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LMCC > Endo > Flashcards

Endo Flashcards

1
Q

Hormone used to titrate antithyroid meds for Grave’s

A

Free T4

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2
Q

Grave’s disease antibody

A

Anti TSH receptor

Acts on TSHr in pituitary gland –> over-activation of thyroid to produce T3 and T4

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3
Q

Most common benign thyroid nodule

A

Follicular adenoma

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4
Q

Most common neoplasm of thyroid (benign and malignant combined)

A

Follicular adenoma

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5
Q

Most common malignant cancer of the thyroid

A

Papillary carcinoma

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6
Q

DeQuervain thyroiditis

A

AKA subacute granulomatous thyroiditis
Benign
Follows infection
Presents as painful nodule

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7
Q

Doppler ultrasound finding of benign nodular hyperplasia

A

Ring of fire

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8
Q

Follicular adenoma of thyroid characteristics

A

Red light on colour dopplery U/S
Confined in capusle
Different growth pattern from surrounding parenchyma

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9
Q

Most sensitive means of differentiating primary from secondary causes of hyperaldosteronism

A

Aldosterone-to-renin-ratio (ARR) = ratio of plasma aldo to plasma renin activity
-Measures the rate of production of angiotensin I from endogenous angiotensinogen via renin
-As aldo secretion rises, ARR should fall b/c of Na retention
(RAS decreases when BP high)

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10
Q

Renin function

A

Angiotensinogen to Angiotensin I

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11
Q

ACE function

A

Angiotensin I to Angiotensin II

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12
Q

Aldosterone is produced from

A

Adrenal cortex

Signalled by Ang II

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13
Q

Primary aldosteronism

A

Conn’s Syndrome
Increased production of aldosterone from adrenal gland –> decreased renin
Renin levels may fall well before plasma aldo is increased
Triad of:
HTN
Hypokalemia
Metabolic alkalosis

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14
Q

Secondary hyperaldosteronism

A

Decreased renal blood flow (ie. due to obstruction, edematous d/o such as CHF/nephrotic syndrome/cirrhosis, renal vasoconstriction)
RAS stimulated –> aldo hypersecreted
Aldo and renin HIGH

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15
Q

Hashimoto’s antibody

A

Anti-TPO

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16
Q

Timeframe to recheck TSH

A

Wait >6wks to recheck TSH after dose change

Regular monitoring is 2-3mo then annually once stable

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17
Q

Hyperthyroid tx

A

Methimazole (high rate of relapse)

I-131

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18
Q

Starting insulin dose

A

0.3-0.5 U/kg

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19
Q

Rapid acting insulins (bolus dosing)

A 
Insulin aspart (NovoRapid)
Insulin lispro (Humalog)
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20
Q

Short-acting insulins (bolus dosing)

A

Humulin-R

Novolin-ge Toronto

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21
Q

Intermediate acting insulin (basal dosing)

A

Humulin-N

Novolin-ge NPH

22
Q

Long-acting insulin (basal dosing)

A 
Insulin detemir (Levemir)
Insulin glargine (Lantus)
23
Q

Carcinoid syndrome

A

Flushing (histamine, bradykinin), secretory diarrhea (serotonin), abdo pain, tricuspid regurg, skin color changes, wheezing
Result from carcinoid tumour (slow growing neuroendocrine tumours)
Usually asymptomatic
Once carcinoid symptoms occur then metastasis to LIVER likely has already occurred

24
Q

Biochemical test to confirm carcinoid syndrome

A

5-hydroxyindoleacetic acid (5-HIAA) measured in 24h urine sample
Serotonin released by carcinoid tumours –> metabolized by monoamine oxidases in liver, lungs and brain –> 5-HIAA
+ imaging
+ hepatic panel if liver met

25
Q

Carcinoid tumour mgmt

A 
Cytoreductive surgery (debulking) on primary or met 
Somatostatin analogues (ie. octreotide) have hormone blocking properties --> help with symptoms 
\+/- chemoembolization of mets (esp in liver)
26
Q

Most common location of carcinoid tumour

A

Ileum

sometimes appendix

27
Q

Thyroid nodule with high TSH next step

A

FNA biopsy with cytology

28
Q

Thyroid nodule with low TSH next step

A

Radioiodine 123 scan or Technetium-99 scan to test for nodule functionality
+ fT4 and T3

29
Q

Cold thyroid nodule

A

FNA biopsy, U/S

R/O malignancy

30
Q

Homogeneously diffusely hot thyroid nodule

A

Graves

31
Q

Hetereogeneously diffusely hot thyroid nodule

A

Toxic multinodular goiter

32
Q

Focal diffuse hot thyroid nodule

A

Functioning adenoma

33
Q

No pick up on I123 thyroid scan

A

Thyroglobulin levels
If high –> ?thyroiditis
If low –> ?thyrotoxicosis

34
Q

Most common thyroid cancer

A

Papillary carcinoma

35
Q

Syndrome a/w medullary thyroid cancer

A

MEN-2A/B

36
Q

Tx for thyroid CA

A

Thyroidectomy +/- I131 radiation

37
Q

Parathyroid hormone action

A

hypercalcemia + hypophosphatemia

38
Q

Vitamin D association with Ca and P

A

Increases GI absorption of both

39
Q

MEN-1

A

Often a/w zollinger-ellison syndrome
Auto dominant d/o
Tumours in parathyroid gland (causes hyperca), pancrea, pituitary gland

40
Q

If TSH < ___ in pregnancy with negative anti-TPO, no need to treat

A

4

41
Q

Treatment for Graves in pregnancy

A

Propylthiouracil during preconception and 1st trimester
Switch to methimazole after first triemster to reduce maternal hepatotoxicity
Follow b/w q4-6wks

42
Q

Propylthiouracil excreted in breastmilk T/F

A

True

43
Q

Sick euthyroid syndrome

A

Abnormal thyroid function a/w acute severe non-thyroidal illness
Low T3 + normal T4 and TSH
If severe, serum T4 may also drop and TSH may be high or low

44
Q

Creutzfelt-Jakob disease

A

Neurodegenerative prion based brain disorder that has long incubation period with rapid progressive mental deterioration and myoclonus
Incurable and fatal
Spong-like appearance of brain
Brain bx is gold standard for dx

45
Q

Adrenal cytoplasmic antibodies positive in what disease?

A

Addison’s disease

46
Q

Addison’s disease

A

Primary adrenal insufficiency

Hypocortosolism

47
Q

Conn’s syndrome

A

Primary hyperaldosteronism

48
Q

Paget disease lab findings

A

Increased ALP, normal Ca, phosphate and PTH

Urinary pyridine and deoxypyridine levels increased

49
Q

Hypercalcemia treatment

A

IVF (+/- furosemide to prevent HF)

Adjunctive tx: Alendronate, calcitonin

50
Q

Hypercalcemia tx secondary to hormonal treatment

A

Prednisone

51
Q

TSH screening in pregnancy

A

q4wks during first half of pregnancy

At least once each trimester in latter half of pregnancy

52
Q

Insulinoma

A

Raised insulin –> fasting hypoglycemia

Plasma C-peptide

LMCC (22 decks)

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