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ABFM First Aid > Endocrinology > Flashcards

Endocrinology Flashcards

(50 cards)

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1
Q

Diagnostic criteria for DM

A
  1. Random plasma glucose of > 200 with symptoms
  2. Glucose >126 after 8 hr fasting
  3. Glucose > 200, 2 hrs after 75 g GGT
  4. A1C > 6.5%
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2
Q

USPSTF recommends screening —– for T2DM.

A

Overweight or obese individuals age 40-70 or those who are symptomatic

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3
Q

C/I to metformin

A

GFR <30

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4
Q

C/I to Rosiglitazone or pioglitazone

A

NYHA class 3-4, bladder cancer or osteoporosis

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5
Q

C/I to exenatide, liraglutide, albiglutide

A

gastroparesis(causes delayed gastric emptying), CrCl <30, hx of Medullary thyroid cancer

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6
Q

C/I to SGLT-2 inhibitors(-flozins)

A

renal or liver failure

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7
Q

Most chronic complications of DM start — years after disease onset.

A

5

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8
Q

Most common functional pituitary adenoma?

A

prolactinomas

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9
Q

You find a pituitary mass incidentally on MRI. What should you do next?

A

Check: Prolactin, IGF-1, 24 hr urine cortisol, ACTH, TSH, LH, FSH & Testosterone. If all normal just monitor. If + then treat condition

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10
Q

Pituitary adenoma compressing the optic chiasm will result in ——(pattern of vision loss)

A

bitemporal hemianopia

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11
Q

Diabetes Insipidus is caused by low —-.

A

ADH = inability to concentrate urine.

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12
Q

Central Diabetes Insipidus vs Nephrogenic DI

A 
Central = decrease ADH release from pituitary 2/2 trauma, genetic or idiopathic
Nephrogenic = resistance to ADH most often due to Lithium or another med
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13
Q

In Diabetes Insipidus urine osmolality will be —, serum osmolality will be —, Na will be — & ADH will be —.

A

Low urine osm, high serum osm, high Na, Low ADH

**per truleson you dnt need a high Na for DI, just someone whos drinking gallons and gallons of water a day.

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14
Q

Treatment for central vs nephrogenic DI

A 
Central = desmopressin(DDAVP)
Nephrogenic = stop rx
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15
Q

Causes of SIADH

A

CNS(tumors, hemorrhage, stroke, infarct), Pulm( pneumonia, cystic fibrosis, Asthma), Tumors(small cell carcinoma of the lungs is the most common), Drugs(commonly: carbamazepine, SSRIs, vincristine, haloperidol, amitriptyline, amiodarone)

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16
Q

SIADH is a —volemic —osmolar —natremia.

A

euvolemic hypoosmolar hyponatremia

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17
Q

First line treatment for GH excess

A

transphenoidal resection – carries 80% risk of hypopituitarism or DI

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18
Q

First line treatment for prolactinoma

A

bromocriptine or cabergoline or stop offending rx.

**if cannot be controlled with rx may be transsphenoidal resection

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19
Q

Dopamines effect on prolactin?

A

inhibits

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20
Q

Tumors associated with MEN1

A

Pancreatic(insulinoma, gastrinoma), Parathyroid, Pituitary tumors

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21
Q

Tumors associated with MEN2A

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A

Mendullary thyroid cancer(calcitonin secreting), pheochromocytoma, parathyroid hyperplasia

22
Q

Tumors associated with MEN2B

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A

Medullary thyroid cancer, mucosal neuromas, pheochromocytoma

23
Q

You check a TSH and its elevated so you check a T3/T4 & its also elevated. Whats the next step?

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A

RAI - could be parathyroid secreting TSH adenoma

24
Q

Causes of increased RAI uptake?

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A

Graves(diffuse), active nodule(single focus)

25
Causes of decreased RAI uptake?
exogenous thyroid hormone, thyroiditis
26
Which vitamin suppliment can cause false +/- readings for TSH?
Biotin
27
Which labs need to be monitored for a patient on methimazole or PTU? why?
CBC looking for agranulocytosis
28
Most common type of thyroid cancer? Prognosis? whats it produce?
Papillary - excellent prognosis, secrete Thyroglobulin
29
What are the two most aggressive thyroid cancers? Which one is worse?
anaplastic > follicular
30
which thyroid cancer is most likely to mets to bone, lungs & brain?
Follicular **often retains ability to make TH = "functioning thyroid cancer"
31
Which thyroid cancer secrets calcitonin?
medullary = associated with MEN2B
32
Nodule on thyroid US with low TSH. Next steps?
RAI uptake - FNA all cold nodules as these are more likely cancer! *DO NOT FNA hot nodule*
33
Hypocalcemia due to hypoparathyroidism will have what P & PTH levels?
elevated P, Low PTH
34
Hypocalcemia due to CKD will have what P & PTH levels?
elevated P, elevated PTH
35
Hypocalcemia due to Vit D deficiency will have what P & PTH levels?
low P, elevated PTH
36
Hypocalcemia due to low Mag will have what P & PTH levels?
low P, low PTH
37
Paget Disease labs + imaging
* *elevated alk phos, normal GGT & other liver enzymes, Ca & P often normal. * *XR shows increase bone denisty, Bone scintigraphy showed increase uptake due to increased bone osteoclast activity
38
X
X
39
Most common cause of adrenal insufficiency in the US
Addisons disease
40
Which type of anemia would falsely elevate A1c?
Iron deficiency anemia -smaller red blood cells stay around longer * a1c will also be increased with hypertriglyceridemia, splenectomy, renal failure, aplastic anemia
41
Pioglitazone improves outcomes of those with…
CVA and non fatal MI
42
3 medications Approved for use and diabetes in children
MetForman, liraglutide and insulin * Other medications are used they’re just not officially approved
43
Which ethnicity do you see the highest rate of diabetes?
Native Americans
44
Pt with DKA. When do u switch to 1/2 NS + dextrose w/K?
Glucose around 250
45
Best indicator for successful healing of diabetic foot ulcer?
Distal pulses
46
Things that effect thyroid supplimentation…
Desiccated thyroid(poor quality), T3 alone(poor quality studies), iron, sulcrafate, anticonvulsant, grapefruit, amiodarone, lithium, SSRI, retinoids
47
Things that ca effect T4 to T3 conversion
OCPs, steroids, chemotherapy, lithium, SSRIs, Fenelton, IV contrast, theophylline, beta blockers, Florida, opioids, estrogen, Stress, Asian, alcohol use, fasting, radiation, some vegetables in excess, low ferritin, soy, pesticides, hemachromatosis, smoking and kidney disease
48
Patient finds a thyroid nodule. What’s the first test u run?
TSH then US
49
Goal TSH in pregnancy?
<3
50
When should you check TSH after postpartum thyroiditis & why?
Check TSH two months after toxic phase to look for hypothyroidism. If hypothyroid go ahead and treat with Synthroid however this medication can Often be weaned off after 6 to 12 months

ABFM First Aid (22 decks)

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