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USMLE STEP 2 CK RETAKE > Endicrinology > Flashcards

Endicrinology Flashcards

1
Q

Prolactinoma Presentation

A

Female- Amenorrhea, Galctorrhea, Microadenoma

Male-Decreased libido, Macroadenoma visual field changes

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2
Q

Pralctinoma Dx

A

Medications
TSH
Prolactin
MRI to find tumor

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3
Q

Prolactinoma Treatment

A

Dopamine Agonists

Carbegoline>Bromocriptine

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4
Q

Acromegaly Presenation

A 
kids-gigantism 
Adults-Hands, Feet, Face]visceral organs
diabetes, Diastolic HF 
Dx: ILGF-1
Glucose Supression Test 
Tx: Surgery 
Octreotide
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5
Q

Hypopituitarism Acute Causes

A

Infection, Infarction, Iatrogenic

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6
Q

Hypopituitarism Acute Presentation

A 
Cortisol-Hypotensive, Tachycardia
TSH-Lethargy, Coma 
Dx: Cortisol
T4
Tx: Replace hormones
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7
Q

Diabetes Insipidus Presentation

A

Polydipsia, Polyuria, Normal glucose, no glucose in the urine
Dx: H2O Deprivation test
Tx: PP- stop drinking water
Central- DDAVP
Nephrogenic-Gentle Diuresis, HCTZ, Amiloride

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8
Q

H20 Deprivation Results

A

increase uOSM=PP
Give ADH-uOSM and it corrects means central
Give ADH with no change means nephrogenic

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9
Q

SIADH Presentation

A 
Pt: Hyponatremia 
Dx: U/A-
uNa increased 
increase uOsm
sOsm decreased 
Tx: Water Restriction 
Demeclocycline
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10
Q

Hyperthyroidism Presentation

A

Tachycardia, Diarrhea, Heat intolerance, increased DTR, Weight loss, A-Fib
Dx: TSH decreased
Free T4 increased
Tx: Surgery
Radioactive iodine ablation for everything else

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11
Q

Hypothyroidism Presentation

A 
Bradycardia 
Constipation
decreased DTR 
Weight gain 
Dx: TSH increased 
T4 Decreased 
RAIU
Tx: Levothyroxine
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12
Q

Treatment for thyroid storm

A
  1. Propanolol
  2. PTU/methimazole
  3. Steroids
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13
Q

Thyroid Nodule history risk of cancer

A

Hx of radiation to the head and neck
H/O of cancer or cancer in the family
Hoarseness
Age, <20, >60

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14
Q

Thyroid nodule Physical exam for risk of cancer

A

Fixed, Firm, Hard, Non-tender Lymph nodes
U/S: Solid, Hypoechoic, Size >2cm
Microcalcifications, irregular borders

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15
Q

Thyroid nodule <1 cm

A

Repeat U/S in 6-12 months

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16
Q

Thyroid Nodule >1 cm

A

FNA

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17
Q

FNA findings thyroid

A

CA- Resection
Not CA- Repeat U/S 6-12 months
Inconclusive-repeat FNA

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18
Q

Paipillary CA description

A

Most common
Orphan Annie Nuclei
Ts: Resection

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19
Q

Follicular CA description

A

FNA shows normal thyroid
hematogenous spread
Tx: Radioactive iodine ablation

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20
Q

Medullary CA description

A

C-cells, Calcitonin
Associated with MEN 2A 2B
RET oncogene and pheochromocytoma

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21
Q

Anaplastic CA description

A

affects the elderly

Locally invasive usually fatal

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22
Q

Cushing Syndrome Presentation

A

HTN, Diabetes, Obesity,

Acne (Moon Facies), Truncal obesity, Buffalo Hump, Purple Striae

23
Q

Cushing Sydrome Diagnostic tests

A

Low dose dexamethasone suppression-if cushings should fail to suppress cortisol THEN
check ACTH level
if low then do high dose dexa suppression

24
Q

Cushing Syndrome ACTH normal

A

primary adrenal tumor

MRI Resection

25
Q

Cushing Syndrome ACTH elevated

A

ACTH dependent THEN
High dose dexamethasone
Fails-Ectopic tumor
Suppressed-Cushing disease from pituitary tumor -resection

26
Q

if you get the low dose dexamethsone test what other tests should you get?

