Endocrinology Flashcards
(24 cards)
anti-GAD antibodies
Type 1 DM
Treatment goals for Type 2 DM, preventative measurements
glucose 80-120mg.dl
HbA1c
For which patients is metformin contraindicated? Important side effect
Renal insufficiency, hepatic insufficiency, heart failure
Lactic acidosis
Glipizide, glyburide, Glimepiride: class, mechanism, side effects
Sulfonylureas
Incr endogenous insulin secr
Hypoglycemia
Rosaglitazone, pioglitazone: class, mechanism, side effects
Thiazolidinediones
Treatment of hyperthyroid
Methimazole, propylthiouracil
Treatment of thyroid storm
IV propanolol, propylthiouracil, corticosteroids
High dose postassium iodide
Delayed relaxation of DTRs
Assoc with hashimotos
Treatment myxedema coma
IV levothyroxine, IV hydrocortisone
MEN1 vs MEN2A vs MEN2B
MEN1: pancreatic neuroendocrine, pituitary adenoma, parathyroid hyperplasia
MEN2A: Pheo, medullary thyroid ca, parathyroid hyperplasia
MEN2B: Pheo, medullary thyroid ca, mucosal neuroma
criteria for osteoporosis; common fxs
BMD
“mosaic” lamellar bone pattern on xray; assoc lab abnormality
Paget’s
incr alk phos, normal ca, phos
secondary vs tertiary hyperparathyroid
secondary: physiologic incr PTH after renal insufficiency, Ca def, Vit D def
tertiary: dialysis pts, long-standing secondary hyperplasia leads to parathyroid hyperlasia, autonomous PTH secr
hypercalcemia: sx and treatment
Sx: stones, bones, moans, groans, psychiatric overtones
Tx: IV fluids, loop diuretics, IV bisphosphonates
Ectopic PTHrP: assoc cancers, PTH/Ca/PO4
Breast, lung
Decr PTH, Incr Ca, Decr PO4
primary hyperparathyroidism: Assoc labs, workup, medical treatment
hypercalcemia, hypophosphate, hypercalciuria
DEXA, 99mTC sestamibi scan, thyroid ultrasound
cancalcet: calcimimetic
cushing syndrome vs cushing disease
syndrome: too much cortisol
disease: ACTH-producing pituitary adenoma
Cushing syndrome: screening tests, pituitary vs adrenal
24hr free urine cortisol
2 midnight salivary cortisol
1mg dexamethasone suppression test
ACTH dep vs indep:
AM cortisol and ACTH
Tx + Dx of acromegaly
Dx: IGF1 incr, confirm with glucose suppression test
Tx: octreotide (somatostatin analog)
pegvisomant (GH receptor antagonist)
Dx + tx hyperprolactinemia
Prolactin >200
Tx: dopamine agonist (cabergoline, bromocriptine)
dx + tx central vs nephrogenic di
Dx: DDAVP admin: central: decr UOP, incr urine osm nephrogenic: no effect Tx: Central: DDAVP nephrogenic: salt restriction, water intake; thiazide diuretics
dx, tx SIADH
Dx: urine osm >50-100 mosm/kg, serum hypoosm; urinary sodium > 20meq/L
Tx: restrict fluid, hypertonic saline if
Dx of adrenal insufficiency
Hyponatremia and eosinophilia
Hyperkalemia in primary AI only
Confirm with 8Am cortisol (18ug/dl)
hyperaldosteronism: dx and tx
Dx: hypokalemia, mind hypernatremia, alkalosis, hypomagnesemia, incr aldost/plasma renin activity
Tx: surgical or spironolactone
