Shit - Endo UWorld Flashcards Preview

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Flashcards in Shit - Endo UWorld Deck (30):
1

Gastrinoma presentation

Refractory ulcers, especially in jejunum (abnormal)
Also abd. pain and diarrhea

2

MEN 2A+B gene and what that means for lineage

RET oncogene
ALL NEURAL CREST CELLS!

3

Reverse T3: role and synthesis

Inactive form of T3 to down regulate the response
Formed via peripheral T4

4

Aromatase inhibitors

anastrozole, letrozole, exemestane

5

Papillary vs Follicular thyroid cancer

Papillary = Orphan annie, nuclear grooves, psammoma, RET/BRAF, childhood irradiation

Follicular = invade capsule, HEMATOGENOUS mets

6

Esrtogen and TH

increases TBG by decreasing catabolism; increased total T4 pool and free T4, but normal T3 .: EUthyroid

7

Down Syndrome levels

1st timester: low PAPP-A, high b-hCG; nuchal translucency and hypo plastic nasal bone

2nd timester: high b-hCG, LOW AFP, low estriol, high inhibin A

8

MCC of high AFP readings

Underestimation of gestational age
(if correct age, then body wall defect or multiple gestations

9

T2DM MCCD

MI

10

Levels of stuff in Kleinfelters

LH and FSH: high
Inhibin and T: low
Sperm count: zero
Estrogen: high [E:T ratio determines extent of feminization/disease]

11

GH vs IGF-1 effects

GH form AP causes increased liver IGF-1 production

GH:
- insulin resistance
- lipolysis
- protein synthesis

IGF-1:
- growth and development of bones, cartilage, soft tissue (muscles)

12

Excess Iodine effects

1) wolf-Chaikoff: inhibition of TPO .: decreased oxidation, iodination (organification), and coupling [.: production]
2) competitive inhibition @ NIS (outcompete smaller amounts of radioactive Iodine in chemical exposures)
3) decrease amount of T3/T4 released

13

Iodine uptake in DeQuervain subacute thyroiditis

Initial thyrotoxicosis via release of stored T3/T4, then hypothyroidism with pain.

NEVER increase iodine uptake! initial thyrotoxicosis via increased release, not increased production.

14

Ransom receptors that increase or decrease insulin release

Increase:
M3 (Gq)
GCG (Gs/Gq)
B2 (Gs)
GLP-1 (Gs)
Hist (H2)

Decrease:
a2 (Gi)
Somatostatin-2 (Gi)

15

Winters formula and what it means

PaCO2 = [HCO3- * 1.5] + 8 +/- 2

If PaCO2 differs from this predicted PaCO2, then there is a mixed acid-base disorder

i.e. severe DKA, expect low PaCO2 to compensate for metabolic acidosis, but PaCO2 is high indicating respiratory failure (pull. deem or altered mental status) adding a respiratory acidosis on top

16

DOC for hyperthyroidism

Methimazole
Pregnancy = PTU
Thyroid storm = PTU (because also blocks T4 to T3 peripherally)

17

Iodine uptake blockers vs. peripheral conversion blockers

Block I- uptake:
- Perchlorate
- Pertechnetate
- Thiocyabate

Block peripheral T4 to T3 conversion:
- PTU
- beta blockers
- ipodate (contrast agent)

18

Cushing disease results in what cellular changes in the adrenals

HyperPLASIA of fasiculata and reticularis
(also some hyperTROPHY of fasiculata)

19

XX with ambiguous genetalia and maternal virilization: enzyme deficient?

Aromatase

20

Male-pattern baldness rx

finasteride (5a-reductase inhibitor)
Minoxidil

21

What drug to co-administer with flutamide

continuous GnRH agonist i.e. leuprolide
[flutamide = non-steroid androgen-R blocker, so will cause feedback up regulation of Testosterone which would nullify the drugs effects]

22

Mechanism of drugs to decrease proptosis/opthamology problems in graves

Decrease inflammatory infiltration
[i.e. glucocorticoids; also decrease peripheral T4 to T3]

23

drugs that inhibits DHF

Trimethoprim (bacteria)
methotrexate (human)
pyrimethamine (toxo/plasmodia)

24

PCOS DOC and mechanism

OCP

Suppress LH, decreasing total androgen production
Increase SHBG - more T bound, less free for virualization

25

Orthostatic HYPERtension =

hyperaldosteronism

26

When to use OGTT

Gestational DM
CF
When other tests are equivocal

27

bHCG shot for infertility used to mimic what hormone?

LH surge (LH, FSH, bHCG all look similar)

28

Best marker for menopause

FSH

29

Drugs causing lipodystrophy and lipoatrophy

Lipodystrophy = protease inhibitors
Lipoatrophy = NRTI (stavudine and zidovudine)

30

SGLT-2 inhibitors - check for what

BUN + creatinine