Endocrine

Question 1

What is the difference between primary and secondary adrenal insufficiency

Answer 1

primary = Addison disease
mc in USA from autoimmune destruction of adrenals
see: low cortisol AND aldosterone

secondary = mc from exogenous steroid use
see: low cortisol

low cortisol = hypoglycemia and eosinophilia
low aldosterone = hypoNa, hyperK, met acidosis, azotemia

Question 2

treatment for SIADH

Answer 2

Demeclocycline (a tetracycline abx)
can cause nephrogenic DI
AE: tooth damage in children

Question 3

How do you treat central diabetes insipidus? nephrogenic?

Answer 3

central - desmopressin (DDAVP) - this is synthetic ADH
nephro - thiazide diuretics

(recall: central is a problem with releasing ADH, nephrogenic is when there is renal ADH resistance)

Question 4

When you suspect SAIDH do this first

Answer 4

fluid restriction

Question 5

Osmolality of urine and plasma in SIADH?

Answer 5

SIADH causes a euvolemic hypOnatremia

see low plasma osmolality (100-150mOsm/kg)

high urine sodium

failure to correct when given IVF

(ps: diabetes insipidus is the mc cause of euvolemic hypERnatremia)

Question 6

euvolemic hypo/hyper natremia?

Answer 6

hypER - DI
hypO - SIADH

Question may say “moist mucus membranes”

Question 7

anti TSH receptor Ab

Answer 7

Grave’s disease

Question 8

Signs of hyperthyroidism, elevated T4, elevated TSH

Answer 8

pituitary adenoma (abnormally elevated TSH level)

Question 9

Hyperthyroidism, TSH low, RAIU high

Answer 9

Graves

Question 10

painful hyperthyroid

Answer 10

subacute thyroiditis

Question 11

anti thyroid peroxidase Ab

Answer 11

Hashimotos

Question 12

The stuff in the colloid that makes T4 and T3 and uses iodine

Answer 12

Thryoglobulin

Question 13

Methimazole vs. PTU

Answer 13

These are the “thioamides”

PTU prevents peripheral conversion of T4–> T3

both inhibit T4 synthesis by inhibiting thyroidperoxidase

Question 14

Anti Thyroid Peroxidase Ab

Answer 14

Hashimotos