Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

Step 2 > Endo > Flashcards

Endo Flashcards

1
Q

Which diabetic pts should be on a statin

A

All, provided they are over 40 and have at least one other cv rf

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

Bp management in diabetics

A

Strict control to <140/80, first line aceis and arbs

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

Which diabetic pts should get the pneumonia vaccine

A

All above age 19

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

In hhs, glucose is above

A

600

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

Serum osmolality in hhs is

A

> 320 mosm/kg

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

Is there acidosis in hhs

A

No

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

Tx of hhs

A

Aggressive fluids, electrolyte replacement, insulin

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

What do you see on biopsy in a pt with diabetic nephropathy

A

Kimmelstein wilson nodules

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

Most Common cause of death in diabetic patients

A

Cv dz

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

Tx diabetic gastroparesis with

A

Metoclopramide or erythromycin

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

Criteria for metabolic syndrome

A

Weighht- need three out of five

Waist Expanded
Impaired Glucose
Htn
Hdl decreased
Tgs increased
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

Can tbg be elevated in pregnancy and estrogen admin

A

Yes

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

Difference between hyperthyroid and thyrotoxicosis

A

Hyperthyroid-increased synthesis of t3/t4

Thyrotox-increased levels of t3/t4

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

Graves is the __ form of hyperthyroidism. ___ increase synth of t3/t4

A

Autoimmune

Thyroid stimulating antibodies

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

Thyroid storm is a life threatening form of ___ that may cause ___, ___ and ___

A

Thyrotoxicosis

Af, fever, delirium

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

Tx of thyroid storm

A

Antithyroid drugs (methimazole, propylthiouracil), then iodine, iv esmolol and steroids and admit to icu

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

Symptomatic tx of hyperthyroid

A

B blocker

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

As blood sugars decrease to 250-300 in tx of dka, what should you add

A

5% dextrose to decrease risk of hypoglycemia

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

___ tbg levels in pregnancy lead to ___ free t3/t4 levels and __ tsh

A

Increased
Decreased
Increased

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

What should you do to levothyroxine dose in preggos

A

Increase

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

Hashimoto thyroiditis is associated with what antibodies

A

Antithyroglobulin and antithyroid peroxidase (anti-tpo)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

What kind of hernia can you see in congenital hypothyroid

A

Umbilical

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

What lipid abnormalities can you see in hypothyroid

A

High ldl

High tgs

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

In asymptomatic hypothyroid treat with levothyroxine if tsh is above

A

10 mU/L

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
Q

Increased serum alk phos level with normal ggt level points to what etiology

A

Bone, not liver

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
26
Q

Bone pain and hearing loss, think

A

Paget’s disease

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
27
Q

Low serum phosphorus feedback loop

A

Low serum phosphorus converts 25 vit D to 1,25 vit D, which causes release of phosphate from bone matrix and increased intestinal reabsorption

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
28
Q

Lab values in paget dz of bone (alk phos, calcium, phosphate)

A

High serum alk phos, normal calcium and phosphate

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
29
Q

Pth works on what two organs to increase calcium

A

Renal tubular cells to reabsorb calcium and bone to stimulate calcium release

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
30
Q

Parathyroid hormone stimulates production of 1,25 vit d, which causes calcium reabsorption from the

A

Gut

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
31
Q

Stones, bones, moans, groans and psychic overtones indicate what

A

Hypercalcemia

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
32
Q

Tx of hypercalcemia

A

Fluids then loop diuretics and iv bisphosphonate

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
33
Q

Pth ___ phosphorus

A

Decreased

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
34
Q

Primary hyperparathyroidism reveals __calcemia, __phosphotemia, and ___calciuria

A

Hyper
Hypo
Hyper

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
35
Q

In secondary hyperparathyroidism, If etiology is renal failure what is phosphate level

A

High

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
36
Q

What is familial hypocalciuric hypercalcemia

A

Inherited disorder due to mutations in calcium sensing receptor present in parathyroid and kidney. Have normal pth, hypercalcemia and hypocalciuria. Asymptomatic and no tx necessary

