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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
sign of metastases on adrenal incidentaloma
bilateral
25
when to resect benign adrenal incidentalomas
> 2 cm
26
most common pituitary adenoa
Prolactinoma
27
tx for prolactinomas (3)
dopamine agonists: Bromocriptine & Cabergoline surgery radiotherapy
28
increased risks with GH-secreting adenomas? (3)
DM HTN CAD
29
imaging finding on acromegaly (4)
enlarged sella frontal bossing thickened skull tufting of terminal phalanges
30
labs for acromegaly/gigantism
random serum IGF-1: for adenoma 1 hr glucose tolerance test Prolactin levels
31
GH-secreting pituitary adenoma tx (4)
Somatostatin analogs (Octreotide & Lanreotide) Dopamine agonists (Bromocriptine & Cabergolide) GH receptor antagonist (Pegvisomant) transsphenoidal microsurgery & radiation
32
slower growth rate, height below 3rd percentile, normal body proportions, chubby build, immature face
pituitary dwarfism
33
reduced energy, depressed mood, emotional changes, decreased libido... similar to aging
GH deficiency in adults
34
ACTH deficiency with atrophic pituitary gland | ACTH stimulation test result
negative
35
ACTH stimulation test result with a functional pituitary gland but an ACTH deficiency
positive
36
tx for ACTH deficiency (2)
hydrocortisone | prednisone
37
tx for TSH deficiency
Levothyroxine
38
tx for gonadotropin deficiency (4)
OCPs estrogen progesterone testosterone
39
stalk effect
compression of pituitary stalk --> decreased dopamine --> increased prolactin
40
common cause of elevated prolactin
stalk effect --> decreased dopamine
41
sulfonylureas (2)
Glipizide (Glucotrol XL) | Glimepiride (Amaryl)
42
Meglitinides (2)
Repaglinide (Prandin) | Nateglinide (Starlix)
43
two drug classes of insulin secretagogues
sulfonylureas | meglitinides
44
side effects of Metformin (4)
iodine contrast risk lactic acidosis intense diarrhea minimal weight gain
45
TZDs (2)
Proglitazone (Actos) | Rosiglitizone (Avandia)
46
a-glucosidase inhibitors (2)
Acarbose (Precose) | Miglitol (Glyset)
47
drug classes of insulin sensitizers (3)
biguanides TZDs a-glucosidase inhibitors
48
incretin mimetic
Exenatide (Byetta)
49
indications for Exenatide (Byetta)
failed metformin, sulfonylurea, or both
50
useful in type 1 and type 2 diabetes
Pramlintide acetate (Symlin)
51
DPP-4 inhibitors (2)
Sitagliptin (Januvia) | Saxagliptin (Onglyza)
52
SGLT2 inhibitors (2)
Canagliflozin (Invokana) | Dapagliflozin (Farxiga)
53
signs of microvascular dz in DM (3)
retinopathy nephropathy neuropathy
54
rebound hyperglycemia due to nocturnal hypoglycemia
Somogyi phenomenon
55
insulin lispro onset, peak, and effective duration
onset: <15 min peak: 1 hr effective duration: 2-4 h
56
regular insulin onset, peak, effective duration
onset: 0.5-1 hr peak: 2-3 hr effective duration: 3-6 h
57
NPH onset, peak, effective duration
onset: 2-4 h peak: 6-12 h effective duration: 10-16 h
58
glargine onset, peak, effective duration
onset: 1-2 h peak: no peak duration: 20-24+ h
59
dopamine agonists (2)
Bromocriptine | Cabergoline
60
somatostatin analogs (2)
Octreotide | lanreotide
61
GH receptor agonist
Pegvisomant
62
most common type of thyroid cancer
papillary
63
painful glandular enlargement w/ dysphagia | assoc. w/ viral illness
thyroiditis
64
diagnostic signs of hypoparathyroidism (2)
Chvostek sign | Trousseau phenomenon
65
symptoms of hyperparathyroidism (4)
bones, stones, moans, groans
66
#1 cause of hyperparathyroidism
parathyroid adenoma
67
hyperthyroidism tx (4)
methimazole PTU radioiodine ablation surgery
68
HbA1c for diabetes diagnosis
6.5%
69
fasting plasma glucose for diabetes diagnosis
126 mg/dl or greater
70
random plasma glucose for diabetes diagnosis
greater than 200 | with symptoms of hyperglycemia
71
sweating, tremor, tachycardia, anxiety, hunger | dizziness, headache, clouded vision, confusion, seizures, coma
hypoglycemic symptoms
72
when are you safe to increase the bedtime insulin dose?
if blood sugar drops between 2-4 am

Clin Med 2 (8 decks)

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