Endocrinology Flashcards by lionel varela

DIAGNOSIS-MEN ASYMPTOMATIC, WOMEN: CANNOT LACTATE

PROLACTIN DEFICIENCY

How well did you know this?

Not at all

Perfectly

DIAGNOSIS-WOMEN: NO OVULATION, AMENORHEIC MEN:NO SPERM,DECREASE HAIR&LABIDO

FHS AND LH DEFICIENCY

How well did you know this?

Not at all

Perfectly

DIAGNOSIS-DECREASED FSH,LH FROM LOW GnRH ANOSMIA AND RENAL AGENESIS IN 50%

KALLMAN SYNDROME

How well did you know this?

Not at all

Perfectly

DIAGNOSIS-SHORT STATURE, ADULTS FEW SYMPTOMS:CENTRAL OBESITY, INCREASED LDL AND CHOL. REDUCED LEAN MASS

GH DEFICIENCY

How well did you know this?

Not at all

Perfectly

DIAGNOSIS- ALL ABOVE SX.

PANHYPOPITUITISM

How well did you know this?

Not at all

Perfectly

INITIAL TEST- PANHYPOPITUITISM

HYPONATREMIA, MRI OF PITUITARY

How well did you know this?

Not at all

Perfectly

INITIAL TEST- CONFIRM LOW HORMONE PANHYPOPITUITISM WITH LOW TSH, T4 IN BLOOD

DECREASE IN TSH IN RESPONSE TO TRH

How well did you know this?

Not at all

Perfectly

INITIAL TEST-CONFIRM LOW HORMONE PANHYPOPITUITISM WITH LOW ACTH AND CORTISOL

COSYNOTROPIN(ACTH)=CORTISOL RISE (ACUTE), CORTICOTROPIN(CRH)=INC.ACTH BUT NO CORTISOL

How well did you know this?

Not at all

Perfectly

INITIAL TEST- CONFIRM LOW HORMONE PANHYPOPITUITISM WITH LOW LH, FSH,TEST

NO CONFIRMATORY TEST

How well did you know this?

Not at all

Perfectly

TIP- OLDER TESTS FOR PANHYPOPITUITISM

METYRAPONE(CAUSE ACTH LEVEL RISE), INSULIN STIMULATION(CAUSE GH TO RISE)= ABNORMAL SHOULD RESULT OPP.

How well did you know this?

Not at all

Perfectly

INITIAL TREAT- PANHYPOPITUITISM

TIP- OXYTOCIN HAS NO DISEASE? TRUE OR FALSE

REPLACE HORMONES: CORTISONE, THYROXINE, TESTOSTERONE/ESTRO,GH

TRUE

How well did you know this?

Not at all

Perfectly

P.ASS.-POST- STROKE,TUMOR, TRAUMA HYPOXIA OR INFITRATION OF THE PIT GLAND INFECTION/IFLAM.

P.ASS.-CHRONIC PYELONEPHRITIS, AMYLOIDOSIS, MYELOMA OR SICKLE CELL, HYPERCALCEMIA, HYPOKALEMIA, LI

DIAGNOSIS- POLYURIA AND HYPERNATREMIA (CONFUSION,LETHARGY, SEIZURES /COMA

INITIAL TEST-
INITIAL TREAT-
INITIAL TREAT-

DIABETES INSIPIDUS CENTRAL

DIABETES INSIPIDUS NEPHROGENIC

DIABETES INSIPIDUS

SERUM SODIUM THEN VASOPRESSIN TEST: BETTER IN CENTRAL AND NO CHANGE IN NEPHROGENIC

CENTRAL DI= LONG-TERM VASOPRESSIN (DESMOPRESSIN/ ADH)

NEPHROGENIC DI= TREAT CAUSE:(E.G.HYPOKALEMIA OR HYPERCALCEMIA), HYDROCHLOROTHIAZIDE, AMILORIDE, PROSTAGLANDIN INH (INDOMETHACIN)

How well did you know this?

