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Final Exam Prep > Endocrine > Flashcards

Endocrine Flashcards

1
Q

What gene is DMI associated with

A

GAD65

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2
Q

Smogyl effect and treatment

A

Early morning hyperglycemia caused by nocturnal hypoglycemia
Tx: reduce bedtime insulin

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3
Q

Dawn phenomenon and treatment

A

Tissues desensitized to nocturnal insulin progressively elevating BG in am
Tx: increase bedtime insulin

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4
Q

What is syndrome X

A

Obesity, HTN, abnormal lipid profile

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5
Q

What is metabolic syndrome

A

Increased weight circumference, elevated triglycerides, HTN, elevated glucose, low HDL
3 or more is Metabolic syndrome
Places patient at risk for sudden cardioembolic death

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6
Q

Serum fasting glucose, random glucose, Hgb A1C that indicate diabetes

A

More than one occasion
Fasting: >126
Random: >200
Hgb A1C: >6.5

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7
Q

Type 2 DM treatment

A

Weight control, diet, exercise
Metformin first then can add GLP1 agonist (duleglutide) prior to starting insulin

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8
Q

Side effects of Metformin

A

GI complaints, muscle pain
Lactic acidosis when used with contrast

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9
Q

GLP1 agonist Duleglutide (Ozempic) side effects

A

GI disturbances, pancreatitis, THYROID CA

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10
Q

Jardiance side effect

A

Euglycemic metabolic acidosis

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11
Q

DKA diagnostics

A

Serum glucose: 250-300, ph <7.0, BHB >8, positive ketones

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12
Q

DKA treatment

A

Protect airway
IVF , insulin drip (0.1units/kg bolus with 0.1u/kg/hr drip)
Switch to D5 1/2 NSS when BG hits 250
Ensure K is not low, if less than five consider repletment first

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13
Q

HHNL s/s, diagnostics, and treatment

A

polyuria, weakness, hypotension, poor skin tugor
Labs: Glucose >600, hyperosmolarity >310, normal pH and anion gap
Tx: protect airway, IVF, insulin drip 0.1u/kg/hr, switch to D5 1/2 NSS when BG hits 250

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14
Q

What is the most common presentation of hyperthyroidism

A

Graves’ disease

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15
Q

S/s of hyperthyroidism

A

Nervousness, sweating, fatigue, hyperreflexia, increased appetite, weight loss, hyper metabolic, exopthalamus, tachycardia, heat intolerance

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16
Q

Hyperthyroidism labs/diagnostics/ treatment

A

Labs: low TSH, elevated T3 and T4, elevated ANA
Diagnostics: iodine uptake
Tx: Endocrine referral, propranolol for hyper metabolism, methimozole, PTU, radioactive iodine, thyroid surgery

17
Q

What is thyroid storm and treatment

A

Hyperparathyroidism exacerbation
PTU or methimazole or iodine w/ propranolol w/hydrocortisone within the first hour
NO ASPIRIN

18
Q

Hypothyroidism s/s, labs, diagnostics, and tx

A

Hashimoto’s
S/s: sluggish, cold intolerance, dry skin, hair loss, weight gain, brittle nails, bradycardia, slow DTRs
Tx: Levothyroxine

19
Q

Myxedema coma treatment

A

Intubate, fluid replacement, synthroid IV, rewarm slowly

20
Q

What is the difference between Cushing syndrome and disease

A

Disease: pituitary issue causing ACTH release
Syndrome: tumor making too much cortisol

21
Q

Causes of Cushings

A

Tumor, glucocorticoids

22
Q

Cushing disease s/s, labs, diagnostics, and treatment

A

S/s: moon face, buffalo hump, central obesity, thin arms/legs, purple striae, impotence, hyperglycemia
Labs: hyperglycemia, hypernatremia, hypokalemia, elevated plasma cortisol
Diagnostics: dexamethasone suppression test, serum ACTH
Tx: Aldactone or norvasc for HTN, Ketoconazole for hypercortisolism, surgical removal

23
Q

Causes of Addison’s disease, s/s, labs, and treatment

A

Auto immune, cancer, adrenal hemorrhage, sepsis
S/s: hyperpigmentation in skin creases, diffuse tanning/freckles, orthostasis, hypotension, scant pubic hair
Labs: Hypoglycemia, hyponatremia, hyperkalemia, elevated ESR, low plasma cortisol
Diagnostic: Cosyntropin test
Management: Glucocorticoids and mineral corticoids

24
Q

What is SIADH, s/s, management

A

Release of too much ADK
S/s neuro changes, decreased DTR, hypothermia, n/v, cold intolerance, concentrated urine
Labs: Hyponatremia despite euvolemia, decreased serum osmo, increased urine osmo
Management: treat underlying cause, Na (fluid restriction, 3% Na and lasix)

25
Q

DI what is it, s/s, labs, management

A

Inadequate ADH
Causes: pituitary tumor, idiopathic, trauma, meds, psychogenic, renal
S/S: large amount of dilute urine, excessive thirst, hypotension
Labs: hyponatremia, elevated BUN/CRT, serum osmo elevated, urine osmo low, 1.10-1.30 elevated urine specific gravity
Management: D5W IV 1/2 volume in 24 hours (too rapid causes cerebral edema), switch to 1/2 NSS or NSS. Vasopressin DDAVP

26
Q

What is pheochormocytoma s/s, labs, and treatment

A

Excessive catecholamine release typically caused by tumor release
S/s: HTN, diaphoresis, hyperglycemia, tremor, tachycardia, weight loss
Labs: TSH should be normal, blood/urine metanepherines, urine catecholamines, 24 Hr urine
Treatment: alpha adrenergic meds, tumor removal
Post op concerns: hypotension, adrenal insufficiency, and hemorrhage

27
Q

Serum fasting glucose and random glucose along with A1C that indicate diabetes

A

Fasting: >126 on more than one occasion
Random: >200 with signs of hyperglycemia
A1C: >6.5

28
Q

Black box warning for Metformin

A

Lactic acidosis secondary to IV contrast
D/C on admission to hospital

29
Q

SGLT2 inhibitors (glifozin) side effects

A

Increased risk for foot and leg amputations

30
Q

What is the presentation difference between DKA and HHS

A

DKA has kussmal breathing and fruity breath

31
Q

What medication class is given to diabetics as the first pharmacological therapy after weight reduction methods in order to reduce weight?

A

Gilaunides (metformin)

32
Q

What is the reaction between sulfanyreas and ETOH

A

Hypoglycemia

33
Q

Hypothyroidism. What lab do you follow to evaluate the effectiveness of treatment

A

TSH

34
Q

What is a vasopressin challenge

A

Used to confirm DI and differentiates between nephrogenic and central DI

35
Q

When should synthroid levels be optimal

A

May increase dose every 1-2 weeks until symptoms stabilize

36
Q

Blood glucose, sodium, and potassium effects with Cushings

A

BG: hyperglycemia
Hypernatremia
Hypokalemia

37
Q

BG, sodium, and potassium with Addison’s

A

Hypoglycemia, hyponatremia, and hyperkalemia

Final Exam Prep (19 decks)

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