Endo Flashcards
Which 2 diabetic medication classes lead to increased risk of pancreatitis?
DPP4 inhibitors (-gliptins) and GLP1 mimetics (exenatide, liraglutide)
24 hour urine cortisol greater than what value suggests a Cushing problem?
Greater than 100 mg/dl
If a diabetic patient requires insulin therapy and had normal renal function, how many units/kg is the recommended daily insulin requirement?
0.5 units/kg
On the morning of surgery, what changes should be made to long acting insulin in diabetic patients?
Give half the dose of long acting insulin
Individuals who have both Addison’s Disease and Hashimoto thyroiditis are known to have what syndrome?
Schimdt’s Syndrome (autoimmune polyglandular type II)
Two fasting blood sugars greater than what # will diagnose diabetes mellitus?
125 mg/dl
What are the triad of diseases in multiple endocrine neoplasia (MEN) type I?
Parathyroid, pituitary, and pancreatic–remember them as the 3P’s of MEN I
What condition is often associated with antibodies positive to glutamic acid decarboxylase?
Type 1 Diabetes Mellitus
Rapid fire assoc: Hypertension, hypokalemia, metabolic alkalosis
1º hyperaldosteronism (Conn syndrome)
Rapid fire assoc: “Brown” tumor of bone
Hyperparathyroidism or osteitis fibrosa cystica (deposited hemosiderin from hemorrhage gives brown color)
What is the best screening blood test for acromegaly?
Insulin growth factor 1 (IGF-1)
Rapid fire txt: Carcinoid syndrome
Octreotide
Rapid fire txt: Diabetes insipidus
Desmopressin (central); hydrochlorothiazide, indomethacin, amiloride (nephrogenic)
Rapid fire assoc: Enlarged thyroid cells with ground-glass nuclei with central clearing
“Orphan Annie” eyes nuclei (papillary carcinoma of the thyroid)
Thyroid (Medullary Carcinoma) and parathyroid tumors, pheochromocytoma
MEN 2A (autosomal dominant RET mutation)
Thyroid tumors (Medullary Carcinoma), pheochromocytoma, ganglioneuromatosis
MEN 2B (autosomal dominant RET mutation)
What is the best way to prevent foot ulcers from occurring in diabetic patients?
Perform monofilament testing
Which class of anti-diabetic agents should be avoided in patients who have underlying congestive heart failure (CHF)?
Thiazolidinedione (glitazones)
Which class of antibiotics is most notoriously contraindicated in individuals with myasthenia gravis?
Aminoglycosides (amikacin, tobramycin, neomycin)
Skin hyperpigmentation, hypotension, fatigue Dx?
1º adrenocortical insufficiency (ed, Addison disease) causes ↑ ACTH and ↑ α-MSH production)
No lactation postpartum, absent menstruation, cold intolerance Dx?
Sheehan syndrome (pituitary infarction)
Which two hyperthyroid conditions will cause low radioactive iodine uptake?
Thyroiditis and exogenous use of thyroid medication
What thyroid test level tends to be elevated in patients who have sick euthyroid syndrome?
Reverse T3 (rT3)
What type of reflexes would you expect in a patient who has uncontrolled hypothyroidism?
Delayed
Work up of amenorrhea, FSH >35 Suggest what diagnosis?
Primary ovarian failure. Level should be <20
In what diseases causing hirsutism do we expect the DHEA (17 OH ketosteroid) to be elevated?
Cushing dz, adrenal carcinoma, congenital adrenal hyperplasia
What are the reflexes you would expect in an individual who has antibodies to postsynaptic acetylcholine receptors? What is the Condition in which you find this?
Normal; myasthenia gravis
In patient with antibodies to presynaptic acetylcholine receptors, are reflexes increased or decreased?
Decreased (condition is Eaton-Lambert Syndrome)
What medication is given as an injectable for osteoporosis?
Teriparatide
Patients with elevated igf1 should have confirmatory testing with what?
Oral glucose suppression test (75 g oral glucose load)
