Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

Flash Card Reema > Endocrine > Flashcards

Endocrine Flashcards

1
Q

-When to stop metformin ??

-Maximum dose of metformin per day?

A
  • GFR less than 30 ml/min (renal insufficiency)

-2000 mg

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

Hypoglycaemia pt , what to do, if pt :
1- conscious
2- can’t tolerate orally
3- can’t access iv line
??

A

1- oral juice
2- iv 5% dextrose
3- IM glucagon

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

-DKA pt, insulin regimen is?

-Hospitalized DM pt, best insulin regimen?

A

-(fixed regular)

-Basel ,bollus

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

Best medication shown to reduce mortality in DM pt?
A. SGLT-2
B. GLP-1
C. Metformin

A

Sglt

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

Ulcer on medial side ?
Artery or vein ?

A

Medial is vein
Lateral is Artery

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

What is the appropriate rate to reduce glucose in a patient with DKA ?

And why not more?

A
  • 6mmol/L per hour
    Or 100mg/dl/h

-to prevent cerebral oedema

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

Diabetic neuropathy ttt?

A

1- Amitriptyline
2-pregabalin
3- gabapentin

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

-what is honeymoon period in DM?

-what is somogi effect?

A
  • when there is still residual pancreatic functioning cells , and u need to lower insulin dose in this period

-early morning hyperglycaemia , similar condition to Dawn phenomenon

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

-side effect of amiodarone ?

A

-hyperthyroidism

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

Sick euthyroid, what is the TSH ,T3 ,T 4 lab result?

A

Low TSH , high T4, N or low T3

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

Graves disease management?

A

1- BB (propranolol) > protect the heart , given initially but in MCQs, choose methimazole!
2- antithyroid medications (PTU, methimazole -1st line ttt!-)
3-radioactive iodine
4- surgery

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

Thyroiditis ttt??

A

1-BB
2- NSAID (more important than BB!!)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

-multi nodular toxic goiter/solitary toxic adenoma ttt?

A

-radio active iodine
-surgery

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

-dose of thyroxine should be adjusted according to???
A. T3
B. T4
C.TSH
D. All TFT

-how many weeks should be pass before repeating TFT to adjust the dose???

-pt diagnosed with hypothyroidism and started thyroxine, came after 2 weeks from starting medication, TSH still high, what to do?

A

-According to TSH

-6 weeks

-continue same ttt, send home , follow up after one month ( 6 weeks most pass :)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

When to ttt subclinical hypothyroidism?? ( 3 indications)

A

See the pic

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

Thyroid nodule, FNA is done, what is the management for each result is in the following:
1- class one or not diagnostic result?

2-class 2 or benign lesion

3- class 3 or atypia of undetermined significance/or follicular lesion of undetermined significance

4- class 4 or suspicious of follicular neoplasm

5- class 5 or suspicious of malignancy

6- class 6 or malignant lesion

A

1- Repeat FNAC

2-Follow up by US

3-Repeat FNAC

4-hemi thyroidectomy

5-hemi thyroidectomy or near total thyroidectomy

6- near total thyroidectomy

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

Thyroid ca that is associated with increase level of calcitonin is???

A

Medullary carcinoma

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

Approach of thyroid nodule ?

A

Start always with
1- TFT
Then
2-radioactive iodine uptake
3-US (usually done with radioactive iodine uptake test)
4-FNA
——————-
Note:after radioactive iodine test, if hot nodule is detected, no need to do US (risk of malignancy is low)
-in opposite, if cold nodule or euthyroid, FNA most be done , because of high risk of malignancy.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

-MC nerve injury after thyroidectomy is????
-post thyroidectomy and pt have hoarseness of voice+ repeated chocking, what nerve is injured?

A

Recurrent laryngeal nerve !

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

-TSH is abnormal, what is the next step??

A. start treatment
B. T3
C. T4
D. Wait until symptoms appear

A

C!

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q
  • pt came with hypothyroidism S and S, normal TSH, what is ur next step?
A

-repeat TSH after 4 weeks and if still normal , check T4, and T3

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

Approach of hyperthyroidism in pregnancy?

A

-Methimazole is CI in the 1st trimester, PTU is indicated instead, u can use methimazole in the 2nd and 3rd trimester

-if gestational age not mentioned in the Q, choose PTU then.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

CI of methimazole use in hyperthyroidism?

