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Step 1 prep > Endocrine > Flashcards

Endocrine Flashcards

1
Q

MC thyroid cancer (70-75%)

A

Papillary Carcinoma

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2
Q

2nd MC thyroid cancer (10%)

A

Follicular Carcinoma

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3
Q

Activation of receptor tyrosine kinases

A

Papillary and Medullary carcinoma

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4
Q

Hashimoto thyroiditis is a risk factor

A

B-cell lymphoma

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5
Q

Cancer arising from Parafollicular C cells

A

Medullary Carcinoma

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6
Q

Commonly associated with RAS mutation or PAX8-PPAR gamma 1 rearragement

A

Follicular carcinoma

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7
Q

Commonly associated with rearrangements in RET oncogene or NTRK1

A

Papillary carcinoma

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8
Q

MC mutation in the BRAF gene (serine/threonine kinase)

A

Papillary carcinoma

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9
Q

What should you measure in a thyroidectomy patient with post-op perioral tingling?

A

Calcium level. If parathyroids are removed during thyroidectomy then the pt will be hypocalcemic

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10
Q

How is Hb glycosylated in diabetes (HbA1c)?

A

Non-Enzymatic glycosylation

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11
Q

What cells have GLUT-2 receptor?

A

Beta cells of the pancreas (important bc glut2 receptors allow beta cells to monitor glucose levels)
Small intestine
Liver
Kidney

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12
Q

Which tissues require insulin for glucose uptake?

A

Skeletal muscle, Adipose tissue (GLUT-4)

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13
Q

What enzyme converts glucose to sorbitol?

A

Aldose reductase

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14
Q

Which tissues lack sorbitol DH, the enzyme that converts sorbitol to fructose?

A

Schwann cells, Retina and lens, Kidney

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15
Q

Lactic acidosis is a rare, but worrisome AE

A

Metformin

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16
Q

MC AE is hypoglycemia

A

Sulfonylureas:

  • Glyburide
  • Glimepiride
  • Glipizide
17
Q

Recommended first-line tx for most pts

A

Metformin

18
Q

Not safe in settings of hepatic dysfunction or CHF

A

TZDs

  • Pioglitazone
  • Rosiglitazone
19
Q

Should not be used in pts with elevated serum creatinine

A

Metformin

20
Q

Shouldn’t be used in pts with cirrhosis or IBD

A

Alpha-glucosidase inhibitors

  • Miglitol
  • Acarbose
21
Q

Not associated with weight gain

A

Metformin, DPP-4 inhibitors, GLP-1 analogs

22
Q

Metabolized by liver, excellent choice in pts with renal dz

A

TZDs

23
Q

MOA: Closes K channel on beta cells, leading to depolarization=>Calcium influx=>insulin release

A

Sulfonylureas

  • Glyburide
  • Glimepiride
  • Glipizide
24
Q

MOA: inhibits alpha-glucosidase at intestinal brush border

A

Alpha-glucosidase inhibitors

  • Acarbose
  • Miglitol
25
Q

MOA: agonist at PPAR-gamma receptors=> improved target cell response to insulin

A

TZD:
Pioglitazone
Risoglitazone

26
Q

MOA: decreases hepatic gluconeogenesis

A

Metformin

27
Q

Good for weight loss

A

GLP-1 Agonist

28
Q

Avoid in hypoglycemia

A

Sulfonylureas

29
Q

Best treatment for anyone with organ failures (renal, liver, heart)

A

Insulin

30
Q

What are the five categories for the diagnosis of metabolic syndrome

A 
Abdominal obesity
Elevated triglycerides
Low HDL
Elevated BP
Elevated glucose
31
Q

At what BMI is a pt considered obese?

A

> 30

32
Q

What are the three functions of vitamin D?

A

Calcium absorption from gut
Phosphate absorption from gut
Bone resorption of Ca and PO4

33
Q

How does PTH increase Ca levels

A

Increasing bone resorption

Increasing renal reabsorption in the DCT

34
Q

Where does PTH “trash” phosphate?

A

PCT

35
Q

What cells make PTH?

A

Chief cells of the parathyroid

36
Q

What cells make Calcitonin?

A

Parafollicular C cells of the thyroid

37
Q

what are the two signs of hypocalcemia

A

Chvostek’s sign
-tap the cheek=>facial muscle contraction
Trousseau’s sign
-Tighten a BP cuff on the arm=>Carpopedal spasm

38
Q

What are the two MCC of primary hyperparathyroidism?

A

Solitary parathyroid adenoma

Parathyroid hyperplasia

Step 1 prep (14 decks)

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