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Clin Med 2 > Endocrine > Flashcards

Endocrine Flashcards

0
Q

high cortisol, low ACTH

A

ACTH-independent Cushing’s

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1
Q

most common cause of ACTH-dependent Cushing’s

A

pituitary adenoma

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2
Q

high cortisol, high ACTH

A

ACTH-dependent Cushing’s

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3
Q

causes of ACTH-independent Cushing’s (4)

A

adrenal hyperplasia
neuroendocrine tumors
other hyperplasia
pheochromocytoma

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4
Q

definitive test for Cushing’s

A

24h urine free cortisol

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5
Q

gold standard for Cushing’s

A

dexamethasone suppression test

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6
Q

Cushing’s rx (3)

A

Mitotane
Ketoconazole
Metyrapone

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7
Q

cosyntropin stimulation test uses

A

adrenal hypofunction
Cushing’s
adrenal insufficiency

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8
Q

clonidine suppression test use

A

diag. of pheochromocytoma

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9
Q

hallmark tetrad of adrenal insufficiency

A

weakness/fatigue
wt loss
hyperpigmentation
hypotension

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10
Q

weakness, fatigue, hypoglycemia, wt. loss, N/V, abd pain

A

glucocorticoid deficiency

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11
Q

hyponatremia, salt craving, hypovolemia, orthostatic hypotension, hyperkalemia, mild metabolic acidosis

A

mineralocorticoid deficiency

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12
Q

loss of axillary and pubic hair in females, amenorrhea

A

adrenal androgen deficiency

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13
Q

low cortisol, high ACTH

A

adrenal gland failure

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14
Q

low cortisol, low ACTH

A

hypopituitarism

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15
Q

gold standard for adrenal insufficiency

A

cosyntropin stimulation test

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16
Q

salivary sampling expected results for Cushing’s

A

high nighttime cortisol

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17
Q

salivary sampling results for adrenal insufficiency

A

low morning cortisol

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18
Q

adrenal insufficiency tx (5)

A 
hydrocortisone
prednisone
dexamethasone
fludrocortisone
DHEA creams/oral
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19
Q

HTN, hypokalemia, muscle weakness, parestesias, headache, polyuria, polydipsia

A

Primary Hyperaldosteronism

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20
Q

labs: increased plasma and urine aldosterone, low plasma renin

A

Primary hyperaldosteronism

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21
Q

headache, sweating, palpitations, paroxysmal HTN

A

pheochromocytoma

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22
Q

pheochromocytoma tx (2)

A

IV nitro & B-blocker for acute attacks/control

Surgery is definitive treatment

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23
Q

inhomogenous w/ central necrosis, unilateral, diameter > 4 cm, calcifications, low lipid content

A

adrenal carcinoma

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24
Q

sign of metastases on adrenal incidentaloma

A

bilateral

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25
Q

when to resect benign adrenal incidentalomas

A

> 2 cm

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26
Q

most common pituitary adenoa

A

Prolactinoma

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27
Q

tx for prolactinomas (3)

A

dopamine agonists: Bromocriptine & Cabergoline
surgery
radiotherapy

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28
Q

increased risks with GH-secreting adenomas? (3)

A

DM
HTN
CAD

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29
Q

imaging finding on acromegaly (4)

A

enlarged sella
frontal bossing
thickened skull
tufting of terminal phalanges

30
Q

labs for acromegaly/gigantism

A

random serum IGF-1: for adenoma
1 hr glucose tolerance test
Prolactin levels

31
Q

GH-secreting pituitary adenoma tx (4)

A

Somatostatin analogs (Octreotide & Lanreotide)
Dopamine agonists (Bromocriptine & Cabergolide)
GH receptor antagonist (Pegvisomant)
transsphenoidal microsurgery & radiation

32
Q

slower growth rate, height below 3rd percentile, normal body proportions, chubby build, immature face

A

pituitary dwarfism

33
Q

reduced energy, depressed mood, emotional changes, decreased libido… similar to aging

