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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
Name the MC precipitating factor for the development of subacute thyroiditis:
preceding URI or other viral syndrome
26
What is the MC setting for silent (PAINLESS) thyroiditis to occur?
post-partum
27
What are the typical lab findings in a pt w/ silent (PAINLESS) or lymphocytic thyroiditis?
sed rate is normal
28
What is the recommended next step for a pt who has a single firm thyroid nodule but normal thyroid fxn tests?
FNA bx
29
What is the MC type of endocrine malignancy?
thyroid cancer
30
Pts w/ iodine deficiency are at highest risk for the development of what type of thyroid cancer?
follicular cancer
31
What type of thyroid cancer is most difficult to identify via a FNA bx?
follicular cancer
32
What is the MCly identified underlying cause for hyperparathyroidism?
parathyroid adenoma (80%)
33
What are the 2 MC disorders resulting in high bone turnover that results in hypercalcemia?
1. hyperthyroidism | 2. immobilization
34
What eye disorder is visible in a pt w/ long-standing hyperparathyroidism?
banded keratopathy
35
gray ring around the iris that occurs from high calcium levels
banded keratopathy
36
What bone disorders result from chronic hyperparathyroidism?
osteopenia & bone cysts (osteitis fibrosa cystica)
37
What are the 2 MC etiolgies for hypoparathyroidism?
1. iatrogenic | 2. Mg deficiency
38
What PE is MCly seen in a pt w/ familial hypertriglyceridemia?
eruptive & palmar xanthomas
39
What is the optimal LDL goal for a pt who suffered a high risk for coronary artery event or who has coronary artery equivalent?
<70 LDL
40
What is the MCly used fibrate used in clinical medicine?
fenofibrate (Tricor)
41
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
Somogyi phenomena
42
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
Dawn phenomenon
43
What is the motor abnormality that results when CN III is involved w/ diabetic motor neuropathy?
diplopia & ptosis
44
What is the motor deficit for CN IV & VI?
diplopia
45
What is the most likely underlying condition for necrobiosis lipodica diabeticorum?
DM
46
Glitazones should be avoided in what clinical conditions?
liver dz & HF
47
What class of diabetic meds decrease post prandial blood glucose, decrease glucagon secretion, decreased hepatic glucose pdt'n & decreases food consumption & gastric empyting?
Amylins
48
What is the main synthetic amylin analog that is used in the US?
Pramlintide [Symlin]
49
2 hormones that are released by the post. pit gland
1. vasopressin (ADH) | 2. oxytocin
50
What is the MC infiltrative dz that affects the pit. gland?
hemochromatosis
51
Hypopituitarism caused by pituitary stalk dysfxn that occurs as a result of post-partum hemorrhage or post-partum HoTN is known as:
Sheehan's syndrome
52
Uterine failure due to overzealous stripping of the uterine cavity during a D&C
Asherman's syndrome
53
Type of surgical procedure approach MCly done to resect pituitary tumor:
transphenoidal approach
54
TOC for pts w/ central diabetes insipidus
desmopressin (DDAVP)
55
What electrolyte abnormality is seen in a pt w/ Sarcoidosis?
hypercalcemia
56
What test is typically ordered to follow a pt w/ Sarcoidosis?
ACE levels
57
TOC for pts w/ Sarcoidosis
Corticosteroids
58
Name the MC medication cause of nephrogenic DI
Lithium carbonate
59
What is the MC secreted hormone for pts w/ pituitary turmor?
Prolactin
60
What is the initial visual loss that occurs in a pt w/ pituitary tumor?
bitemporal hemianopsia
61
Evaluation test of choice for pts w/ suspected pit. tumor
MRI
62
Group of meds that may promote prolactin secretion
Antipsychotics
63
Pt w/ pit. dysfxn who has coarse facies, HTN, CM, & insulin resistance most likely has excess secretion of what pit. hormone?
Growth hormone
64
What is the medication of choice used in the mgmt of Graves' dz during pregnancy?
PTU (proplythiouracil)
65
What anti-thyroid med acts to suppress thyroid hormone release & also decreased peripheral conversion of T4 to T3?
PTU
66
What is the MCC of hypothyroidism in the US?
Hashimoto's thyroiditis
67
What is the MCC of hypothyroidism in the world?
iodine deficiency
68
How soon should TSH levels be checked after starting thyroid replacement w/ levothyroxine?
6-8 wks after starting therapy
69
Name this serious endocrine condition: hypoxia, hyponatremia, hypothermia, & HoTN
Myxedema coma
70
What GI tract radiographic abnormality is assoc. w/ hypothyroidism?
toxic megacolon
71
initial diagnostic procedure performed in the assessment of thyroid nodule
FNA
72
MC type of thyroid cancer
papillary
73
Type of cancer that MCly results in ACTH-secreting tumor:
small cell lung cancer
74
Screening test for the evaluation of Cushing's dz:
24-h urine cortisol
75
Confirmatory test for proving that a pt has Cushing's dz:
dexamethasone suppression test
76
MCC of primary chronic adrenal insufficiency:
Addison's dz
77
Name the 2 electrolyte abnormalities that are seen in Addison's dz:
low sodium & high potassium
78
normal stimulation for the pdt'n & release of aldosterone
hypotension, hypovolemia
79
Screening test used for pheochromocytoma:
urinary metanephrines
80
Pts w/ hypertriglyceridemia should be assessed for what two other endocrinopathies
hypothyroidism & DM
81
HLA-DR3 & HLA-DR4 are assoc. w/ what endocrine disorder?
