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Clinical Medicine III > ENDOCRINE: overview > Flashcards

ENDOCRINE: overview Flashcards

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1
Q

What is the most common cause of primary adrenocortical insufficiency?

A

Autoimmune disease

Other causes include tuberculosis, HIV, amyloidosis, sarcoidosis, bilateral tumors, vascular causes, and drugs.

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2
Q

What are common symptoms of Addison’s Disease?

A
  • Hyperpigmentation
  • Hypotension
  • Fatigue
  • Myalgia
  • GI upset
  • Weight loss
  • Amenorrhea
  • Salt craving
  • Nausea/Vomiting
  • Low blood glucose
  • Infertility
  • Fetal loss
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3
Q

What laboratory findings are indicative of Addison’s Disease?

A
  • Decreased cortisol
  • Increased ACTH
  • Decreased sodium
  • Increased potassium
  • Metabolic acidosis
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4
Q

What is the treatment for Addison’s Disease?

A

Hydrocortisone orally daily, possibly adding Fludrocortisone later

Patients should wear a medical alert bracelet.

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5
Q

What is an adrenal crisis?

A

Acute adrenal cortical insufficiency

It is a life-threatening condition requiring immediate treatment.

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6
Q

What are the symptoms of an adrenal crisis?

A
  • Acute GI symptoms
  • Back pain
  • Arthralgia
  • Fatigue
  • Delirium
  • Coma
  • Hypotension
  • Orthostatic hypotension
  • Cardiomyopathy
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7
Q

What are the causes of an adrenal crisis?

A
  • Major or minor stressors
  • Hyperthyroid
  • Noncompliance with steroid replacement
  • Pituitary destruction
  • IV etomidate
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8
Q

What is Waterhouse-Friderichsen syndrome?

A

A cause of Addison’s disease and adrenal crisis characterized by vascular adrenal gland hemorrhage/rupture

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9
Q

What pathogens are associated with Waterhouse-Friderichsen syndrome?

A
  • Neisseria meningitidis
  • Pseudomonas aeruginosa
  • Haemophilus influenzae
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10
Q

What is the most common deficiency in congenital adrenal hyperplasia?

A

21-hydroxylase deficiency

It is associated with the CYP21-A2 gene.

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11
Q

What are the symptoms of congenital adrenal hyperplasia due to 21-hydroxylase deficiency?

A
  • Weak androgen activity at birth
  • Congenital adrenal insufficiency
  • Low blood glucose
  • Salt wasting
  • Abnormal genitalia at birth due to excess androgens
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12
Q

What is Cushing syndrome?

A

Prolonged exposure to cortisol

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13
Q

What are the common symptoms of Cushing syndrome?

A
  • Hypertension
  • Increased blood glucose
  • Increased insulin levels
  • Central obesity
  • Buffalo hump
  • Moon face
  • Striae
  • Hirsutism
  • Increased infection risk
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14
Q

What laboratory findings are indicative of Cushing syndrome?

A
  • Increased cortisol
  • Decreased potassium
  • Normal or low ACTH
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15
Q

What is hyperaldosteronism?

A

Mineralocorticoid excess

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16
Q

What are the primary and secondary types of hyperaldosteronism?

A
  • Primary: zona glomerulosa, renin independent
  • Secondary: renin dependent
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17
Q

What are the classic triad symptoms of primary hyperaldosteronism?

A
  • Hypertension
  • Hypokalemia
  • Metabolic alkalosis
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18
Q

What is the treatment for primary hyperaldosteronism?

A

Spironolactone or Eplerenone if pregnant

Other antihypertensive drugs can also be used.

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19
Q

What is a pheochromocytoma?

A

A catecholamine secreting tumor of the adrenal medulla

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20
Q

What are common symptoms of pheochromocytoma?

A
  • Headaches
  • Hypertension
  • Sweating
  • Palpitations
  • Chest pain
  • Abdominal pain
  • Fatigue
  • Weight loss
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21
Q

What is the first-line treatment for pheochromocytoma?

A

Alpha blocker (Phenoxybenzamine/Doxazosin)

Surgery follows after 1-2 weeks of medical therapy.

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22
Q

What is the most common pituitary adenoma?

A

Prolactinoma

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23
Q

What are the symptoms of prolactinoma in females?

A
  • Oligomenorrhea
  • Infertility
  • Low libido
  • Vaginal dryness
  • Galactorrhea
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24
Q

What are the laboratory findings for prolactinoma?

