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Medicine Clerkship > Endocrine > Flashcards

Endocrine Flashcards

1
Q

Prolactinoma

A

A tumor that produces prolactin. Causes galactorrhea, loss of peripheral vision, decreased libido. Can also be caused by meds, hypothyroidism.

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2
Q

How to treat prolactinoma

A

Bromocriptine or surgery

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3
Q

How does hypothyroidism cause prolactinoma?

A

Because TRH (increased in hypothyroidism) stimulates prolactin release from anterior pituitary

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4
Q

Hormones produced by anterior pituitary

A

ACTH, TSH, GH, LH/FSH

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5
Q

Hormones produced by the posterior pituitary?

A

Oxytocin and ADH.

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6
Q

Acromegaly

A

Tumor producing GH. Causes gigantism in children, causes acromegaly in adults with diabetes, diastolic heart failure

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7
Q

How to diagnose acromegaly?

A

Look at IGF-1 level, confirm with MRI, also glucose suppression test

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8
Q

Glucose suppression test

A

Glucose challenge, GH should decrease. In acromegaly it doesnt.

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9
Q

How to treat acromegaly?

A

Octreotide or surgery.

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10
Q

Acute hypopituitarism caused by? Presentation?

A

Infection, infarction (sheehan’s, apoplexy), surgery, radiation
Presentation: lethargy, coma, hypotension.

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11
Q

Empty sella syndrome

A

Pituitary is outside sella but still functions.

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12
Q

How to treat empty sella syndrome?

A

Do nothing

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13
Q

Chronic hypopituitarism caused by?

A

Autoimmune disease, deposition, cancer

Presents with decreased libido, decreased GH. Much less severe.

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14
Q

How to diagnose chronic hypopituitarism

A

Insulin stimulation test, with insulin, GH and epi should increase

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15
Q

SIADH

A

Brain lesion produces lots of ADH, water retained, very concentrated urine, decrease in serum osms.

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16
Q

How to treat SIADH

A

Demeclocycline, vaptans, stop taking drug, water restriction

17
Q

Diabetes insipidus

A

Polydipsia, polyuria, normal BG, diagnose with water deprivation test.

18
Q

How to treat central diabetes insipidus?

A

Vasopressin

19
Q

How to treat nephrogenic diabetes insipidus?

A

Gentle diuresis.

20
Q

How to conduct water dep test?

A

Deprive water, measure U osm. if increases, then polygenic polydipsia. Then add ADH, if U osm increases, then Central DI. If it doesn’t then nephrogenic DI.

21
Q

Symptoms of hyperthyroidism

A

Tachycardia, diarrhea, increased DTRs, heat intolerance, weight loss, +/- afib

22
Q

How to diagnose hyperthyroidism

A

Decreased TSH, increased free T4, increased radioactive iodine uptake.

23
Q

Graves disease

A

Autoimmune with antibody stimulation, diffuse growth of thyroid with diffuse radioactive iodine uptake. Exopthalmos and pretibial myxedema.

24
Q

Thyroid storm

A

Shock, fever, delirium after a stress.

25
Q

How to treat thyroid storm?

A

IVF + cooling blankets, PTU/Methimazole, B blocker, IV steroids.

Then surgery and iodine ablation.

26
Q

Thyroiditis

A

Transient hyperthyroidism followed by hypothyroidism. Can heal or can become hashimotos.

27
Q

Hypothyroidism

A

Bradycardia, constipation, decreased DTRs, cold intolerance, increased weight.

Caused by hashimotos, iatrogenic

28
Q

Myxedema coma

A

Shock, cold, coma

Treat with IVF, warm blankets, T4 and T3.

29
Q

How to work up thyroid nodules

A

If the patient is elderly or has radiation exposure in the past, do an FNA. Otherwise check a TSH/T4.

If TSH and T4 is normal, do an FNA, if TSH is down, do an RAIU scan.

If RAIU is positive, then resect the hot nodule.

If RAIU is negative, do a FNA.

30
Q

Papillary carcinoma

A

Orphan annie eyes, psammoma bodies. Most common. Tx resect

31
Q

Follicular carcinoma

A

FNA may appear normal, hematogenous spread. Treat with I2 ablation

32
Q

Medullary carcinoma

A

C cells produce calcitonin. Common in MEN2A/@B.

33
Q

Anaplastic carcinoma

A

Elderly, fatal

Medicine Clerkship (12 decks)

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