ENDO Flashcards
What is the difference between somogyi and dawn effect?
both are hyperglycemia but somogyi is d/ t insulin, dawn is d/t catecholamines and GH
What is the difference between somogyi and dawn effect?
both are hyperglycemia but somogyi is d/ t insulin, dawn is d/t catecholamines and GH
What lipid tx med should be avoided with gout pts?
niacin
What is metabolic sx?
abdominal obesity, HTN, hyperglycemia, high trig, low HDL
What does high beta-hydroxybutyrate mean?
DKA
What is sipple sx?
MEN 2a (hyperparathyroid, medullary thyroid CA, pheochromocytoma)
What is wermers sx?
MEN 1 (parathyroid, pituitary, pancreatic)
Pt has secondary corticoadrenal insufficiency, what happens to cortisol levels after cosyntropin stimulation?
cortisol will increase
What does no change with cosyntropin stimulation mean?
primary corticoadrenal insufficency
Nodules on thyroid without exophthalmos?
plummers dz
What lipid tx can cause flushing, pruritis, nausea?
niacin
What is LDL goal for patients with heart dz?
What DM meds can cause pancreatitis?
DPP4 inhibitor (-gliptin) , GLP1 analogs (byetta)
What lipid tx may cause increase in glucose levels?
niacin
What lipid tx is good for LDL control?
statins
What lipid tx is good for trig control?
niacin, omega 3
What meds cause lipid elevation?
thiazide
Hyperlipidemia is associated with what dz?
hypothyroidism
What are 2 long acting insulin?
insulin glargine and insulin detemir
What are 3 short acting insulin?
glullsine, lispro, aspart
What meds should not be given to patients with G6PD?
sulfonylureas
What are 2 tx for gestational DM?
insulin and lifestyle changes
What values during a 24-48week gestation 75gm 2hrs GTT are dx for DM?
one hr >180, 2hr >153
What is dx for fasting gestational DM?
> 92
What can be added onto metformin?
insulin, sulfonylureas, pioglitazone, GLP1
Pt had MI 2years ago, what is goal A1C and LDL?
What screening is recommended for DM patients?
A1C testing q6mo; annual monofilamint testing, eye exam, PVD screening, lipid screening, UA microalbumin
What are relative contraindication for metformin?
HF, liver failure, ETOH abuse, hypoperfusion states
What is absolute contraindication for metformin?
kidney failure
What are the criteria for DM?
fasting >126, 2hr GTT >200, A1C > 6.5, random BG >200
Which MEN sx has neuromas?
MEN 2b
Sx of polyuria, polydipsia, increase serum osmolarity, decrease urine osmolarity?
DI
Osteoporosis, bone pain, renal calculi, GI sx, and psychiatric overtones?
hyperparathyroidism
Tx for central DI and DI in pregnancy?
desmopressin
Which type of thyroiditis has fever, pain, and neck mass?
supparitive thyroiditis from staph, strep
How to tx hyperthyroidism in pregnancy?
PTU during first trimester, methimazole for the rest
What are 2 causes for thyroiditis?
lithium, amiodarone (antiarrythemia), interferon alpha, interleukin 2 (cancer)
Cold nodule on thyroid uptake scan means?
malignancy
PE/Sx for pituitary ademona?
visual change, galactohrrea
3 meds for Cushing sx tx if surgery is not an option?
mitotane, ketaconazole, metyrapone
What screening should be done with Cushing sx?
DEXA
Decrease ACTH, high cortisol with dexamethasone suppression means?
Cushing primary
Increase ACTH from dexamethasone suppression means?
Cushing secondary
What is the diff between cushing sx and disease?
sx is primary, disease is secondary
What is the tx for corticoadrenal insufficiency?
hydrocortisone
What is the common cx of primary corticoadrenal insufficiency?
addison
What to expect on CMP lab with addison patient?
hyponatremia
What to expect on lab with addison patient?
hyponatremia
What lipid tx med should be avoided with gout pts?
niacin
What is metabolic sx?
abdominal obesity, HTN, hyperglycemia, high trig, low HDL
What does high beta-hydroxybutyrate mean?
DKA
What is sipple sx?
MEN 2a (hyperparathyroid, medullary thyroid CA, pheochromocytoma)
What is wermers sx?
MEN 1 (parathyroid, pituitary, pancreatic)
Pt has secondary corticoadrenal insufficiency, what happens to cortisol levels after cosyntropin stimulation?
cortisol will increase
What does no change with cosyntropin stimulation mean?
primary corticoadrenal insufficency
Nodules on thyroid without exophthalmos?
plummers dz
What lipid tx can cause flushing, pruritis, nausea?
niacin
What is LDL goal for patients with heart dz?
less than 70
What DM meds can cause pancreatitis?
