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Flashcards in Rapid Review Endocrine Deck (99)
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1

Most common cause hypothyroidism

Hashimotos

2

Lab findings in Hashimotos

High TSH, low T4, anti-TPO ab, antimicrosomal ab

3

Exopthalmos, pretibial myxedema, decreased TSH, thyroid bruits

Graves

4

Most common cause Cushing's syndrome

Iatrogenic corticosteroid administration
2nd: Cushing's disease

5

Pt presents w/ signs hypocalcemia, high P, low PTH

Hypoparathyroidism

6

Stones, bones, groans, psychiatric overtones

S/S hypercalcemia

7

Pt c/o HA, weakness, polyuria; exam: HTN, tetany; Labs: hyperNa, hypoK, metabolic alkalosis

Primary hyperaldosteronism (due to Conn's syndrome of bilateral adrenal hyperplasia)

8

Pt presents with tachycardia, wild BP swings, HA, diaphoresis, altered mental state, sense of panic

Pheochromocytoma

9

First in Tx of pheochromocytoma

Alpha antagonist: phentolamine or phenoxybenzamine

10

Pt w. Hx lithium use presents with copious amounts of dilute urin

Nephrogenic DI

11

Tx central DI

DDVAP and free water restriction

12

Postop pt with significant pain presents with hyponatremia and normal volume status

SIADH due to stress

13

Antidiabetic agent associated with lactic acidosis

Metformin

14

Pt presents with weakness, N/V, weight loss, new skin pigmentation. Labs show hyponatremia and hyperkalemia. Tx

Primary adrenal insufficiency- Addision's
Tx: glucocorticoids, mineralocorticoids, IVF

15

Goal HgA1c for DM

<7.0

16

Beta blockers CI in DM

Mask hypoglycemia Sx

17

HLA association with DM I

HLA DR 3,4,DQ

18

4 ways to dx DM

1. Random plasma glc >=200 with sx DM
2. FPG>=126 on 2 occasions
3. Plasma glc >=200 after 74 g OGT
4. HgA1c >=6.5^

19

Mechanism biguanides
Adverse effects

METFORMIN
Dec hepatic gluconeogenesis, inc insulin activity, reduce LDL and raise HDL

GI, lactic acidosis, dec b12 absorption,

CI Renal and liver insufficiency

20

Sulfonylureas
Mechanism
Adverse effects

Glyburide, glimepiride, glipizide
Stimulate insulin release, reduce glucagon, inc insulin binding on tissue receptors

Adverse: hypoglycemia

CI: renal and hepatic insufficiency due to in risk hypoglycemia

21

Thiazolidinediones
Mechanism
Adverse

"Glitazones"
Increase tissue uptake of glc, dec gluconeogenesis

Adverse: weight gain, fluid retention (CI CHF), inc LDL, rare liver toxicity

22

Oral hypoglycemic associated with increased risk MI

Rosiglitazone

23

DPP IV inhibitors
Mechanism
Adverse effects

"Gliptin"
Inhibits degradation of incretin-->dec glucagon, inc insulin, delays gastric emptying

Adverse: diarrhea, constipation, edema

24

Incretin mimetics
Mechanism
Adverse

Exenatide, liraglutide
Agonizes GLP 1 receptor- same as DPP IV inhibitors

Adverse: mild weight loss, n, hypoglycemia, GI, risk pancreatitis

SC injection!!

25

Alpha glucosidase inhibitors

Acarbose
Decreases GI absorption of starch and disaccharides

Adverse: diarrhea flatulence, GI

26

Meglitinides
Mechanism
Adverse

Stimulate insulin release

Adverse: hypoglycemia, expensive with little added benefit over sulfonylureas

27

HHNS vs DKA labs

HHNS: glc >800. No acidosis
DKA: glc 300-800, dec Na, normal or inc K (total body K decreased), dec P, anion gap metabolic acidosis, serum and urine ketones

28

2 types diabetic retinopathy
Tx

Background retinopathy: no neovascularization, tx by controlling risks
Proliferation retinopathy: neovascularization which increases risk hemorrhage, tx photo coagulation

29

EM findings in diabetic nephropathy

Kimmelstiel Wilson nodules in glomeruli

30

Changes of diabetic kidney

Inter capillary glomerulosclerosis, mesangial expansion, BM degeneration