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Endo Flashcards

1
Q

When epinephrine is released as a counterregulatory hormone to hypoglycemia, what is the MC clinical manifestation?

A

sweating

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2
Q

What are the 2 main physiologic activities for vasopressin (ADH)?

A
  1. conserves water

2. raise BP by causing constriction of the arterioles

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3
Q

What are the 2 main physiologic activities of oxytocin?

A
  1. Milk ejection from breasts

2. stimulates uterine contraction

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4
Q

What effect does somatostatin have on GH?

A

inhibits the release of GH from ant. pit.

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5
Q

How can a pt w/ prolactinoma be treated medically in order to dec. prolactin release?

A

dopamine agonists can suppress prolactin hormone release

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6
Q

What are the 2 main physiological effects of growth hormone in the body?

A
  1. promotes the growth of bone & muscle mass

2. increases blood glucose

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7
Q

What hormone deficiency state is the reason for the majority of adults to present to clinical practice?

A

FSH & LH deficiency

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8
Q

What is the medical therapy for a pt w/ excess GH secretion in a pt who is post-pubertal?

A

somastostatin analog (ex octreotide)

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9
Q

What dopamine agonists are used in the mgmt of prolactinoma?

A

cabergoline & bromocriptine

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10
Q

What hormones are secreted from the various portions of the adrenal gland?

A

Medulla: catecholamines Epi & NE
Zona glomerulosa: mineralocorticoids
Zona fasciculata: glucocorticoids
Zona reticularis: androgens

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11
Q

What is the classic WBC findings in a pt w/ Cushing’s Syndrome?

A

leukocytosis

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12
Q

Where is the MC site of ectopic cortisol pdt’n leading to Cushing’s Syndrome?

A

lung cancer (particularly small cell)

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13
Q

What clinical sign is seen in a pt w/ Addison’s dz that is not in a pt w/ other causes of adrenal insufficiency?

A

hyperpigmentation

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14
Q

What is the main test used in the assessment of a pt suspected of having Addison’s dz?

A

ACTH stimulation test

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15
Q

Name the condition that occurs as a result of hemorrhage into both adrenal glands.

A

Waterhouse-Friderichsen Syndrome

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16
Q

What catecholamine is secreted to the greatest extent in a pt w/ pheochromocytoma?

A

NE > Epi > dopamine

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17
Q

What metabolic effect condition is MCly confused w/ pheochromocytoma?

A

hyperthyroidism

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18
Q

What effect is seen in the thyroid gland in a pt who has struma ovarii?

A

hyperthryoidism

- due to increased secretion b/c these ovarian tumors have ectopic thyroid tissue capable of secreting thyroid hormone

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19
Q

What 2 PE signs will be seen in a pt w/ Graves’ dz vs other causes of hyperthyroidism?

A
  1. pretibial myxedema

2. exophthalmus

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20
Q

What is the most serious SE that occurs in a pt w/ hyperthyroidism that is treated w/ PTU or methimazole?

A

agranulocytosis

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21
Q

For a pt w/ hyperthyroidism who is treated w/ radioactive iodine, what is the average length of time until the pt becomes euthyroid?

A

2-3 mths

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22
Q

What is the classic DTR abnormality that occurs in a pt w/ hypothyroidism?

A

delayed tendon reflex relaxation

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23
Q

What 2 thyroid Abs are ordered in the assessment of Hashimotos’s thyroiditis?

A
  1. thyroid peroxidase

2. antithyroglobulin Abs

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24
Q

What are the 2 MC metabolic effects seen in a pt w/ myxedema coma?

A

hyponatremia & hypoglycema

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25
Q

Name the MC precipitating factor for the development of subacute thyroiditis:

A

preceding URI or other viral syndrome

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26
Q

What is the MC setting for silent (PAINLESS) thyroiditis to occur?

A

post-partum

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27
Q

What are the typical lab findings in a pt w/ silent (PAINLESS) or lymphocytic thyroiditis?

