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Step II CS > Endocrine > Flashcards

Endocrine Flashcards

1
Q

BBlox can mask sx of ____

A

hypoglycemia

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2
Q

Insulinoma tx

A

diazoxide and octreotide

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3
Q

How does increase in ETOH lead to hypoglycemia?

A

NADPH is used up converting ETOH. Liver cant use for gluconeogenesis.

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4
Q

GIVE THIAMINE BEFORE GLUCOSE

A

GIVE THIAMINE BEFORE GLUCOSE

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5
Q

Painful goiter

A

DeQuervian (subacute)/viral?

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6
Q

What thyroid tx can acutely worsen sx of hyperthyorid state?

A

RAI - can worsen Graves OPTHO acutely. Also may temporarily worsen hyperthyroid state

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7
Q

metabolic abnl assoc w hypothyroid

A

hyperLDL and hypoNa

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8
Q

Tx for acromegaly

A

Octreotide, cabergoline, pegvisomat

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9
Q

Sheehan synd

A

after pregnancy - pituitary necrosis. Pan hypopit. Loss of pubic hair etc

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10
Q

FLudrocortisone

A

strong mineralocorticoid used to replace in decreased adrenal fcn

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11
Q

CAH

A

dx with increased 17 OH progesterone

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12
Q

Triad of hyperaldosteronism

A

HTN, hypoK, metabolic ALKalosis

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13
Q

Chronic ingestion of what can look like hyperaldosteronism

A

Licorice. Prevents cortisol to cortisone. Stimulates aldosterone receptors more than cortisol

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14
Q

HHS

A

VERY high glucose, precipitated by some stressor (URI/illness), typically DMII

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15
Q

Causes of eosinophilia

A 
DNAAACP
Drugs
Neoplasm
Allergies/asthma/churgg strauss
Addisons
AIN
Collagen vasc dz
Parasite (loeffler's eosinophilic pneumonitis (Ascaris))
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16
Q

Acromegaly and peptic ulcers

A

THINK MENI

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17
Q

Early sx of ASA o/d

A

Tinnitus

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18
Q

DM, liver failure, heart failure

A

Hemochromatosis

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19
Q

Best way to control diabetic nephropathy?

A

HTN control

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20
Q

First step in evaluating suspected Hyperaldost?

A

Check Aldost/Renin ratio

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21
Q

1st step to evaluate hypercalcemia

A

Check PTH, no matter the clinical suspeicion

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22
Q

Methimazole AE

A

Agranulocytosis. Also, not in preggers

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23
Q

What electrolyte abnormality is a contraindication to succinylcholine use?

A

Hyper K

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24
Q

Fastest way to correct hyperkalemia

A

Insulin/glucose

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25
Q

Hashimotos Abs

A

Anti Thyroidperoxidase

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26
Q

Graves Dz Abs

A

Thyroid stimulating Abs (especially TSH receptor Abs)

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27
Q

Cardiac Tamponade CXR

A

normal cardiac silhouette

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28
Q

Dipyridamole/cardiac steal phenom

A

It’s an Anti PLT and VasoD. Used to check to see which vessels can dilate anymore. When given, the dead vessels cannot expand any more. So blood will flow away from diseased vessels to healthy vessels

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29
Q

Native valve endocarditis s/p dental work

A

Viridans strep (mutans, sanguis, mitis, salivaria)

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30
Q

Work up for cold leg following MI -

A

Get ECHO to check for mural thrombus

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31
Q

Crescendo/decrescendo systolic murmur, left sternal border w/o radiation to carotids

A

HCM

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32
Q

What risk factor is associated with highest risk of AAA growth and rupture?

A

Smoking

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33
Q

Mechanical complications s/p MI

A

MR from papillary mm rupture
LV free wall rupture
IV septum rupture

34
Q

Lipid lowering tx with statins rec’d 40-75 in pts w CV risk event rate of 7.5% or greater

A

Lipid lowering tx with statins rec’d 40-75 in pts w CV risk event rate of 7.5% or greater

35
Q

Best way to lower HTN?

A

Weight loss, followed closely by DASH diet. Smoking doesn’t help all that much

36
Q

Pressors like NE can cause symmetrical ischemia of distal fingers and toes 2/2 vasospasm

A

Pressors like NE can cause symmetrical ischemia of distal fingers and toes 2/2 vasospasm

37
Q

Dig tox

A

n/v/d, vision changes. arrhythmias. Can be precipitated by stress (virus/diuretic/volume depletion)

38
Q

Very high levels of diphenhydramine tox can mimic ?

A

Anti M

39
Q

Emotional syncope

A

Vasovagal syncope. Dx w tilt table test

40
Q

What is the most common valve defect in infectious endocarditis

A

MVP and regurg

41
Q

What drugs to hold prior to cardiac stress test?

