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HARRISSONS > Endo > Flashcards

Endo Flashcards

1
Q

Renal complication of DM that have propensity for hyperkalemia and acidemia. Exacerbated by ACEI, ARBS and Aldo-antagonists

A

Type IV RTA

Hyporeninemic Hypoaldosteronemic

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2
Q

2 factors for diabetic kidney disease

A

Albuminuria + decreased GFR <60ml/min

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3
Q

In DM is associated with increased risk of cardiovascular disease

A

Albuminuria

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4
Q

Pathogenesis related to chronic hyperglycemia

A

Angiotensin II
GF
ENDOTHELIN
AGEs

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5
Q

Spot urinary albumin to CREA ratio

A

Albuminuria

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6
Q

Interventions effective in slowing progression from micro albuminuria to macro albuminuria

A
  1. Improve glycemic control
  2. Strict Bp
  3. Administration of ACE-I or ARBs
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7
Q

BP goal in patients with DM nephropathy with risk of CVD and CKD

A

<130/80

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8
Q

BP goal in patients with DM nephropathy with proteinuria

A

125/75

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9
Q

Protein intake in Diabetic kidney disease

A

0.8 mg/kg/day

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10
Q

Referral for transplant evaluation once GFR is

A

<20ml/min

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11
Q

Major risk factors for diabetic neuropathy

A

Increased BMI

Smoking

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12
Q

Most common form of diabetic neuropathy

A

Distal symmetric polyneuropathy

DSPN

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13
Q

Major risk factors for foot ulceration sand falls

A

LOPS Loss of protective sensation

DSPN Distal symmetric polyneuropathy

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14
Q

Most prominent Gastric complication in CM by parasympathetic dysfunction

A

Delayed gastric emptying (gastroparesis)
Altered small and large bowel motility
( constipation and diarrhea)

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15
Q

DM RELATED GI autonomic neuropathy

A

Nocturnal diarrhea alternating with constipation

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16
Q

If with known CHD with DM

A

Ace-I or ARBS, statin and Aspirin

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17
Q

DM AND POST MI

A

Beta blocker

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18
Q

Dm and CHF

A 
Avoid THIAZOLDINEDIONES (pioglitazone) due to edema 
Use metformin instead if with good renal fx
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19
Q

What drug is recommended for primary prevention in DM patients with increased CV risk (>50 years old, at least 1 risk factor -HTN, DYSLIPIDEMIA, smoking, albuminuria and family history)

A

Aspirin

20
Q

Use of moderate intense statin

A

Age 40-75 without additional risk,
<40 y/o but with additional risk,
All with DM + Age >75years oks

21
Q

Intensity of statin if DM + atherosclerotic CVD disease

A

High intensity statin therapy

22
Q

Combo statin + fenofibrate is not recommended except if

A
  1. With recent ACS

2. If LDL remains >70mg/dL in an individual with diabetes and CVD on a statin

23
Q

If LDL remains >70mg/dL in an individual with diabetes and CVD on a statin

A

Add ezetimibe

24
Q

Bp goal for most patients with DM and with hypertension

A

<140/90

25
Q

Bp goal of YOUNGER DM px or with increased cardiovascular risk

A

<130/80

26
Q

Dm foot ulceration is most commonly at the

A

PLANTAR FOOT SURFACE

27
Q

Most common pathogen in infected ulcer

A

AEROBIC GRAM POSITIVE COCCI

Staph
MRSA
Group A and B STREP

28
Q

Most specific modality for infected ulcer

A

MRI

29
Q

Interventions with demonstrated efficacy in diabetic foot wounds

A
  1. Off loading
  2. Debridement
  3. Wound dressing
  4. Appropriate use of antibiotics
  5. REVASCULARIZATION
  6. Limited amputation
30
Q

Antibiotics Severe infection in infected ulcer

A

Vancomycin + BLAC INHIBITOR
OR
VANCOMYCIN + QUINOLONE + metronidazole

31
Q

Rare infection seen exclusively in DM

A
  1. RHINOCEREBRAL MUCORMYCOSIS
  2. EMPHYSEMATOUS INFECTIONS OF THE GALL BLADDER
  3. “Malignant” or invasive OTITIS MEDIA
    sec to pseudomonas aeruginosa
32
Q

SERM approved for Osteoporosis

A

RALOXIFENE

33
Q

SERM USED IN BREAST CA AND FOR OSTEOPOROSIS

A

Tamoxifen

34
Q

SERM combined with conjugated estrogen

A

BAZEDOXIFENE

35
Q

Drug for osteoporosis that suppresses osteoclasts activity by direct action on osteoclasts calcitonin receptor

A

Calcitonin

36
Q

Strongest antiresorptive that Benefit among postmenopausal women with osteoporosis to reduce fracture over 3 years

A

DENOSUMAB

37
Q

Most common cause of pituitary hormone hyposecretion and hypersecretion syndromes in adults

A

PITUITARY ADENOMA

38
Q

Feature of type A insulin resistant syndrome

A

Affects young women
Severe hyperinsulinism
Features of hyperandrogenism

39
Q

Classic triad of pheochromocytoma

A

Profuse sweating
Headache
Palpitation

+ hypertension = diagnosis

40
Q

Dominant sign of pheochromocytoma

A

Hypertension

41
Q

Disorders of Male reproduction that have hypogonadotrophic hypogonadism

A

Kallman’s syndrome
Adrenal congenital hypoplasia ACH
Gnth receptor mutation

42
Q

Most common location of primary hyperparathyroidism

A

Inferior parathyroid glands

43
Q

Increase giant multinucleated osteoclasts in scalloped areas of the surface of the bone (HOWSHIP LACUNAE) and a replacement of the normal cellular and marrow elements by fibrous tissue
Sec to primary hyperparathyroidism

A

OSTEITIS FIBROCA CYSTICA

44
Q

Definitive therapy for primary hyperparathyroidism

A

Surgical excision

45
Q

Bone disease seen in patients with secondary hyperparathyroidism and CKD

A

Renal osteodystrophy

46
Q

Glucocorticoids May be of benefit to the ff for controlling hypercalcemia

A

Vitamin D and A intoxication

Hypercalcemia of Granulomatous disease

47
Q

Most common cause of primary adrenal insufficiency

A

Autoimmune adrenalitis

HARRISSONS (62 decks)

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