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ENDO Flashcards

1
Q

DMT1 HLA?

AB?

A

DR3, DR4

Anti-glutamic acid decarboyxlase (anti-GAD) Abs

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2
Q

Two ketone bodies in DKA

A

B-hydroxybutyric acid

Acetoacetic acid

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3
Q

Dx an insulinoma

A

Dec glucose ie.

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4
Q

What is adrenal medulla from?

A

Neural crest, from chromaffin cells

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5
Q

Tx for prolactinoma?

A

Bromocriptine - DA agonist

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6
Q

Tx for GH adenoma

A

Ocreotide - somatostatin analog

OR pegvisomant - GH R antagonist

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7
Q

Graves Histo? Tx?

A

H: scalloped colloid (like a grave), chronic inflam
Tx: PTU, thioamide

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8
Q

Hashimotos HLA?

A

HLA-DR5

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9
Q

2 Hashi Abs?

A

Antithryoglobulin Ab

Antithyroid peroxidase Ab

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10
Q

MEN1

A

Pituitary
Pancreas endocrine tumor ie. isulinoma
Parathyroid adenoma - I PTH, I Ca2+, D Phosphate

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11
Q

MEN2A

A

Parathyroids
Thyroid medullary CA
Pheo

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12
Q

MEN2B

A

Thyroid medullary CA
Pheo
Marfanoid body
Bumps on lips

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13
Q

Histo for subacute DeQuervain’s granulomatous thyroiditis

A

Lymphocytic infiltrate with multinucleated giant cells

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14
Q

Pheo urine finding?

A 
Vanillylmandelic acid (VMA)
Metanephrines
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15
Q

Hashi’s Histo

A

large number of lymphocytes and few abnl follicular cells with eosinophilic granular cytoplasm

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16
Q

Thyroid storm meds

4 P’s

A

Propranolol 1st
PTU
Prednisolone
Potassium iodide

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17
Q

Why does sorbitol accumulate in lens in DM pt?

A

Normally aldose reductase reduces glucose to sorbitol.

this gets trapped and pulls in water = swollen

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18
Q

DMT1 kidney damage?

A

= DM glomerulosclerosis

Kimmelstiel Wilson nodule - ovoid hyaline, PAS+ structures at the mesangial core

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19
Q

DMT2 started on drug, not has malaise, myalgia, resp distress. Rx?
Predisposes you to what other serious?

A

Metformin

Lactic acidosis

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20
Q

Pseudohypoparathyroidism in a kid?

A

Developmental delay, Dec Ca2+, Inc Ph and PTH
Shortened metacarpals
Cause? decreased expression of Gs

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21
Q

Sulfonylurea drugs MOA

Names

A

Inhibit B cell K-atp = insulin release
1st gen: chlorproplamide
2nd gen start with G end with ide
–glimepiride, glipizide

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22
Q

Total peripheral resistance in paralel?

A

1/RT - add all 1/x together

ie. 1/2mmHg + 1/2 + 1/2 + 1/2 = 4/2 = 2/1 (flip it) = .5

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23
Q

Graves exopthalamos from what immune response?

A

Th1 releasing cytokines that increase GAGs

24
Q

Glucagonoma presents

A

Necrolytic migrating erythema - elevated painful puritic rash on face, groin - large lesion with central clearing of bronze induration
Tumor of the alpha cells

25
High dose corticosteroids
Psychosis, increased neuts from demargination this leads to dec neut recruitment and inc risk of infection
26
Carcinoid syndrome at risk for what vit def?
Niacin Because tryptophan is precursor for both 5HT and niacin will lead to Pellagra
27
Hypertension with HYPOkalemia?
Conn syndrome | MC: aldosterone secreting tumor of adrenal gland
28
Graves tx while pregnant?
Propythiouracil - PTU | Methimazole can cause fetal scalp defects
29
Type of HS for Graves?
T2 noncytotoxic HS - Ab interfere with function of cell, but don't destroy it
30
Ex of T2 cytotoxic HS?
Rheumatic heart dz
31
Bad side effect of methimazole?
Agranulocytosis - early: fever, sore throat | Tx: filgrastim
32
What Ig is increased with Riedel's thyroiditis?
IgG4
33
Papillary carcinoma
Hx of radiation exposure Inc RET H: psammoma bodies, Orphan Annie eyes - clear nuclei and nuclear groove
34
Medullary carcinoma
Parafollicular C cells -> Inc calcitonin = D, flushing Congo Red Stain Mut: RET (remember endocrine tumors) MEN 2A 2B
35
Primary hyperparathyroidism
``` Gland making too much Adenoma - 1 gland big Hyperplasia - 4 big Lab: I PTH --> I Ca2+ D Ph Stones, bones, groans ```
36
Secondary hyperparathyroidism
Something causing gland to make more PTH Ie. renal failure, vit D def Lab: D Ca2+ --> I PTH, D Ph
37
Tx Nephrogenic DI
HCTZ = forces them to lose Na+ and plasma vol decreases then PCT starts to reabsorb Na+ and H2O follows
38
Tx SIADH
Demeclocycline - ADH antagonist = diuretic in SIADH
39
3 Causes of Cushings?
Pituitary adenoma - Making ACTH Adrenal adenoma - making Cortisol = D ACTH Ectopic ie. small cell lung CA - I ACTH
40
To distinguish if pit tumor or lung CA causing Cushings from too much ACTH, do dexamethasone suppression
Pit tumor will listen | CA never listens
41
21 hydroxylase def
HypOtension | Virilization
42
17 def
HTN | No virilization, get ambiguity of genitalia
43
11 def
HTN from weak MC - 11-deoxycorticosterone | Virlization
44
Waterhouse Friederichson Syn
B/L hemorrhagic infarction of adrenals | Assoc: N. meningitidis
45
Chronic adrenal insuff
``` Addisons No salt, sugar or sex Inc ACTH acts like MSH = skin hyper pig West = AI Developing = TB ```
46
Desmopressin to tx?
ADH analog Central DI Noc enuresis
47
When you increase pH, what happens to calcium?
you increase the affinity of albumin to bind to Ca2+ | = hypocalcemia
48
PTH
Phosphate trashing hormone | When Ca2+ is low = I secretion
49
PTH release =
I Ca2+ - bone resorption and Ca resorption in DCT D Phosphate - D reabsorption in PCT I 1,25(OH)2 D3 (calcitriol) I urine cAMP
50
Calcitonin
Opposes action of PTH | Tones down Ca2+
51
T3 is responsible for the 4B's
Brain maturation Bone growth B-adranergic effects BMR increased
52
What converts T4 to T3 in periphery?
5' deiodinase
53
Conn Syndrome
Adrenal adenoma = Inc aldosterone and Dec renin HA, tired, m. weakness HTN + HypOK
54
Intractable peptic ulcers think?
Gastrinoma - gastin > 1000 | Assoc. MEN1
55
#1 RF for pancreatic carcinoma?
``` Smoking #2 is pancreatitis ```
56
Migratory thrombophelbitis
Sign of Pancreatic CA
57
Pancreatic markers?
CA 19-9 | CEA

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