A

24 hour urine cortisol or
late night salivary cortisol
you need two tests to says cushing syndrome

27
Q

Addisons disease Acute Presentation

A

Nausea, Vomiting, Hypotension, Coma - At deaths door

28
Q

Addisons disease Chronic presentation

A

Orthostatic, Hyperpigmentation, decreased Na and increased potassium

29
Q

Addisons disease Diagnostic tests

A
  1. Early AM cortisol
  2. Cosyntropin Stimulation
    (Give ACTH)
30
Q

Consyntropin Stim Test increases Cortisol, Addisons disease

A

Anterior Pituitary problem
MRI
Replace Cortisol

31
Q

Cosyntropin Stim Test No change in cortisol, addisons

A

Adrenal Gland
CT/MRI
Cortisol & Fludrocortisone

32
Q

Conn Syndrome Presentation

A

HTN, Hypokalemia

secondary hypertension-to 3 or more medications

33
Q

Conn Syndrome aldosterone:renin=>30
Aldosterone increased
Renin Decreased

A

Conns
do salt suppression test
doesnt suppress perfomr MRI
perform adrenal vein sampling

34
Q

Conn syndrome
Increased aldosterone
Increased Renin
Ratio <10

A

Renal vascular disease
FMD-Stent
AS-no stent

35
Q

Pheochromocytoma Presentation

A

Paroxysmal pain-HA
Pressure-HTN
Palpitations-HTN
Perspiration

36
Q

Pheochromocytoma diagnostic tests

A

Plasma free catecholamines
24 hr urine metanephrines, VMA
CT/MRI Abd
Adrenal vein sampling

37
Q

Pheochromocytoma Treatment

A

first Alpha blockade
then Beta blockade
Then resect

38
Q

Diabetes screening Random BG

A

one time plus symptoms

>200

39
Q

Diabetes screening Fasting BG

A

two times
>125=DM
100-125=pre diabetes
<100= normal

40
Q

Diabetes screening HbA1c

A

> 6.5=DM
5.7-6.5=Pred diabetes
<5.7=Normal

41
Q

Contraindications for metformin

A

CKD, CHF, Liver disease

42
Q

Biguanides-Metformin AE

A

Diarrhea

43
Q

Sulfonylureas-glipizides/glyburide AE

A

Hypoglycemia

44
Q

TZD-glitazone AE

A

CHF, weight gain

45
Q

DDP4i-gliptins

A

Weight neutral

46
Q

glp1-utides

A

weight loss

47
Q

a-glucosidase-acarbose

A

diarrhea, flatulence

48
Q

SGLT2i-gliflozins

A

euglycemia, DKA

49
Q

hypoglycemia in non-diabetic

A

check C-peptide

decreased=injecting-factitous

50
Q

increased C-peptide in non-diabetic, hypoglycemia

A 
secretagogue screen 
positive-ingesting
negative-insulinoma
72 hr fast 
CT/MRI/Abd
51
Q

Diabetic with hypoglycemia Treatment

A

Awake-PO Glucose

Come- IV D50

52
Q

DKA presentation

A 
too much sugar 
Diabetes, Coma, Ketones, Acidosis 
Dx: BG>300-500
U/A-Ketones 
ABG:Acidosis 
BMP: GAP,K
53
Q

DKA Treatment

A

Glucose: 10u IV insulin
GAP: NS/LR BMP -When BG normalizes gap is open give D5 1/2 normal
Potassium: check potassium is >4 before insulin and replace when is low

USMLE STEP 2 CK RETAKE (15 decks)

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