A
  • severe eye disease ( graves)
    -pregnancy first trimester
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

-pt on thyroxine, came for follow up, his TSH is high but normal T4, what is the explanation for this condition?

A

-medication non compliance ( ماكان ياخذ علاجة الا قبل الموعد :)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
Q

What are the Hyperparathyroidism lab results (Ca, phosphate, parathyroid hormone) for:

1-primary HPT

2-secondary HPT

3-tertiary HPT

A

1-(primary)mainly happen due to, Parathyroid gland adenoma (85%) ,
-Hyperplasia or multiple adenomas (∼ 15%)
In rare cases:
-Carcinomas (∼ 0.5%)
-Idiopathic
-Multiple endocrine neoplasia type 1 or 2
-Medication: lithium or thiazide diuretics

2- Secondary hyperparathyroidism caused by:
-Chronic kidney disease (most frequent cause)
-Malnutrition
-Vitamin D deficiency (e.g., reduced exposure to sunlight, nutritional deficiency, liver cirrhosis)
-Cholestasis

Note: no matter what’s is the lab results, if u find low vit D3, go with secondary!!!

3-Tertiary hyperparathyroidism: caused by persistent secondary HPT

Lab results: see the pic

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
26
Q

-signs of hypercalcemia ?

A
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
27
Q

-what are the indications for surgery when pt have primary HPT ?

A

Parathyroidectomy is done if any of the following is present: see the pic

28
Q
  • what is the galactorrhea approach ??
A
29
Q

-cushing syndrome is suspected, what is ur approach??

A

First! Make sure , does cortisone high? See the pic

Second, what is the cause of high cortisone? Measure the ACTH level
(See the algorithm in another flash card)

Note:**
Diagnostic test for cushing is :low dose dexamethasone suppression test!!

30
Q

-cushing disease is suspected, high cortisone is confirmed, what is ur next step??

A

-look for the cause, start by measuring ACTH level , see the algorithm below

31
Q

-approach in adrenal insufficiency??

A

-1st (initial) cortisone level

-2nd Short ACTH stimulation test (synacthen test)»diagnostic!!!
**in this test, cortisone will fail to increase in both primary and secondary adrenal insufficiency!

-3rd measure the ACTH level to know the cause(see the pic for interpretation)

32
Q

What is the Diagnostic test for cushing syndrome????

A

Diagnostic test for cushing is :low dose dexamethasone suppression test!!

33
Q

-what is the adrenal insufficiency diagnostic test???

A

-short ACTH stimulation test or synacthen test.

34
Q

Refractory HTN + Hypokalaemia, what ur next step???

A

-measure aldosterone -renin ratio!!!

35
Q

-symptoms of Addison dis???

-difference between Addison disease and crisis ? ( only one difference)

A

1- see the pic

2- only difference is hypotension, addison disease > postural hypotension while crisis> persistent hypotension even after given proper iv fluid (MC happen after stressful event such as infection or surgery)

36
Q

-Which type of adrenal insufficiency can be present with skin pigmentation??

-what is the reason of skin pigmentation in adrenal insufficiency?

A

-primary (pic)

-high ACTH

37
Q

-what is the type of cortisone given to adrenal insufficiency crisis???

A

-Hydrocortisone

38
Q
  • what is the most appropriate test to detect the cause of high cortisone in the pt body????
A

-high dose dexamethsone suppression test!

(Be careful, low dose is diagnostic , high dose used to detect the exact cause )

39
Q

-multiple endocrine neoplasia (MEN) syndrome (1,2a and 2b)??

A
40
Q

1- DM type 2 pt since 12 ys , all her lab tests are normal, strict glycemic control, ask u about a way to prevent diabetic nephropathy ( secondary prevention) what is ur next step?

2- DM pt came for follow up, poor glycemic control, high creatinine, what is ur next step to prevent further progress of diabetic nephropathy in this pt after control of Blood suger?

A

1- order random urine micro-albuminuria level (pt not having diabetic nephropathy yet)

2- give ACE inhibitor therapy (already have the complication)

41
Q

-hashimoto thyroiditis antibody name???

-graves antibodies?

