindicated in renal insufficiency)

56

Sulfonylureas

Names: chlorpropramide and tolutamide (first gen); glimepiride, glipizide, glyburide (second gen)

MOA; Close K+ channel in beta cell membane resulting in depolarization and insulin release

Use: Type 2 DM only

ADRs: risk of hypoglycemia; disulfiram-like effects for first gen only

DDIs: non-specific beta blockers can mask symptoms of hypoglycemia

57

Thiazolidinediones

Names: pioglitazone, rosiglitazone

MOA: increase insulin sensitivity by binding PPAR-gamma

Use: Type 2 DM

ADRs: weight gain, hepatotoxicity, risk of fracture

58

GLP-1 agonists

Names: exenatide, liraglutide

MOA: increase insulin, decrease glucagon release

Use: Type 2 DM

ADRS: pancreatitis, N/V

59

DPP-4 inhibitors

Names: linagliptin, saxagliptin, sitagliptin

MOA: increase insulin, decrease glucagon release

Use: Type 2 DM

ADRs: urinary or resp infections

60

Amylin analogs (pramlintide)

MOA: decreases gastric emptying and decreases glucagon

Use: Type 1 and type 2 DM

ADRs: hypoglycemia