Endocrine Flashcards
What is the most common type of thyroid cancer?
Papillary Carcinoma
Describe the physical exam findings of papillary thyroid cancer?
Hard, solitary cold nodule
What lab can be used as a tumor marker in medullary thryoid cancer?
Calcitonin
What is the genetic pattern of multiple endocrine neoplasia (MEN)?
Autosomal Dominant
What medication can be used in patients with an iodine allergy to block the release of thyroid hormone?
Lithium
What is the treatment for thyroid storm?
- Beta-blocker (propranolol, esmolol)
- Thionamide (propylthiouracil, methimazole)
- Iodine solution
- Glucocorticoids
What is the most common etiology of hypoparathyroidism?
Partial or total thyroidectomy
What is Chvostek sign?
Contraction of facial muscles after tappin the facial nerve. Associated with hypocalcemia.
What is Trousseau Sign?
Induction of carpopedal spasm. Seen in hypocalcemia.
What congenital syndrome results in hypocalcemia due to the absence of the parathyroid glands?
DiGeorge Syndrome
What lab values are associated with hypoparathyroidism?
- Low PTH
- Low calcium
- High phosphorus
What is a common dermatological manifestation associated with Graves disease and commonly found on the legs?
Pretibial myxedema
What is the most significant side effect of methimazole?
Teratogenicity
What type of cells are affected by autoimmune destruction in diabetes mellitus type 1?
Pancreatic beta cells
What is the USPSTF’s guidelines on screening for Type 2 Diabetes?
Screen adults aged 35-70 years who are overweight or obese every 3 years
What Glycated hemoglobin (A1C) level is needed to diagnose diabetes?
Two A1C test results >/= 6.5
What fasting glucose level is diagnostic for diabetes?
> /= 126 mg/dL
What is goiter?
Enlargement of the thryoid gland
What is the most common cause of goiter?
Iodine deficiency (Worldwide)
Autoimmune Hashimoto’s thyroiditis, or Graves disease (U.S.)
What imaging modality is needed to confirm the diagnosis of goiter?
Ultrasound
Would a patient with Cushing syndrome be more or less prone to infections?
Cushing Syndrome = elevated cortisol
Glucocorticoids decrease immune function = increased risk of infection
Acanthosis nigricans should make you think of what diagnoses?
Ones associated with insulin resistence
* Diabetes
* PCOS
* Obesity
What hormones are secreted by a pheochromocytoma?
Epinephrine and norepinephrine
A diffuse even uptake of iodine on a radioactive iodine test should make you think of what diagnosis?
Grave’s Disease (point uptake might indicate a neoplasm)
In primary hypothyroidism will TH and TSH be normal, elevated, or low?
TH decreased
TSH increased
What is the most common cause of primary hyperaldosteronism?
Adrenal hyperplasia (66%)
What is Hashimoto’s disease?
An autoimmune cause of hypothyroidism
What role does C-peptide play in the diagnosis of diabetes?
It is a marker of insulin production
- Elevated = DM2
- Decreased = DM1
Name two medications that cause hypothyroidism?
- Lithium
- Amiodarone
- Anti-seizure medications (phenytoin, carbamazapine, valproate)
Which thyroid cancer is the most aggressive?
Anaplastic
What is the treatment for myxedema?
Levothyroxine and slow warming
How often should a diabetic Hgb A1C be checked and what should it be?
What is the lifespan of an RBC?
Every 3 months and less than 6.5%
120 days
Which gland secretes oxytocin?
Posterior pituitary
What is the best imaging study for a thyroid nodule?
Ultrasound
What specific breathing pattern is associated with DKA?
Kussmaul Respirations
What is the most common cause of Addison’s Disease?
Autoimmune destruction of the adrenal cortex
List 4 PE findings associated with Cushing’s Syndrome?
- Moon Face
- Buffalo Hump
- Purple Striae
- Central Obesity
- Supraclavicular fat pads
- Easy Bruising
What class of medications is the first line for lowering LDL?
Statins
As it relates to diabetes, what is the dawn phenomenon?
Reduced insulin response between 5 and 8 am
What are the target organs of parathyroid hormone?
Bone, kidney, and small bowel
Hyperpigmentation in the skin folds with hypotension, hypoglycemia and depression should make you think of what diagnosis?
Corticoadrenal insufficiency
Does niacin increase or decrease HDL?
Increase
What is Sheehan’s syndrome?
Ischemia of the pituitary due to volume depletion during or after child birth
Pretibial myxedema should make you think of what diagnosis?
Graves Disease
Will ACTH be elevated or decreased in Addison’s disease?
Elevated
Which form of Vitamin D is generally preferred for the treatment of Vitamin D deficiency?
Vitamin D3 (Cholecalciferol)
What are the 5 criteria for metabolic syndrome?
- HDL < 40 men and <50 women
- BP >136/85
- Triglycerides > 150
- Fasting glucose > 100
- Waist > 40 in men and > 35 in women
What HgB A1C level indicates pre-diabetes?
5.7-6.5%
What is the cause of Cushing Disease
Pituitary adenoma producing excess ACTH
How is obesity defined in children using the CDC growth chart?
BMI >/= 95th percentile for age and sex
What blood pressure medication class should be used in a patient with diabetes?
ACEI (protects against diabetic nephropathy)
What is gigantism?
Pituitary adenoma producing excess GH before puberty
What is acromegaly?
Pituitary adenoma producing excess GH after puberty onset and the growth plates have closed
What is the initial test for working up a pheochromocytoma?
24 hour urine for catecholamines
What are three reasons to do a fine needle aspiration of the thyroid?
- Painful/tender
- Rapid enlargement
- Palpable nodule
What is the initial diagnostic study when evaluating a single thyroid nodule?
Ultrasound
