Endocrine Flashcards
What two hormones are produced in the posterior pituitary?
Oxytocin and antidiuretic hormone (ADH, vasopressin)
What is Sheehan’s syndrome?
Ischemia of the pituitary due to volume depletion during or after childbirth
How do glitazones work?
They improve insulin sensitivity
What is the most common pituitary adenoma?
Prolactinoma
Large doughy hands should make you think of what diagnosis?
Gigantism
Diabetes insipidus is caused by a deficiency of which hormone?
Vasopressin
How much more potent is T3 than T4?
3-4X
What is the best imaging for a thyroid nodule?
Ultrasound
Patient presents with erectile dysfunction and complains of some numbness in his feet. On second thought he diagnosis should you be thinking of?
Diabetic neuropathy
Pretibial myxedema should make you think of what diagnosis?
Grave’s Disease
A 35 year old female presents with heat intolerance, weight loss, and palpitations. What diagnosis should you be thinking of?
Hyperthyroidism
What is the first line medical treatment for a patient who presents with palpitations and nervousness secondary to hyperthyroidism?
Beta blockers
What is Hashimoto’s disease?
An autoimmune cause of hypothyroid
How does levothyroxine work?
It helps convert T4 to T3
What is the most common thyroid cancer?
Papillary makes up about 80% of thyroid cancers
What is the least aggressive thyroid cancer?
Papillary
Name the four thyroid cancers.
Papillary, follicular, medullary, anaplastic
Which thyroid cancer is the most aggressive?
Anaplastic
In a patient with hyperthyroidism will TSH be decreased or elevated?
Decreased
How do vibrates work to affect the lipid profile/
They inhibit synthesis of VLDL and elevate lipoprotein lipase
What medication must you use prior to thyroidectomy in a patient with hyperthyroidism?
Methimazole or propylthiouracil (PTU)
What is included in Whipple’s triad of hypoglycemia?
History of previous hypoglycemia, serum glucose less than 40, immediate recovery upon administration of glucose
Positive antithyroid peroxidase and antithyroglobulin antibodies should make you think of what diagnosis?
Hashimoto’s
What is the treatment for myxedema?
Levothyroxine and slow warming
What is the most common cause of hypoparathyroid?
Post thyroidectomy with the complication of parathyroidectomy
What is Chvostek’s sign?
Tap on facial nerve to get a twitch with low Ca
Cortical adrenal insufficiency is also known as what disease?
Addison’s disease
What is Trousseau’s sign?
Inflate BP cuff and hold for 3 minutes. Patient with low Ca will get carpel tunnel syndrome.
What is the most common cause of hyperparathyroidism?
Single parathyroid adenoma in 80% of cases
Is Cushing’s syndrome an elevated or decreased ACTH?
Elevated
What is Grave’s disease?
The most common cause of hyperthyroidism. It is an autoimmune disease
What specific breathing pattern is associated with diabetic ketoacidisos?
Kussmal respirations
List 4 physical exam findings for Cushing’s syndrome.
Moon face, buffalo hump, purple strai, central obesity, supraclavicular fat pads, easy bruising
Name two tests you might use to rule out Cushing’s syndrome
24 hour free cortisol urine test and dexamethasone suppression test
List two ectopic tumors that may produce ACTH and give a paitient cushings syndrome?
Small cell lung cancer, pancreatic islet cells, thymomas
What is the treatment for Addison’s disease?
Hydrocortisone or prednisone
What is the test to begin with if you suspect pheochromocytoma?
24 hour urine for catecholamines
What is the first line medical treatment for pheochromocytoma?
Beta blockers
Exophthalmos should make you think of what disease?
Hyperthyroidism
What percentage of diabetes in the US is type 2?
80-90%
HLA-DR gene is a marker for which endocrine disorder?
DM type 1
What is the main function of parathyroid hormone?
Increase serum Ca
List four diagnostic criteria for diabetes?
Randome glucose over 200, fasting plasma greater than 126, two hour post-prandial glucose greater than 200, A1c greater than 6.5%
Moans, groans, stones, and bones describes some symptoms of what endocrine problem?
Hyperparathyroid
Stocking glove should make you think of what diagnosis?
Diabetic neuropathy and B12 deficiency neuropathy
Fruity breath should make you think of what diagnosis?
DKA
As it relates to diabetics, what time is the dawn phenomenon?
Reduces insulin response between 5 and 8 AM
What is the most common cause of hypopituitarism?
Tumor
How does metformin work?
Decreases the hepatic glucose production and increases peripheral glucose uptake
How do sulfonylureas medications work?
They stimulate the production of insulin
What class of medications does pioglitazone (Actos) fall into?
Thiazolidinediones known as glitazones
What is the suffix associated with sulfonylureas?
-ide
Typically, what is the first medication started in type 2 DM?
Metformin
How often should a diabetics A1C be checked and what should it be?
Every 3 months (remember the life of an RBC is 90-120 days) and it should be below 6.5%.
What are the 5 criteria for metabolic syndrome?
HDL less than 40 men, less than 50 females, BP glucose greater than 100, Waist greater than 40 inches in men, greater than 35 inches in women
What class of medications is the first line for lowering LDL?
Statins
Which lipid medication may cause flushing?
Niacin
What life threatening side effect do statins have?
Rhabdomyolysis
Does niacin increase or decrease HDL?
Increase
What medication class does metformin fall into?
Biguanide
List the 5 insulin’s in order of peak efficacy
Lispro 1-2 hours, Regular 2-4 hours, NPH 5-7 hours, Lente 4-8 hours, Ultralente 8-14 hours
Is metformin indicated or contraindicated in renal failure?
Contraindicated
What is the most common type of DM type 1?
Autoimmune destruction of the islet cells in the pancreas
Propranolol belongs to what class of medication?
Beta blockers
During pregnancy which is the preferred method of treatment for hyperthyroidism: PTU or methimazole?
PTU
What heparin complication is relevant to endocrinology?
Adrenal infarct leading to a cushing’s syndrome
How does nicotinic acid work to affect the lipid profile?
It inhibits secretion of VLDL
Hyper pigmentation of the skin along with skin creases should make you think of what diagnosis?
Addison’s disease
How do statins affect the lipid profile?
They slow the rate limiting step of the cholesterol synthesis
Will ACTH be elevated or decreased in Addison’s disease?
Elevated if the problem is at the adrenal glands
What role does c-peptide play in the diagnosis of diabtetes?
It is a marker of insulin production. Elevated C-peptide points to DM 2. Decreased C- peptide points towards DM 1
