Endocrinology Flashcards Preview

Master the Boards > Endocrinology > Flashcards

Flashcards in Endocrinology Deck (79):
1

additional finding in kallman syndrome

RENAL AGENESIS in 50%

2

growth hormone deficiency in adults

RARELY have symptoms,
subtle signs
- central obesity
- increased LDL and CH levels
- reduced lean mass

3

GH levels low

NOT that helpful since GH is pulsatile and maximum at night

4

confirming low GH

no response to arginine infusion
no response to GHRH

5

prolactin levels low confirmatory Dx

no response to TRH

6

metyrapovnse normally causes...

ACTH to rise, since inhibits 11 beta hydroxyls, thus decreasing output of the adrenal gland

7

before starting thyroxine what should you do,, for panhypopituitarism,,,,

CORTISONE before thyroxine

8

additional info for PC acromegly

carpal tunnel
body odour
colonic polyps
arthralgias
HTN

9

what can give a similar picture as acromegaly

GH abuse

10

best initial test for acromegaly

IGF-1

11

when should MRI be done in acromegaly

AFTER laboratory identification of acromegaly

12

what is co-secreted with GH

PRL

13

possible drugs for tx of acromegaly

cabergoline: DA agonist, inhibits GH release
octreotide or lanreotide: somatostatin inhibits GH release
PEGVISOMANY

14

PEGVISOMANT

GH receptor antagonist-- inhibits IGF release from the liver

15

physiologic causes of hyperPRL

- pregnancy
- intense exercise
- renal insufficiency
- increased chest wall stimulation
- cutting pituitary stalk-- no dopamine-- no inhibition of PRL

16

drug causes of hyperPRL

- antipsychotic meds
- methyldopa
- metoclopramide
- opiods
- TCA's
- verapamil

17

ONLY CCB to cause hyperPRL

VERAPAMIL

18

first thing necessary to do if patient has hyperPRL

PREGNANCY TEST

19

work up for hyperPRL

- TFTs
- Bun/Cr (since kidney insuff elevates PRL)
- LFTs (since cirrhosis elevates PRL)

20

which dopamine agonist is preferred for tx of hyperPRL

CABERGOLIN

21

when to tx hypothyroidism

High TSH (X2) + normal T4

22

when to decide on thyroid replacement in hypothyroidism

anti-TPO when TSH high, and T4 normal

23

involuted non palpable thyroid

exogenous thyroid hormone use

24

low TSH and decreased RAIU

- subacute thyroiditis-- painful
- painless "silent" thyroiditis
- exogenous thyroid hormone use

25

tx of silent thyroiditis

NONE

26

tx of subacute thyroiditis

ASPIRIN

27

which thiourea drugs is preferred for hypthyeroidism

METHIMAZOLE

28

tx of graves opthalmopathy

STEROIDS

29

what must you do if FNA says follicular adenoma

REMOVE SURGICALLY-- since can't tell if benign or malignant from FNA alone

30

90% of hypercalcemia seen in

CANCER PATIENTS

31

tx of hypercalcemia of malignancy

saline
bisphosphonates
------ if not working yet--> CALCITONIN

32

how to tx hypercalcemia from granulomatous disease/ sarcoidosis

PREDNISONE

33

how long does it take for bisphosphonates to work

SEVERAL DAYS

34

bone effects imaging for hyperPTH

DEXA is greater than bone xr

35

imaging of neck for hyperPTH

dont pre-op for planning surgery

36

3 new random causes of hypocalcemia

1. hypoMg: since need magnesium to cause release of PTH
2. renal failure
3. low albumin: causes decrease in 0.8 calcium

37

low albumin causing hypocalcemia

decrease total calcium
normal free calcium= ASYMPTOMATIC

38

EKG for hypocalcemia

PROLONGED QT

39

extra tid bits of info for cushings

- erectile dysfunction in men
- cognitive disturbance--> psychosis
- polyuria

40

best initial test for hypercortisolism

24-hr urine cortisol-- more specific

41

next best test for hypercortisolism

1mg overnight DXM

42

FP's with 1 mg overnight DXM suppression test

- depression
- alcoholism
- obesity

43

best initial test for determining the cause/location of hypercortisolism

ACTH level

44

ACTH level in cushing disease

increased

45

ACTH level in cushing syndrome

decreased

46

ACTH level increased, now what

MRI brain

47

negative MRI brain for cushings, now what

inferior petrosal sinus sampling for ACTH, possibly after stimulating with CRH

48

general endocrine rule

confirm the lab results first, THEN do imaging

49

cushing disease suppression test

YES suppresses

50

cushing syndrome/ cancer

NO doesn't suppress

51

labs in cushings

hyperglycemia
hyperlipidemia
HYPOKalaemia
metabolic alkalosis
LEUKOCYTOSIS

52

why is adrenal crisis from the pituitary less common?

because the pituitary makes ACTH, which has a very little role in regulating aldosterone

53

labs in hypoadrenalism

hypoglycemia
hyponatremia
HIGH BUN
HYPERkalaemia
metabolic acidosis
EOSINOPHILIA

54

what type of white cell is elevated in hypoadrenalism

EOSINOPHILS

55

dx or tx of adrenal crisis more important

TX

56

which steroid should we give when patient with hypoadrenalism has postural instability

fludrocortisone-- has sufficient aldosterone-like effect

57

steroid in adrenal crisis

hydrocortisone-- LIFE SAVING

58

best initial test for phaeo

24hr urine metanephreines, VMA

59

after biochemical testing for phaeo

CT adrenals

60

location of phaeo outside the adrenals imaging,

MIBG scanning

61

dx of DM

2 FBG > 125
1 random glucose >200 + symptoms
OGTT-- increased glucose
HbA1c> 6.5%

62

goal HbA1c level in DM

less than 7%

63

which diabetes drugs cause weight loss

incretin mimetics

64

nateglinide, repaglinide

stimulators of insulin release, but don't contain sulfa

65

onset: rapid acting insulin

5-15 minutes

66

peak action: rapid acting insulin

1 hour

67

duration: rapid acting insulin

3-4 hours

68

onset: short acting insulin

30-60 minutes

69

peak action: short acting insulin

2 hours

70

duration: short acting insulin

6-8 hours

71

onset: intermediate acting insulin

2-4 hours

72

peak action: intermediate acting insulin

6-7 hours

73

duration: intermediate acting insulin

10-20 hours

74

onset: long acting insulin

1-2 hours

75

peak action: long acting insulin

1-2 hours

76

duration: long acting insulin

24hrs

77

DKA presentation

in BOTH DMT1 and DMT2

78

potassium replacement DKA

replace potassium when levels are approaching normal

79

what factor indicates severity of DKA

serum bicarb (if very low, risk of death)