Brainscape's Knowledge GenomeTM


Top Flashcards (Certified)
All Flashcards

Step 3 > Endocrinology > Flashcards

Endocrinology Flashcards

(80 cards)

Start Studying
1
Q

Nelson syndrome

A

rapid enlargement of pituitary adenoma after removal of both adrenal glands for Cushing’s disease; characterized by bitemporal hemianopsia and hyperpigmentation

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

Dx. nelson’s syndrome

A

MRI - suprasellar extension of pituitary adenoma

labs - very high plasma ACTH levels

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

tx. nelsons syndrome

A

surgery and/or pituitary radiation

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

lab findings in non-functioning pituitary adenoma

A
  1. hypogonadism - low levels of FSH and LH

2. serum alpha subunit levels are elevated

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

preferred therapy for nonfunctioning pituitary adenoma

A

trans-sphenoidal surgery

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

tx. prolactin-secreting adenomas

A

DA agonists ex. cabergoline

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

what dyslipidemia is common in HIV pt

A

triglyceridemia

assoc. with elevated LDL and TC & decreased HDL

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

tx. of hypertriglyceridemia in HIV pt on antiretroviral therapy

A

if TG> 500 -> fibrate medication (gemfibrozil)

if TG < 500, can use a statin

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

amiodarone effects on thyroid

A

decreased conversion from T4 to T3 = decreased T3 and increased T4 levels
- may also cause hypothyroidism and thyrotoxicosis due to high iodine content

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

diagnoses of DM

A
  1. two FPG > 126
  2. one random glucose > 200 with symptoms
  3. abnormal OGTT
  4. HbA1c > 6.5%
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

pt with type 2 DM that is not adequately controlled with metformin - next step?

A

add sulfonylurea

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

S/E of metformin

A

lactic acidosis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

contraindications of metformin

A 
renal insufficiency (Cr > 1.4, CCl < 50)
use of contrast agents --> ARF
alcohol abuse
CHF
liver disease
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

what should you do in pt on metformin about to have a contrast procedure done?

A
  1. stop metformin 1 d prior

2. if high risk for RF, give NaHCO3 or NS before procedure, adequately hydrate

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

s/e of sulfonylrureas

A

hypoglycemia

SIADH

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

DPP-IV inhibitors

A

sitagliptin, saxigliptin

- increase insulin release and block glucagon

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

C/I to rosiglitazone/pioglitazone

A

CHF

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

insulin secretagogues

A

nateglinide, repaglinide

  • short acting
  • cause hypoglycemia
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

GLP analogs

A

exenatide, liraglutide

  • decrease gastric motility (increase feeling of fullness)
  • increase satiety
  • promote weight loss
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