A

sed rate is normal

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28
Q

What is the recommended next step for a pt who has a single firm thyroid nodule but normal thyroid fxn tests?

A

FNA bx

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29
Q

What is the MC type of endocrine malignancy?

A

thyroid cancer

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30
Q

Pts w/ iodine deficiency are at highest risk for the development of what type of thyroid cancer?

A

follicular cancer

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31
Q

What type of thyroid cancer is most difficult to identify via a FNA bx?

A

follicular cancer

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32
Q

What is the MCly identified underlying cause for hyperparathyroidism?

A

parathyroid adenoma (80%)

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33
Q

What are the 2 MC disorders resulting in high bone turnover that results in hypercalcemia?

A
  1. hyperthyroidism

2. immobilization

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34
Q

What eye disorder is visible in a pt w/ long-standing hyperparathyroidism?

A

banded keratopathy

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35
Q

gray ring around the iris that occurs from high calcium levels

A

banded keratopathy

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36
Q

What bone disorders result from chronic hyperparathyroidism?

A

osteopenia & bone cysts (osteitis fibrosa cystica)

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37
Q

What are the 2 MC etiolgies for hypoparathyroidism?

A
  1. iatrogenic

2. Mg deficiency

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38
Q

What PE is MCly seen in a pt w/ familial hypertriglyceridemia?

A

eruptive & palmar xanthomas

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39
Q

What is the optimal LDL goal for a pt who suffered a high risk for coronary artery event or who has coronary artery equivalent?

A

<70 LDL

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40
Q

What is the MCly used fibrate used in clinical medicine?

A

fenofibrate (Tricor)

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41
Q

phenomena due to nocturnal hypoglycemia which results in an increase in the release of counterregulatory hormones usch as Epi which causes rebound hyperglycemia by 7 AM

A

Somogyi phenomena

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42
Q

phenomena in which there is an early AM circadian increase in the plasma glucose that occurs as a result of normal spikes of nocturnal GH

A

Dawn phenomenon

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43
Q

What is the motor abnormality that results when CN III is involved w/ diabetic motor neuropathy?

A

diplopia & ptosis

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44
Q

What is the motor deficit for CN IV & VI?

A

diplopia

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45
Q

What is the most likely underlying condition for necrobiosis lipodica diabeticorum?

A

DM

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46
Q

Glitazones should be avoided in what clinical conditions?

A

liver dz & HF

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47
Q

What class of diabetic meds decrease post prandial blood glucose, decrease glucagon secretion, decreased hepatic glucose pdt’n & decreases food consumption & gastric empyting?

A

Amylins

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48
Q

What is the main synthetic amylin analog that is used in the US?

A

Pramlintide [Symlin]

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49
Q

2 hormones that are released by the post. pit gland

A
  1. vasopressin (ADH)

2. oxytocin

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50
Q

What is the MC infiltrative dz that affects the pit. gland?

A

hemochromatosis

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51
Q

Hypopituitarism caused by pituitary stalk dysfxn that occurs as a result of post-partum hemorrhage or post-partum HoTN is known as:

A

Sheehan’s syndrome

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52
Q

Uterine failure due to overzealous stripping of the uterine cavity during a D&C

A

Asherman’s syndrome

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53
Q

Type of surgical procedure approach MCly done to resect pituitary tumor:

A

transphenoidal approach

54
Q

TOC for pts w/ central diabetes insipidus

A

desmopressin (DDAVP)

55
Q

What electrolyte abnormality is seen in a pt w/ Sarcoidosis?

A

hypercalcemia

56
Q

What test is typically ordered to follow a pt w/ Sarcoidosis?

A

ACE levels

57
Q

TOC for pts w/ Sarcoidosis

A

Corticosteroids

58
Q

Name the MC medication cause of nephrogenic DI

A

Lithium carbonate

59
Q

What is the MC secreted hormone for pts w/ pituitary turmor?

