Brainscape's Knowledge GenomeTM


Top Flashcards (Certified)
All Flashcards

Step 2 > Step Up- Endocrine > Flashcards

Step Up- Endocrine Flashcards

(75 cards)

Start Studying
1
Q

Most common cause of hyperthyroidism

A

Graves disease

-IgG to TSH receptor (TSIg)

Young women

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

Three signs of hyperthyroidism that are specific to graves disease

A

Exopthalmos

Pretibial myxedema

Thyroid bruit

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

What is the purpose of a radioactive T3 uptake test?

A

The T3 can either be taken up by free TBG or by the resin that is given to the patient.

If the resin takes up the T3 as seen on the scan, then the TBG is likely saturated with T3 and therefore hyperthyroidism is a likely diagnosis.

This helps to diagenose true hyperthyroidism with elevated TBG

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

Normal free thyroxine index?

A

4-11

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

First line management of hyperthyroidism? Major side effect?

A

PTU and methimazole

Agranulocytosis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

Contraindications to radioactive iodine treatment

A

Breastfeeding and pregnancy

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

Treatment of thyroid storm…

A

B-blocker for HR control

PTU

Dexamethasone to impair peripheral conversion of T4 to T3

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

Patients with hasimotos have increased risk of these cancers

A

thyroid lymphoma

thyroid carcinoma

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

Elevated TSH with normal T4

A

Subclinical hypothyroidism

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

antimicrosomal antibodies are increased in this form of hypothyroidism

A

Hashimoto’s

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

Subacute, or viral, thyroiditis is associated with this human leukocyte antigen…

A

HLA-B35

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

What is one of the defining physical finidings in subacte granulomatous thyoiditis?

A

PAINFUL thyroid

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

Ab present in chronic lymphocytic thyroiditis

A

antiperoxidase antibodies (90%)

antithyroglobulin antibodies (50%)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

progressive replacement of the thyroid with fibrous tissue. Presents as painless hardened thyroid

A

Reidel’s thyroiditis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

Characteristics that suggest malignancy in a thyroid nodule

A
  • Fixed
  • unusually firm
  • solitary
  • Hx of radiation
  • Rapid growth
  • Vocal cord paralysis
  • Cervical adenopathy
  • FMHx
  • Elevated Serum Ca
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

First step in thyroid nodule evaluations

A

FNA (95% Sen and Sp.)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

Which thyroid cancer is FNA NOT reliable for?

A

Follicular

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

Syndromes associated with thyroid cancer

A

Gardner’s syndrome and Cowden’s syndrome–> Papillary

MEN type II for meduallary thyroid cancer

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

Most common form of thyroid cancer

A

Papillary (also least aggressive)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

Papillary thyroid cancer is most commonly associated witht his risk factor

A

radiation exposure

(Papillary is Pounded by radiation)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

This form of thyroid cancer commonly matastasizes to distant organs (brain, bone, lung, liver)

A

Follicular

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

How does papillary thyroid cancer spread?

A

Via lymphatics

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

MEN II is associated with this form of thyroid cancer

A

Medullary

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

Medullary thyroid cancer is associated with this electrolyte distubance

Why?

