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Internal Medicine- Endocrine Flashcards

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0
Q

What are s/s of prolactinoma?

A

HA, diplopia, CN3 palsy, impotence, gynecomastia, galactorhea, amenorrhea, female virilization

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1
Q

What is prolactinoma?

A

OD prolactin secretion

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2
Q

50% of prolactinomas are…

A

hypopituitarism

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3
Q

What is dx for prolactinoma?

A

MRI/CT, Increased insulin like growth factor

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4
Q

hat is the tx for prolactionma?

A

Bromocriptine (dopamine agonist)

Transpenoidal surgery

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5
Q

What are GH in adults called?

A

acromegaly

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6
Q

What are s/s of acromegaly?

A

increased shoe size, glove size, coarse features, voice deepening, peripheral neuropathies

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7
Q

What is GH called in children?

A

gigantism

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8
Q

What is the tx for OD GH?

A

Surgery/radiation + octreotide (somatostatin-like)

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9
Q

What is hypopituitarism?

A

decrease in hormones from ant pit- LH, FSH, GH, TSH, ACTH

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10
Q

What are mc cause of hypopituitarism? other causes?

A

hypothalamic/pituitary tumor

radiation, sheehans, infiltration, head trauma

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11
Q

What is dx of hypopituitarism?

A

low levels of hormones/ MRI

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12
Q

what is the tx for hypopituitarism?

A

replacement of hormones

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13
Q

What is central DI?

A

WATER DEPRIVATION TEST:LOW urine osmolality w/ dehydration and RESPONDS TO ADH

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14
Q

What is nephrogenic DI

A

low urine osmolality before and after ADH

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15
Q

What are s/s of DI?

A

polyuria/polydipsia + hypernatremia

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16
Q

What is the treatment for central DI?

A

Desmopressin (DDAVP) - ADH replacement

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17
Q

What is nephrogenic tx?

A

thiazide diuretics

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18
Q

SIADH- syndrome inappropriate ADH is…

A

TOO MUCH ADH

HYPONATREMIA! - highly concentrated urine

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19
Q

What is dx of SIADH?

A

Water load test

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20
Q

What is the treatment of SIADH?

A

Water restriction,
DEMECLOCYCLINE/LITHIUM CARBONATE

symptomatic pts: isotonic saline

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21
Q

What happens when you replace Na too quickly?

A

CENTRAL pontine myelinolysis

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22
Q

What is the most common cause of hypoparathyroidism?

A

NECK SURGERY!

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23
Q

What is s/s of hypoparathyroid?

A 
cardiac arrythmias, prolonged QT, 
Rickets, osteomalacia
NUMBNESS/ TINGLING 
TETANY
neuromuscular irritability
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24
What do you see in hypoparathyroid tetany?
Chvostek- tap facial nerve | Trousseau's sign- inflate BP cuff x 3 mins ->carpal spasm
25
What is diagnostic for hypoparathyroid
Low calcium, High phosphate, low PTH
26
What is treatment for hypoparathyroid?
IV calcium gluconate/oral calcium, Vit D
27
What is hyper parathyroidism's mc cause?
hypercalcemia
28
What is secondary cause of hyperparathyroidism?
elevated PTH because of low calcium
29
What are s/s of hyperparathyroidism?
stones, bones, groans, psych overtones | SHORT QT
30
what is diagnostic hyperparathyroidism?
high Ca + low phosphorus + high PTH
31
What is the treatment of hyper pth?
surgery is the only tx, increase fluids + loop diuretics DONT GIVE THIAZIDE DIURETICS!
32
What is Diabetes Type 1?
Destruction of pancreatic Beta Cells -> INSULIN DEFICIENCY
33
What are s/s of type 1?
polyuria, polydipsia, polyphagia, weight loss, DKA
34
What is diagnostic for type 1?
RANDOM BG >200, Fasting BG >125 X 2 2 hour oral glucose >200
35
What is the tx for type 1?
insulin
36
What are some complications for type 1 diabetes?
DKA
37
What are some s/s of DKA ?
kussmaul breaths= deep labored abdominal pain, dehydration, urine/blood ketones + ANION GAP, hyperkalemia, hyperglycemia
38
What fungal infection do you get with DKA?
mucormycosis
39
What is the treatment of DKA?
Fluids #1-> rehydrate Insulin: give potassium too Add glucose once hyperglycemia normalizes
40
What is Type 2 diabetes?
peripheral insulin resistance
41
What are s/s of T2Dm?
polydipsia, polyphagia, polyuria | Infections-> yeast, mucormycosis, skin staph aureus
42
What is the diagnosis of T2DM?
Random bg >200, Fasting BG >125 x2 , 2 hour glucose test > 200
43
What is the tx for T2DM?
oral hypoglycemic insulin Acei
44
What are the major complications of T2DM?
Macrovascular, microvascular, Neuropathy, | Hyper-Osmolar Hyperglycemic non-ketosis
45
What is HONK?
-precipitated by stress Glucose is >1000 No acidosis Renal failure + confusion
46
What is the treatment of HONK?
Rehydration
47
What is insulinoma?
MC benign- tumor secreting insulin
48
What does insulinoma cause?
Hypoglycemia- diaphoresis, anxiety, tremors, elevated BP
49
What is diagnostic for insulinoma?
72 hour fast ( insulin does not decrease with hypoglycemia)
50
What is the tx of insulinoma?
excision
51
What is zollinger ellison syndrome?
pancreatic islet cell tumor secreting gastrin increases acid secretion ulcers
52
What are s/s of Zollinger ellison syndrome?
Peptic ulcer/diarrhea weight loss abd pain
53
What is diagnostic of ZES?
Secretin test- after secretin injection-> gastrin is supposed to decrease if it does not decrease, think ZES
54
What is the treatment of ZES?
High Dose PPI, | Excision of tumor
55
What is glucagonoma?
glucagon-> hyperglycemia causes necrotizing migratory erythema Tx: excision
56
What are causes of cushings?
iatrogenic, pituitary adenoma adrenal hyperplasia ectopic ACTH
57
what are s/s of cushings?
moon facies, buffalo hump, truncal obesity, striae, hirsutism, amenorrhea, impotence, acne, more susceptible to infection
58
What is diagnostic for cushings?
24 hour urine cortisol 4x elevated | high dose dexamethasone suppression test
59
What is the tx for cushings?
``` excision of the tumor, inhibit p450 ( ketoconazole, aminoglutethimide) ```
60
What is adrenal insuffiency
low cortisol ( opposite of cushings)
61
What is primary adrenal insuffiency
ADDISONS dx- low cortisol and high ACTH
62
What are the causes of addisons?
AUTOIMMUNE is mc | granulomatous dz
63
What is waterhouse friderichsen?
hemorrhagic necrosis of medulla with meningococcemia
64
What is the s/s of addisons?
fatigue, anorexia, n/v/d, constipation, hyperkalemia, hyponatremia-> salt craving HYPERPIGMENTATION (elevated ACTH)
65
What is dx of addisons?
hyperpigmented + elevated ACTH
66
What is secondary adrenal insufficiency:
low acth and high cortisol response to ACTH NO HYPERPIGMENTATION tx: CORTISOL replacement
67
What is acute adrenal crisis?
cause: stress mc/ chronic adrenal insuffiency Tx: increase cortisol replacemtn
68
What is adrenal cortical hyper function?
high aldosterone

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