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
37
Q

What is cinacalcet

A

Lowers serum pth levels and is used for hyperparathyroidism due to pts with renal failure or who can’t undergo surgery

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
38
Q

What is Sheehan syndrome

A

Pituitary infarction secondary to postpartum hemorrhage

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
39
Q

Most common cause of Cushing syndrome

A

Prolonged tx with exogenous corticosteroids

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
40
Q

Difference between Cushing syndrome and Cushing diseAse

A

Syndrome: too much cortisol

Disease: too much cortisol from acth producing pit adenoma

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
41
Q

Dx of Cushing syndrome

A

Dexamethasone suppression of plasma cortisol, or measure 24h urinary free cortisol

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
42
Q

How to determine if Cushing syndrome is due to adrenal tumor or acth dependent Cushing syndrome

A

Measure plasma acth and cortisol after dexamethasone suppression test. If acth is suppressed, it’s an adrenal tumor

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
43
Q

Water deprivation test: what happens in psychogenic polydipsia

A

More concentrated urine

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
44
Q

Water deprivation test: what happens in central and nephrogenic di

A

Pts excrete a high vol of inappropriately dilute urine

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
45
Q

What will desmopressin do in central di

A

Decrease urine output and increase urine osmolarity

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
46
Q

What will desmopressin do in nephrogenic di

A

No effect

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
47
Q

First line tx of nephrogenic di

A

Salt restriction and take in water

Thiazides can help

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
48
Q

Very common cause of euvolemic hyponatremia

A

Siadh

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
49
Q

If pt is severely hyponatremic (<110) or is symptomatic (seizing, coma), what should you do

A

Cautiously give hypertonic saline, monitor for central pontine myelonolysis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
50
Q

Tx of siadh

A

Fluid restrict

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
51
Q

Cause of siadh

A

Persistent adh release independent of serum osmolality

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
52
Q

Acth secretion is __ in primary adrenal insufficiency

A

Increased, this causes the hyperpigmentation

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
53
Q

Most common cause of secondary AI

A

Cessation of long term glucocorticoid tx

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
54
Q

Aldosterone is ___ in primary AI, ___ in secondary AI

A

High

Normal

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
55
Q

Acth is ___ in primary AI, ___ in secondary AI

A

High

Low

56
Q

Pheochromocytomas are associated with what syndromes

A

Men 2A and men 2B

57
Q

Why don’t you do b blockade first in pheochromocytomas

A

Unopposed a adrenergic stimulation can lead to severe hypertension

58
Q

Medullary carcinoma is associated with ___ syndromes, so screen for ____, ____ before you remove thyroid

A

Men 2A/B

Vma and metanephrines

59
Q

Elevated ___ level is dx of 21 hydroxylase deficiency

A

17 hydroxyprogesterone

60
Q

Tx of 21 hydroxylase def

A

Immediate fluid resus and salt repletion

61
Q

Pts with hhs or dka have __ levels of serum potassium but __ levels of total body potassium due to ___

A

Normal or elevated

Low

Due to excessive urinary potassium loss caused by osmotic diuresis

62
Q

Insulin therapy for hhs can ___ serum potassium levels and cause ___

A

Lower

Severe hypokalemia

63
Q

What happens to pituitary gland in Sheehan syndrome

A

Ischemic necrosis of the gland

64
Q

Approx 40% of calcium is bound to

A

Albumin

65
Q

Serum calcium decreases by ___ with every 1g/dL decrease in serum albumin

A

0.8 mg/dL

66
Q

Can myopathy occur with hypothyroidism

A

Yes

67
Q

Thyrotoxicosis causes what four cv findings

A

Tachycardia
Systolic htn
Widened pulse pressure
Afib/glitter

68
Q

Hyperthyroidism causes a ___ in svr

A

Decrease

69
Q

Increased bp in thyrotoxicosis is due to

A

Increased myocardial contractility

70
Q

Rapid onset hirsutism suggests very high levels of ___ possibly due to ___. Check __ and ___ levels