Not at all

Perfectly

P.ASS- PITUTARY ADENOMA, GASTRINOMA OR INSULINOMA OR ECTOPIC GH OR GHRH (LYMPHOMA OR BRONCHIAL CARCINOID)

DIAGNOSIS- INCREASED HAT,RING,SHOE SIZE, CARPAL TUNNEL, ODOR,DEEPVOICE,COLONIC POLYPS,ARTHRALGIAS,HYPERTENSION, CHF, ED

INITIAL TEST- ACROMEGALY
ACC. TEST- ACROMEGALY
INITIAL TREAT- ACROMEGALY

ACROMEGALY

SERUM IGF-1, GLUCOSE (INTOLERANCE), HYPERLIPIDEMIA THEN MRI

GLUCOSE SUPPRESSION TEST

SURGERY (TRANSPHENOIDAL RESEC)OR RADIATION, PHARM:CABERGOLINE(DOPAMINE), OCTREOTIDE OR LANREOTIDE (SOMATOSTATIN), PEGVISOMANT

How well did you know this?

Not at all

Perfectly

P.ASS.-INC.GH/TRH(HYPOTHYROIDISM), PIT ADENOMA, PREGNANCY,EXCERISE,RENAL INS.,CHEST STIMULATION, LOW DOPAMINE (DRUGS)

DIAGNOSIS- WOMEM: GALACTORRHEA, AMENORRHEA, INFERTILITY/MEN:ED GYNECOMASTIA

INITIAL TEST- HYPERPROLACINEMIA
INITIAL TREAT- HYPERPROLACTINEMIA

HYPERPROLACTINEMIA

ANTIPSYCHOTICS, METHYLDOPA, METOCLOPROMIDE, OPIOIDS, TRICYCLICS, VERAPAMIL

SERUM PROLACTIN, TFT, PREGNANCY TEST, BUN/CR, LFT THEN MRI(PROBABLE TUMOR)

DOPAMINE AGONIST(CABERGOLINE/BROMOCRIPTINE), TRANSPHENOIDAL SURGERY, RADIATION (RARE)

TIP- DRUGS THAT INCREASE PROLACTIN

How well did you know this?

Not at all

Perfectly

DIAGNOSIS- BODILY ROCESSES BEING SLOWED DOWN

INITIAL TEST-
INITIAL TREAT-

HYPOTHYROIDISM

LAB: TSH, T4/T3

IF DOUBLE TSH; THEN= THYROXINE

TIP- COMMON CAUSE OF HYPOTHYROID=HASHIMOTO, DIET, AMIODARONE

TIP- IF TSH IS HIGH BUT NOT DOUBLE RUN? IF POSITIVE THEN WHAT?=ANTITHYROID PEROXIDASE/ANTITHYROGLOBULIN ANTIBODIES THEN TREAT WITH THYROXINE

How well did you know this?

Not at all

Perfectly

DIAGNOSIS-EYE PROPTOSIS AND SKIN, HYPERTHYROID, ELEVATED RAID

DIAGNOSIS- TENDER THYROID, HYPERTHYROID

DIAGNOSIS- NONTENDER THYROID, HYPERTHYROID

DIAGNOSIS- INVOLUTED GLAND (NOT PALPABLE), HYPERTHYROID

DIAGNOSIS- HIGH TSH AND HYPERTHYROID

Study These Flashcards

GRAVES

SUBACUTE THYROIDITIS

PAINLESS SILENT THYROIDITIS

EXOGENOUS THYROID HORMONE USE

PITUITARY ADENOMA

INITIAL TEST- PITUITARY ADENOMA
INITIAL TREAT- GRAVES
INITIAL TREAT-SUBACUTE THYROIDITIS
INITIAL TREAT-PAINLESS HYPERTHYRIOD
INITIAL TREAT- EXOGENOUS THYROID USE
INITIAL TREAT- PITUITARY ADENOMA 
TIP- METHIMAZOLE VS PROPYLTHIOURACIL

