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1
Q

MC cause of hypothyroidism?

A

Hashimoto Thyroiditis

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2
Q

TSH level in Hasimoto Thyroiditis?

A

elevated TSH

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3
Q

Which 2 antibodies positive in Hashimoto Thyroiditis?

A

positive anti-thyroid peroxidase antibodies

positive anti-thyroglobulin antibodies

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4
Q

T4 level in Hashimoto Thyroiditis?

A

low T4

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5
Q

Test for Diabetes Insipidus?

A

Desmopressin stimulation test

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6
Q

Sodium levels in DI?

A

Hypernatremia

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7
Q

DKA fluid deficit about how much?

A

5-10L (100mL/kg)

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8
Q

Best IVF for DKA?

A

NS

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9
Q

Rate of insulin infusion for DKA?

A

0.1U/kg/hr

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10
Q

When to change fluid during treatment for DKA?

A

When BGL at 200.

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11
Q

When BGL at 200 in DKA what to change fluid to? To prevent what?

A

Change to 5% Dextrose in 0.45% Saline and reduce insulin infusion. To avoid iatrogenic hypoglycemia and cerebral edema.

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12
Q

When to stop insulin infusion in DKA? (2 things)

A

Ketonemia clears and anion gap normalized

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13
Q

How much does sodium level decrease by for every 100 glucose above 100?

A

1.6 (140 at 100 to 138.4 at 200)

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14
Q

PTH deficiency does what to calcium levels?

A

Hypocalcemia

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15
Q

Hypocalcemia does what to muscles?

A

Neuromuscular irritability, increased DTRs, Trousseau carpal pedal spasm and Chovstek’s facial contractionsign

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16
Q

Hypocalcemia on EKG?

A

Prolonged QT interval

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17
Q

Low PTH does what to Phosphorus?

A

High P

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18
Q

Free T4 level in hypothyroidism?

A

Low!

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19
Q

TSH levels in hypothyroidism?

A

High!

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20
Q

Define thyrotoxicosis

A

Excessive thyroid hormone concentration

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21
Q

Thyroid storm is an extreme manifestation of what?

A

thyrotoxicosis

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22
Q

What predominently causes thyroid storm?

A

Grave’s dz

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23
Q

Euthyroid sick syndrome happens when?

A

Abnormal thyroid tests when someone is sick and usually has normal thyroid

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24
Q

When does Euthyroid sick syndrome get better?

A

after recover from underlying illness

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25
MC metabolic problem in neonates?
Hypoglycemia
26
Tx for neonate hypoglycemia?
5mL/kg of 10% Dextrose (aka D10)
27
Primary Adrenal Insufficiency aka
Addison Disease
28
Addison Disease skin and mucuous membranes?
Hyperpigmented skin and mucus membranes
29
Hyperpigmentation in Addisson’s Dz due to what?
Increased ACTH
31
Na and K in Addison Disease?
Hyponatremia | Hyperkalemia
32
Addison Disease due to low levels of which hormone?
Cortisol
33
Glucose levels in Addison Disease?
Low
34
Tx for Addison Disease?
Hydrocortisone and other supportive measures
35
Addison Disease MC due to?
autoimmune dz
36
Tx for pituitary adenmoma >1cm?
Surgical resection
37
Pituitary adenoma causes vision problem by compressing what?
Optic chiasm
38
Which condition makes women more likely to develop DM2? (hint: think female parts)
PCOS
39
What causes myxedema coma?
Hypotension
40
Which hormone is very low in myxedema?
Thyrioid
41
Why IV T3 rarely used for myxedema?
Can cause dysrhythmias leading to sudden cardiac death
42
Tx for myxedema
Levothyroxine (T4)
43
MC type of pituitary tumor?
Prolactinoma
44
Tx for central DI?
Demopressin
45
Pheochromocytoma sx triad?
1. Episodic HA 2. Diaphoretic 3. Tachy w/HTN
46
Test for pheochromocytoma?
24 urine of catecholamines and metanephrine
47
Tx for pheochromoctyoma prior to surgery?
Alpha-adrenergic blockers
48
Lab to test for acromegaly?
IGF-1
49
Tx for sx of prolactinoma?
Cabergoline
50
Which class of oral DM meds can cause hypoglycemia?
Sulfonylurea (ex glipizide)
51
Tx for thyroid storm if OD on Synthroid
Beta-blocker and dexamethasone
52
What does Metformin decrease and increase?
Decrease hepatic glucose production | Increase cell insulin sensitivity
53
Graves Dz aks
Toxic diffuse goiter
54
Graves Dz produces what against thyroid receptors
Autoantibodies to thyroid hormone receptors
55
Diffuse goiter + exophthalmos, and pretibial myxedema think of
Graves Dz
56
DM can be diagnosed if serum glucose is above what number after 75g oral glucose?
Above 200 two hours after 75g oral glucose
57
Which thioamide for hyperthyroid to use in first trimester of preggers in Graves Dz?
PTU
58
Which thioamide for hyperthyroid to use in 2nd and 3rd trimester of preggers in Graves Dz?
Methimazole
59
De Quervain Thyroiditis aka
Subacute Thyroiditis
60
Subacute Thyroiditis usually due to what
neutrophillic inflammation of the thyroid
61
Subacute Thyroiditis usually preceded by what?
upper resp infx
62
Early Subacute Thyroiditis presents as what condition?
Hyperthyroid
63
Later stages of Subacute Thyroiditis present as what condition?
Hypothyroid
64
Tx for Subacute Thyroiditis?
NSAIDs for pain. usually self-limited.
65
First and second medications used for thyroid storm?
Beta-blocker then PTU
66
Can dx DM if patient current symptomatic and BGL is what?
above 200
67
Graves dz and thyroid levels?
Increased!
68
Hashimotos and thyroid levels?
Decreased!
69
K and BP in primary hyperaldosteronism?
Hypokalemia | HTN
70
DTRs in hypothyroid?
Delayed
71
Bicarb levels in DKA?
Low!
72
When to check serum cortisol levels in Addison’s workup?
Morning
73
What to block first when a pheochromocytoma emergency?
Alpha-blockade before beta-blockade! Use phenoxybenzamine.
74
MC feature in Cushing’s Syndrome?
Central obesity
75
MC trigger of thyroid storm?
Infection
76
Metformin which class?
Biguanide
77
Slow increase in ring and shoe size which condition?
Acromegaly
78
MC type of thyroid cancer?
Papillary carcinoma
79
DI urine osmolality, serum osmolality?
Low urine osmolality | High serum osmolality
80
When to retest TSH after starting levothyroxine?
6 weeks

PANCE (6 decks)

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