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The Final Step > Endocrine > Flashcards

Endocrine Flashcards

1
Q

What two hormones are produced in the posterior pituitary?

A

Oxytocin and antidiuretic hormone (ADH, vasopressin)

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2
Q

What is Sheehan’s syndrome?

A

Ischemia of the pituitary due to volume depletion during or after childbirth

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3
Q

How do glitazones work?

A

They improve insulin sensitivity

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4
Q

What is the most common pituitary adenoma?

A

Prolactinoma

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5
Q

Large doughy hands should make you think of what diagnosis?

A

Gigantism

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6
Q

Diabetes insipidus is caused by a deficiency of which hormone?

A

Vasopressin

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7
Q

How much more potent is T3 than T4?

A

3-4X

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8
Q

What is the best imaging for a thyroid nodule?

A

Ultrasound

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9
Q

Patient presents with erectile dysfunction and complains of some numbness in his feet. On second thought he 􏰖􏰈􏰘􏰅􏰄􏰛􏰗􏰍􏰎􏰂􏰓􏰅􏰘􏰍􏰉􏰄􏰍􏰃􏰎􏰈􏰄􏰗􏰅􏰆􏰛􏰇􏰔􏰡􏰊􏰍􏰈􏰅􏰈􏰄􏰓􏰅􏰆􏰛􏰇􏰔􏰓􏰍􏰆􏰘􏰍􏰈􏰢􏰅􏰅􏰕􏰖􏰈􏰗􏰅 diagnosis should you be thinking of?

A

Diabetic neuropathy

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10
Q

Pretibial myxedema should make you think of what diagnosis?

A

Grave’s Disease

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11
Q

A 35 year old female presents with heat intolerance, weight loss, and palpitations. What diagnosis should you be thinking of?

A

Hyperthyroidism

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12
Q

What is the first line medical treatment for a patient who presents with palpitations and nervousness secondary to hyperthyroidism?

A

Beta blockers

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13
Q

What is Hashimoto’s disease?

A

An autoimmune cause of hypothyroid

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14
Q

How does levothyroxine work?

A

It helps convert T4 to T3

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15
Q

What is the most common thyroid cancer?

A

Papillary makes up about 80% of thyroid cancers

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16
Q

What is the least aggressive thyroid cancer?

A

Papillary

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17
Q

Name the four thyroid cancers.

A

Papillary, follicular, medullary, anaplastic

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18
Q

Which thyroid cancer is the most aggressive?

A

Anaplastic

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19
Q

In a patient with hyperthyroidism will TSH be decreased or elevated?

A

Decreased

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20
Q

How do vibrates work to affect the lipid profile/

A

They inhibit synthesis of VLDL and elevate lipoprotein lipase

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21
Q

What medication must you use prior to thyroidectomy in a patient with hyperthyroidism?

A

Methimazole or propylthiouracil (PTU)

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22
Q

What is included in Whipple’s triad of hypoglycemia?

A

History of previous hypoglycemia, serum glucose less than 40, immediate recovery upon administration of glucose

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23
Q

Positive antithyroid peroxidase and antithyroglobulin antibodies should make you think of what diagnosis?

A

Hashimoto’s

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24
Q

What is the treatment for myxedema?

A

Levothyroxine and slow warming

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25
Q

What is the most common cause of hypoparathyroid?

A

Post thyroidectomy with the complication of parathyroidectomy

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26
Q

What is Chvostek’s sign?

A

Tap on facial nerve to get a twitch with low Ca

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27
Q

Cortical adrenal insufficiency is also known as what disease?

A

Addison’s disease

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28
Q

What is Trousseau’s sign?

A

Inflate BP cuff and hold for 3 minutes. Patient with low Ca will get carpel tunnel syndrome.

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29
Q

What is the most common cause of hyperparathyroidism?

A

Single parathyroid adenoma in 80% of cases

30
Q

Is Cushing’s syndrome an elevated or decreased ACTH?

A

Elevated

31
Q

What is Grave’s disease?

A

The most common cause of hyperthyroidism. It is an autoimmune disease

32
Q

What specific breathing pattern is associated with diabetic ketoacidisos?

A

Kussmal respirations

33
Q

List 4 physical exam findings for Cushing’s syndrome.

