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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
Q

High dose corticosteroids

A

Psychosis, increased neuts from demargination this leads to dec neut recruitment and inc risk of infection

26
Q

Carcinoid syndrome at risk for what vit def?

A

Niacin
Because tryptophan is precursor for both 5HT and niacin
will lead to Pellagra

27
Q

Hypertension with HYPOkalemia?

A

Conn syndrome

MC: aldosterone secreting tumor of adrenal gland

28
Q

Graves tx while pregnant?

A

Propythiouracil - PTU

Methimazole can cause fetal scalp defects

29
Q

Type of HS for Graves?

A

T2 noncytotoxic HS - Ab interfere with function of cell, but don’t destroy it

30
Q

Ex of T2 cytotoxic HS?

A

Rheumatic heart dz

31
Q

Bad side effect of methimazole?

A

Agranulocytosis - early: fever, sore throat

Tx: filgrastim

32
Q

What Ig is increased with Riedel’s thyroiditis?

33
Q

Papillary carcinoma

A

Hx of radiation exposure
Inc RET
H: psammoma bodies, Orphan Annie eyes - clear nuclei and nuclear groove

34
Q

Medullary carcinoma

A

Parafollicular C cells -> Inc calcitonin = D, flushing
Congo Red Stain
Mut: RET (remember endocrine tumors) MEN 2A 2B

35
Q

Primary hyperparathyroidism

A 
Gland making too much
Adenoma - 1 gland big
Hyperplasia - 4 big
Lab: I PTH --> I Ca2+ D Ph
Stones, bones, groans
36
Q

Secondary hyperparathyroidism

A

Something causing gland to make more PTH
Ie. renal failure, vit D def
Lab: D Ca2+ –> I PTH, D Ph

37
Q

Tx Nephrogenic DI

A

HCTZ = forces them to lose Na+ and plasma vol decreases then PCT starts to reabsorb Na+ and H2O follows

38
Q

Tx SIADH

A

Demeclocycline - ADH antagonist = diuretic in SIADH

39
Q

3 Causes of Cushings?

A

Pituitary adenoma - Making ACTH
Adrenal adenoma - making Cortisol = D ACTH
Ectopic ie. small cell lung CA - I ACTH

40
Q

To distinguish if pit tumor or lung CA causing Cushings from too much ACTH, do dexamethasone suppression

A

Pit tumor will listen

CA never listens

41
Q

21 hydroxylase def

A

HypOtension

Virilization

42
Q

17 def

A

HTN

No virilization, get ambiguity of genitalia

43
Q

11 def

A

HTN from weak MC - 11-deoxycorticosterone

Virlization

44
Q

Waterhouse Friederichson Syn

A

B/L hemorrhagic infarction of adrenals

Assoc: N. meningitidis

45
Q

Chronic adrenal insuff

A 
Addisons
No salt, sugar or sex
Inc ACTH acts like MSH = skin hyper pig
West = AI
Developing = TB
46
Q

Desmopressin to tx?

A

ADH analog
Central DI
Noc enuresis

47
Q

When you increase pH, what happens to calcium?

A

you increase the affinity of albumin to bind to Ca2+

= hypocalcemia

48
Q

PTH

A

Phosphate trashing hormone

When Ca2+ is low = I secretion

49
Q

PTH release =

A

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
Q

Calcitonin

A

Opposes action of PTH

Tones down Ca2+

51
Q

T3 is responsible for the 4B’s

A

Brain maturation
Bone growth
B-adranergic effects
BMR increased

52
Q

What converts T4 to T3 in periphery?

A

5’ deiodinase

53
Q

Conn Syndrome

A

Adrenal adenoma = Inc aldosterone and Dec renin
HA, tired, m. weakness
HTN + HypOK

54
Q

Intractable peptic ulcers think?

A

Gastrinoma - gastin > 1000

Assoc. MEN1

55
Q

1 RF for pancreatic carcinoma?

A 
Smoking
#2 is pancreatitis
56
Q

Migratory thrombophelbitis

A

Sign of Pancreatic CA

57
Q

Pancreatic markers?

A

CA 19-9

CEA

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