Endocrine Review

Question 1

Type 1 diabetic
hyperglycemic
metabolic acidosis
leukocytosis
hyperkalemia
abdominal pain

Answer 1

Diabetic ketoacidosis

Question 2

Reasons to have high insulin but low glucose

Answer 2

Insulin overdose

Insulinoma

Question 3

Diabetes drugs that cause hypoglycemia

Answer 3

SFUs (glyburide)
amylin analogues
insulin

Question 4

Dibabetes drug that causes lactic acidosis

Answer 4

Metformin

Question 5

Diabetes drug that causes CHF/fluid retention

Answer 5

Thiazolindinediones (pioglitazone)

Question 6

Diabetes drug that causes pancreatitis

Answer 6

GLP-1 analogues (exenatide)

Question 7

Mechanism of action of SFUs

Answer 7

Causes depolarizations of beta cells that triggers extra insulin release (only works in Type 2)

Question 8

Mechanism of action of metformin

Answer 8

unknown -> dec gluconeogen, inc glycolysis, inc peripheral glucose uptake

Question 9

MOA of alpha-galactosidase inhibitors

Answer 9

inhibit brush border glucose absorption enzymes

Question 10

MOA of TZDs

Answer 10

increase insulin sensitivity in peripheral tissues by binding to PPAR-gam nuclear transcription regulator

Question 11

AE of alpha galactosidase inhibitors

Answer 11

horrible flatulence

Question 12

Two causes of high plasma sodium

Answer 12

dehydration and diabetes insipidus

Question 13

myxedema coma

Answer 13

profound hypothyroidism causing altered mental status

Question 14

Drug that classically causes diabetes insipidus

Answer 14

Lithium

Also: demeclocycline

Question 15

Delayed DTR relaxation phase

Answer 15

hypothyroidism

Question 16

Mech of graves

Answer 16

antibodies to TSH receptor

Question 17

recently gave birth
low TSH
high T4
low thyroid uptake

Answer 17

Postpartum thyroiditis

Question 18

TSH and T4 levels are increased

Answer 18

pituitary tumor or exogenous TSH production

Question 19

Exopthalmos
thyroid bruit
diffuse uptake on thyroid scan

Answer 19

Grave’s disease

Question 20

Tender thyroid

post URI

Answer 20

Thyroiditis

Question 21

hyperthyroid
low uptake on scan
no URI

Answer 21

surreptitious levothyroxine use

Question 22

AE of PTU

Answer 22

agranulocytosis
aplastic anemia
hepatotoxicity

Question 23

After illness

Low TSH, T3 and T4

Answer 23

Euthyroid sick syndrome

Question 24

calcitonin producing thyroid nodule

Answer 24

Medullary carcinoma

Question 25

Diseases associated with medullary thyroid carcinoma

Answer 25

MEN 2A and MEN2B

Question 26

carpopedal spasm tetany fingertip parasthesias Chvostek's sign (tapping on jaw)

Answer 26

Hypocalcemia

Question 27

Type of lung cancer that produces PTrH

Answer 27

sqamous cell lung carcinoma

Question 28

Cancers that can cause hypercalcemia

Answer 28

Multiple myeloma prostate squamous cell lung

Question 29

hypotension hyperkalemia acidosis skin and mucosal hyperpigmentation

Answer 29

Addison's disease

Question 30

``` increased mineralcorticoids decreased cortisol dec sex hormones hypertension hypokalemia lack of secondary sexual characteristics ```

Answer 30

17 alpha hydroxylase deficiency

Question 31

increased sex hormones decreased mineralcorticoids and cortisol salt wasting and pernicious puberty

Answer 31

21-hydroxylase deficiency

Question 32

``` decreased aldosterone increased 11-deoxycorticosterone increased sex hormones hypertension virulization ```

Answer 32

11 beta hydroxylase

Question 33

``` incrased thirst normal Na low K high bicarb normal creatinine ```

Answer 33

overproduction of aldosterone

Question 34

lung nodule low Na high urine osmolarity

Answer 34

SIADH

Question 35

Consequence of correcting Na levels too quickly

Answer 35

central pontine myelinolysis

Question 36

``` amenorrhea/oligomenorrhea hirsutism ance infertility associated with obesity ```

Answer 36

Polycystic ovarian syndrome

Question 37

amenorrhea galactorrhea headaches High prolactin levels

Answer 37

prolactinoma

Question 38

prominent forehead heavy brow ridge thick tongue large thick hands and feet

Answer 38

Acromegaly

Question 39

Best marker for acromegaly

Answer 39

Insulin-like growth factor-1

Question 40

MEN type 1

Answer 40

pit- pituitary tumors para- parathyroid tumors panc- pancreatic endocrine tumors

Question 41

prolactinoma kidney stones stomach ulcers

Answer 41

MEN type 1

Question 42

pregnant woman vaginal bleeding abdominal pain

Answer 42

placental abruption: premature seperation of placenta from uterine wall

Question 43

painless vaginal bleeding at ~30 weeks gestation

Answer 43

Placenta Previa: placenta overlies cervical os

Question 44

Severe painless postpartum hemorrhage | previous C section of placenta previa

Answer 44

Placenta accreta: attaches to myometrium without penetrating it

Question 45

Painful massive postpartum hemmorrage

Answer 45

uterine rupture

Question 46

Long labor | soft uterus

Answer 46

uterine atony

Question 47

no lactation DI after delivery shock

Answer 47

Sheehan's syndrome

Question 48

Post menopausal vaginal bleeding

Answer 48

Endometrial cancer until proven otherwise

Question 49

Abdominal pain LMP 6-8 weeks ago positive UPT adnexal mass

Answer 49

ectopic pregnancy

Question 50

Severe HTN after 20 weeks gestation | Proteinuria or end organ injury

Answer 50

preeclampsia

Question 51

Preeclampsia Low platelets elevated LFTs hemolysis

Answer 51

HELLP syndrome

Question 52

Post partum complications:

Answer 52

depression cardiomyopathy PE amniotic fluid embolism

Question 53

Cloudy amniotic fluid | septic newborn

Answer 53

Group B Strep