1.2 Endocrinology Flashcards
drugs that raise prolactin level
- antipsychotic medications
- tricyclic antidepressants
- methlydopa
- verapamil
- opioids
- metoclopramide
drugs that can cause gynecomastia
- spironolactone
- opiates
- oral ketoconazol
- estrogen
what are the 3 main causes of hyper parathyroidism
- solitary adenoma
- hyperplasia of all 4 glands
- parathyroid malignancy
how do you treat hypercalcemia from sarcoidosis or any other granulomatoues disease?
prednisone
what are the indications for removal of the parathyroid glands?
- bone disease
- renal involvement (Even stones)
- age <50
- calcium consistently >1 pt above normal
EKG in calcium disorders
hypercalcemia: short QT
hypocalcemia: prolonged QT
Cushing Syndrome vs Cushing Disease
Syndrome = hypercortisolism
Disease = pituitary overproduction of ACTH
🚩 “I feel weak and tired and I notice hair growth and strange marks on my stomach”
hypercortisolism!
evaluation of adrenal incidentaloma?
- metanephrines of blood urine to excluse pheochromocytoma
- renin and aldosterone levels to exclude hyperaldosteronism
- 1 mg overnight dexamethasone suppression test
what drug should the patient recieve before being operated for pheochromocytoma?
phenoxybenzamine (alpha blocker)
causes of primary hyperaldosteronism?
- solitary adenoma (80%)
- bilateral hyperplasia
- malignancy
🚩 high BP + hypokalemia
primary hyperaldosteronism
🚩 aldosterone/renin 20:1
aldosterone >15
hyperaldosteronism
🚩 hypoglycemia + high insulin level
insulinoma
MEN 1
parathyroid
anterior pituitary
pancreatic islets
MEN 2A
parathyroid
medullary thyroid
pheochromocytoma
MEN 2B
mucosal neuroma
mudellary thyroid
pheochromocytoma
marfanoid
tests that should be sent to a patient with suspected virilization, hirsutism and irregular emnstrual periods
prolactin
DHEA, testosterone
FSH/LH
17-hydroxyprogesterone
diagnostic criteria for PCOS
- clinical hirsutism OR high testosterone/DHEA
- irregular menstruation
- 10 cysts on pelvic sonogram wiht enlarged ovary (>10cm)
only 2/3 needed to diagnose
in what patients is metformin contraindicated
renal dysfunction
accumulates and causes metabolic acidosis
what diseases cause nephrogenic DI
- chronic pyelonephritis
- amyloidosis
- myeloma
- sickle cell disease
- hypercalcemia
- hypokalemia
what effect does dopamine have on growth hormone?
INHIBITS!
Pegvisomant
GH receptor antagonist
inhibitis IGF release from liver
acromegaly
hypercalcemia 💡
cancer
primary hyperparathyroidism
what effect does calcium have on gastrin?
STIMULATES
Cinacalcet
inhibits release of PTH
primary hyperparathyroidism
what effect does albumin have on calcium?
every point decrease in albumin, the calcium level decreases by 0.8
pasireotide
somatostatin analog
hypercortisolism post surgery
mitotane
inhibitorof steroidogenesis
cytotoxic to adrenal tissue
adrenal metastic mass non-operable in hypercortisolism
cosyntrhopin
synthetic ACTH
used in: Cosynthropin Stimulation Test (hypoadrenalism)
in what patients are thiazolidinediones contraindicated
CHF
fluid overload
