Lab Study Guide- Endocrine Flashcards Preview

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Flashcards in Lab Study Guide- Endocrine Deck (54):
1

What labs would you check in primary testicular failure? (primary hypogonadism)

LH, FSH, testosterone, semen analysis

2

Decreased sperm count
Decreased LH
Decreased FSH
Decreased testosterone

Hypothalamic-pituitary abnormality

3

What should you measure next with hypothalamic-pituitary abnormality?

Measure prolactin
MRI of hypothalamic pituitary region

4

Decreased sperm count
Increased LH or FSH
Decreased or normal testosterone

Primary testicular abnormality

5

Decreased sperm count
Normal testosterone and LH
Normal or increased FSH
Sperm Present

Acquired Primary Hypogonadism

6

Decreased sperm count
Normal testosterone and LH
Normal or increased FSH
Sperm Absent
Absent Seminal Fluid frutose

Congenital absence of seminal vesicles and vas deferans

7

Decreased sperm count
Normal testosterone and LH
Normal or increased FSH
Sperm Absent
Present Seminal Fluid frutose
Normal testicular biopsy

Ductal obstruction

8

Decreased sperm count
Normal testosterone and LH
Normal or increased FSH
Sperm Absent
Present Seminal Fluid frutose
Abnormal testicular biopsy

Spermatogenic failure

9

Decreased sperm count
Increased LH or FSH
Decreased or normal testosterone
No testes
Increased testosterone on hCG stimulation

Cryptorchidism

10

Decreased sperm count
Increased LH or FSH
Decreased or normal testosterone
No testes
No increased testosterone on hCG stimulation

Anorchia

11

Decreased sperm count
Increased LH or FSH
Decreased or normal testosterone
Small, firm Testes present

Klinefelter's

12

Decreased sperm count
Increased LH or FSH
Decreased or normal testosterone
Postpubertal size testes (normal and soft)

Acquired primary hypogonadism

13

Normal OGTT 2 hours postprandial

<140mg/dl

14

OGTT 2 hours postprandial diagnostic of DM

> or equal 200mg/dl

15

Diagnosis of impaired glucose tolerance if 2 hour postload OGTT

>or equal 140 and <200

16

If a nodule is "hot" after radionuclide scan, what should you do?

clinical follow-up with or without treatment depending on whether the patient is euthyroid or thyrotoxic

17

If a nodule is warm or cold after radionuclide scan and has suspicious cytology, what should you do?

raises question of cancer and necessitates surgical excision

18

What is a cold nodule?

Cold nodules are nonfunctioning; malignancy is associated with a cold nodule

19

What are warm or hot nodules?

Functioning thyroid nodules

20

Normal total T4

4.5-10.9 mcg/mL

21

Normal free T4

0.8-2.7 ng/dL

22

Normal total T3

60-181 ng/dL

23

Normal TSH

.5-4.7 ng/dL

24

Elevated total T4, elevated free T4, elevated T3, decreased TSH

Hyperthyroidism

25

What will labs look like for hypothyroidism?

Low Total T4
Low Free T4
Low total T3
High TSH

26

What is the most definitive test for thyroid cancer?

serum thyroglobulin measurements

27

What is diagnostic for diabetes insipidus?

DDAVP (synthetic vasopressin) intranasally that causes a 50% greater increase in urine osmolality

28

When you are diagnosed with DI by DDAVP what test should be done?

Evaluation of the pituitary and hypothalamus via MRI

29

Urine osmolality < plasma osmolality and <45% increase in urine osmolality for ____________ diabetes insipidus

nephrogenic DI

30

What are the parameters for diagnosis of neurogenic DI?

Urine osmolality > plasma osmolality
>50% increase in urine osmolality

31

What would you expect to see on labs if a DM patient is having nephropathy?

Proteinuria and HTN

32

_______ is inaccurate guide to degree of GFR impairment when screening for diabetic nephropathy

Measurement of SCr

33

In diabetic nephropathy, screening for proteinuria should be performed __________, starting at time of diagnosis for Type 2 and ________ after diagnosis in Type 1

Annually
5 years after dx

34

What is the simplest method for screening microalbuminuria?

Ratio of protein (albumin) to Cr in random spot urine specimen (measurement correlates closely with 24 hour urinary protein estimates)

35

What would microalbuminuria be in 24 hours urinary protein estimates?

<300gm/24hours

36

What is the best tests to measure hypopituitarism?

IGF-1, plasma testosterone, TSH, Free T4, plasma cortisol response to synthetic ACTH

37

Diagnosis of pituitary tumors is confirmed by

MRI

38

What is Fine needle aspiration the initial evaluation of choice for?

Thyroid nodule patients

39

After FNA, you should do what for cystic and solid thyroid masses?

Ultrasound- assists in evaluating for size and cystic components
Thyroid nuclear scans- to confirm functional state

40

Metastatic and follicular tumors associated with ______ serum thyroglobulin

Increase

41

Medullary tumors show what on labs?

increased serum calcitonin
CEA antigen

42

Thyroid US is useful for?

differentiating solid nodules vs cystic nodules (may help guide FNA as well)

43

FNA is useful for?

used to obtain thyroid cells for cytologic evaluation (differentiate benign vs. malignant disease)

44

What is the testing sequence for thyroid nodule?

FNA (if cytology is malignant- surgery)
If benign- observe x1 year and follow up US
If suspicious on US- radionucleotide scan of nodule uptake

45

Metformin is C/I with what 2 lab findings?

Cr >1.5
Hepatic insufficiency

46

When can someone not be on Rosiglitazone and Pioglitazone (TZDs)?

ALT >2.5x ULN

47

What drug needs dose adjustments for CrCl?

DDP-4 Inhibitors (sitagliptin, saxagliptin)

48

If triclycerides >500mg/dL, what drug is C/I?

Colesevelam (WelChol)

49

With GLP-1 (Exenatide), you should use precaution if CrCl is what?

<30

50

Who should you never give TZD (rosiglitazone, pioglitazone) to?

NYHA class III or IV HF

51

When do you need to be on a statin if DM?

If HDL < 40 or high LDL

52

What is the goal BP of a diabetic?

130/80
Treat with ARB or ACEI

53

What is goal BP of DM patient with renal insufficiency and proteinuira >1g/24hours?

125/75

54

What labs should you get for premature menopause?

Elevated FSH
Elevated serum gonadotropin
Low serum estradiol
Estrogen deficiency symptoms (hot flashes, dry vagina)