Study These Flashcards

MRI
RADIOACTIVE IODINE
ASPIRIN
NONE
STOP USE
SURGERY
METHIMAZOLE

DIAGNOSIS- ANXIETY, PALPITATIONS, FEVER DIARRHEA
INTIAL TREAT- ACUTE HYPERTHYROID
INITIAL TREAT- GRAVES OPHTHALMOPATHY
TIP- AE INCEDIBLY COMMON 5% WOMEN 1% MEN/95% BENIGN (ADENOMA,COLLOID NODULE, CYST)
INITIAL TEST- THYROID NODULE
INITIAL TREAT- THYROID NODULE (FOLICULAR MEDULARY PAPILARY)
TIP-PRIMARY CAUSE OF HYPERCALCEMIA THEN
TIP- OTHER CAUSES OF HYPERCALCEMIA

Study These Flashcards

ACUTE HYPERTHYROID(THYROID STORM)

PROPANOLOL, THIOUREA, IODINATED CONTRAST MATERIAL, STEROIDS, RADIOACTIVE IODINE

STEROIDS THEN RADIATION THEN SURGERY

THYROID NODULE

TSH/T4 AFTER NORMAL TSH FINE-NEEDLE ASPIRATE BIOPSY

SURGERY EXCISION

PRIMARY HYPERPARATHYROIDISM (PTH) THEN ECTOPIC PTH (CANCER)

HIGH VIT D, SARCOIDOSIS OR OTHER GRANULOMA, THIAZIDE, HYPERTHYROIDISM*,METASTASIS TO BONE AND MM

DIAGNOSIS- ACUTE CONFUSION, STUPOR, LETHARGY AND CONSTIPATION, SHORT QT, HBP,OSTEOPOROSIS*,NEPHROLITHIASIS,DI,RENAL INSUF

INITIAL TREAT-

Study These Flashcards

HYPERCALCEMIA

ACUTE HYPERCALCEMIA= HIGH VOL. SALINE, BISPHOSPHONATES + TEMP. CALCITONIN

DIAGNOSIS- HYPERCALCEMIA, PEPTIC ULCER, MUSCLE WEAKNESS, ANOREXIA, OSTEOPOROSIS

INITIAL TEST-
INITIAL TREAT-

Study These Flashcards

HYPERPARATHYROIDISM

PTH LEVELS, LOW PHOSPHATE LEVELS, HIGH CHLORIDE LEVEL, EKG: SHORT QT, ELEVATED BUN/CR, ALK PHOS. THEN SONOGRAPHY OR NUCLEAR SCANNING

SURGERY (REMOVE AFECTED GLANDS) CINACALCET WHEN SURGERY NOT POSSIBLE

TIP- SOLITARY ADENOMA 80%, HYPERPLASIA 15-20%, PARATHYROID MALIGNANCY 1%= HYPERPARATHYROIDISM

DIAGNOSIS- CHVOSTECK SIGN, CARPOPEDAL SPASM,PERIORAL NUMBNESS, MENTAL IRRITATBILITY, SEIZURES, TETANY

INTIAL TEST-
INITIAL TREAT-

Study These Flashcards

HYPOCALCEMIA

EKG:PROLONGED QT, SLIT LAMP SHOWS CATARACTS

SEVERE: IV CALCIUM AND VIT D, MILD: ORAL CALCIUM AND VIT D

TIP- MAIN CAUSES OF HYPOCALCEMIA=HYPOPARATHYROIDISM(THYROIDECTEM) HYPOMAGNESEMIA(HELPS SEC. PTH), RENAL FAILURE

TIP- OTHER CAUSES OF HYPOCALCEMIA=VIT D, GENETIC, FAT MALABSORPTION AND LOW ALBUMIN .1 DECREASES .8 IN CALCIUM

DIAGNOSIS-FAT REDISTRIBUTION, SKIN: STRIAE, EASY BRUISING, THIN SKIN, OSTEOPOROSIS,

DIAGNOSIS- HYPERTENSION, MENSTRUAL DISORDER, ED,BAD COGNITION,POLYURIA(HYPERGLYCEMIA)

