Endocrine Flashcards
(19 cards)
What would you see on a retina in a patient with diabetes
dot-blot hemorrhages (microaneurysms)
flame hemorrhages
cotton- wool spots
neovascularization
What is the MoA for metformin?
Metformin stops gluconeogenesis in the liver
What is the MoA for sulfonureas
They bind to the K+ channels on the beta cells of the pancreas and cause the increase release of endogenous insulin
What is the use of short acting insulin?
Lispro, Aspartate, and Glulisine are used to control postprandial blood glucose spikes.
What are the S/S of DKA?
DKA presents with Nausea, Vomiting, fatigue, polyuria
What class of drug has the same MoA as the sulfylureas but can be used if someone is allergic to sulfa drugs?
Meglitinides can be used as a substitute for sulfonylureas.
They close the K+ channel on the beta cells of the pancreas and increase endogenous insluin release
How do GLP-1 agonists work to decrease blood sugar?
GLP-1 agonists (“-tide”) work to increase the endogenous insulin release and satiety, decrease gastric emptying. and decreased glucagon release
How do the gliptins reduce blood sugar?
the gliptins prevent the breakdown of GLP-1, which promotes insulin release, satiety, decreases gastric emptying, and the release of gastrin.
What diabetes medication can cause pancreatitis?
GLP-1 agonists (“-tide”) can cause pancreatitis
What is the MoA of thiazolidinedones
thiazolidinediones are ligands of the PPAR1 receptor that regulates gene replicaiton within a cell. Thiazolidinediones upregulate adiponectin which increases fatty acid oxidation…
THEY DECREASE TRIGLYCERIDES IN THE BLOOD
How does pheochromocytoma generally present?
pheochromocytoma generally presents with episodic
Headache
tachycardia
hypertension
due to the release of nor-epinepherines
What is the treatment for pheochromocytomas?
treat pheochromocytomas with phenoxybenzamine
then a beta blocker
*phenoxybenzamine is a non-selective alpha-blocker
**If you treat with a beta-blocker alone you will exacerbate the hypertension
What is the presentation for a neurofibroma?
Neurofibromas generally present with
Abdominal Pain
Abdominal mass
Fever
Weight loss
opsoclonus-monoclonus (disorganized eye movements)
ataxia
A hard painless goiter is a classic finding of what?
A hard and painless goiter is a classic finding in
Reiter’s Thyroiditis
*Reiter’s Thyroiditis is an autoimmune disorder affecting the thyroid. Its associated with other systemic fibrosing disorders including IgG4-related systemic disease
an acutely tender goiter is associated with what?
subacute granulomatous thyroiditis
What are the medical treatment of choices for prolactinoma?
Microadenomas of the pituitary gland (usually found in women) are treated with dopamine agonists
bromocriptine
cabergoline (better tolerated but more expensive)
Lupus Criteria
DOPAMINE RASH
- Discord Lupus
- Oral Ulcers
- Photosensitivity
- Arthritis
- Malar Rash
- Immunologic (Anti-smith ab)
- Neurologic symptoms
- Elevated ESR (not a criteria)
- Renal disease
- ANA +
- Serositus (pleurisy)
- hemolytic disease
What are the classic lab values of an adrenal crisis?
Lab values suggestive of an adrenal crisis:
- Hyponatreimia d/t a decrease in aldosterone
- hyperkalemia also d/t a decrease in aldosterone
- hypoglycemia
- low cortisol (an am cortisol < 3 is indicitive of adrenal insufficiency
*remember that a patient experiencing an adrenal crisis may initially present with vague symptoms of adrenal insufficiency like fatigue and weakness. There will be an inciting event (like an illness, surgery, trauma) and the patient will develop intractible abdominal pain, vomiting, fever, etc.
What are the classic findings in Conn’s Syndrome?
Conn’s syndrome is characterized by:
HTN
muscle weakness
hypokalemia
Conn’s syndrome is a result of an aldosterone producing tumor. Diagnose Conn syndrome with an Aldosterone: renin ratio >20