A

-TPO ( thyroid peroxidase anti body)

-TSI ,AKA ( TSHR or TRAB( thyrotropin receptor) )

42
Q

What is the most common thyroid cancer in children and adults???

A

Papillary ca
**M/C site of metastasis of papillary Ca is :LUNG!!!!!

43
Q
  • What r the pathology findings in papillary ca of thyroid???

-what is the prognosis of papillary ca of thyroid?

A

1- psamomma bodies

2-nuclear grooves

3- orphan annie’s Eye nuclei

  • Good prognosis!!
44
Q
  • M/C site of metastasis of follicular CA in thyroid?

-age and gender ??

-how to diagnose??

A

-tumor spread by blood»BONE!! (Present with bone pain and thyroid lump)

-50-60 yo woman

  • see the pic مهممم
45
Q

What is the Prolactin level in :

-prolactinoma

-hypothyroidism

??

A
  • more than 150-200

-less than 100

46
Q

45 y o Woman with more than 12 months amenorrhea , dx??

A

Clinical menopause

47
Q

Which antibiotic should use with caution in diabetic pt??

A

-fluoroquinolones (such as ciprofloxacin )

Why?

Dysglycemia causes (hypo hyper glycemia)

48
Q

Regarding the size of thyroid nodule, when we can do FNA?

A

More than 1 cm

49
Q

-echogenecity of malignant thyroid nodule appear in US as??
Hyper or hypo?

A

Hypoechoic

50
Q

What are the classifications of pituitary adenoma? Sizes and effect? And ttt?

A

All types if asymptomatic then follow up with MRI, if symptomatic, first medical then surgical, medical such as : cabergoline (the best) or promocreptine ( both are dopamine agonist)
1-microadenoma (less than 10 mm-1cm-)

2-macroadenoma more than 1 cm
Usually come with neurological deficit ( such as bitemporal hemianopia )

51
Q

Poor candidate for surgery parathyriodectomy what to give???

-what if pt have osteoporosis??

A

-cinacalcet

-biphosphanate

52
Q

DM type 1, when screen celiac ?

A

At time of diagnosis and every 2 year if asymptomatic

53
Q

What the type of thyroid ca that have the worst prognosis?

And what is the ttt??

A

Anaplastic ca

54
Q

Type of thyroid cancer arise from para follicular c cells, dx??

Most common electrolytes imbalance associated with this ca?

What u need to screen before surgery in this cancer?

A

Medullary ca, it secrete calcitonin, associated with MEN 2A and 2 B

Hypocalcemia

Before surgery u need to screen for 1- hyperthyroidism 2- pheochromocytoma

55
Q

How to dx medullry ca?

What is the m/c site of METS?

A
56
Q

How to diagnose DM?

A
57
Q

Test results in DM and pre diabetic pt :

FBS
2hr PP
HBa1C
When to follow up?

A

See the pic

58
Q

Choice of drugs based based kn Hba1C in DM??

5.7 - less than 7.5 ?

7.5-9 ??

9 - 10??

When symptomatic with Hba1c more than 10 or random is 300 ???

A
59
Q

Ttt of DM:

What is biguanides MOA and give me 3 s/e??

A

biguanides (metformin) MOA:
🚫 gluconeogenisis
🚫 absorption of suger in GI
Increase insulin sensitivity

S/E:

M/C is abdominal discomfort
Lactic acidosis
B12 deficiency

60
Q

Give me 2 side effects of sulphonylureas + example of names

A

S/E: avoid in elderly, it cuz hypoglycaemia + weight gain

61
Q

Dpp4 CI and S/E??

A
62
Q

Contra indication in thiazolidiones? (DM ttt)
-such as rosiglitazone and pioglitazone-

What is the S/E of this medication?

A

Ppray inhibitors (only pioglitazone use now)

CI in HF!

S/E: wight gain, edema, osteoporosis.

63
Q

GLP effect and CI??

A

الادوية الي تنتهي ب تايد tide!!

64
Q

SGLT s/e

What is the Sglt medication that cuz toe amputation??

A

الادوية تنتهي ب فلوزين flozin

65
Q

What are the 2 absolute indication to start insulin?

What is the effect of introducing insulin early??

A

DKA and ACS

Improve beta cell servival

66
Q

How many injection of insulin does the type one DM take everyday?

A

4 , one basal 4 bolus

Flash Card Reema (6 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions