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endo Flashcards

1
Q

ENDOCRINOLOGY

A

ENDOCRINOLOGY

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2
Q

What two hormones are secreted by the posterior pituitary?

A

Oxytocin and antidiuretic hormone (ADH, vasopressin)

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3
Q

What is Sheehan’s syndrome?

A

Ischemia of the pituitary due to volume depletion during or after childbirth.

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4
Q

How do glitazones work?

A

They improve insulin sensitivity.

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5
Q

What is the most common pituitary adenoma?

A

Prolactinoma

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6
Q

Large doughy hands should make you think of what diagnosis?

A

Gigantism

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7
Q

Diabetes insipidus is caused by a deficiency of which hormone?

A

Vasopressin

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8
Q

How much more potent is T3 than T4?

A

3-4x

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9
Q

What is the first line medical treatment for a pheochromocytoma?

A

Alpha blocker. You should never use a pure beta blocker.

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10
Q

What is the best imaging for a thyroid nodule?

A

Ultrasound

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11
Q

A patient presents with erectile dysfunction and complains of some numbness in his feet. On second thought he has noticed significant polyuria and polydipsia. What diagnosis should you be thinking of?

A

Diabetic neuropathy

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12
Q

Pretibial myxedema should make you think of what diagnosis?

A

Graves’ disease

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13
Q

A 35 year old female presents with heat intolerance, weight loss and palpitations. What is the most likely diagnosis?

A

Hyperthyroidism

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14
Q

What is the first line medical treatment for a patient who presents with palpitations and nervousness secondary to hyperthyroidism?

A

Beta Blockers

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15
Q

What is Hashimoto’s disease?

A

An autoimmune cause of hypothyroid

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16
Q

How does levothyroxine work?

A

It is a synthetic T4

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17
Q

What is the most common thyroid cancer?

A

Papillary, makes up about 80% of thyroid cancers.

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18
Q

In a patient with hyperthyroidism will TSH most likely be elevated or decreased?

A

Decreased

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19
Q

How do fibrates work to affect the lipid profile?

A

They inhibit synthesis of VLDL and elevate lipoprotein lipase.

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20
Q

What medication might you use prior to thyroidectomy in a patient with hyperthyroidism?

A

Methimazole or propylthiouracil (PTU)

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21
Q

What is included in Whipple’s triad of hypoglycemia?

A

History of previous hypoglycemia, serum glucose of <40, immediate recovery upon administration of glucose

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22
Q

Positive antithyroid peroxidase and antithyroglobulin antibodies should make you think of what diagnosis?

A

Hashimoto’s

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23
Q

What is the treatment for myxedema?

A

Levothyroxine and slow warming

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24
Q

What is the most common cause of hypoparathyroid?

A

Post thyroidectomy with the complication of parathyroidectomy.

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25
Q

What is Chvostek’s sign?

A

Tap on facial nerve and get a twitch with low Ca.

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26
Q

Cortical adrenal insufficiency is also known as what disease?

A

Addison’s disease

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27
Q

What is Trousseau’s sign?

A

Inflate BP cuff and hold for 3 minutes. Patient with low Ca will get carpel tunnel symptoms.

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28
Q

What is the most common cause of hyperparathyroidism?

A

Single parathyroid adenoma in 80% of cases.

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29
Q

In Cushing’s disease is ACTH elevated or decreased?

30
Q

What is Graves’ disease?

A

The most common cause of hyperthyroidism. It is an autoimmune disease.

31
Q

What specific breathing pattern is associated with diabetic ketoacidosis?

A

Kussmaul respirations

32
Q

What is the least aggressive thyroid cancer?

33
Q

Name two tests you might use to rule out Cushing’s syndrome.

A

24 hour free cortisol urine test and dexamethasone suppression test

34
Q

List two ectopic tumors that may produce ACTH and give a patient Cushing’s syndrome?

A

Small cell lung cancer, pancreatic islet cells, thymomas

35
Q

What is the treatment for Addison’s disease?

A

Hydrocortisone or prednisone

36
Q

What is the test to begin with if you suspect a pheochromocytoma?

