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Flashcards in Endocrine and Diabetes Deck (53):
1

Rapidly developing hyperandrogenism with virilization and management

androgen secreting neoplasm
Measure testosterone and DHEAS levels
Testosterone-ovarian source
DHEAS- adrenal source

2

serum 17 hydroxyprogesterone

Associated with congenital adrenal hyperplasia

3

Chemicals turned into pyruvate

Alanine
Lactate
glycerol-3-phosphate

4

High ACTH
Low Cortisol
Low Aldosterone

Primary Adrenal insuffciency usually autoimmune

5

Low ACTH
Low Cortisol
Normal Aldosterone

Secondary Adrenal insufficiency from chronic steroid use

6

Diabetes Screening Guidelines

Screen everyone above age 45
People at any age with risk factors

7

Screening for lung cancer

Yearly low dose CT for those at high risk between 55 and 80 with a 30 Pack year history or who have quit within the last 15 years.

8

Symptoms of hypercalcemia

Bones
Stones
Groans
Psychic tones

9

Management of hypercalcemia

Repeat calcium level
If still elevated, parathyroid hormone

10

Lab findings in Vit D deficiency

hypocalcemia
hypophosphatemia
elevated PTH

11

Management of erectile dysfunction

document nocturnal penile tumescence
If determined organic then TSH, prolactin level and test level

12

Hypercalcemia of immobilization

Occurs after 4 weeks of immobilization.

Treatment is hydration and bisphosphonates

13

Treatment of thyroid storm

Immediate propranolol
PTU
Iodine
corticosteroids

14

psamomma bodies

papillary thyroid carcinoma
papillary RCC
meningioma
mesothelioma
Ovarian cystadenoma

15

Hurthle Cells

Papillary and follicular thyroid carcinoma

16

thyroid cancer secreting calcitonin

medullary carcinoma

17

thyroid carcinoma with characteristic invasion of the capsule

Follicular carcinoma

18

Urinary 5HIAA excretion

carcinoid syndrome

19

Diabetes
weight loss
neurolytic migratory eryhtema
diarrhea
anemia

Glucagonoma

20

Symptoms of diabetic autonomic neuropathy

Tachycrdia
Postural hypotension
Foot ulcers and poor wound healing
Charcot arthropathy
Gastroparesis
Esophageal dysmotility
Erectile dysfunction
Neurogenic bladder

21

MEN 2A

Medullary thyroid carcinoma
pheochromocytoma
parathyroid tumor

22

MEN 2B

more aggressive
Medullary thyroid carcinoma
pheochromocytoma
mucosal neuromas

23

MEN2A/2B most commonly associated with what mutation

RET

24

Acute management of pheochromocytoma

Alpha blockade first
Beta blockade if necessary

25

Best therapy for controlling diabetic nephropathy

ACE inhibitor

26

Severe Side Effect of PTU and Methamizole

Agranulocytosis

27

Central obesity
Skin atrophy with striae
Hypertension
Glucose intolerance
Skin Hyperpigmentation

Cushing's syndrome from ectopic production of ACTH

28

Prussian Blue Positive in urine

oxadative factors such as heme in the urine
-G6PD

29

elevated glucose
necrotic migratory erythema

Glucagonoma

30

cells where testosterone produced

Leydig cells

31

Side effects of antithyroid drugs

Agranulocytosis
Methamazole: tetratogen, cholestasis
PTU: hepatic failure, ANCA associated vasculitis

32

Which conditions lead to Vit D deficiency

Malabsorption
Celiacs
intestinal bypass surgery
Chronic liver or kidney disease

33

Lab levels in Vit D deficiency

elevated PTH
elevated Alk phos
decreased calcium
decreased phosphate

34

abdominal pain
constipation
polydipsia

hypercalcemia

35

Calcium response in alkalosis

H+ dissociates from albumin and Ca attaches to albumin. Leads to hypocalcemia

36

pain worsening at night and present at rest
stocking/glove distribution

Neuropathic pain

37

Types of neuropathic pain

Small fiber neuropathic-more painful with parastesia
Large fiber- less pain and more sensory loss

38

Treatment of Neuropathic pain

TCAs-amitryptalin, desipramine, nortriptyline
gabapentin
NSAIDS

39

Testing for insulin resistance

2hr glucose 140-199=resistance >200=diabetes

40

First line therapy for PCOS

Weight loss and Oral contraceptives
-block androgen secretion
-block lutenizing hormone secretion
-block LH dependent androgen production

41

Diagnosis of acromegaly

IGF-1 levels

42

antibodies most common in Hashimotos

Anti-thyroid peroxidase
Anti-thyroglobulin

43

anorexia
nausea
vomiting
poor glycemic control
postprandial fullness

Diabetic gastroparesis

44

Treatment of diabetic gastroparesis

metoclopramide is pro kinetic and antiemetic
erythromycin is another pro kinetic agent

45

Major side effect of metoclopramide

EPS

46

Hyperpigmentation
hypotensive
eosinophilia
low sodium
hyperkalemia

primary adrenal insufficency

47

tests for primary adrenal insufficiency

AM cortisol level
ACTH level
cosyntropin (ACTH analog) stimulation test

48

MEN1 disease

pituitary adenomas
primary hyperparathyroidism
Pancreas/GI malignancy

49

Mechanism of exopthalmos

circulating thyroid antibodies active fibroblasts causing tissue expansion

50

Tests for hypercortisolism

urine free cortisol
Nighttime salivary test
low dose dexamethasone suppression test
High dose dexamethasone suppression test if the ACTH is high

51

Lab values in PTHrH related hypercalcemia

Elevated calcium
decreased phosphorus

52

Metabolic syndrome criteria

1)Abdominal obesity
2)Fasting glucose >100-110
3BP >130/80
4 Triglycerides >150
5 HDL

53

Most common cause of primary adrenal insufficiency

Developed world - autoimmune
Developing world- TB (calcified adrenals)