INITIAL TEST- 1-2-3
INITIAL TREAT-

Study These Flashcards

CUSHING SYNDROME

FIND HIGH CORT.:#1—-24 HOUR URINE CORTISOL, IF NOT POSSIBLE 1MG OVERNIGHT DEXAMETHASONE SUPPRESSION TEST-#2—FIND CAUSE: ACTH TESTING (NARROWS IT TO TWO) AND CUSHING DISEASE IS SUPPRESSED WITH DEX(NARROW TO ONE), MRI OR PETROSAL ACTH-#3—-FIND P.ASS: HYPERGLYCEMIA, HYPERLIPIDEMIA, HYPOKALEMIA, METABOLIC ALKOLOSIS, LEUKICYTOSIS

SURGERY

TIP- LOW CALCIUM= TWITCHY AND HYPER; HIGH CALCIUM-SLOW AND LETHARGIC

TIP- ETIOLOGY: CUSHING DISEASE»>ADRENAL HYPER>ECTOPIC ACTH>UNKNOWN ACTH SOURCE

TIP- FALSE POSSITIVE FOR 1MG DEXAMETHASONE SUPPRESSION TEST= DEPRESSION, ALCOHOLISM, OBESITY

TIP- ANTI-INSULIN HORMONES?

Study These Flashcards

GH, CORTISOL, GLUCAGON

TIP- INCIDENTALOMA ARE 5% COMMON TEST FOR:

Study These Flashcards

METANEPHRINES, RENIN, ALDOSTERONE, SUPPRESSION TEST

DIAGNOSIS- WEAKNESS, FATIGUE, ALTERED MENTAL STATUS, NAUSEA, VOMITING, ANOREXIA, HYPOTENSION, HYPNATREMIA, HYPERKALEMIA INITIAL TEST: INITIAL TREAT:

HYPOADRENALISM (CHRONIC: HYPERPIGMENTATION) COSYNTROPIN (ACTH) TEST (NORMAL: RISE IN CORTISOL AFTER) OR LESS SP. TEST FOR PRIMARY OR SECONDARY: ACTH HIGH OR LO W SERUM:HYPOGLYCEMIA,HYPERKALEMIA, MET ACIDOSIS, HYPONATREMIA, HIGH BUN. HYDROCORTISONE AND FLUDROCORTISONE( GOOD ALDOSTERONE EFFECT)

TIP: ETIOLOGY OF HYPOADRENALISM (ADDISON) TIP: ETIOLOGY OF ACUTE HYPOADRENALISM TIP- EOSINOPHILIA IS FOUND IN HYPOADRENALISM? TRUE OR FALSE TIP- IN ACUTE ADRENAL INSUFFICIENCY ALWAYS?

80% AUTOIMMUNE THEN INFECTION(TB), ADRENOLEUKODYSTROPHY, MET. CANCER ACUTE:HEMORRHAGE, SURGERY, HYPOTENSION REMOVE CHRONIC HIGH DOSE STERIODS TRUE TREAT AND TEST AFTER HX AND GEN. LABS

DIAGNOSIS- UNDER AGE 30 OR OVER 60, HYPERTENSION( PHARM: DOES NOT WORK), HYPOKALEMIA INITIAL TEST- ACC. TEST- INITIAL TREAT-

