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Step 1 > Endo > Flashcards

Endo Flashcards

1
Q

Pretibial myxedema vs generalized myxedema

A

pretibial = Graves (hyper) vs generalized (face, arms, periorbital, etcs) = hypothyroidism

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2
Q

Scalloped colloid

A

Graves–> grabbing at edges to make t3/t4

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3
Q

auto-IgG to TSH (stimulating)

A

Graves. This auto-Ab is called THYROID STIMULATING IMMUNOGLOBULIN. OFTEN PRESENTS DURING STRESS (Pregnancy)

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4
Q

Exopthalmos

A

Graves

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5
Q

Most sensitive test for Graves:

A

TSH. Should be decreased because neg feedback from increased T3/T4

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6
Q

hypothyroid conditions that initially are transiently hyperthyroid

A

Hashimotos and Subacute de quervian granulomatous thyroiditis

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7
Q

Primary hypothyroidism

A

increased TSH

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8
Q

Secondary/Tertiary hypothyroidism

A

decreased TSH

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9
Q

Kid with mental retardation, short stature or dwarfism, failure to thrive, goiter

A

Cretinism (congenital hypothyroid)

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10
Q

Thyroid condition associated with a non hodgkin lymphoma (diffuse b cell)

A

Hashimoto

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11
Q

Hurthle cells: appearance and dx

A

large pink staining eosinophilic cells seen in Hashimoto

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12
Q

thyroid condition with lymphoid aggregate and germinal centers

A

Hashimoto

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13
Q

viral illness/flu that leads to thyroid condition

A

Subacute (de quervain). GRANULOMAS = pathology.

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14
Q

very tender thyroid, increased ESR, and jaw pain

A

Subacute (de quervain) –> de querpain”

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15
Q

thyroid replaced by fibrous tissue

A

Reidel thyroiditis. can extend into local structures i.e. cause hoarseness

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16
Q

Polyuria with high serum Na

A

Diabetes Insipidus (both central and nephrogenic)

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17
Q

Polyuria with low serum Na

A

Primary (polygenic) polydipsia

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18
Q

Change in urine osmolality after water deprivation in Diabetes Insipidus

A

No change (or mild increase)

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19
Q

Change in urine osmolality after water deprivation in normal pt

A

increased

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20
Q

change in urine osmolality after water deprivation in primary polydipsia

A

increased

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21
Q

Change in urine osmolality after water deprivation test followed by ADH: Primary Polydipsia

A

No additional change in osmolality. Since primary polydipsia there is no problem with endogenous ADH/receptor, water deprivation test = maximal endogenous ADH

22
Q

Tx for central DI

A

Desmopessin (ADH analog)

23
Q

Tx for nephrogenic DI

A
  1. Thiazide ( induce mild hypovolemia = increased na and h20 reabsorption at PCT) 2. Indomethacin (decrease synth of PG)
  2. Amiloride (decrease Li)
24
Q

dexamethasone suppression test

A

Cushings (excess ACTH –> excess cortisol). If pituitary adenoma, will show decreased ACTH and cortisol in response.

25
Q

ACTH stimulation test

A

adrenocorticoid insufficiency

26
Q

normal pt: cortisol fluctuation by time of day

A

highest in morning, lowest at night

27
Q

cushings pt: cortisol fluctuation by time of day

A

loss of circadian cortisol fluctation. thus, measure cortisol levels at night (because will be high, vs normal pt will have low cortisol at night)

28
Q

anti-TPO and anti-thyroglobulin

A

Hashimoto

29
Q

diffuse lymphocytic infiltrate of thyroid + germinal centers

A

Hashimoto

30
Q

pancreatic islet infiltrate in Diabetes

A

Type 1: Leukocytic

Type 2: Amyloid Peptide

31
Q

Diabetes: HLA linkage vs genetic predisposition

A

T1: HLA linkage (HLA-DR3/4)
T2: Strong genetic predisposition

32
Q

Diabetes: autoimmune vs genetic predisposition

A

T1: autoimmune destruction of B cells
T2: resistance to insulin, genetically predisposed

33
Q

Pathophys of amenorrhea in anoxerix

A

decreased Leptin (dec adipose tissue stores) inhibits pulsatile GnRH = dec LH and FSH = low estrogen

34
Q

failure to lactate after birth

A

Sheehan syndrome: ischemic necrosis of pituitary

35
Q

episodic headaches

A

pheochromocytoma

36
Q

which cells pheo come from

A

Chromaffin cells of adrenal medulla

37
Q

genes implicated in pheo

A

RET, VHL, NF1

38
Q

Medullary thyroid carcinoma path:

A

sheets of polygonal/spindle shaped extracellular AMYLOID deposits (derived from calcitonin)

Neuroendocrine tumor that arises from parafollicular calcitonin-secreting C cells

39
Q

tx of PCOS

A

no desire pregnancy: OCP (minimize endometrial prolif), wt loss
desire to be pregnant: Clomiphene –> SERM that prevents neg feedback inhibition on hypothal and AP by circulating estrogen

40
Q

Sx of Carcinoid (usually a GI tract mass)

A 
Flushing
Recurrent Diarrhea
Wheezing (asthmatic)
Right sided valvular lesions (goes to IVC)
Increase 5-HIAA in urine
41
Q

What tumor can give you Pellagra/niacin def?

A

Carcinoid, because uses up tryptophan

42
Q

Tx of Carcinoid

A

Somatostatin analog –> Ocreotide

43
Q

Recurrent ulcers in duodenum/jejunum

Peptic ulcer disease, abdominal pain, diarrhea

A

Gastrinoma (Z-E syndrome)

44
Q

Positive secretin stimulation test

A

Gastrin remains high after secretin (normally inhibits it) = Gastrinoma (Z-E syndrome)

can be ass. with Men 1 (pancreas)

45
Q

Histo of T1dm vs T2dm

A

T1: Leukocytes infiltrate in islet
T2: Amyloid infiltrate in inslet

46
Q

Amylin

A

Released with insulin, so will see in t2dm but not t1

47
Q

Glucagonoma (this is NOT z-e)

A

Dermatitis (necrolytic migratory erythema)
Diabetes (hyperglycemia)
DVT
Depression

48
Q

failure to lactate
cold intolerance
absent menstruation
(postpartum)

A

Sheehans: ischemic infarct of pituitary

49
Q

Euvolemic hyponatremia

can be caused by small cell lung cancer or cyclophosphamide

A

SIADH: Excessive free water retention, but clinically normal volume.

Urine osmolality>serum osmolality

body decreases water retention with decreased aldosterone aka hyponatremia–? correct slowly

50
Q

What are you going to see in hyperparathyroidism?

A

FIRST THING YOU THINK WHEN YOU SEE HYPERPARATHYROID:

STONES BONES GROANS(constipation) PSYC OVERTONES BITCH

51
Q

Primary vs Secondary Hyperparathyroidism

A

Primary: Increased Ca, low PO4. Increased ALP, Increased cAMP

Secondary: low Ca (chronic renal disease –> no vit D), increased PO4, increased ALP.

52
Q

Treatment for prolactinoma

A

Bromocriptine or cabergoline (dopamine agonists)

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