A

Androgen
Androgen-secreting neoplasm
Testosterone and dheas

71
Q

Androgen producing tumor-where am I?: high testosterone and normal dheas

A

Ovarian source

72
Q

Androgen producing tumor-where am I?: high dheas

A

Adrenal tumor

73
Q

Hypothyroid can cause ___lipidemia

A

Hyper

74
Q

First dx step of hypercalcemia after correcting for albumin

A

Measure pth level

75
Q

Clinical features of neonatal thyrotoxicosis

A

Warm moist skin, tachycardia, poor feeding, irritability, poor weight gain, low birth weight

76
Q

Cause of neonatal thyrotoxicosis

A

Transplacental passage of maternal anti-tsh receptor antibodies

77
Q

Diagnosis of neonatal thyrotoxicosis

A

Maternal anti-tsh receptor antibodies >500%

78
Q

Tx of neonatal thyrotoxicosis

A

Self resolves in three months

Short term can use methimazole and b blockers

79
Q

Can hashimoto thyroiditis cause recurrent pregnancy loss

A

Yes

80
Q

Optimization of glycemic control in dm is associated with reduced risk of micro or macro vascular complications

A

Micro

81
Q

Can hypocalcemia cause hyperreflexia

A

Yes

82
Q

Tx of acute hypocalcemia

A

Ivcalcium gluconate/chloride

83
Q

Carpal spasm, trousseau sign, is a sign of

A

Hypocalcemia

84
Q

How does transfused blood cause hypocalcemia

A

Citrate in transfused blood bonds ionized calcium. If you have liver issues, can’t metabolize citrate.

85
Q

Porphyria cutanea tarda is associated with what condition primarily

A

Hep c

86
Q

Pt with htn and hypokalemia: high renin and high aldosterone

A

Secondary hyperaldo

87
Q

Pt with htn and hypokalemia: low renin and high aldo

A

Primary hyperaldo

88
Q

Pt with htn and hypokalemia: low renin and low aldo

A

Non-aldo causes: cah, Cushing for example

89
Q

Four causes of secondary hyperaldo

A

Renovascular htn
Malignant htn
Renin secreting tumor
Diuretics

90
Q

Hyperaldo presents with

A

Htn, headache, polyuria, muscle weakness

91
Q

In hyperaldo, labs show ___kalemia and metabolic ____.

A

Hypokalemia

Metabolic alkalosis

92
Q

Refeeding syndrome is due to a surge in ___ after body resumes anabolism

A

Insulin

93
Q

What electrolytes are depleted in refeeding syndrome

A

Phosphate
Mag
Potassium

Because rapid insulin secretion starts glycogen, fat and protein synthesis again, which needs these electrolytes and rapidly depletes already small stores of them

94
Q

Deficiencies in potassium and magnesium in refeeding syndrome can cause

A

Cardiac arrhythmia s

95
Q

Aggressive refeeding with electrolyte repletion can cause __ failure

A

Cardiopulmonary

96
Q

Aldosterone escape in hyperaldo limits what two things

A

Edema and hypernatremia (despite htn and increased blood volume)

97
Q

Hypomag is very common among hospitalized ___

A

Alcoholics

98
Q

How can hypomag cause hypocalcemia

A

By inducing resistance to pth and decreasing pth secretion

99
Q

Hyperthyroid causes __ osteoclastic activity and bone ___, resulting in ___calcemia

A

Increased
Resorption
Hyper

100
Q

Can you see hypercalciuria in hyperthyroid

A

Yes, due to neg feedback due to hypercalcemia

101
Q

Fetal hyperthyroid can be seen in moms who have___, not toxic adenoma causing hyperthyroid