DPP4 inhibitor (-gliptin) , GLP1 analogs (byetta)
What lipid tx may cause increase in glucose levels?
niacin
What lipid tx is good for LDL control?
statins
What lipid tx is good for trig control?
niacin, omega 3
What meds cause lipid elevation?
thiazide
Hyperlipidemia is associated with what dz?
hypothyroidism
What is the procedure called to tx acromegaly with pituitary adenoma?
trans-sphenoid resection
What are 3 short acting insulin?
glullsine, lispro, aspart
What meds should not be given to patients with G6PD?
sulfonylureas
What are 2 tx for gestational DM?
insulin and lifestyle changes
What values during a 24-48week gestation 75gm 2hrs GTT are dx for DM?
one hr >180, 2hr >153
What is dx for fasting gestational DM?
> 92
What can be added onto metformin?
insulin, sulfonylureas, pioglitazone, GLP1
Pt had MI 2years ago, what is goal A1C and LDL?
What screening is recommended for DM patients?
A1C testing q6mo; annual monofilamint testing, eye exam, PVD screening, lipid screening, UA microalbumin
What are relative contraindication for metformin?
HF, liver failure, ETOH abuse, hypoperfusion states
What is absolute contraindication for metformin?
kidney failure
What are the criteria for DM?
fasting >126, 2hr GTT >200, A1C > 6.5, random BG >200
Which MEN sx has neuromas?
MEN 2b
Sx of polyuria, polydipsia, increase serum osmolarity, decrease urine osmolarity?
DI
Osteoporosis, bone pain, renal calculi, GI sx, and psychiatric overtones?
hyperparathyroidism
Tx for central DI and DI in pregnancy?
desmopressin
Which type of thyroiditis has fever, pain, and neck mass?
supparitive thyroiditis from staph, strep
How to tx hyperthyroidism in pregnancy?
PTU during first trimester, methimazole for the rest
What are 2 causes for thyroiditis?
lithium, amiodarone (antiarrythemia), interferon alpha, interleukin 2 (cancer)
Cold nodule on thyroid uptake scan means?
malignancy
PE/Sx for pituitary ademona?
visual change, galactohrrea
3 meds for Cushing sx tx if surgery is not an option?
mitotane, ketaconazole, metyrapone
What screening should be done with Cushing sx?
DEXA
Decrease ACTH, high cortisol with dexamethasone suppression means?
Cushing primary
Increase ACTH from dexamethasone suppression means?
Cushing secondary
What is the diff between cushing sx and disease?
sx is primary, disease is secondary
What is the tx for corticoadrenal insufficiency?
hydrocortisone
What is the common cx of primary corticoadrenal insufficiency?
addison
What sx can occur with sudden withdrawal of steroids?
severe N/V/D, hyponatremia, hyperkalemia, hypoglycemia
What to expect on lab with addison patient?
hyponatremia
What to expect on CBC lab with addison patient?
eosinophila
Prolonged hypoparathyroidism can mimic what dz?
parkinson
Prolonged hypoparathyroidism can cause what neurological sx?
seizure
Parathyroid hormone affects what 3 organs?
GI absorption, bone absorption, renal reabsorption
What to PE tests can you do for hypoparathyroidism?
chvosteck sign and troursseau
Hyperparathyroidism can be d/t what mineral deficient?
Mg
What 3 meds can cause hyperthyroidism?
lithium, amiodarone, levothyroxine
What meds can cause both hyper and hypothyroidism?
lithium and amiodarone
What is the most common secondary cause of hyperparathyroidism?
ESRF
What AB are positive in hashimoto and grave?
antithyroglobulin, antithyroid peroxidase
Most common cause of hypothyroidism?
hashimoto
Which class of HIV causes hyperlipidemia?
protease inhibitor
Which lipids can cause pancreatitis?
trig
What med can cause angioedema?
ezetimibe
45 yo male has hypoglycemia with parathyroid, what MEN is this?
MEN 1
Patient has medullary thyroid CA and develops HTN that is resistant to tx, what should be r/o?
pheochromocytoma, MEN 2a, MEN 2b
Urine osmolarity will be high or low in DI?
low
What is the procedure called to tx acromegaly with pituitary adenoma?
trans-sphenoid resection
Patient does has normal ACTH levels but comes back with high coritsol levels with high dexamethasone suppression test?
ectopic CA
Increased cortisol level with cosyntropin test is primary or secondary corticoadrenal insufficiency?
secondary
Radiation induced thyroiditis has hard or tender thyroid?
tender