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1
Q

AE of sulfonyurea

A

Hypoglycemia

24 hour long

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2
Q

Which hypoglycemic drug is CI in heart failure

Why

A

TZD’s = cause fluid retention
Rosiglitazone
Pioglitazone

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3
Q

AEs of Rosiglitazone

A

Increased LDL

Increased risk of MI

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4
Q

Which hypoglycemic agent causes weight gain

A

TZDs

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5
Q

Which hypoglycemic drugs cause hypoglycemia

A

Sulfonyurea

Meglitinides

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6
Q

What are Kussmaul’s respirations

A

Blow off CO2 to compensate for acidosis

Slow deep breathing

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7
Q

How to differentiate DKA and HHNK

A

HHNK

  1. Serum glucose > 800
  2. No acidosis
  3. No ketones

DKA

  1. Serum glucose 300-800
  2. Acidosis
  3. Ketones
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8
Q

DX for Diabetic Gastroparesis

A

Gastric emptying study

Pt swallows barium, watch w fluoroscopy to see if emptying into duodenum is present. If not, then we have DX

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9
Q

TX for Diabetic Gastroparesis

A

Increase gastric motility
Cisapride
Erythromycin
Metoclopramide = DOC

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10
Q

CI of Cisapride

A

P450 so CI with
Macrolides
Antifungals
Phenothiazines - chlorpromazine

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11
Q

TX of choice for insulinoma

A

Surgical Resection

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12
Q

If can’t do surgery for insulinoma, TX

A

Diaoxipide

Octreotide

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13
Q

Hypoglycemia - Iatrogenic Labs

A

High insulin

Normal C-peptide

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14
Q

Hypoglycemia - Insulinoma labs

A

High insulin

High C-peptide

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15
Q

Pathophys of Grave’s

A

AI

Autoabs to TSI

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16
Q

Increased TBG seen in?

A

Pregnancy

OCPs

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17
Q

Decreased TBG in ?

A

Nephrotic syndrome

Androgen use

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18
Q

Toxic adenoma/multinodular TX

A

Same as Grave’s
Methimazole, PTU
RAI

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19
Q

Subacute thyroiditis

DeQuervian’s

A

Painful goiter

Decreased uptake on scan

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20
Q

Indications for digoxin

Why

A

Heart failure
A fib

Improves contractility
Slows down conduction of heart

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21
Q

Avoid what in thyroid storm

A

ASA

Interferes with TBG

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22
Q

Hashimoto’s assn’s

A

Depression = hypothyroidism

Lymphoma

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23
Q

Abs in Hashimoto’s

A

Anti-TPO (Thyroid Peroxidase )
Anti-microsomal
Anti-thyroglobulin

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24
Q

Hyperthyroidism followed by hypothyroidism DDX

Differentiate?

A

DeQuervian’s
Hashimoto’s

DeQuervian - painful goiter
Hashimoto’s - painless goiter

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25
Most Common thyroid cancer
Papillary | Good prognosis
26
Most malignant thyroid cancer
Anaplastic
27
Medullary cancer presentation
Produces calcitonin | MEN IIa and IIb assn's
28
Unexplained hyperlipidemia?
Hypothyroidism
29
Unexplained Hyponatremia
Hyperthyroidism
30
Unexplained High CPK
Hyperthyroidism
31
What is Jod Basedow Phenomenom
Hyperthyroidism from Iodine, i.e. contrast from scan
32
TX for proliferative diabetic retinopathy
Laser Photocoagulation
33
TX for diabetic peripheral neuropathy
Gabapentin Pregabalin Duloxetine
34
MCC Hyperparathyroidism
Parathyroid Adenoma | Parathyroid Hyperplasia
35
MCC of Pancreatitis (4)
Alcoholism Gallstones Hypertriglyceridemia Hypercalcemia
36
Renal induced hypoparathyroidism labs
High PTH High PO4 Low Ca
37
Pseudohypoparathyroidism labs
High PTH High PO4 Low Ca
38
Differentiate bt Renal induced hypoparathyroidism and Pseudohypoparathyroidism
BUN/Cr high in renal failure | Signs of uremia
39
High PAC: Low PRA
Conn's syndrome
40
High PAC: Low PRA
Secondary hyperaldosteronemia
41
Low PAC: LOW PRA
Cushing's Syndrome | Chronic Licorice
42
Presentation of biliary colic
Severe epigastric pain exacerbated by fatty meals Can defer to right shoulder pain No fever No leukocytosis
43
Pathophys of biliary colic
Fatty meal causes GB contraction, which presses gallstones against cystic duct opening, increasing pressure within GB and causing distension and colicky pain
44
Presentation of unstable placental abruption and management
CTX + bleeding + pain Unstable if low BP, tachycardia, continued bleeding Emergency C section
45
What is COPD compliance
Increased due to loss of alveolar and elastic tissue
46
What is increased in COPD
Increased TLC, FRC, RV lead to hyperinflation and diaphragmatic flattening
47
What does flattening of diaphragm cause in COPD
Increases work of breathing due to increased difficulty in decreasing intrathoracic pressure during inhalation
48
Intraventricular hemorrhage Presentation
``` Premature, Esp <1500g (3.3 lb) Underweight neonates Decreased tone Decreased movements Seizures Rapidly increasing head circumference Tense fontanels ```
49
Pathophys of intraventricular hemorrhage
Blood accumulates in subarachnoid space - impairs arachnoid villi from absorbing CSF -> Communicating hydrocephalus
50
Presentation of infantile milk protein allergy
``` Blood-streaked stools Painless rectal bleeding Non-projectile emesis Only in infants Resolves by 1 you ```
51
What is Diamond-Blackfan anemia
Congenital pure RBC aplasia Presents in 1st 3 months Pallor + poor feeding
52
MCC painless hemotochezia in young toddler
Meckel's diverticulum
53
Intussusception Presentation WU
``` Severe, intermittent abdominal pain Possible hemotochezia WU Abdominal US Air enema ```
54
Indications for surgery of umbilical hernia
``` Persists to 3-4 yoa Exceeds 2 cm diameter Symptomatic Strangulation Progressively enlarges after 1-2 you ```
55
MCC of AR in young adults in developed countries | Developing?
Congenital bicuspid aortic valve | Rheumatic fever
56
Murmur of ASD
Wide fixed split S2 | Ejection systolic murmur heard best over left 2nd IC space
57
HOCM murmur
Harsh crescendo-decresendo systolic murmur heard best at apex and Left lower sternal border
58
WU of VSD
EKG | Echo
59
WU Of ASCUS
``` 21-24 Yoa - Repeat cytology in 1 year > 25 yoa 1. HPV DNA test 2. If positive -> Colposcopy If negative -> Repeat pap and HPV in 3 years ```
60
What is Carboxyhemoglobinemia
CO posioning
61
EPO in OSA
increased due to hypoxemia sensed by kidneys which increase EPO
62
Renal calculi dietary recommendations
Decrease: Protein Oxalate Sodium Increase Fluid intake Dietary Calcium
63
SVC syndrome WU
CXR | Malignancy is the MCC

DIT (3 decks)

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