EM - Endocrine Flashcards
etiology of addisons disease
autoimmune
MC autoantigen in addisons disease
21-hydroxylase
result of different deficiencies in addison’s disease
-21 hydroxylase: decreased cortisol and aldosterone and increased androgen
-CYP11A1: decreased cortisol and testosterone and increased aldosterone
-12-alpha-hydroxylase: decreased aldosterone and testosterone and increased cortisol
s/s of addisons disease
-hyperpigmentation
-anorexia
-weight loss
-fatigue
-abdominal pain
-hypotension
-change in body hair
s/s of adrenal crisis
-severe fever
-abdominal pain with n/v
-hypotensive shock
diagnosis of addison’s disease
-ACTH stimulation test
-8am plasma cortisol <3
treatment of addison’s disease
hydrocortisone
etiology of cushing’s syndrome
-exogenous cortisol
-ectopic secretion of ACTH or CRH
s/s of cushing’s syndrome
-weight gain
-buffalo hump
-striae
-menstrual irregularities
Diagnosis of Cushing’s Syndrome
-24 hour urine free cortisol
-dexamethasone suppression
-late night salivary cortisol
treatment of cushing’s syndrome
-titrate down dose
-surgical removal of tumor
etiology of diabetes insipidus
-primary: increased secretion of ADH (I thought it was Lack of ADH??)
-secondary: damage to the hypothalamus or pituitary stalk
-nephrogenic: defect in kidneys
s/s of diabetes insipidus
-thirst
-polyuria
diagnosis of diabetes insipidus
-24 hour urine collection
-water deprivation followed by vasopressin challenge test
interpretation of vasopressin challenge test
-central: decrease in thirst and polyuria
-psychogenic: improves after patient stops drinking water
-nephrogenic: thirst and polyuria doesn’t improve
treatment of diabetes insipidus
Desmopressin
Diagnosis of Diabetes
FPG >126
2h PPG >200
A1c >6.5% (7?)
etiology of diabetic ketoacidosis
-insulin deficiency
-triggered by illness, trauma, pregnancy etc.
s/s of diabetic ketoacidosis
-n/v
-abdominal pain
-fruity breath
-kussmaul respirations
diagnosis of DKA
-elevated glucose (>250?or is it 5 hundo)
-low bicarb (<7.3, <15bicarb?)
-B-hydroxybutyrate
(Anion Gap?)
management of DKA
-fluid repletion
-insulin
-potassium
etiology of primary hyperparathyroidism
-adenoma
s/s of primary hyperparathyroidism
-hypercalcemia
-often asymptomatic
-“getting old” sx
diagnosis of primary hyperparathyroidism
-elevation of PTH
-24 hour urine calcium
-low phosphate
treatment of primary hyperparathyroidism
-parathyroidectomy
-sensispar
etiology of secondary hyperparathyroidism
CKD
s/s of secondary hyperparathyroidism
-hypocalcemia
-elevated phosphorus
treatment of secondary hyperparathyroidism
Tx CKD
etiology of hypothyroidism
-US: hoshimotos
-worldwide: iodine deficiency
s/s of hypothyroidism
-dry skin
-weight gain
-cold intolerance
-constipation
diagnosis of hypothyroidism
-low T4, high TSH
-anti-TPO
s/s of myxedema crisis
-hypothermia
-hypoventilation
-hyponatremia
-hypoglycemia
-hypotension
From sever hypothyroidism :( </3
treatment of hypothyroidism
levothyroxine
etiology of hyperthyroidism
-graves disease
-excess iodine
s/s of hyperthyroidism
-tachycardia
-weight loss
-heat intolerance
-bulging eyes
diagnosis of hyperthyroidism
-Low TSH, high T3 and T4
-anti-TSI
-radioactive iodine uptake scan
treatment of hyperthyroidism
-methimazole
-PTU
-radioactive iodine destruction
-surgery
etiology of hyperglycemic hyperosmolar state (HHS)
-relative insulin deficiency
s/s of HHS
-extreme dehydration
-thirst
-lethargy
-mental confusion
-hypotension
diagnosis of HHS
-BS 600-1200
-pre-renal azotemia
treatment of HHS
-fluid repletion
-insulin
-potassium
etiology of subacute thyroiditis
-viral URI
etiology of suppurative thyroiditis
nonviral thyroid gland infection
etiology of riedel thyroiditis
-systemic fibrosis
treatment of subacute thyroiditis
ASA or NSAIDs
treatment of suppurative thyroiditis
ABX ( I think a PEN)
treatment of riedel thyroiditis
tamoxifen
Ah geez typo uhhhh sawy
occurs in an attempt to maintain a specific posture or position against the force of gravity
simple kinetic tremor
during voluntary movements that are not target directed
action postural tremor
occurs in an attempt to maintain a specific posture or position against the force of gravity
intentional tremor
worsens as the body part approaches its target
task specific tremor
-occurs during a specific task (derrr)
action isometric tremor
-occurs during a muscle contraction against a rigid stationary object
s/s of essential tremor
-bilateral
-hands and arms
-goal oriented movements
-resolves with rest
-exacerbated by emotion, hunger, fatigue
-improves with alcohol
-progressive overtime
diagnostic criteria of essential tremor
-isolated tremor consisting of bilateral upper limb action
-at least 3 years in duration
-with or without tremor in other locations
-absence of other neurologic signs
management of essential tremor
Propranolol and primidone