A
  • Increased prolactin
  • Decreased FSH
  • Decreased LH
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25
What is the treatment for prolactinoma?
Dopamine agonists (Cabergoline, Bromocriptine) ## Footnote Surgical resection is considered if refractory or larger than 3 cm.
26
What is SIADH?
Inappropriate release of ADH causing impaired water excretion
27
What are the laboratory findings for SIADH?
* Decreased serum sodium * Decreased plasma osmolarity * Increased urine sodium * Increased urine osmolarity
28
What is the treatment for SIADH?
* Fluid restriction * 3% saline * Furosemide * Conivaptan * Tolvaptan
29
What is the most common cause of hypothyroidism?
Hashimoto's thyroiditis
30
What are the symptoms of hypothyroidism?
* Cold intolerance * Fatigue * Constipation * Dry skin * Weight gain * Brittle hair * Bradycardia
31
What are the typical laboratory findings in primary hypothyroidism?
* Increased TSH * Decreased free T4
32
What is the treatment for primary hypothyroidism?
Levothyroxine
33
What is the most common cause of hyperthyroidism?
Graves' disease
34
What are the symptoms of hyperthyroidism?
* Weight loss * Anxiety * Heat intolerance * Palpitations * Tachycardia * Fine, thin, moist skin * Proptosis * Exophthalmos
35
What are the laboratory findings for hyperthyroidism?
* Increased free T4 or T3 * Decreased TSH
36
What is the treatment for hyperthyroidism?
* Methimazole * Propylthiouracil (if pregnant) * Beta-blockers for cardiac symptoms * Radioactive iodine * Surgery
37
What is thyroid storm?
A severe, life-threatening state of hyperthyroidism
38
What is myalgia?
Muscle pain ## Footnote Myalgia can be associated with various conditions including viral infections and autoimmune diseases.
39
What are the symptoms of hyperthyroidism?
Increased metabolism, weight loss, heat intolerance, anxiety ## Footnote Symptoms can vary but often include a rapid heartbeat and sweating.
40
What are the symptoms of hypothyroidism?
Fatigue, weight gain, cold intolerance, depression ## Footnote Symptoms may also include dry skin and hair loss.
41
What are the common signs of suppurative thyroiditis?
Fever, heat, pain, redness, swelling ## Footnote Indicates an infectious process within the thyroid.
42
What is Hashimoto's thyroiditis?
An autoimmune thyroid disorder leading to hypothyroidism ## Footnote Characterized by goiter and increased anti-TPO antibodies.
43
What laboratory findings are associated with subacute thyroiditis?
Increased ESR, abnormal TFTs (↓TSH, ↑T3, ↑T4) ## Footnote These findings help differentiate it from other thyroid conditions.
44
What are the treatment options for subacute and postpartum thyroiditis?
Self-limited, B-blockers, T4 supplementation, Aspirin ## Footnote These treatments aim to alleviate symptoms and restore thyroid function.
45
What is a goiter?
Enlarged thyroid gland ## Footnote Can be associated with iodine deficiency or thyroid disease.
46
What is the most common cause of goiter worldwide?
Iodine deficiency ## Footnote However, in the US, multinodular goiter and Hashimoto's are more common causes.
47
What symptoms may indicate compressive symptoms from a goiter?
Dysphagia, dyspnea, hoarseness ## Footnote These symptoms arise from pressure on surrounding structures.
48
What laboratory tests are used to evaluate goiter?
TSH, Free T4 ## Footnote These tests assess thyroid function and help determine treatment.
49
What is the most common type of thyroid cancer?
Papillary carcinoma ## Footnote Other types include follicular, medullary, and anaplastic carcinoma.
50
What are the characteristics of anaplastic thyroid carcinoma?
Most aggressive form of thyroid cancer ## Footnote It often presents with a hard, fixed mass and can metastasize rapidly.
51
What are the common laboratory findings in primary hyperparathyroidism?
↑Ca+, ↑PTH, ↓phosphorus ## Footnote These findings help confirm the diagnosis of hyperparathyroidism.
52
What are the symptoms associated with hyperparathyroidism?
Kidney stones, bone pain, arthralgia, constipation, depression ## Footnote This condition can lead to a variety of systemic symptoms.
53
What is the most common cause of hypoparathyroidism?
Surgical removal of the parathyroid glands ## Footnote Other causes include autoimmune conditions and genetic syndromes.
54
What are the symptoms of hypoparathyroidism?
Tingling, tetany, cataracts ## Footnote These symptoms arise due to low calcium levels.
55
What is renal osteodystrophy?
