Flashcards in Endocrine Review Deck (71)
What two hormones are secreted by the posterior pituitary?
Oxytocin and antidiuretic hormone (ADH, vasopressin).
What is Sheehan's syndrome?
Ischemia of the pituitary due to volume depletion during or after childbirth.
How do glitazones work?
They improve insulin sensitivity.
What is the most common pituitary adenoma?
Large doughy hands should make you think of what diagnosis?
Diabetes insipidus is caused by a deficiency of which hormone?
How much more potent is T3 than T4?
What is the first line medical treatment for pheochromocytoma?
Alpha blocker. You should never use a pure beta blocker.
What is the best imaging for a thyroid nodule?
Patient presents with erectile dysfunction and complains of some numbness in his feet. On second thought he has noticed significant polyuria and polydipsia. What diagnosis should you be thinking of?
Pretibial myxedema should make you think of what diagnosis?
A 35 year old female presents with heat intolerance, weight loss and palpitations. What is the most likely diagnosis?
What is the first line medical treatment for a patient who presents with palpitations and nervousness secondary to hyperthyroidism?
What is Hashimoto's disease?
An autoimmune cause of hypothyroid.
How does levothyroxine work?
It helps convert T4 to T3
What is the most common thyroid cancer?
Papillary makes up about 80% of thyroid cancers.
In a patient with hyperthyroidism will TSH most likely be elevated or decreased?
How do fibrates work to affect the lipid profile?
They inhibit synthesis of VLDL and elevate lipoprotein lipase.
What medication might you use prior to thyroidectomy in a patient with hyperthyroidism?
Methimazole or propylthiouracil (PTU).
What is included in Whipple's triad of hypoglycemia?
History of previous hypoglycemia, serum glucose of <40, immediate recovery upon administration of glucose.
Positive antithyroid peroxidase and antithyroglobulin antibodies should make you think of what diagnosis?
What is the treatment for myxedema?
Levothyroxine and slow warming
What is the most common cause of hypoparathyroid?
Post thyroidectomy with the complication of parathyroidectomy.
What is Chvostek's sign?
Tap on facial nerve and get a twitch with low Ca.
Cortical adrenal insufficiency is also known as what disease?
What is Trousseau's sign?
Inflate BP cuff and hold for 3 minutes. Patient with low Ca will get carpel tunnel symptoms.
What is the most common cause of hyperparathyroidism?
Single parathyroid adenoma in 80% of cases.
In Cushing?s disease is ACTH elevated or decreased?
What is Graves' disease?
The most common cause of hyperthyroidism. It is an autoimmune disease.
What specific breathing pattern is associated with diabetic ketoacidosis?
What is the least aggressive thyroid cancer?
Name two tests you might use to rule out Cushing's syndrome.
24 hour free cortisol urine test and dexamethasone suppression test.
List two ectopic tumors that may produce ACTH and give a patient Cushing's syndrome?
Small cell lung cancer, pancreatic islet cells, thymomas.
What is the treatment for Addison's disease?
Hydrocortisone or prednisone
What is the test to begin with if you suspect pheochromocytoma?
24 hour urine for catecholamines.
Exophthalmos should make you think of what diagnosis?
What percentage of diabetes in the US is type 2?
HLA-DR gene is a marker for what endocrine disorder?
DM type 1
What is the main function of parathyroid hormone?
Increase serum Ca
List four diagnostic criteria for diabetes?
Random glucose >200, fasting plasma >126, two hour postprandial glucose >200, HgA1c >6.5%.
Moans, groans, stones and bones describe symptoms of what endocrine problem?
Stocking glove should make you think of what diagnosis?
Diabetic neuropathy and B12 deficiency neuropathy.
Fruity breath should make you think of what diagnosis?
As it relates to diabetics, what is the dawn phenomenon?
Reduced insulin response between 5 and 8 am.
What is the most common cause of hypopituitarism?
How does metformin work?
Decreases the hepatic glucose production and increases peripheral glucose uptake.
How do sulfonylureas medications work?
They stimulate the production of insulin.
What class of medications does pioglitazone (Actos) fall into?
Thiazolidinediones also known as glitazones.
What is the suffix associated with sulfonylureas?
Ide is the suf.x. Examples: glipizide, tolbutamide, tolazamide.
Typically what is the first medication started in type 2 DM?
How often should a diabetic's HgbA1C be checked and what should it be?
Every three months (remember the life a RBC is 90-120 days) and it should be below 6.5%.
What are the 5 criteria for Metabolic syndrome?
HDL 135/85, Triglycerides >150, Fasting glucose >100, Waist >40 inches in men >35 inches in women.
What class of medications is the first line for lowering LDL?
Which lipid medication may cause flushing?
What life threatening side effect do statins have?
Does niacin increase or decrease HDL?
What medication class does metformin (glucophage) fall into?
List the 5 insulines in order of peak efficacy?
Lispro 1-2 hrs, Regular 2-4 hrs, NPH 5-7 hrs, Lente 4-8 hrs, UltraLente 8-14 hrs.
Is metformin indicated or contraindicated in renal failure?
What is the most common cause of DM type 1?
Autoimmune destruction of the islet cells in the pancreas.
List 4 physical exam findings for Cushing's syndrome.
Moon face, buffalo hump, purple strai, central obesity, supraclavicular fat pads, easy bruising
Propranolol belongs to what class of medication?
During pregnancy which is the prefered treatment of hyperthyroidism PTU or methimazole?
Name the four thyroid cancers.
Papillary, Follicular, Medullary, Anaplastic
What heparin complication is relevant to endocrinology?
Adrenal infarct leading to a cushing's syndrome.
How does nicotinic acid work to affect the lipid profile?
It inhibits secretion of VLDL.
Hyperpigmentation of the skin along creases should make you think of what diagnosis ?
Which thyroid cancer is the most aggressive?
How do statins work to affect the lipid profile?
They slow the rate limiting step of cholesterol synthesis.
Will ACTH be elevated or decreased in Addison's disease?
Elevated if the problem is at the adrenal glands.