Endocrine Flashcards
Benign pituitary adenomas summary
Def: tumor of on one of the type of cells in the pituitary gland
SS:
Hormone hypersecretion
headache
Eval:
MRI w/ contrast - gold
CT
Txt:
dopamine agonists
Surgery
Hypersecretion of Growth Hormone summary
Def: Excessive release of GH due to GH-secreting pituitary adenoma
SS:
Kids - Gigantism
Adults acromegaly
Eval:Serum IGF-I (most sensitive)
Oral Glucose Tolerance Test (specific)
Txt:Surgery
Somatostatin analogs
GH receptor antagonist
Cushing’s syndrome summary
Def: Constellation of clinical features from excess glucocorticoids of any etiology
SS: Moon facies Obesity Diabetes mellitus Diastolic hypertension Hirsutism Striae Buffalo hump Central adiposity
Eval:
24 hour urinary free cortisol excretion
MRI
CT
Adrenal Insufficiency summary
SS: weakness/Fatigue pigmentation of skin Weight loss Ab pain Myalgias and arthralgias Fever
Eval:
Short ACTH stimulation test
ECG
Txt:
IV hydrocortisoneoral hydrocortisone
Diabetes insipidus summary
Def: deficiency of ADH
SS:
Polyuria
polydipsia
nocturia
Eval:
Water deprivation test
Graves Disease
Def: most common hyperthyroid diagnosis
SS: diplopia lacrimation photphobia heat intolerance tachycardia exopthalmos lid lag
Tx: Propylthiouracil Methimazole radioactive iodine thyroidectomy
Hashimoto thyroiditis
Def: most common adult cause of hypothyroidism;
SS: firm goiter myexedema puffy face extra weight thickened skin
Tx:
d/c or lower dose of offending medication
Levothyroxine 1.7 mcg/kg/day
DM 1
Def: metabolic disorder with abnormally increased blood glucose concentration
SS: polyuria weight loss dehydration N/V ab pain blurred vision diabetic ketoacidosis
Eval:
FPG >=126 mg/dl
Hbg A1C >=7
Txt:
Insulin .5 U/kg/day
DM 2
Def: metabolic disorder with abnormally increased blood glucose concentration
SS: asymptomatic blurred vision retinopathy metabolic syndrome
Eval:
Test post prandial glucose and C-peptide
Txt: Metformin 500 mg bid, 100 mg bid glipizide 2.5 mg qd, 5 mg qd Meglitinides Thiazolidinediones alpha-glucosidase inhibitors DPP-4 inhibitors GLP-1 receptor agonists (Exenatide) 5 mcg sq bid Amylin mimetics Bile acid Dopamine-2 agonists Sodium-glucose co-transporter 2 inhibitor Insulin .1 U/kg/day
Obesity
SS: overweight >= 25 - 29.9
BMI >= 30
Morbidly obese >= 40
Eval:
BMI
Waist circumference
waist-hip ratio
Txt: Lifestyle Orlistat 120 mg tid w/ meal Phentermine Diethylpropoin Phentermine/topiramate Lorcaserin Naltrexone/Bupropion Liraglutide Surgery