A

Moon face, buffalo hump, purple strai, central obesity, supraclavicular fat pads, easy bruising

34
Q

Name two tests you might use to rule out Cushing’s syndrome

A

24 hour free cortisol urine test and dexamethasone suppression test

35
Q

List two ectopic tumors that may produce ACTH and give a paitient cushings syndrome?

A

Small cell lung cancer, pancreatic islet cells, thymomas

36
Q

What is the treatment for Addison’s disease?

A

Hydrocortisone or prednisone

37
Q

What is the test to begin with if you suspect pheochromocytoma?

A

24 hour urine for catecholamines

38
Q

What is the first line medical treatment for pheochromocytoma?

A

Beta blockers

39
Q

Exophthalmos should make you think of what disease?

A

Hyperthyroidism

40
Q

What percentage of diabetes in the US is type 2?

A

80-90%

41
Q

HLA-DR gene is a marker for which endocrine disorder?

A

DM type 1

42
Q

What is the main function of parathyroid hormone?

A

Increase serum Ca

43
Q

List four diagnostic criteria for diabetes?

A

Randome glucose over 200, fasting plasma greater than 126, two hour post-prandial glucose greater than 200, A1c greater than 6.5%

44
Q

Moans, groans, stones, and bones describes some symptoms of what endocrine problem?

A

Hyperparathyroid

45
Q

Stocking glove should make you think of what diagnosis?

A

Diabetic neuropathy and B12 deficiency neuropathy

46
Q

Fruity breath should make you think of what diagnosis?

A

DKA

47
Q

As it relates to diabetics, what time is the dawn phenomenon?

A

Reduces insulin response between 5 and 8 AM

48
Q

What is the most common cause of hypopituitarism?

A

Tumor

49
Q

How does metformin work?

A

Decreases the hepatic glucose production and increases peripheral glucose uptake

50
Q

How do sulfonylureas medications work?

A

They stimulate the production of insulin

51
Q

What class of medications does pioglitazone (Actos) fall into?

A

Thiazolidinediones known as glitazones

52
Q

What is the suffix associated with sulfonylureas?

A

-ide

53
Q

Typically, what is the first medication started in type 2 DM?

A

Metformin

54
Q

How often should a diabetics A1C be checked and what should it be?

A

Every 3 months (remember the life of an RBC is 90-120 days) and it should be below 6.5%.

55
Q

What are the 5 criteria for metabolic syndrome?

A

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

56
Q

What class of medications is the first line for lowering LDL?

A

Statins

57
Q

Which lipid medication may cause flushing?

A

Niacin

58
Q

What life threatening side effect do statins have?

A

Rhabdomyolysis

59
Q

Does niacin increase or decrease HDL?

A

Increase

60
Q

What medication class does metformin fall into?

A

Biguanide

61
Q

List the 5 insulin’s in order of peak efficacy

A

Lispro 1-2 hours, Regular 2-4 hours, NPH 5-7 hours, Lente 4-8 hours, Ultralente 8-14 hours

62
Q

Is metformin indicated or contraindicated in renal failure?

A

Contraindicated

63
Q

What is the most common type of DM type 1?

A

Autoimmune destruction of the islet cells in the pancreas

64
Q

Propranolol belongs to what class of medication?

A

Beta blockers

65
Q

During pregnancy which is the preferred method of treatment for hyperthyroidism: PTU or methimazole?

A

PTU

66
Q

What heparin complication is relevant to endocrinology?

A

Adrenal infarct leading to a cushing’s syndrome

67
Q

How does nicotinic acid work to affect the lipid profile?

A

It inhibits secretion of VLDL

68
Q

Hyper pigmentation of the skin along with skin creases should make you think of what diagnosis?

A

Addison’s disease

69
Q

How do statins affect the lipid profile?

A

They slow the rate limiting step of the cholesterol synthesis

70
Q

Will ACTH be elevated or decreased in Addison’s disease?

A

Elevated if the problem is at the adrenal glands

71
Q

What role does c-peptide play in the diagnosis of diabtetes?

A

It is a marker of insulin production. Elevated C-peptide points to DM 2. Decreased C- peptide points towards DM 1

The Final Step (9 decks)

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