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Uworld Step 2 > Block 70,71: Endocrine > Flashcards

Block 70,71: Endocrine Flashcards

1
Q

chronic weakness, weight loss, hyponatremia, hyperkalemia with low-normal cortisol level

A

primary adrenal insufficiency (addison disease)

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2
Q

initial evaluation for Addison disease

A

8 AM serum cortisol
plasma ACTH

ACTH stimulation test is faster (cosyntropin test)

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3
Q

Lab values for Eurthroid sick syndrome

A

Low in total and free T3 levels

normal T4 and TSH

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4
Q

Riedel’s (fibrous) thyroiditits

A

inflammatory disorder

- fibrosclerosis of thyroid and non thyroid structures

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5
Q

patient has UTI that is treated. comes back days later and has dark urine. with urine sample stains positive with Prussian blue

A

glucose-6-phosphate dehydrogenase deficiency

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6
Q

a positive Prussian blue stain indicates what in urine

A

hemosiderin

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7
Q

Heinz bodies

A

G6PD

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8
Q

Most common cause of primary adrenal insufficiency in developed countires

A

autoimmune adrenalitis

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9
Q

what is the difference between primary adrenal insufficiency and central adrenal insufficiency

A

PAI: hyperpigmentation and hyperkalemia

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10
Q

Difference between follicular thyroid cancer and benign follicular adenomas

A

FTCL invasion of tumor capsule and/or blood vessels. Hematogenous spread to distant tissues

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11
Q

hyperosmolar hyperglycemic state in type 2 diabetes mellitus

A

severe hyperglycemia and hyperosmolality

altered sensorium

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12
Q

characterize corticosteroid-induced psychosis

A

delusions, hallucinations

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13
Q

weight loss, tachycardia with proptosis and impaired extraocular motion

A

graves ophthalmopathy

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14
Q

Graves disease

A

TSH receptor antibody

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15
Q

what causes Graves ophthalmopathy

A

T cell activation and stimulation of orbital fibroblasts by TSH receptor autoantibdoies

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16
Q

Type 1 multiple endocrine neoplasia

A
  • primary hyperparathyroidsim
  • pituitary tumors
  • GI/pancreatic endocrime tumors
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17
Q

glucagonoma

A

hyperglycemia
necrolyic migratory erythema
weight loss
anemia

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18
Q

cause of hypocalcemia in alcoholics ? explain phosphorus levels

A

hypomagnesemia

- decreases PTH release, but Phosphorus levels are not elevated

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19
Q

what causes graves Ophthalmopathy

A

activated t cells and thyrotropin receptor antibodies on TSH receptors

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20
Q

what treatment can worsen graves ophthalmopathy

A

radioactive treatment

- raise thyrotropin receptor antibodies

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21
Q

treatment for macroprolactinoma ( 1cm greater) or symptomatic prolactinoma

A

Dopaminergic agonists

Cabergoline, bromocriptine

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22
Q

presenting signs of glucagonoma

A
  • mild diabetes or hyperglycemia

- necrotic migratory erythema

23
Q

most beneficial therapy to reduce progression of diabetic nephropathy is

A

blood pressure control

130/80 goal

24
Q

what percent is normal saline

A

.9%

25
Q

oral estrogen preparations increase levels of what? what happens when you are on thyroid replacement

A

thyroxine-binding globulin

- higher dose of thyroid

26
Q

acute thyrotoxicosis with mild thyroid gland enlargement and suppressed TSH

A

painless thyroiditis

27
Q

thyroid scintigraphy for painless thyroiditis shows

A

decreased radioiodine uptake

28
Q

Is thyroid enlarged in struma ovarii

A

no

29
Q

is thyroid enlarged in painless thyroiditis

A

yes

30
Q

pseudodemantia

A

major depression in elderly

31
Q

hoarsness if throat is a sign of

A

hypothyroidism

32
Q

hypothyroidism can cause reversible changes in

A

memory and mentation

33
Q

high volume blood transfusion can cause what

A

symptomatic hypocalcemia due to chelation of ionized calcium by citrate in transfused blood
- increase risk with hepatic function impaired due to decrease clearance of citrate by liver

34
Q

what is and when does carpal spasm ( trousseau sign)

A

hypocalcemia

- flexed wrist with abduction of thumb

35
Q

next step in determining hypocalcemia

A

check PTH then vitamin D

36
Q

easy bruisability, hyperpigmentation, hyperandrogenism

A

cushing

37
Q

Potassium level for mild primary hyperaldosteronism, especially if on diuretic

A

hypoK

38
Q

when do you not give metformin for type 2 initially

A

renal insufficiency

39
Q

side effect of GLP-1

A

weight loss and lower hypoglycemia risk

40
Q

hypocalcemia, hyperphosphatemia, and increased PTH characteristic of

A

secondary hyperPTH in chronic renal failure

41
Q

somes symptoms of hyperosmolar hyperglycemic state

A

neurologic symptoms ( blurry vision, lethargy)

42
Q

what trigger thyroid storm

A 
non-thyroid surgery 
trauma
infection
iodine contrast
childbrith
43
Q

tachycardia, hypertension, cardiac arrhthmias, high fever, tremor , altered mentation, lid lag

A

thyroid storm

44
Q

estrogen increases the levels of what for thyroid

A

T4- binding globulin

Euthroid state for normal people, b/c thyroid increases production to keep up with globulin

45
Q

when do you screen for diabetes

A
  • blood pressure 135/ 80 and greater

- 45 and over

46
Q

what tests do you use to screen for diabets

A
  • fasting plasma glucose
  • 2-hour oral glucose tolerane test
  • Hemoglobin A1c
47
Q

Name aldosterone antagonists

A

Spironolactone

Elperenone

48
Q

What is typical for patients with central-type obesity and is the key to devleopment of type 2, hypertension, dyslipidiemia

A

insulin resistance

49
Q

initial step in hyperosmolar hyperglycemic state

A

normal saline

50
Q

how does hypoalbuminemia change electorlytes

A

decrease total serum calcium

ionized calcium remains stable

51
Q

who makes vasoactive intestinal peptide (VIP)

A

pancreatic cells

52
Q

Biggest symtpoms for VIPoma

A

watery diarrhea

hypokalemia

53
Q

fever and sore throat is any patient taking antithyroid drug suggests

A

agranulocytosis

54
Q

Methimazole

A

anti- thyroid drug

Uworld Step 2 (30 decks)

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