60
Q

What is the initial visual loss that occurs in a pt w/ pituitary tumor?

A

bitemporal hemianopsia

61
Q

Evaluation test of choice for pts w/ suspected pit. tumor

62
Q

Group of meds that may promote prolactin secretion

A

Antipsychotics

63
Q

Pt w/ pit. dysfxn who has coarse facies, HTN, CM, & insulin resistance most likely has excess secretion of what pit. hormone?

A

Growth hormone

64
Q

What is the medication of choice used in the mgmt of Graves’ dz during pregnancy?

A

PTU (proplythiouracil)

65
Q

What anti-thyroid med acts to suppress thyroid hormone release & also decreased peripheral conversion of T4 to T3?

66
Q

What is the MCC of hypothyroidism in the US?

A

Hashimoto’s thyroiditis

67
Q

What is the MCC of hypothyroidism in the world?

A

iodine deficiency

68
Q

How soon should TSH levels be checked after starting thyroid replacement w/ levothyroxine?

A

6-8 wks after starting therapy

69
Q

Name this serious endocrine condition: hypoxia, hyponatremia, hypothermia, & HoTN

A

Myxedema coma

70
Q

What GI tract radiographic abnormality is assoc. w/ hypothyroidism?

A

toxic megacolon

71
Q

initial diagnostic procedure performed in the assessment of thyroid nodule

72
Q

MC type of thyroid cancer

73
Q

Type of cancer that MCly results in ACTH-secreting tumor:

A

small cell lung cancer

74
Q

Screening test for the evaluation of Cushing’s dz:

A

24-h urine cortisol

75
Q

Confirmatory test for proving that a pt has Cushing’s dz:

A

dexamethasone suppression test

76
Q

MCC of primary chronic adrenal insufficiency:

A

Addison’s dz

77
Q

Name the 2 electrolyte abnormalities that are seen in Addison’s dz:

A

low sodium & high potassium

78
Q

normal stimulation for the pdt’n & release of aldosterone

A

hypotension, hypovolemia

79
Q

Screening test used for pheochromocytoma:

A

urinary metanephrines

80
Q

Pts w/ hypertriglyceridemia should be assessed for what two other endocrinopathies

A

hypothyroidism & DM

81
Q

HLA-DR3 & HLA-DR4 are assoc. w/ what endocrine disorder?

82
Q

What formulation of insulin has the quickest onset of activity when injected?

83
Q

What type of insulin lasts 24h, does not have a peak:

A

Lantus (glargine insulin)

84
Q

Known SE is pt take metformin (Glucophage) & is exposed to ionic dyes:

A

lactic acidosis

85
Q

Most severe type of retinopathy that is related to DM & is the leading cause of blindness

A

proliferative

86
Q

Method by which proliferative retinopathy is treated to bring a/b a quiescent state:

A

laser photocoagulation

87
Q

Target level of Hb A1C in pts w/ DM according to the American College of endocrinolgists:

88
Q

Preprandial glucose goals in pts w/ DM:

A

80-120 mg/dl

89
Q

Most important dietary limitation for pts w/ T2DM:

90
Q

Humalog (Lispro) is classified as what type of insulin?

A

very rapid acting

91
Q

Class of medication for metformin (Glucophage)

92
Q

Acarbose (Precose) is classified as what type of diabetic agent?

A

alpha glucosidase inhibitor

93
Q

Adv. for the use of metformin over other agents used in the mgmt of T2DM:

A

promotes wt. loss

94
Q

Name the conditions assoc. w/ CHAOS or Syndrome X:

A 
CHAOS
Coronary heart dz 
HTN
Atherosclerosis
Obesity
Stroke
95
Q

2 meds that are utilized in the mgmt of Syndrome X:

A

Metformin & statins

96
Q

Length of time for the 1/2 life of T4:

97
Q

TOC for myxedema coma:

A

IV levothyroxine (Syntrhoid)

98
Q

A pt w/ proptosis & hyperthyroidism is known to have what specific type of hyperthyroidism?