A

Hypercalcemia

Cancer derived from parafollicular (c cells) which produce calcitonin

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
Worst form of thyroid cancer
anaplastic
26
What is the tx for most thyroid cancers?
Lobectomy (papillary) or total thyroidectomy (all others) with adjuvent radioiodine therapy
27
Medications associated with hyperprolacinemia
Psychiatric medications H2 blockers metoclopromide verpamil estrogen
28
Treatment of prolactinoma
bromocroptine (dopamine agonist) Continue tx for 2 years before considering sugery unless otherwise indicated Cabergoline may be better tolerated
29
Most common cause of death in patients with acromegaly
Hypertrophic cardiomyopathy (heart disease)
30
Levels of this are significantly elevated in acromegaly
Somatomedin C (IGF-1)
31
How does an oral glucose suppression test work?
If glucose load fails to suppress GH, this can confirm diagnosis of acromegaly
32
Normal serum osmolality
250-290
33
How to diagnose diabetes insipidis (neuro v. nephro v. psychiatric issue)
water deprivation test
34
Treatment for central DI
Desmopressin (nasal, oral, IM) or Chlorpropamide and tx underlying cause
35
Tx for nephrogenic DI
discontinue offending agent Sodium restriction and thiazide diuretic (depletes sodium leading to increased absorbtion in the proimal tubule of water and Na which decreases urine volume)
36
Is edema seen in SIADH? Why or why not?
NO Despite hyponatremia, naturesis is occuring due to the increased release of atrial naturitic peptide and the inhibition of the Renin-angiotensin-aldosterone system
37
Treatments for SIADH id patient is asymptomatic
Water restriction Loop diuretic Lithium carbonate or demeclocycline (inhibit ADH in the kidney)
38
Danger of raising Na too quickly in SIADH?
Central pontine myelinolysis (replacement should no exceed 0.5meq/L/hr)
39
After establishment of cushing syndrome and high ACTH (or no suppression with low dose), how does the high dose dexamathasone suppression test work?
If the high dose dexamethasone does no suppress the production of ACTH the tumor is most likely and ectopic ACTH producing tumor--\> Chest CT, abdominal CT and octreotide scan If the suppression test does suppress then the tumor is most likely pituitary in origin--\> head MRI
40
Pheochromocytomas are most commonly found here
adrenal medulla-- arising from chromaffin cells
41
Rule of 10s for pheochromocytoma
10% familial 10% bilateral 10% malignant 10% multiple 10% in children 10% extra adrenal
42
How to diagnose pheo
Urine screen for metanepherine, VMA, HMA, and normetenepherine
43
Drug used to pretreat in removal of pheo
alpha blockade with phenoxybenzamine 10-14d prior to surgery propanolol 2-3d prior (alpha blockade for BP abd Beta for HR)
44
MEN type I is composed of these abnormalities
Parathyroid hyperplasia pancratic islet tumors pituitary tumors
45
MEN IIA is composed of these clinical findings
(MPP) Medullary thyroid carcinoma Pheochromocytoma Pharathyroid abnormalities
46
MEN IIB is composed of...
"MMMP" Mucosal neuromas Medullary thyroid tumors Marfanoid body Pheo
47
electrolyte disturbance present in hyoeraldosteronism
Sodium retention Hypokalemia Metabolic alkylosis (loss of H+ in the mudullary collecting tubules)
48
Most common cause of hyperaldosteronism
Adrenal adenoma-- conn syndrome most common Adrenal hyperplasia (almost always bilateral) Rarely adrenal carcinoma
49
laboratory study to evaluate for hyperaldosteronism
plasma adosterone:renin ratio \>30 inappropriately elevated aldosterone with a decrease in renin activity
50
Confirmatory test for hyoperaldosteronism (there are two)
1. Saline infusion test Infusion of saline should result in decrease in plasma aldosterone in normal patients. It will not in patient with hyoperaldosteronism 2. Oral sodium loading - should result in decreased aldosterone. Increased aldosterone in the setting of increased urine sodium confirms the diagnosis
51
How can venous versus arterial blood elucidate the cause of hyperaldosteronism
Aldosterone high on venous side= adenoma Aldosterone high on venous and arterial side= hyperplasia
52
Tx for aldosterone producing adeoma Tx for bilateral hyperplasia
Resection for adenoma Spironolactone for bilateral hyperplasia
53
Most common infectious cause of primary adrenal insufficiency worldwide? Industrialized nations?
Tuberculosis Idiopathic (likely autoimmune) addison disease
54
Most common cause of secondary adrenal insufficiency?
Long term steroid therapy
55
Symptoms of lack of cortisol?
GI pain Hypoglycemia Hyperpigmentation (due to increased ACTH and melanocyte stimulating hormone) hypotension and shock Hyponatremia and hypovolemia Hyperkalemia
56
How do the treatements for primary and secondary adrenal insufficiency difffer?
Primary: both glucocorticoid (prednisone/hydrocortisone) need to be replaced due to low cortisol and low aldosterone Secondary: Glucocorticoid replacement is necessary but mineralocorticoid is not because aldosterone is normal
57
This enzyme is the most commonly deficient enzyme in congenital adrenal hyperplasia
21-hydroxylase
58
High levels of this enzyme are present in individuals with 21-hydroxylase deficiency
17-hydroxyprogesterone
59
What is the pathophysiology of congential adrenal hyperplasia and how it causes virilization?
As precursors to 21-hydroxylase build up they are shunted to synthesis of androgens (DHEA and Testosterone) --Females born with ambiguous genitalia but normal uterus and ovaries
60
What major electrolyte disturbance is associated with congenital adrenal hyperplasia?
Hyponatremia and hyperkalemia dye to lack of mineralocorticoid
61
Difference betwen dawn phenomenon and symogyi effect
Dawn phenomenon: morning hyperglycemia in response to growth hormone Symogyi effect: morning hyperglycemia in response to nocturnal hypoglycemia
62
This hyperglycemic agent is contraindicated in patients with renal failure
Metformin
63
Hyaline deposition in one area of the kidney (nodular glomerular sclerosis) is pathognomonic for this....
Diabetic nephropathy
64
Why may ketones be falsely negative in ciruclatory collapse?
The production of lactate shifts the production of ketones to B-hydroxybtyrate over acetoacetate. Acetoacetic acid is normally the one that is measured.
65
Sodium correction in DKA
Add 1.6 to measured Na for every 100 mg/dL increase in glucose.
66
What causes the need for Na correction in DKA
glucose causes osmotic shift of fluid from ICF to ECF thus diluting the Na.
67
Describe the changes in potassium that are caused by DKA
Initially hyperkalemia due to shift from acidosis Insulin and overall loss in the urine causes intracellular shift of K leading to dangerous hyperkalemia ALWAYS A TOTAL DEFICIT
68
Findings in hyperosmolar, hyperglycemic, non-ketotic state?
Hyperosmolarity-- due to osmotic diuresis Hyperglycemia non-ketotic-- due to enough basal insuline to suppress ketogenisis
69
This should always be given before or with glucose in hypoglycemia
Thiamine to avoid wenicke encephalopathy
70
Insulinoma is assocaited with this syndrome
MEN1
71
Gastrinoma, also known as
zollinger-ellison syndrome-- a pacreatic islet cell tumor that secrets gastrin Leads to high gastric acid levels and ulcers
72
Gastrinoma triangle
cystic duct superiorly, second and third portion of duodenum inferiorly, and neck of pancreas medially
73
In zollinger-ellison syndrome, gastrin increases substantially after administration of this...
secretin
74
Glucagonoma is associated with this dermatologic manifestation
necrotizing migratory erythema
75
watery diarrhea, achlorhydria, hyperglycemia and hypercalcemia
VIPoma

Step 2 (14 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2025 Bold Learning Solutions. Terms and Conditions