Deck 73: Endocrine Flashcards
3 treatment options for Graves
Anti-thyroid drugs
radioactive iodine therapy
thyroidectomy
Patient with sore throat and fever taking Methimazole?
agranulocytosis
stop drug
name 2 antithyroid drugs
propylthiouracil
Methimazole
black box warning for propylthiouracil
severe liver injury
what do you give first trimester pregnancy when patient is hyperthyroid
Propylthiouracil
insulin is made from what cells
beta-cells
hypothyroidism can cause what metabolic abnormalities? what some metabolic conditions these patients have
- hyperlipidemia
- hyponatremia
- asymptomatic Cr and serum transaminases increase
- hypercholestrolemia
- hypertriglyceridemia
initial screening test for primary hyperaldosteronism? confirmatory test
plasma aldosterone/ plasma rennin
Adrenal suppression
most sensitive test for adrenal adenoma vs. bilateral adrenal hyperplasia in patients without discrete unilateral adrenal mass on imaging
adrenal venous sampling
first line treatment for central Diabetes insipidus
Desmopressin (intranasal)
what distinguishes central and nephrogenic diabetes
water deprivation and then give desmopressin
central: increase urine osmolality
Treatment for polycystic ovary syndrome
weight loss oral contraceptive ( estrogen and progestin)
Best markers for indicating resolution of DKA are
- serum anion gap
- beta-hydroxybutyrate levels
who should always receive a statin regardless
diabetic age 40-75
what is A1c level with adequately controlled diabetes
less than 7.0
fever, neck pain, and a tender goiter following an upper respiratory illness
subacute ( de Quervain ) thyroiditis
treatment for subacute (de Quervain) thyroiditis
symptomatic with beta blockers and NSAIDS
weight gain, psychiatric symptoms, hirsutism, hypertension and hyperglyciemia
cushing
what causes milk-alkali syndrome
excessive intake of calcium and absorbable alkali
in hyperthyroidism increased radioactive iodine uptake suggests
de novo thyroid hormone synthesis
in hyperthyroidism, decreased radioactive iodine uptake suggests
release of preformed hormone or exogenous hormone intake
thyrotoxicosis due to exogenous thyroid hormone is characterized by
low serum thyroglobulin levels
most common cause of neuropathic ulcers
diabetes
treatment for primary hyperparathyroidism who present with symptoms or have increased risk of complication
parathyroidectomy
Anorexia, nausea, vomiting, early satiety, postprandial fullness, and impaired glycemic control
diabetic gastroparesis
treatment for diabetic gastroparesis
Prokinetic agents
metoclopramide, erythromycin, cisapride
how does carcinoid tumor cause of vitamin deficiency
- increases production of serotonin from tryptophan ( required for niacin)
what drug is used to prevent diabetic nephropathy
ACE inhibitors
what is used to predict the risk of future ulcers in diabeteics
monofilament testing
fine-needle aspiration biopsy of thyroid shows
large cells with ground glass cytoplasm, pale nuclei contaning inclusion bodies and central grooving consistent with papillary thyroid cancer
papillary thyroid cancer
primary treatment for papillary thyroid carcinoma
surgical resection
level of dehydroepiandrosterone sulfate levels in androgen-producing adrenal tumors
elevated
hypertension, mild hypernatremia, metabolic alkalosis, and suppressed plasma renin activity
primary hyperaldosteronism
proximal muscle weaknes in setting of hyperthyroidism
chronic hyperthyroid myopathy
calcitonin-producing tumors of thyroid parafollicular C cells
medullary thyroid cancer
what should you suspect with medullary thyroid cancer
MEN 2A and B
- pheochromocytoma
lab test ordere for rapidly developing hyperandrogensism in female
testosterone and DHEAS
normal DHEAS: normal ovarian source
elevated DHEAS: adrenal source
tight blood glucose control in patients with diabetes decreases the risk of
microvascular complications
tight blood glucose control in patients with diabetes increases the risk of
hypoglycemia
all-cause mortality
untreated hyperthyroid patients are at risk for
rapid bone loss
cardiac tachyarrhythmias
a. fib
MEN2B
medullary thyroid cancer
pheochromocytoma
marfanoid habitus
mucosal neuromas
MEN2A: add primary hyperparathyroidism
systolic hypertension in thyrotoxicosis is caused by
increased Myocardial contractility and heart rate
difference between thyroid storm and pheochromocytomas
thyroid: temperature
pheochromocytoma: more severe hypertension
Hyperthyroidism from toxic adenoma is due to
autonomous production of thyroid hormones