99
Q

Loss of lateral 1/3rd of eyebrows is classically assoc. w/ what condition?

A

hypothyroidism

100
Q

A pt given an iodine contrast agent who then has an increase in thyroid hormone release w/ resultant hyperthyroidism has a condition that is known as:

A

Jod Basedow phenomena

101
Q

A pt who has thyroid stimulating immunoglobulin that binds to the TSH receptor & acts as a receptor agonist is said to have what dz?

102
Q

What is the main med class that is used in the tx of hyperthyroidism which prevents the peripheral conversion of T4 to T3?

103
Q

MCC of subacute thyroiditis:

A

viral - mumps, coxsackie

104
Q

Antimicrosomal Abs may be seen in what type of thyroid dz?

A

postpartum thyroiditis

105
Q

increased urinary osmolality in comparison to serum osmolality

106
Q

TOC for adrenal crisis

A

IV cortisol

107
Q

Somatostatin (octreotide) is given continuously for what pituitary disorder?

A

Acromegaly

108
Q

What hormone marker is MCly used to identify a female’s perimenopausal state?

A

increased FSH

109
Q

What sensory defect will pts w/ Kallman’s sydnrome have?

A

lack of smell

110
Q

In addition to increased serum calcium levels, what other lab abnormality will be seen in a pt w/ Paget’s dz?

A

Increased serum alkaline phosphatase

111
Q

2 MC tx modalities for acute hypercalcemia:

A

IV NS for fluid expansion followed by Lasix & IV infusion of bisphosphonates

112
Q

T score is MCly used in the assessment of what condition

A

Osteoporosis

113
Q

Adv to the use of calcitonin in the mgmt of osteoporosis:

A

analgesic effects

114
Q

Category of med for raloxifene (Evista)

A

SERM (selective estrogen receptor modulator)

115
Q

Hormonally-related problem that may worsen when a pt takes raloxifene:

A

increase in hot flashes

116
Q

TOC for pts w/ Paget’s dz

A

bisphosphonate

117
Q

Serious complication that may be assoc. w/ long-standing Paget’s dz: s

A

osteogenic sarcoma

118
Q

What emd is commonly prescribed to pts who are taking INH in order to prevent peripheral neuropathy?

A

Vit. B6 - pyridoxine

119
Q

Cretinism is due to the lack of:

A

Thyroid hormone

120
Q

70/.30 insulin administration typically consists of what type component of insulin?

A

70% NPH & 30% regular

121
Q

MCC of treduced total serum calcium:

A

hypoalbuminemia

122
Q

MCC of non-caseating granuloma in the lung in a young AAF

A

Sarcoidosis

123
Q

Give the lab presentation for subclinical hypothyroidism:

A

TSH elevated w/ a normal T4 level

124
Q

3 tx that are used for hyperthyroidism

A
  1. surgery
  2. antithyroid meds
  3. radioactive iodine
125
Q

Name 3 meds that are assoc. w/ thyroid dysfxn

A
  1. amiodarone
  2. lithium
  3. iodine
126
Q

What is the preferred tx for an elderly person w/ hyperthyroidism?

A

radioactive iodine

127
Q

what is the cornerstone of therapy for the tx of T2DM?

A

lifestyle modifications

128
Q

in a normal risked individual w/o sx, what is the MCly used age to screen for DM?

129
Q

What hormone will be released in a pt who has acute decreased Mg levels?

A

parathyroid hormone

130
Q

what single grp of pts is at highest risk for the development of hyperparathyroidism?

A

elderly females

131
Q

What is the MC renal complication of primary hyperparathyroidism?

A

renal calculi

132
Q

What is the name of the bone complication seen in primary hyperparathyroidism?

A

osteitis fibrosa cystica

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