A

GH deficiency in adults

34
Q

ACTH deficiency with atrophic pituitary gland

ACTH stimulation test result

A

negative

35
Q

ACTH stimulation test result with a functional pituitary gland but an ACTH deficiency

A

positive

36
Q

tx for ACTH deficiency (2)

A

hydrocortisone

prednisone

37
Q

tx for TSH deficiency

A

Levothyroxine

38
Q

tx for gonadotropin deficiency (4)

A

OCPs
estrogen
progesterone
testosterone

39
Q

stalk effect

A

compression of pituitary stalk –> decreased dopamine –> increased prolactin

40
Q

common cause of elevated prolactin

A

stalk effect –> decreased dopamine

41
Q

sulfonylureas (2)

A

Glipizide (Glucotrol XL)

Glimepiride (Amaryl)

42
Q

Meglitinides (2)

A

Repaglinide (Prandin)

Nateglinide (Starlix)

43
Q

two drug classes of insulin secretagogues

A

sulfonylureas

meglitinides

44
Q

side effects of Metformin (4)

A

iodine contrast risk
lactic acidosis
intense diarrhea
minimal weight gain

45
Q

TZDs (2)

A

Proglitazone (Actos)

Rosiglitizone (Avandia)

46
Q

a-glucosidase inhibitors (2)

A

Acarbose (Precose)

Miglitol (Glyset)

47
Q

drug classes of insulin sensitizers (3)

A

biguanides
TZDs
a-glucosidase inhibitors

48
Q

incretin mimetic

A

Exenatide (Byetta)

49
Q

indications for Exenatide (Byetta)

A

failed metformin, sulfonylurea, or both

50
Q

useful in type 1 and type 2 diabetes

A

Pramlintide acetate (Symlin)

51
Q

DPP-4 inhibitors (2)

A

Sitagliptin (Januvia)

Saxagliptin (Onglyza)

52
Q

SGLT2 inhibitors (2)

A

Canagliflozin (Invokana)

Dapagliflozin (Farxiga)

53
Q

signs of microvascular dz in DM (3)

A

retinopathy
nephropathy
neuropathy

54
Q

rebound hyperglycemia due to nocturnal hypoglycemia

A

Somogyi phenomenon

55
Q

insulin lispro onset, peak, and effective duration

A

onset: <15 min
peak: 1 hr
effective duration: 2-4 h

56
Q

regular insulin onset, peak, effective duration

A

onset: 0.5-1 hr
peak: 2-3 hr
effective duration: 3-6 h

57
Q

NPH onset, peak, effective duration

A

onset: 2-4 h
peak: 6-12 h
effective duration: 10-16 h

58
Q

glargine onset, peak, effective duration

A

onset: 1-2 h
peak: no peak
duration: 20-24+ h

59
Q

dopamine agonists (2)

A

Bromocriptine

Cabergoline

60
Q

somatostatin analogs (2)

A

Octreotide

lanreotide

61
Q

GH receptor agonist

A

Pegvisomant

62
Q

most common type of thyroid cancer

A

papillary

63
Q

painful glandular enlargement w/ dysphagia

assoc. w/ viral illness

A

thyroiditis

64
Q

diagnostic signs of hypoparathyroidism (2)

A

Chvostek sign

Trousseau phenomenon

65
Q

symptoms of hyperparathyroidism (4)

A

bones, stones, moans, groans

66
Q

1 cause of hyperparathyroidism

A

parathyroid adenoma

67
Q

hyperthyroidism tx (4)

A

methimazole
PTU
radioiodine ablation
surgery

68
Q

HbA1c for diabetes diagnosis

A

6.5%

69
Q

fasting plasma glucose for diabetes diagnosis

A

126 mg/dl or greater

70
Q

random plasma glucose for diabetes diagnosis

A

greater than 200

with symptoms of hyperglycemia

71
Q

sweating, tremor, tachycardia, anxiety, hunger

dizziness, headache, clouded vision, confusion, seizures, coma

A

hypoglycemic symptoms

72
Q

when are you safe to increase the bedtime insulin dose?

A

if blood sugar drops between 2-4 am

Clin Med 2 (8 decks)

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