HYPERALDOSTERONE, CONNS SYNDROME HIGH ALDOSTERONE=RATIO: ADOSTERONE TO PLASMA RENIN (HIGH RENIN EXCLUDES PRIMARY HYPERALD.) PRIMARY ADENOMA=VENOUS BLOOD DRAIN: HIGH ALDOSTERONE LEVEL THEN SERUM:K,ADOSTERONE, RENIN THEN CT HYPERADRENALISM= SURGERY ( UNILATERAL ADENOMA) OR EPLERENONE OR SPIRONOLACTONE(BILATERAL HYPERPLASIA)

TIP- ETIOLOGY- OR HIGH ALDOSTERONE

SOLITARY ADENOMA OR HYPERPLASIA

TIP- NEVER START WITH SCAN IN ENDOCRINOLOGY? TRUE OR TRUE

TRUE

DIAGNOSIS- EPISODIC HYPERTENSION, HEADACHE, SWEATING, PALPITATIONS TREMOR INITIAL TEST- INITIAL TREAT-

PHEOCHROMOCYTOMA 24 HOUR URINE FREE METANEPHRINES COLLECTION (VANILLYLMANDELIC ACID LESS SENSITIVE)THEN CT OR MRI THEN MIBG(NUCLEAR ISOTOPE) PHENOXYBENZAMINE, CCB AND BETA BLOCKERS THEN SURGERY

DIAGNOSIS: GLUCOSE: >125MG/DL TWICE, YOUNG, POLYURIA-PHAGIA-DIPSIA

DM 1

DIAGNOSIS- GLUCOSE: >125MG/DL TWICE, ADULT, OBESITY, POLY:URIA-PHAGIA-DIPSIA

DM 2

INITIAL TEST- DM | INITIAL TREAT- 1-2-3

GLUCOSE (TWICE: >125 FASTING) GLUCOSE (SINGLE: >200 NON-FASTING) HIGH GLUCOSE (TOLERANCE TESTING) HBA1C >6.5% (ALSO CONTROL) 1.(DIET, EXERCISE, WEIGHT LOSS) 2. ORAL HYPOGLYCEMIC: METFORMIN>INCRETINS>SULFONYLUREAS/GLINIDES (NO CHF)>GLITAZONES>PRAMLINTIDE(AMYLN)>ALPHA GLU INH TRUE ``` 3. INSULIN: LONG ACTING (GLARGINE OR NPH) + SHORT ACTING: (LISPRO, ASPART,GLULISINE AND SOMETIMES REGULAR) ``` TIP: INSULIN-ONSET-PEAK-DURATION: FOR SHORT AND LONG ACTING= SHORT: 1-15MIN(30-60REG)-1 HR(2HR REG)-3-4HR(6-8HRS REG) LONG: 1-2HR(2-4NPH)-NO PEAK(6-7NPH)-24HRS(10-20NPH) TIP: REVIEW PHARM NAMES

DIAGNOSIS-ABDOMINAL PAIN, HYPERVENTILATION,DEC. MENTAL STATE,METABOLIC ACID,HYPERKALEMIA,INC ANION INITIAL TREAT- INTIAL TEST-

DKA LARGE VOLUME SALINE + INSULIN THEN POTASSIUM WHEN GLUCOSE IS APPROACHING NORMAL BICARB (VERY LITTLE CAN KILL YOU)

TIP- DM CONTROL | TIP- DM COMPLICATIONS-1-2-3-4-5 AND TX

PNEUMO VACCINE, EYE EXAM YEARLY, LIPIDS, BP (>130/80), ACEi FOR MICROALBUMINURIA OR BP, FOOT EXAM AND ASPIRIN CARDIO:(MI,STROKE,CHF, LIPIDS) RENAL: MICROABLBUMINURIA 30-300MG PER 24HRS GI: PARESIS(METOCLOPROMIDE AND ERYTHROMYCIN) EYE: RETINOPATHY NEUROPATHY:(DAMAGE TO VASONERVORUM-TX:PREGABALIN,GABAPENTIN OR TRICYCLICS)

Endocrinology Flashcards

(35 cards)