A

24 hour urine for catecholamines

37
Q

Exophthalmos should make you think of what diagnosis?

A

Hyperthyroidism

38
Q

What percentage of diabetes in the US is type 2?

39
Q

HLA-DR gene is a marker for what endocrine disorder?

40
Q

What is the main function of parathyroid hormone?

A

Increase serum Ca

41
Q

List four diagnostic criteria for diabetes?

A

Random glucose >200, fasting glucose >126, two hour postprandial glucose >200, HgA1c >6.5%

42
Q

Moans, groans, stones, bones, psychiatric overtones describe symptoms of what endocrine problem?

A

Hyperparathyroid

43
Q

Stocking glove anesthesia should make you think of what diagnosis?

A

Diabetic neuropathy and B12 deficiency neuropathy

44
Q

Fruity breath should make you think of what diagnosis?

A

Diabetic ketoacidosis

45
Q

As it relates to diabetics, what is the dawn phenomenon?

A

Reduced insulin response between 5 and 8 am

46
Q

What is the most common cause of hypopituitarism?

47
Q

How does metformin work?

A

Decreases the hepatic glucose production and increases peripheral glucose uptake

48
Q

How do sulfonylureas work?

A

They stimulate the production of insulin.

49
Q

What class of medications does pioglitazone (Actos) fall into?

A

Thiazolidinediones also known as glitazones

50
Q

What is the suffix associated with sulfonylureas?

A

Ide is the suffix. Examples: glipizide, tolbutamide, tolazamide.

51
Q

Typically what is the first medication started in type 2 DM?

52
Q

How often should a diabetic’s HgbA1c be checked and what should it be?

A

Every three months (remember the life of an RBC is 90-120 days) and it should be below 6.5%

53
Q

What are the 5 criteria for metabolic syndrome?

A

HDL <40 men <50 females, BP>135/85, Triglycerides >150, Fasting glucose>100, Waist >40 inches in men >35 inches in women

54
Q

What class of medications is the first line for lowering LDL?

55
Q

Which lipid medication may cause flushing?

56
Q

What life threatening side effect do statins have?

A

Rhabdomyolysis

57
Q

Does niacin increase or decrease HDL?

58
Q

What medication class does metformin (Glucophage) fall into?

59
Q

List the 5 insulins in order of peak efficacy?

A

Lispro 1-2 hrs, Regular 2-4 hrs, NPH 5-7 hrs, Lente 4-8 hrs, Ultralente 8-14 hrs

60
Q

Is metformin indicated or contraindicated in renal failure?

A

Contraindicated

61
Q

What is the most common cause of DM type 1?

A

Autoimmune destruction of the islet cells in the pancreas

62
Q

List 4 physical exam findings for Cushing’s syndrome.

A

Moon face, buffalo hump, purple striae, central obesity, supraclavicular fat pads, easy bruising

63
Q

Propranolol belongs to what class of medication?

A

Beta blockers

64
Q

During pregnancy which is the prefered treatment of hyperthyroidism PTU or methimazole?

65
Q

Name the four thyroid cancers.

A

Papillary Follicular Medullary Anaplastic

66
Q

What heparin complication is relevant to endocrinology?

A

Adrenal infarct leading to a Cushing’s syndrome

67
Q

How does nicotinic acid work to affect the lipid profile?

A

It inhibits secretion of VLDL.

68
Q

Hyperpigmentation of the skin along creases should make you think of what diagnosis ?

A

Addison’s disease

69
Q

Which thyroid cancer is the most aggressive?

A

Anaplastic

70
Q

How do statins work to affect the lipid profile?

A

They slow the rate limiting step of cholesterol synthesis.

71
Q

Will ACTH be elevated or decreased in Addison’s disease?

A

Elevated if the problem is at the adrenal glands.

72
Q

What role does C-peptide play in the diagnosis of diabetes?

A

It is a marker of insulin production. Elevated C-peptide points to DM 2. Decreased C-peptide points towards DM 1.

PANCE Final Step Cards (15 decks)

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