A

Graves

102
Q

Do you get high fever in thyroid storm

A

Yes

103
Q

Tx of thyroid storm

A

B blocker, ptu, glucocorticoids

104
Q

Do you get high ck in thyroid storm

A

Yes

105
Q

Most common cause of congenital hypothyroid

A

Thyroid dysgenesis

106
Q

Pt with acute serious illness, normal T4 and TSH but low T3 likely has

A

Euthyroid sick syndrome

107
Q

Can hyperthyroid cause myopathy

A

Yes

108
Q

For primary hyperparathyroid who should get parathyroidectomy

A

Pts with symptomatic hypercalcemia

109
Q

Acth deficiency, hypothyroid and infertility + loss of libido in men and amenorrhea in women

A

Hypopit

110
Q

Can hashimoto thyroiditis cause vitiligo

A

Yes

111
Q

Best markers of resolution of dka

A

Serum anion gap or beta hydroxybutyrate level

112
Q

Manifestations of men1 syndrome (three)

A

Pituitary adenomas, primary hyperparathyroid, pancreatic/gastrointestinal neuroendocrine Tumors (eg gastrinoma, vipoma)

113
Q

Desmopressin is first line treatment for central or nephrogenic di

A

Central

114
Q

Bad side effect of ptu and methimazole

A

Agranulocytosis

115
Q

In case of getting exogenous thyroid hormone, thyroglobulin will be

A

Low

116
Q

Most androgen producing adrenal tumors overproduce

A

Dhea

117
Q

Myopathy in Cushing syndrome is characterized by weakness in the __ muscles and is due to __

A

Proximal

Direct catabolic effects of cortisol on skeletal muscles leading to muscle atrophy

118
Q

How do toxic adenomas cause hyperthyroid

A

Autonomous thyroid production without tsh stimulation

119
Q

Most common cause of oculomotor (cn iii) nerve palsy in adults

A

Ischemic neuropathy due to poorly controlled dm

120
Q

Ischemic cn iii palsy presentation

A

Ptosis, down and out gaze, preserved pupillary response

121
Q

Una is __, pt is __volemic, pt is ___tonic and hyponatremic

Gi losses

A

Una<10
Hypovolemic
Hypotonic

122
Q

Una is __, pt is __volemic, pt is ___tonic and hyponatremic

Skin losses

A

Una<10
Hypovolemic
Hypotonic

123
Q

Una is __, pt is __volemic, pt is ___tonic and hyponatremic

Diuretics

A

Una>10
Hypovolemic
Hypotonic

124
Q

Una is __, pt is __volemic, pt is ___tonic and hyponatremic

Cirrhosis, chf, nephrotic syndrome

A

Una<10
Hypervolemic
Hypotonic

125
Q

Una is __, pt is __volemic, pt is ___tonic and hyponatremic

Aki
Ckd

A

Una>10
Hypervolemic
Hypotonic

126
Q

Urine osmolality is __, pt is __volemic, pt is ___tonic and hyponatremic

Siadh, Addison’s, thyroid

A

Urine osm>100
Normovolemic
Hypotonic

127
Q

Urine osmalilty is __, pt is __volemic, pt is ___tonic and hyponatremic

Psychogenic

A

Urine osmolality<100
Normovolemic
Hypotonic

128
Q

Two kinds of hypernatremia

A

Low urine osmolarity (<300)
And
High urine osmolarity (>600)

129
Q

Nephrogenic di is a __natremic state with __ urine osmolarity

A

Hyper

Low (100-300)

130
Q

Central di is a __natremic state with __ urine osmolarity

A

Hyper

Low (<100)

131
Q

Na+ gain and extrarenal losses are a __natremic state with __ urine osmolarity

A

Hyper

High

132
Q

Go losses due to vomiting causes __chloremia, __kalemia and ____ bicarb

A

Hypo
Hypo
Elevated

133
Q

Pt, especially young one, with htn and hypokalemia, suspect

A

Primary hyperaldo

134
Q

Best screening test for hyperaldo

A

Early-morning plasma aldosterone concentration (pac) to plasma renin activity ratio

135
Q

Estrogen ___ tbg

A

Increases

Step 2 (16 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions