Thyroid, Corticosteroids, Gonadal hormones

Question 0

Treatment for myxedema coma?

Answer 0

Levothyroxine IV

Plus IV Hydrocort if with adrenal or pituitary insufficiency

Question 1

Medical emergency presenting as end stage of untreated HYPOthyroidism?
Hypogly, thermia, natremia, ventilation

Answer 1

Myxedema coma

Question 2

DOC for pregnant hyperthyroidism?

Answer 2

PTU
Block TPO, dec organification.
Also inhibit peripheral conversion of T4 to T3

Question 3

PTU given together with what drug during first 3-4 weeks for symptomatic relief?

Answer 3

Beta blockers

Question 4

DOC for NONpregnant hyperthyroidism?

Answer 4

Methimazole
Taken OD - better compliance
PTU taken TID

Question 5

Prenatal exposure to methimazole may cause?

Answer 5

“Met a CUTe guy!”
Aplasia cutis congenita
Congenital focal absence of epidermis

Question 6

Thioamides PTU and Methimazole have this common side effect?

Answer 6

Agranulocytosis

Acute severe neutropenia

Question 7

Treatment of thioamide induced agranulocytosis?

Answer 7

Discontinue drug

Give GCSF to accelerate recovery

Question 8

Definitive treatment of hyperthyroidism, contraindicated in pregnant and nursing women?

Answer 8

RAI

Question 9

Most common AE of RAI?

Answer 9

Permanent hypothyroidism

By destroying thyroid parenchyma

Question 10

Used in preop thyroidectomy to decrease size and vascularity?

Answer 10

Potassium iodide (Lugol’s)

Question 11

Lugol’s also used in?

Answer 11

Radiation prophylaxis

To prevent radiation-induced papillary thyroid cancer

Question 12

Common AE of Lugol’s?

Answer 12

Iodism

Acneiform rash, swollen salivary glands, mucous membrane ulcerations

Question 13

Prenatal exposure to KI causes?

Answer 13

Fetal goiter

Question 14

Wolf Chaikoff vs Jod Basedow

Answer 14

WC: ingest iodine, dec TH via negative feedback
JB: ingest iodine, inc TH

Question 15

What causes drug-induced HYPERthyroidism?

Answer 15

MAC

1. Methadone 2. Amiodarone 3. Clofibrate

Question 16

Amiodarone causes hypothy (block t4 to t3) and hyperthy (inflamm, leak TH). Treatment?

Answer 16

Hypo: Levothyroxine
Hyper: PTU, Methimazole, Steroids (anti-inflamm)

Question 17

Which drugs inhibit peripheral conversion of T4 to T3?

Answer 17

1. PTU
2. Propranolol
3. Hydrocort

Question 18

Treatment for thyroid storm?

Answer 18

PTU to block hormone synthesis (PTU first to prevent JB).
SSKI to retard release of TH.
Propranolol for symptomatic relief.
Hydrocortisone to protect against shock and to inhibit peripheral conversion

Question 19

Criteria used for thyroid storm?

Answer 19

Burch Wartofsky

Question 20

Short acting, low potenct GC used for acute adrenal insufficiency, contact derm, thyroid storm and status asthmaticus?

Answer 20

Hydrocortisone

Question 21

GC used for brain swelling and post chemo emesis?

Answer 21

Prednisone

Used to dec ICP only if caused by brain tumor

Question 22

GC used for fetal lung maturity?

Answer 22

Beta or Dexamethasone

High anti inflamm properties

Question 23

How to avoid adrenal insufficiency in patients with long term therapy?

Answer 23

Give stress doses during serious illness or before major surgery

Question 24

Mineralocorticoid that inc Na reabsorption, K and H secretion used for Addison's? (CAI)

Answer 24

Fludrocortisone

Question 25

Fludrocortisone also used for?

Answer 25

Replacement therapy post adrenalectomy | Do not use with loops and thiazides, worsen hypoK

Question 26

Addison's vs Conn's

Answer 26

Addisons - ADDrenal insufficiency | Conn's - Excess (Exconn)

Question 27

Squa ca vs Small cell lung ca?