DM
82
What formulation of insulin has the quickest onset of activity when injected?
Lispro
83
What type of insulin lasts 24h, does not have a peak:
Lantus (glargine insulin)
84
Known SE is pt take metformin (Glucophage) & is exposed to ionic dyes:
lactic acidosis
85
Most severe type of retinopathy that is related to DM & is the leading cause of blindness
proliferative
86
Method by which proliferative retinopathy is treated to bring a/b a quiescent state:
laser photocoagulation
87
Target level of Hb A1C in pts w/ DM according to the American College of endocrinolgists:
<6.5
88
Preprandial glucose goals in pts w/ DM:
80-120 mg/dl
89
Most important dietary limitation for pts w/ T2DM:
calories
90
Humalog (Lispro) is classified as what type of insulin?
very rapid acting
91
Class of medication for metformin (Glucophage)
biguanide
92
Acarbose (Precose) is classified as what type of diabetic agent?
alpha glucosidase inhibitor
93
Adv. for the use of metformin over other agents used in the mgmt of T2DM:
promotes wt. loss
94
Name the conditions assoc. w/ CHAOS or Syndrome X:
``` CHAOS Coronary heart dz HTN Atherosclerosis Obesity Stroke ```
95
2 meds that are utilized in the mgmt of Syndrome X:
Metformin & statins
96
Length of time for the 1/2 life of T4:
one week
97
TOC for myxedema coma:
IV levothyroxine (Syntrhoid)
98
A pt w/ proptosis & hyperthyroidism is known to have what specific type of hyperthyroidism?
Graves dz
99
Loss of lateral 1/3rd of eyebrows is classically assoc. w/ what condition?
hypothyroidism
100
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:
Jod Basedow phenomena
101
A pt who has thyroid stimulating immunoglobulin that binds to the TSH receptor & acts as a receptor agonist is said to have what dz?
Graves dz
102
What is the main med class that is used in the tx of hyperthyroidism which prevents the peripheral conversion of T4 to T3?
BBs
103
MCC of subacute thyroiditis:
viral - mumps, coxsackie
104
Antimicrosomal Abs may be seen in what type of thyroid dz?
postpartum thyroiditis
105
increased urinary osmolality in comparison to serum osmolality
SIADH
106
TOC for adrenal crisis
IV cortisol
107
Somatostatin (octreotide) is given continuously for what pituitary disorder?
Acromegaly
108
What hormone marker is MCly used to identify a female's perimenopausal state?
increased FSH
109
What sensory defect will pts w/ Kallman's sydnrome have?
lack of smell
110
In addition to increased serum calcium levels, what other lab abnormality will be seen in a pt w/ Paget's dz?
Increased serum alkaline phosphatase
111
2 MC tx modalities for acute hypercalcemia:
IV NS for fluid expansion followed by Lasix & IV infusion of bisphosphonates
112
T score is MCly used in the assessment of what condition
Osteoporosis
113
Adv to the use of calcitonin in the mgmt of osteoporosis:
analgesic effects
114
Category of med for raloxifene (Evista)
SERM (selective estrogen receptor modulator)
115
Hormonally-related problem that may worsen when a pt takes raloxifene:
increase in hot flashes
116
TOC for pts w/ Paget's dz
bisphosphonate
117
Serious complication that may be assoc. w/ long-standing Paget's dz: s
osteogenic sarcoma
118
What emd is commonly prescribed to pts who are taking INH in order to prevent peripheral neuropathy?
Vit. B6 - pyridoxine
119
Cretinism is due to the lack of:
Thyroid hormone
120
70/.30 insulin administration typically consists of what type component of insulin?
70% NPH & 30% regular
121
MCC of treduced total serum calcium:
hypoalbuminemia
122
MCC of non-caseating granuloma in the lung in a young AAF
Sarcoidosis
123
Give the lab presentation for subclinical hypothyroidism:
TSH elevated w/ a normal T4 level
124
3 tx that are used for hyperthyroidism
1. surgery 2. antithyroid meds 3. radioactive iodine
125
Name 3 meds that are assoc. w/ thyroid dysfxn
1. amiodarone 2. lithium 3. iodine
126
What is the preferred tx for an elderly person w/ hyperthyroidism?
radioactive iodine
127
what is the cornerstone of therapy for the tx of T2DM?
lifestyle modifications
128
in a normal risked individual w/o sx, what is the MCly used age to screen for DM?
45 yoa
129
What hormone will be released in a pt who has acute decreased Mg levels?
parathyroid hormone
130
what single grp of pts is at highest risk for the development of hyperparathyroidism?
elderly females
131
What is the MC renal complication of primary hyperparathyroidism?
renal calculi
132
What is the name of the bone complication seen in primary hyperparathyroidism?
osteitis fibrosa cystica

Challenge Bowl (9 decks)

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