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COMAT - IM > Endo Part 1 > Flashcards

Endo Part 1 Flashcards

1
Q

What is the pneumonic to remember Metabolic Syndrome?

A

WEIGHHT

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2
Q

What are the findings with Metabolic Syndrome?

A

WEIGHHT
- Waist Expanded
- Impaired Glucose
- HTN
- HDL decreased
- Triglycerides increased

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3
Q

What is the treatment for Metabolic Syndrome?

A

Lifestyle modifications
+/- metformin for weight loss
+/- BP medications

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4
Q

What is most of T4 bound to in the bloodstream? What increases this?

A

TBG – increases in pregnancy

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5
Q

Graves disease involves TSH receptor stimulating antibodies. What are findings that are only present with this cause of hyperthyroidism? (4)

A

Exophthalmos
Pretibial myxedema
Acropachy – hand swelling
Thyroid bruit

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6
Q

If someone with Graves disease choose to undergo Iodine ablation, what will worsen?

A

Eye disease – exophthalmos

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7
Q

In a pregnant woman with Graves disease, what is a potential adverse effect?

A

Fetal thyroxicosis
– TSH antibodies cross placenta and stimulate fetal thyroid

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8
Q

What is the treatment for Thyroid eye disease?

A

Steroids

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9
Q

What is used for symptom control with hyperthyroidism?

A

Beta blocker – propranolol

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10
Q

Which hyperthyroidism medication should be used in pregnancy?

A

PTU

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11
Q

What are some adverse effects of PTU and Methimazole

A

Both = Agranulocytosis
PTU = Liver failure
Methimazole = Cholestasis

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12
Q

What is the only definitive treatments (2) for hyperthyroidism?

A

Radioactive iodine ablation
Thyroidectomy

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13
Q

What is the next most common cause of hyperthyroidism following Graves disease?

A

Thyroid adenoma – hot nodule

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14
Q

With UNtreated hyperthyroidism, what is the potential adverse effect?

A

Osteoporosis and bone resorption
=> Fractures and hypercalcemia

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15
Q

How may Thyroid storm present?

A

HIGH fever
Afib
Delirium/coma

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16
Q

What is the treatment order for a thyroid storm (4)?

A

Beta blocker
PTU/Methimazole
Iodine
+/- steroids

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17
Q

What occurs with Euthyroid sick?

A

Serious illness causes T4 to be converted to reverse T3 which is NON-functional

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18
Q

What will the levels of TSH, T4 and T3 be with Euthyroid sick?

A

NORMAL TSH and T4
- LOW T3

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19
Q

Hashimoto’s thyroiditis may have which 2 antibodies?

A

Anti-TPO
Anti-Thyroglobulin

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20
Q

There are many Thyroiditis conditions – postpartum, postviral, subacute; how may they present?

A

Hyperthyroid –> Hypothyroid

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21
Q

Which Thyroiditis has a painful goiter (though all can have a nonpainfaul goiter)? What precedes this?

A

Subacute Thyroiditis
– preceded by viral illness

22
Q

Which Thyroiditis will have elevated ESR/CRP?

A

Subacute Thyroiditis

23
Q

What are some features of congenital hypothyroidism?

A

Umbilical hernia
Failure to thrive/hypotonia
Prolonged jaundice

24
Q

What are 2 features seen with Papillary thyroid cancer?

A

Psammoma bodies
Orphan annie nuclei

25
Q

What are 2 features seen with Papillary thyroid cancer?

A

Psammoma bodies
Orphan annie nuclei

26
Q

How does Papillary thyroid cancer spread?

A

Lymphatic

27
Q

How does Follicular thyroid cancer spread?

A

Hematologic

28
Q

Where is Medullary thyroid cancer and what is produced?

A

Thyroid C cells –> Calcitonin

29
Q

MEN 1

A

3 P’s
- Pituitary
- Parathyroid
- Pancreas

30
Q

MEN 2A

A

2 P’s
- Parathyroid
- Pheochromocytoma
- Medullary Thyroid carcinoma

31
Q

MEN 2B

A

1 P
- Pheochromocytoma
- Medullary Thyroid carcinoma
- Marfanoid habitus

32
Q

What derm finding is seen with a Glucagonoma?

A

Necrolytic Migratory Erythema

33
Q

What derm finding is seen with a Glucagonoma?

A

Necrolytic Migratory Erythema

34
Q

How does Necrolytic Migratory Erythema look?

A

Large indurate plaques with CENTRAL CLEARING

35
Q

If someone takes in too much calcium or alkali like antacids, what are they at risk for?

A

Milk Alkali Syndrome

36
Q

What will the levels of Calcium, HCO3 and GFR be with Milk Alkali syndrome?

A

– excess intake of calcium/alkali/antacids
= HIGH calcium and HCO3
= LOW GFR

37
Q

What is Paget Disease of Bone?

A

Bone formation AND resorption

38
Q

Paget Disease commonly presents at the skull. What are characteristic symptoms?

A

Bone pain + nerve entrapment + hearing loss

39
Q

If someone presents with bone pain and hearing loss… expect what?

A

Paget Disease of bone

40
Q

What lab value is elevated with Paget Disease of Bone? What are patients at an increased risk for?

A

HIGH Alk Phos
–> Osteosarcoma risk

41
Q

What will an X-ray show with Paget Disease of Bone?

A

Mosaic pattern
– cortex sclerosis + thickened trabeculae

42
Q

Lab values of PTH, Ca, P with Primary Hyperparathyroidism?

A

HIGH PTH and Ca
LOW P

43
Q

Lab values of PTH, Ca, P with Secondary Hyperparathyroidism?

A

HIGH PTH and P
LOW Ca

44
Q

What commonly causes Secondary Hyperparathyroidism?

A

Renal failure

45
Q

What commonly causes Tertiary Hyperparathyroidism?

A

Chronic hypocalcemia that causes autonomously functioning parathyroid glands

46
Q

Lab values of PTH, Ca, P with Tertiary Hyperparathyroidism?

A

ALL HIGH

47
Q

What causes Pseudohypoparathyroidism?

A

PTH resistance
– common with Albright Osteodystrophy (shortened 4th/5th fingers)

48
Q

Lab values of PTH and Ca with Pseudohypoparathyroidism?

A

High PTH and Low Ca

49
Q

What scan may be helpful with hyperparathyroidism?

A

Sestamibi scan

50
Q

What may get too high and need treatment with Secondary hyperparathyroidism?

A

Phosphate – phosphate binders (ex. sevelamer)

COMAT - IM (17 decks)

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