Endo Flashcards
Increased thirst, urinary frequency, dilute urine (Osm<300), Desmopressin increases urine Osm to 450
Central DI: deficiency in ADH leads to decreased water reabsorption in the kidney, hypernatremia and increased volumes of dilute urine.
Primary Amonorrhea w/o secondary sexual characteristics, anosomia
Kallmann’s syndrome: disorder of GnRH synthesis
Hypothyroid in pt w/ chronic afib, med SE?
Amiodarone, inhibits production of triiodothyronine, toxic to follicular cells
HTN, hyperreflexia, weakness, hypernatremia, hypokalemia, met alkalosis (high bicarb), decreased renin, unilateral abd mass on CT
primary hyperaldosteronism: adrenal adenoma hypersecreting mineralocorticoids.
hypercalcemia pt w/ sarcoidosis, other lab finding?
elevation in angiotensin-converting enzyme (ACE), hypercalcemia via increased production of 1,25 (OH)2 vitamin D by macrophages within the granulomas.
Pt p/w fever, tachycardia, tender anterior neck, increased TSH and thyroxine; dx? Rx?
subacute (de Quervain’s) thyroiditis; rx: NSAIDS
Hormone levels in pt w/ high androgen state (virilization), enlarged ovaries, irregular menstuation?
polycystic ovarian syndrome: increased levels of androgens lead to high estrogen levels, which suppress FSH and lead to increased LH levels.
Drugs that can cause secondary hypocalcemia
Carbamazepine, phenytoin, rifampin, and theophylline activate cytochrome P450 in the liver that inactivate vitamin D.
Pt p/w HTN, tachycardia, headache, palpitations, and tremor, suprarenal mass, high serum calcium and glucose
pheochromocytoma (w/elevated urinary catecholamine) rx: α-adrenergic blocker such as prazosin; resection
Pt p/w recent flushing, diarrhea, hypotension, systolic murmur accentuated by inspiration, JVD
Carcinoid syndrome w/ increased urine 5-HIAA, a by-product of serotonin, tricuspid regurge via fibrous deposits, right-sided heart failure
Newborn p/w constipation, prolonged jaundice secondary to delayed maturation of glucuronide conjugation, failure to thrive, and open fontanelles, umbilical hernias, genital swelling
Congenital hypothyroidism
Child p/w abn facies, cleft palate, congenital heart defects, thymic aplasia, and parathyroid hypoplasia with hypocalcemia
DiGeorge’s syndrome, with deletion of chromosome 22q11
Hypotensive w/ skin pigmentation, wt loss and fatigue, eosinophilia, hyponatremia, hyperkalemia, non AG met acidosis/ hyperchloremic acidosis work up? Dx? Rx?
primary adrenal insuf/ Addison’s dz; low morning cortisolACTH (central), Cosyntropin 250ug (ACTH) stimulation (cortisol normally rises >20 w/in 30-60min)
Hypotensive, wt loss, fever, cough, hyponatremia, hyperkalemia, adrenal gland calcification? Dx? PH?
primary adrenal insuf from TB inf; Hypoaldosteronism causes non AG metabolic acidosis
Glucose>600, no/low ketones, normal AG, serum Osm>320, bicarb>18
Hyperosmolar Hyperglycemic State, p/w more confusion, usually in elderly w/ DMT2
Glucose 200-500, ketonuria, AG acidosis, serum Osm<320, bicarb<18
Diabetic Ketoacidosis, p/w abd pain, hyperventilation, lethargy, ususally in youger w/ DMT1
HTN, hyperreflexia, weakness, hypernatremia, hypokalemia, met alkalosis (high bicarb), increased renin and aldosterone; etiology
Secondary hyperalsdosteronism: renovascular HTN, malignant HTN, renin tumor, diuretic use
Hypoglycemia, hyponatremia, constipation, cold intolerence, bradycardia, erectile dysfunction and low libido, fatigue, delayed DTR; dx?
Panhypopituitarism, w/ hypogonadotropins, glucocorticoid deficiency, hypothyroidism, but normal aldosterone and potassium (Renin/angiotensin dependent)
Antibodies in Hashimoto’s thyroiditis?
Anti-TPO (thyroid peroxidase) and anti-thyroglobulin
Best indicators of resolution of ketonemia (DKA)?
Mesured AG and beta-hydroxybutyrate
Smoker p/w HTN, hypokalemia, metabolic alkalosis, proximal muscle weakness, skin pigmentation; dx?
Ectopic ACTH via Small cell lung cancer;
Recent weightloss, diarrhea, DM, hyperglycemia, (erythamous plaques with eroded borders& central clearing) necrolytic migratory erythema, normocytic normochromic anemia; dx?
Pancreatic Glucagonoma, glucagon>500
Rubbery goiter w/ anti-TPO (thyroid peroxidase) ab; dx?
Hashimoto’s thyroiditis; confirm w/ Core needle bx; increased risk of Lymphoma of the thyroid
Metabolic sx dx? (4/5)
- abd obesity waist>40M,35W; 2. fasting glucose>100-110; 3. BP>130/80; 4. triglycerides>150; 5. HDL<40M,50W
Ambiguos genitalia in girls w/ salt wasting, hopnatremia, hyperkalemia, vomiting, hypotension, elevated testosterone, decreased cortisol and aldosterone; dx? Elevated steroid?
CAH w/ 21-hydroxylase deficiency, elevated 17-hydroxyprogesterone
Ambiguos genitalia in girls w/ HTN, fluid and salt retention, elevated testosterone, decreased cortisol and aldosterone; dx? Elevated steroid?
CAH w/ 11-beta-hydroxylase deficiency, w/ elevated 11-deoxycorticosteone (weak mineralcorticoid)
All pts phenotypically female, decreased cortisol and testosterone, elevated mineralcorticoids, hypokalemia, HTN, fluid and salt retention; dx?
CAH w/ 17-alpha-hydroxylase deficiency
Diabetic, recent URI, p/w headaches, confusion, glucose in urine, dehydration signs, blurred vision, no ketones, hyperglycemia; dx?
Non-Ketotic Hyperosmolar syndrome (NKHS)