Bone disorders associated with chronic kidney disease ## Footnote Includes osteitis fibrosis and osteomalacia.
56
What causes osteomalacia?
Defective mineralization due to vitamin D deficiency ## Footnote In children, this condition is referred to as rickets.
57
What is the average age of diagnosis for Type 1 Diabetes?
14 years ## Footnote This type constitutes about 5% of all diabetes cases.
58
What are the classic symptoms of Type 1 Diabetes?
Polyuria, polydipsia, polyphagia ## Footnote These symptoms result from high blood sugar levels.
59
What is the primary treatment for Type 2 Diabetes?
Lifestyle changes ## Footnote Metformin is commonly used as the first-line medication.
60
What are the laboratory criteria for diagnosing prediabetes?
A1c 5.7-6.4, fasting 100-125, 2 Hr OGTT 140-199 ## Footnote These criteria help identify individuals at risk for developing Type 2 diabetes.
61
What is the first-line treatment for diabetic ketoacidosis?
Fluids (1-3 L) ## Footnote Insulin drip is also essential to manage blood glucose levels.
62
What is the hallmark of hyperosmolar hyperglycemic nonketotic acidosis (HHS)?
BGL >600, ↑ plasma osmolarity ## Footnote This condition primarily occurs in Type 2 diabetes.
63
What is multiple endocrine neoplasia (MEN)?
Autosomal dominant genetic condition with multiple endocrine tumors ## Footnote Genetic testing is recommended for first-degree relatives.
64
What are the common causes of hypoglycemia?
Drug-induced, alcohol, insulinoma ## Footnote It can also occur as a delayed response to insulin release.
65
What are the criteria to diagnose metabolic syndrome?
Must have 3 of the following: obesity, ↑BGL, ↓HDL, HTN, dyslipidemia ## Footnote This syndrome increases the risk of cardiovascular disease.
66
What is the best time to check testosterone levels?
In the morning ## Footnote Testosterone levels can vary throughout the day.
67
What are common causes of gynecomastia in adult men?
Spironolactone, anabolic steroids, idiopathic ## Footnote It can be transient and often resolves once the causative agent is removed.
68
What is hirsutism and its most common cause?
Excessive hair growth in women; PCOS is the most common cause ## Footnote Genetic factors can also contribute to this condition.
69
What lab tests should be conducted for squishy feeling?
Testosterone, LH, FSH, estradiol, hCG levels ## Footnote These tests help evaluate hormonal imbalances that may cause symptoms.
70
What is the purpose of a mammogram?
To evaluate suspected breast cancer ## Footnote A mammogram is an X-ray of the breast used to detect tumors.
71
What is indicated by high hCG or estradiol levels?
Testicular ultrasound ## Footnote These elevated levels may suggest testicular tumors or other conditions.
72
What is the typical treatment for squishy feeling in adults?
Stop causative drug ## Footnote Treatment may vary depending on the underlying cause.
73
What can cause squishy feeling in older men?
Serious issues ## Footnote This symptom can indicate underlying health problems that require further investigation.
74
What is hirsutism?
Facial hair in women ## Footnote It is an excess of male-pattern hair growth in females.
75
What are the characteristics of virilization in women?
Deep voice, muscle tone, baldness ## Footnote Virilization refers to the development of male physical characteristics in females.
76
What is a common cause of hirsutism?
Polycystic Ovary Syndrome (PCOS) ## Footnote Approximately 50% of hirsutism cases are attributed to PCOS.
77
What genetic condition can lead to hirsutism?
21 hydroxylase deficiency ## Footnote This genetic disorder affects adrenal hormone production.
78
What types of tumors can cause hirsutism?
Ovarian tumors, adrenal carcinoma ## Footnote These tumors can lead to increased androgen production.
79
What are some symptoms associated with hirsutism?
Anovulation, amenorrhea, decrease in breast size ## Footnote These symptoms may indicate hormonal imbalances.
80
What lab tests are recommended for evaluating hirsutism?
Serum androgen, total & free testosterone ## Footnote These tests help assess hormonal levels related to hirsutism.
81
What are some treatments for hirsutism?
Laser/topical treatment, contraceptives, spironolactone, flutamide, finasteride, metformin, simvastatin/atorvastatin, surgery ## Footnote Treatments vary based on the underlying cause and severity of symptoms.

Clinical Medicine III (8 decks)

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