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medical review > Endocrine > Flashcards

Endocrine Flashcards

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USMLE® Step 1 flashcards
1
Q

primary function of parathyroid hormone

A

regulate homeostasis of calcium, phosphate and 1,25 dihydroxyvitamin D (calcitriol)

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2
Q

what happens when Calcium receptors on Parathyroid gland sense lower calcium levels

A

PTH is released which causes:
1- within minutes bone resorption begins
2- within minutes calcium reabsorption in the kidney
3- Calcitriol increases the absorption of calcium in the GI tract

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3
Q

Will DPP4 inhibitors cause hypoglycemia

A

No

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4
Q

What is unique about SGLT-2 Inhibitors

A

Reduce CV risk

increase risk of amputations

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5
Q

What can microalbuminuria mean

A

progressive nephropathy

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6
Q

What do GLP-1 meds do

A

enhanced insulin secretion
suppress glucogon secretion
slows gastric emptying
early satiety

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7
Q

never mix which insulin with any other type

A

Insulin Glargine

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8
Q

which vitmain will be depleted with long term metformin use

A

B12

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9
Q

Minimum weight loss goal for pre DM to avoid DM dx.

A

5-10%

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10
Q

Fasting BS level to dx pre diabetes

A

100-125

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11
Q

Pros and cons of ACTOS

A

Pro: 24% reduction of heart attack and stroke, 52% reduction risk of developing DM
Con: Wt gain, Edema, Bone fxr, bladder cancer

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12
Q

Tx options for dm neuropathy

A

Lyrica and Cymbalta FDA approved

TCAs, Tegretol, Venlafaxine

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13
Q

What are the levels of Hypoglycemia

A

Level 1: 54-70
Level 2: <54
Level 3: <54 and requiring assistance

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14
Q

Triad of Hemochromotosis

A

Cirrhosis, DM, Skin Hyperpigmentation

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15
Q

what may slow progression of DM retinopathy

A

Adding fenofibrate to statin tx (Accord trial)

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16
Q

When should you be concerned about kidney fxn after starting ACEI?

A

Rise of Cr to 30% above baseline after two months.

17
Q

Clear indication for ASA 75-162 mg daily

A

DM with CAD or PVD

18
Q

difference between Adding metformin or 30 min of daily moderate exercise to lose 5-10% wt. on Developing DM

A

Metformin 31% reduction risk

Wt loss and exercise 58% reduction risk

19
Q

Do statins increase risk of DM

A

Yes, 9% increased risk
Statins will cause 1 case of new DM for 500 pt treated x one yr
Lack of statins will cause one CV event for 200 pt treated x one yr.

20
Q

Who should have brain MRI in Low T workup

A

Men <40yrs with T <250, Men >60 yrs with T <150

21
Q

Risk for pts with subclinical hypothyroidism?

A

Elevated Lipids and progression to hypothyroidism,

22
Q

Next test to check with Subclinical hypothroidism?

A

anti TPO antibodies

If positive pt WILL become hypothyroid

23
Q

What is thyroid risk in pts taking amiodarone?

A

3% get hyperthyroidism

24
Q

Test to order if TSH low and T4 high

A

Radioactive Iodine Uptake scan

25
Q

Starting dose of thyroid med

A

1.6 mcg / kg recheck in 6 wks.

26
Q

MC thyroid cancer

A

Papillary (10 yr survival is 90%)

27
Q

Define thyrotoxicosis

A

Excess thyroid hormone

28
Q

What is the first thing you need to do when you identify thyrotoxicosis?

A

Determine if it is due to hyperthyroidism or thyroiditis

29
Q

What are some examples of hyper thyroidism?

A

Graves’ disease, toxic, multinodular, goiter, toxic adenoma

30
Q

What are some examples of thyroiditis?

A

This is release of preformed, thyroid hormone, such as after a viral infection,

31
Q

Treatment of thyrotoxicosis

A

It depends on what is causing the thyroid hormone to be elevated. Perhaps just treating symptoms with beta blockers with thyroiditis. Perhaps needs anti-thyroid drugs, such as Graves’ disease

32
Q

who should be screened for DM?

A

all pts over the age of 45 every 3 yrs. any female with hx of GDM every 3 yrs. Anyone younger with risk factors: obesity, 1st degree relative with DM, pt on BP meds. high risk ethnicity

33
Q

How can hypothyroidism cause Hyperprolactinemia?

A

Increased TRH causes release of prolactin as well.

34
Q

Why does risperidone cause prolactin secretion?

A

Dopamine can inhibit the release of prolactin, so dopamine antagonists will contribute to elevated prolactin. Risperidone one of the worse, Abilify resolves this in 80% of trial pts.

35
Q

how to recognize and work up pathologic galactorrhea?

A

Pathologic nipple discharge, characterized by a spontaneous unilateral, uniductal discharge with bloody features, should also be ruled out. Ultrasonography is the first-line modality in women <30 years of age and mammography is the first-line modality in women ≥30 years of age

medical review (27 decks)

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