ENDO

Question 1

Will present with a low TSH and an elevated free T3/T4.

Answer 1

Hyperthyroidism

Question 2

Cushings

• causes
• on PE
• dx
• tx

Answer 2

Way to much steroid
- ↑ACTH d/t tumor secretion (pituitary or ectopic)
• ↑cortisol d/t adrenal adenoma/carcinoma
• Exogenous steroid use

• PE: centrial obesity, buffalo hump, purple stria on belly, flushed fat face, moon facies, hirsutism
• Dx: Cortisol measurements (free and 24 hour) o rovernight dexaethasasone suppression test (+ is elevated cortisol in am)
• Tx: Surgical resection, discontinue exogenous steroids

Question 3

Pheochromcytoma

- dx

Answer 3

• serum metanephrine or 24 hour urine catecholamine

Question 4

Initial Rx of Hyperkalemia

Answer 4

• symptomatic no EKG changes: glucose and insulin
• EKG changes, Calcium Gluconate
• polystyrene (Kayexalate)… onset takes 24 hours

Question 5

Hyperparathyroidism

• primary lab values
• sx

Answer 5

• Hypercalcemia

- Osteoporosis.
Kidney stones.
Excessive urination.
Abdominal pain.
Tiring easily or weakness.
Depression or forgetfulness.
Bone and joint pain.

Question 6

definitive treatments for hyperthyroidism.

Answer 6

Radioactive iodine ablation (CI in pregnancy) or total thyroidectomy

• rendered hypothyroid and require treatment with levothyroxine.

Question 7

most common cause of hypoparathyroidism

Answer 7

Injury to or removal of the parathyroid gland

Question 8

most likely complication to occur in patients taking MAOIs who also ingest tyramine rich foods such as fermented cheese and smoked meats?

Answer 8

Patients taking MAOIs are unable to breakdown tyramine in foods.

Tyramine is a catecholamine releasing agent; the increase in catecholamines can result in hypertensive crisis.