Endocrine Flashcards
How do you make the diagnosis of DM:
Fasting glucose?
Random glucose?
Blood sugar after oral glucose?
> 126.
200 + sxs.
200.
Classic labs for DKA?
What are the lab values for DKA?
Ketones in blood or urine, low CO2, increased serum osmolality.
Glucose >250, Bicarbonate <18, pH <7.3, check urine or serum ketones.
Sulfonyureas do what for DM management?
Name a drug. What is a side effect?
Get pancreas to release more insulin.
Glipizide: hypoglycemia
Bigunaides do what for DM management?
Name a drug. Side effect?
Suppress hepatic gluconeogenesis.
Metformin: Lactic acidosis
Thiazolidenediones doe what in DM management?
Name a drug?
Increase the body’s sensitivity to insulin.
Position(Actos)
Pituitary Dwarfism characteristics are?
Normal intelligence and normal body proportions.
All patients with idiopathic hypopituitarism should be screened for what other disorder?
Hemochromatosis
What is a side effect of Metformin?
What do you need to keep in mind before imaging with contrast?
Lactic acidosis.
Need to determine last dose of Metformin, because contrast dye decreases ability of kidney to excrete Metformin so Lactic acid can build up.
In a patient with DM and hypertension, what is a good antihypertensive drug?
What can be an issue with a BBlocker in someone with asthma?
ACEI: catopril.
BB may induce bronchospasm.
What is the MC pathophysiology behind Addison’s Disease?
Autoimmune destruction of the adrenal cortex causing adrenal insufficiency.
What is the initial tx for DKA?
Fluids: IV salines
What is the diagnosis with elevated TSH and low T3?
Hypothyroidism
What is the diagnosis with decreased TSH and increased T3?
Hyperthyroidism.
Name the disorder: fatigue, weakness, anorexia, weight loss, darkening of skin, electrolyte abnormalities (hyponatremia, hyperkalemia).
Gold Standard Test?
Adrenocortical Insufficiency (Addison's): autoimmune destruction of the adrenal cortex; low AM plasma cortisol. Cosyntropin stimulation test(looking for serum cortisol rise)
Name this disorder: buffalo hump, moon face, pigmented abdominal striae.
What is the test of choice?
Cushings (excess cortisol).
24 hour urine free cortisol.
What is the diagnosis of a decreased T4 and TSH that is not appropriately elevated?
Secondary hypothyroidism. Need MRI–checking for hypothalmic or pituitary pathology
What is the treatment for primary hyperparathyroidism–acute hypercalcemic crisis?
IV hydration, Bisphosphonates,
Furosemide may promote urinary calcium excretion
What condition causes: HA, sweating, heart palpitations with markedly elevated BP and has a lab finding of elevated urine metanephrines.
Benign tumor in the adrenal gland called pheochromocytoma.
What is CREST syndrome associated with?
Scleroderma
Name the disorder that presents with: Serositis (Heart-pericarditis, lungs or peritoneal); Discoid Rash; ANA; Arthritis; proteinuria, cellular casts; hemolytic anemia, leukopenia, thrombocytopenia; sz, psychoses.
What do you see in the CBC lab?
Systemic Lupus Erythematous.
Decreased WBC, anemia, low PLTs
Name the disorder: malaise, fever, dry cough, erythema nodosum or enlargement of parotid glands, CXR: bilateral hilar enlargement.
What is the serum abnormality?
Sarcoidosis.
Elevated angiotensin-converting enzyme.
What is another disorder that hypothyroidism can cause?
Macrocytosis–Pernicious anemia
Paget’s disease of the bone: what are lab findings?
Normal calcium, increased ALP, increased urinary hydroxyproline level.
What are signs of hypoglycemia?
Sweating, confusion, seizures and may cause localized neurological signs like hemiplegia