Answer 27

SquaCa - PTHrp - hyperCa, hypoMg | SC - Inc ACTH - Ectopic cushing's

Question 28

Drug abused by body builders to lower cortisol and prevent muscle loss? Also used for cushing's and breast cancer

Answer 28

Aminoglutethimide "AMINin mo nandaya ka!"

Question 29

MOA of Aminoglutethimide?

Answer 29

Inhibit desmolase | Block conversion of cholesterol to pregnenolone

Question 30

GC synthesis inhibitor also an azole antifungal used for cushing's?

Answer 30

Ketoconazole

Question 31

Common AE of ketoconazole?

Answer 31

Gynecomastia | Some drugs produce awesome knockers

Question 32

DOC for pregnant cushing's? | For pregnant hyperthyroidism?

Answer 32

Cush - Metyrapone | Hyperthy - PTU

Question 33

Use of ethinyl estradiol to dec DVT, osteoporosis and breakthrough bleeding leads to increase in risk of what cancer?

Answer 33

Endometrial and Breast cancer

Question 34

Prevention of cancer by ethinyl estradiol if given with?

Answer 34

Progestin

Question 35

Synthetic estrogen for atrophic vaginitis?

Answer 35

Diethylstilbestrol | DES

Question 36

Prenatal exposure of daughters to DES can cause?

Answer 36

Clear cell vaginal adenocarcinoma

Question 37

The progestin megestrol leads to what side effect?

Answer 37

Weight gain because it stimulates appetite | Mey ges! Kain ako nang kain!

Question 38

Combined OCP used for hypogonadism, acne, endometriosis, contraception causes what AE?

Answer 38

DVT - inc risk in smokers Earlier onset breast Ca Breakthrough bleeding

Question 39

Progestin-only OCP that causes hair loss and delayed return of fertility?

Answer 39

Medroxyprogesterone Acetate | Depo provera IM

Question 40

Postcoital contraceptive?

Answer 40

Levonorgestrel "Leave no trace" Take within 72hours - 4tabs now, 4tabs after 12 hours Yuzpe regimen

Question 41

SERM used for ER PR(+) breast Ca? | Antagonist vs breast, agonist to uterus liver bone

Answer 41

Tamoxifen

Question 42

Tamoxifen prevents osteoporosis and dec atherosclerosis at the risk of causing?

Answer 42

Endometrial carcinoma

Question 43

SERM that inc FSH and LH used for induction of ovulation?

Answer 43

Clomiphene Lead to multiple pregnancies May lead to low grade ovarian ca

Question 44

``` Effective drug against tamoxifen resistant breast Ca? Inhibit aromatase (block pregnenolone to estrogen) ```

Answer 44

Anastroloze

Question 45

Antiandrogen used for endometriosis that is contraindicated in pregnant and nursing women?

Answer 45

Danazol

Question 46

GnRH analog for prostate Ca that cause tumor flare up?

Answer 46

Leuprolide

Question 47

GnRH antagonist that is also used for prostate Ca but does NOT produce tumor flare up?

Answer 47

Ganirelix | "Ganito dapat, walang flare up!"

Question 48

GC receptor antagonist for medical abortion?

Answer 48

Mifepristone RU486

Question 49

Mifepristone causes sepsis due to what organism?

Answer 49

Clostridium sordelli

Question 50

AE of testosterone in females? In males?

Answer 50

Females - virilization | Males - Paradoxical feminization due to suppression of endogenous testosterone

Question 51

Clinical use of testosterone?

Answer 51

Hypogonadism, RBC production, Muscle buildup, weight gain in AIDS

Question 52

Anabolic steroid used as illegal performance enhancing drug in athletes?

Answer 52

Oxandrolone | XANDRO! Lalaking lalaki

Question 53

Androgen antagonist for prostate Ca?

Answer 53

Flutamide (fake androgen - fluta) | Combined with leuprolide to avoid tumor flare up

Question 54

Androgen antagonist used to decrease sexual drive in men due to drugs like pralipexone?

Answer 54

Cyproterone

Question 55

Androgen antagonist DOC for BPH?

Answer 55

Finasteride Five Alpha Reductase Inhibitor FinAsteRIde