s/e exenatide or liraglutide

A

NV
dyspepsia
sensation of fullness/bloating

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

best test to determine severity of DKA

A

serum bicarb

also: ph < 7.3 or anion gap high

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

effect of glucose on Na levels

A

high glucose artificially drops Na levels

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

which hyperlipidemia drug is C/I in diabetes

A

niacin - worsens glucose intolerance

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

Tx. diabetic neuropathy

A

gabapentin

pregabalin

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
Tx. diabetic gastroparesis
erythromycin or metoclopramide
26
lab findings in TSH secreting adenoma
elevated TSH and T3/T4 | increased serum alpha subunit levels
27
TH resistance syndrome
elevated TSH and T3/T4 | symptoms of hypothyroidism
28
increased RAIU
Graves disease goiter tsh secreting adenoma
29
decreased RAIU
subacute/painless thyroiditis | iatrogenic/factitious disorder
30
Grave's opthalmopathy
Tx. does not affect the ocular findings | if severe, may lead to compression of the optic N. with visual field deficits
31
what intervention may decrease severity of graves ophthalmopathy
smoking - increases severity
32
Tx. Grave's disease
PTU or MTZ acutely, then RAI to ablate the gland
33
target TSH levels in treatment of thyroid cancer? if mets?
TSH between 0.1 and 0.3 uU/mL. Even lower in distant mets
34
s/e of treatment with suppressive doses of levothyroxine
bone loss | A.fib
35
silent thyroiditis
autoimmune process with a nontender gland and hypothyroidism; RAIU normal or decreased, + TPO ab
36
Tx. silent thyroiditis
none - spontaneously resolves
37
CF: Subacute thyroiditis
likely due to viral infection; pt presents with fever, tender thyroid gland and hyperthyroid followed by hypothyroid symptoms
38
Lab findings in subacute thyroiditis
TSH low, T4 high | RAIU decreased
39
Tx. subacute thyroiditis
Aspirin propranolol - to decrease sx Steroids - if symptoms severe and not resolving with NSAIDs
40
only cause of hyperthyroidism with an elevated TSH
pituitary adenoma
41
Tx. thyroid storm
iodine PTU or MTZ dexamethasone propranolol
42
MCC of Hypercalcemia
Primary hyperparathyroidism
43
MCC hypophosphatemia
Continuous glucose infusions
44
Clinical presentation of hypophosphatemia
Muscle weakness, ESP. Diaphragm giving respiratory weakness | Decreased cardiac contractility
45
When do you treat hyperparathyroidism surgically? (4)
Symptomatic disease Renal insufficiency Markedly elevated 24 hr urine calcium Very elevated serum calcium > 12.5
46
Presentation of acute severe hypercalcemia
``` Confusion Constipation Short QT syndrome Polyuria, polydipsia from nephrogenic DI Renal insuff, ATN, kidney stones ```
47
Management of acute hypercalcemia
1. Hydration: 3-4 L normal saline 2. Furosemide: only after hydration has been given - if those two don't work, can try calcitonin 3. Bisphosphonate (pamidronate) - chronic management
48
Clinical findings in severe Hypocalcemia
Seizures Neural twitching Arrhythmia prolonged QT
49
Diagnosis of Cushing syndrome
1. 1 mg dexamethasone suppression test - if this fails to suppress: 2. 24 hour urine cortisol test
50
You find a pt to have high cortisol, high ACTH level that suppresses to high dose dexamethasone test. You suspect pituitary adenoma but MRI does not show any lesions. What should you do next?
Inferior petrosal sinus sampling
51
CF of Addison Disease
Fatigue, anorexia, weakness, weight loss, hypotension Thin pt with hyperpigmented skin Concomitant autoimmune disorders
52
Lab findings in Addison's disease
``` Hyperkalemia with metabolic acidosis Hyponatremia Hypoglycemia Neutropenia Peripheral eosinophillia ```
53
Most accurate diagnostic test
Cosyntropin (ACTH) stimulation test | - give ACTH , should have increase in cortisol, if no increase then you have adrenal insufficiency
54
Tx. Addison's disease
1. Acute crisis (ie hypotensive) - give hydrocortisone or dexamethasone (doesn't interfere with cortisol measurement) and IVF 2. Chronic - prednisone 3. If still hypotensive despite steroid replacement, give fludrocortisone
55
CF in hyperaldosteronism
Hypertension Hypokalemia with metabolic alkalosis Weakness Nephrogenic DI from Hypokalemia (polyuria and polydipsia)
56
Diagnostic findings in hyperaldosteronism
Low renin Hypertension Elevated aldosterone level despite salt loading with normal saline
57
Tx. Hyperaldosteronism
Solitary adenoma - surgery | Hyperplasia - spironolactone
58
Best initial tests for pheochromocytoma
High plasma and urinary catecholamine levels | Plasma free metanephrine and VMA levels
59
Most accurate test for pheochromocytoma
CT or MRI of the adrenal glands
60
When do you do a MIBG scan for pheochromocytoma
If >5 cm in size and suspicion of extra renal disease | Positive hormone levels but negative imaging
61
Tx. Hypertensive crisis in pheochromocytoma
IV nitroprusside Phentolamine Nocardipine
62
Tx. Hypotensive crisis in pheo
Normal saline bolus | Pressors if no response
63
Tx. Hypoglycemia in pheo
IV dextrose infusion
64
Cardiac tachyarrhythmias
IV lidocaine or esmolol
65
Medical prep prior to surgery for pheo
Phenoxybenzamine for 10-14 days | Propranolol before surgery (1-2d)
66
Features of all types of CAH
Low aldosterone and cortisol High ACTH levels Tx. Prednisone
67
Most accurate test for prolactinoma
MRI of the brain
68
Best initial therapy for prolactinoma
DA agonists - bromocriptine, cabergoline
69
Best initial test for acromegaly
IGF1 level
70
Most accurate test for acromegaly
OGTT - normally, GH is suppressed by glucose Suppression of GH by glucose excluded acromegaly
71
Tx. Acromegaly
Surgical removal - transsphenoidal resection | Octreotide, cabergoline, bromocriptine - prevent release of GH
72
Pegvisomant
GH receptor antagonist
73
Testicular feminization - features
Female, who does not menstruate Breasts present Exam: vagina ends in blind pouch, no cervix, uterus or ovaries Genetically, XY
74
CF of Klinefelters
Tall men, small testicles XXY karyotype Insensitivity to FSH and LH on their testicles (high levels but no testosterone is produced)
75
Tx. Klinefelters
Testosterone
76
Kallmans syndrome
Anosmia | Hypogonadism - low LH, FSH, GnRH
77
Pituitary apoplexy
Sudden hemorrhage into pituitary gland causing obtundation due to a rapid drop in cortisol level and hypotension that fails to respond to IVF
78
Tx. Pituitary apoplexy
Stabilized with high dose steroids and IVF. Give fludrocortisone
79
In what situation should you not use Ringers lactate solution
Hyperkalemia - it contains K+
80
Insulin dosing prior to surgery
Admin of 1/3 usual insulin dose

Step 3 (20 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2025 Bold Learning Solutions. Terms and Conditions