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STEP 2 AG > Endo > Flashcards

Endo Flashcards

1
Q

Thyroglobulin

A

Precursor of T4 T3, can only be produced by thyroid (or ectopic), test for ca recurrence

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2
Q

Neonatal thyrotoxicosis

A

MOC w Graves, 3rd tri antiTSH receptor Ab crosses the placenta, resolves ~3mo, tx methimazole and Bb

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3
Q

Thyroid storm

A

Pt w subclinical hyperthyroid, surgery/trauma/infx, order thyroid studies, tx Bb, iodine, glucocorticoid, PTU

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4
Q

Thyroid nodules (malig)

A

U/S + TSH (unless >2cm FNA) –> if TSH low ONLY radionucleotide uptake, MC papillary (psammoma, LN), follicular (capsule/vascular invasion, hard, cold, hem spread), medullary (MEN2B, calcitonin)

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5
Q

Congenital hypothyroidism

A

OK for a few months, then apathy, hypotonia, macroglossia, umbilical hernia

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6
Q

Primary adrenal insufficiency

A

dark skin, GI, fatigue/wt loss/weakness, hypoNa, hyperK, hypotension, w/u 8AM cortisol + ACTH + ACTH stim=low cortisol (<5) high ACTH (central has nl aldo/skin/lytes maybe hypoNa)

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7
Q

MEN syndromes

A

MEN1 PTH, pituitary, pancreas
MEN2A PTH, pheo, medullary thyroid
MEN2B (RET) medullary thyroid, mucosal neuromas, pheo MARFANOID HABITUS

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8
Q

Cushing syndrome

A

Proximal muscle weakness 2/2 atrophy, easy bruising (nl plt)*** w/u late night salivary cortisol or 24h urine or low-dose dex supp –> ACTH (high=ectopic ACTH or pituitary –> high dose dex supp, low=exogenous or primary adrenal less common)

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9
Q

Primary hyperaldosteronism

A

U/l (aldosteronoma), b/l (hyperplasia), hypoK muscle pain/weakness, worse w/ diuretics, screen ald/ren>20, dx CT, tx spironolactone

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10
Q

Acute hypoCa

A

Trousseau (BP)/Chvostek (cheek), chelation (citrate tfusion +liver probs, lactate sepsis)

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11
Q

PKU

A

musty urine, phenylalanine

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12
Q

Anti-thyroid Rx

A

methimazole (agranulocytosis BOTH, terat 1st tri), propylthiouracil (hep FAILURE), radioiodine (exophthalmos)

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13
Q

Cirrhosis

A

Hyperestrogenism=hypothalamic hypogonadism, euthyroid

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14
Q

Exophthalmos

A

GRAVES ONLY, anti-TSHr Ab=prolif of orbital tissue

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15
Q

Carcinoid

A

Flushing, diarrhea, tricuspid regurg, GI sometimes liver, inc tryptophan–>SE (5-HIAA) leads to niacin def

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16
Q

Endo causes of myopathy

A

Cushing, hypothyroid, lytes

17
Q

Glycemic control in DM

A

Microvascular (retinopathy, nephropathy)

18
Q

Hyperthyroid bone disease

A

inc osteoclast act (bone resorption, dec density, hyperCa)

19
Q

Secondary amenorrhea w/u

A

UPT –> TSH, FSH, prolactin

20
Q

Gaucher disease

A

Bone pain, HSM, anemia/thrombocytopenia, delayed puberty

21
Q

Milk alkali syndrome

A

HyperCa, met alk, AKI, usually pt taking some kind of OTC supplement (Ca carbonate)

22
Q

HyperCa workup

A

Albumin, ionized Ca –> PTH (primary, familial, Li) –> PTHrp (cancer), vit D

23
Q

Osteomalacia

A

D deficiency (Ricketts kids), PTH high phos low Ca nl-low, cortical thinning dec density

24
Q

DM nephropathy

A

Control HTN, A1C<7

25
Q

Hyperprolactinemia

A

Non-functioning pit adenoma (prolactin slightly high, TSH, LH low), prolactinoma (>200), Rx TSH nl

26
Q

Glucagonoma

A

Mild DM, necrolytic migratory erythema, GI, wt loss, anemia glucagon >500

27
Q

DM peripheral neuropathy

A

Large fibers proprioception/numbness/hyporeflexia, small fibers pain/paresthesias

28
Q

Hyperandrogenism

A

Rapid virilization c/f androgen-secreting tumor, measure testosterone (ovarian), DHEAS (adrenal)

29
Q

Subacute thyroiditis

A

Viral illness, Bb + NSAID

30
Q

Hypothyroidism metabolic abnormalities

A

Hyperlipidemia, CK, LFTs, hypoNa

31
Q

Acromegaly

A

Concentric LV hypertrophy, LV dilation, hypokinesis

32
Q

Graves tx

A

Anti-thyroid + Bb first, then radio-iodine or surg

33
Q

Thyrotoxicosis

A

inc myocardial contractility + HR –> hyperdynamic circulation, HTN

34
Q

Pheochromocytoma

A

Makes you NRVous (NF1 RET/MEN2 VHL) NOT CARCINOID is only flushing and diarrhea

35
Q

Panhypopit

A

Aldosterone is nl

36
Q

Ca + pH

A

High pH —> more Ca-alb = less ionized Ca nl labs but sx hypoCa

37
Q

Medullary thyroid cancer

A

Parafollicular cells make calcitonin, measure for prog + f/u for recurrence (MEN2)

38
Q

Painless thyroiditis

A

Have Abs, transient/self-limiting 3w, small or no nodule no uptake release of pre-formed

39
Q

Hyperglycemia

A

A1C 8-10 post-prandial, >10 hyperglyc all the time

Dawn phenomenon=HYPER in the AM cortisol

STEP 2 AG (16 decks)

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