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INTERNAL MEDICINE > Endocrine > Flashcards

Endocrine Flashcards

1
Q

Initial test in Hyperthyroidism

A

TSH

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2
Q

when to repeat thyroid function test after stating treatment

A

4-6 weeks

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3
Q

most serious complication of graves ophthalmopathy

A

Optic nerve compression

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4
Q

antithyroid DOC for thyroid storm

A

PTU

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5
Q

best treatment for hypothyroidism

A

Levothyroxine

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6
Q

MCC of hypothyroidism worldwide

A

Iodine deficiency
mountain regions , Alps, Andes

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7
Q

MCC of hypothyroidism in iodine sufficient areas

A

Hashimoto thyroiditis (AI) and iatrogenic (tx for hyperthyroidism), post RAI

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8
Q

thyroid nodule with low TSH, what is the test?

A

thyroid scan–> is indicated if the TSH is suppressed to demonstrate HYPERFUNCTIONING state
Toxic adenoma –> mgnt: RAI

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9
Q

Thyroid nodule with high TSH, what is the test?

A

Ultrasound guided FNAB - may be not hyperfunctioning state

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10
Q

what drug inhibits cortisol synthesis at the level of 11b-hydoxylase, ONLY adrenal inhibiting medication administered to pregnant women with cushing syndrome

A

Metyrapone

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11
Q

it inhibits the early steps of steroidogenesis

A

Ketoconazole

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12
Q

MCC of mineralocorticoid excess

A

Primary Hyperaldosteronism

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13
Q

MCC of cushingoid features

A

Iatrogenic Hypercortisolism

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14
Q

MCC of Cushing’s syndrome OVER ALL

A

MEdical use of glucocorticoid for immunosuppression for the treatment of inflammatory disease

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15
Q

primary cause of DEATH in Cushing

A

Cardiovascular Disease

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16
Q

Parameters to diagnose DM`

A

HbA1c - >/6.5 %
FPG - >/126/mgdL (7mmol/L)
2 hr, 75g OGTT - >/200mgdl (11mmol/L)
RBS - >/200mgdl (11mmol/L)l

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17
Q

what need to be assessed in DM ANNUALLY

A

Neuropathy
Nephropathy
Lipids

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18
Q

what need to be assessed in DM, 2x/yr

A

BiAnnual eyes and feet exam

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19
Q

How many times to assessed HbA1C in a yr?

A

2-4x a yr

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20
Q

when to consider DUAL combination therapy in DM?
Consider combination Injectable therapy when A1c, RBS ?

A

DUAL - >/9%
Injectable - Hba1c 10%, RBS >/300mg/dL

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21
Q

Anti DM promotes WEIGHT GAIN

A

Sulfonylureas
TZD
Insulin

22
Q

Anti DM promotes WEIGHT LOSS

A

Metformin
SGLT2 inhibitor
GLP1 receptor agonist

23
Q

Anti DM that is WEIGHT NEUTRAL

A

DPP4 inhibitor

24
Q

Drugs with MOA of increase insulin secretion

A

Sulfonylureas: Glimepiride, Glipizide

25
Q

DM Drugs with MOA of INSULIN SENSITIZERS

A

metformin - reduces hepatic glucose production
TZD: Pioglitazone - react on PPAR-gamma

26
Q

DM Dugs that inhibit intestinal absorption of sugar, it blocks the enzymes that breakdown complex carbs

A

Alpha- glucosidase inhibitor: Acarbose, Vogilbose, MIglitol

27
Q

Insulin prep with long half live (24 hrs)

A

basal insulin analogs: Glargine, Detemir, Degludec

28
Q

Onset of action and duration of Rapid acting insulin

A

RAI: Lispro, Aspart, Glusiline
<15mins, duration: 2-4hrs

29
Q

target LDL in DMT2 with very high risk CV

30
Q

target LDL in DMT2 with high risk CV

31
Q

target LDL in DMT2 with NO RF

32
Q

target LDL in NONDIABETIC

33
Q

first defense against HYPOGLYCEMIA

A

decrease insulin secretion
2nd - Glucagon
3rd - Cortisol

34
Q

Target goal in adults with DM:
HbA1c, pre-prandial, post-prandial, BP

A

HbA1c - <7%
Pre-prandial - 4.4-7.2 mmol/L
Post - prandial - <10
BP - 140/90 –> if with CKD/CVD: <130/80

35
Q

most effective therapy in diabetic RETINOpathy

A

PREVENTION

36
Q

MC pattern of dyslipidemia

A

hypertriglyceridemia
low HDL cholesterol level

37
Q

TRIAD of DKA

A

Hyperglycemia
HAGMA
Ketosis

38
Q

difference of HHS to DKA

A

HHS - Insulin deficiency – hyperosmolarity, osmotic diuresis – dehydration
glucose level >600

39
Q

dominant ketone in ketosis

A

3 hydroxybutyrate

40
Q

major nonmetabolic complication of DKA therapy

A

Cerebral edema

41
Q

method of choice to determine the thyroid SIZE aacurately

A

Ultrasound

42
Q

drug NOT used in thyroid Storm

A

Amiodarone – exacerbate by giving excess Iodide

43
Q

High TSH, Normal FT4

A

Mild subclinical hypothyroidism

44
Q

high TSH, Low FT4

A

Primary hypothyroidism
Autoimmune hypothyroidism

45
Q

low TSH, high FT4

A

primary thyrotoxicosis: Graves, multinodular goiter, toxic adenoma

46
Q

low TSH, normal FT4

A

Subclinical hyperthyrodism
t3 toxciosis

47
Q

monitoring on treatment of thyroid?
stable px?
adjustment of tx?

A

on tx; 3-4mos
stable: 6-12 mons
adjust: 6-8 weeks

48
Q

size of the nodule to be palpable

A

> 1cm in diameter

49
Q

most accurate diagnostic in Cushing syndrome

A

24hr urine cortisol

50
Q

best initial diagnostic test in Cushing syndrome:

A

1mg overnight Dexa suppression test and 24 hr urine cortisol

51
Q

TRIAD of Pheochromocytoma

A

Profuse sweating
headaches
Episodic palpitations

52
Q

human monoclonal antibody to RANKL –>inhibits the formation of osteoclast

INTERNAL MEDICINE (5 decks)

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