A

Anything that can cover up angina. Nitrates, BBlox and CCB

42
Q

How do you treat Asx PVCs?

A

NONE. No need to treat

43
Q

How do you treat Sx PVCs?

A

1) BBlox

2) Amiodarone

44
Q

How does CHF lead to increase in TBW?

A

Renal hypoperfusion - increase RAS - renal aa constrict - increase TBW and sodium retain

45
Q

Treatment for stable SVT?

A

Vagal maneuvers and Adenosine (unstable = cardiovert)

46
Q

Tylenol increases anticoag effects of warfarin

A

so do nsaids and stuff

47
Q

HTN work up should include UA/Chem7/Lipids/EKG

A

HTN work up should include UA/Chem7/Lipids/EKG

48
Q

Diastolic dysfcn, increased wall thick (no increased volume), low voltage ekg, renal abnormalities

A

THINK AMYLOID

49
Q

Single S2, harsh crescendo-decrescendo @ L USB

A

Tetrology

50
Q

Most common cause of death s/p MI

A

Ventricular Arrhythmia. Re-entrant VFib most common

51
Q

Normal JVD

A

Less than 3 cm

52
Q

Dissection

A

Really high HTN, dx with TEE

53
Q

HCM transmission

A

AD

54
Q

Why do you not give BBlox without ABlox in pheo?

A

Block beta, you get unmasked alpha - leads to dangerous increase in BP

55
Q

Pinealomas can sometimes release BHCG and stim leydig cells - causing androgen secretion

A

Dark hair in a kid and all that

56
Q

Addisons has increased in what type of WBC cell line?

A

Eos

57
Q

Obese children and hispanic/black children are at increased risk of precocious pubertal development.

A

In obesity - it’s because leptin activates HPA and pulsatile GNRH release. This activates LH/FSH. Also, high insulin stims ovarian and adrenal androgen production.

58
Q

Workup for acromegaly after igf-1 levels?

A

measure GH after oral glucose suppression test. Those with acromegaly cannot properly suppress GH.

59
Q

severe cystic acne, LH that doesnt increase after GnRH stim test, advanced bone age, coarse axillary and pubic hair,

A

Think non-traditional CAH - 21 a hydroxylase (HTN normal and high sex)

60
Q

What level of sodium do we start seeing altered mental status?

A

120 or lower

61
Q

Weakness and myalgias with very very high bp?

A

Think hyperaldosteronism (weakness frome low K). Also maybe very thirsty

62
Q

Very High Calcium (like 14/15) is most often due to?

A

Malignancy. Hyper PTH usually only mildly elevated

63
Q

irregular periods, infertility, galactorrhea?

A

prolactinoma - tx bromociptine

64
Q

DKA treatment?

A

IVF, K, insulin. Might need to start k bnefore insulin if patient is hypo K

65
Q

Most common type of thyroid nodule

A

colloid nodule (cold nodule). follicular adenoma #2

66
Q

Treatment for SIADH

A

demeclocycline

67
Q

Treatment for DI

A

desmopressin. Patients with central DI increase urine OSM at least 50% with administration of DDAVP

68
Q

thyrotoxicosis with low radioactive Iodine uptake?

A

Think thyroiditis. Graves has HIGH uptake

69
Q

hypercalcemia following long periods of not moving

A

hypercalcemia of immobilization

70
Q

fatigue, myalgias, proximal mm weakness, sluggish ankle reflexes, normal esr and hi CK. dx?

A

Hypothyroid myopathy

71
Q

watery diarrhea, hypoK, mm cramps, achlorhydria. panc mass

A

VIPoma

72
Q

Which calcium form is physiologically available: unbound to albumin or bound to albumin?

A

Unbound

73
Q

What calcium abnormalities do we see with met alk?

A

Low Ca. Increase affinity of Ca to albumin. Making the unbound form less available.

74
Q

How do you dx avascular necrosis of hip?

A

MRI. Steroids can cause

75
Q

Whats the acid base status in primary adrenal insuff?

A

Non AG met acid - also see eosinophils

76
Q

Regardless of RF, when should you test patients for DM/A1C?

A

45 years old

77
Q

most common mechanism for malignancy-induced hyperCa?

A

PTHrP. More common than when cancers secrete osteolytic factors to bone

78
Q

Best initial way to treat severe hypercalcemia of malignancy

A

LOTS OF FLUIDS. Bisphosphonates for long term tx

79
Q

What electrolyte abnormality do we see in SAH?

A

HypoNa because cerebral salt wasting/SIADH

80
Q

How do increased ER states (meds/preg) affect thyroid?

A

Increase TBG. This results in decreased free thyroxine. A normal thyroid will compensate for this. But patients on replacement tx will need higher doses

Step II CS (17 decks)

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