Endocrine

Question 1

Hypothalmus releasing factors

Answer 1

Gonadotropin RH
Growth Hormone RH
Thyroid RH
Corticotropin RH

Question 2

Pituitary Function

Answer 2

Ant: TSH, PRL, FSH/LH, GH, ACTH

Post: ADH, Oxytocin

Question 3

Hyperprolactinemia S/S

Answer 3

Amenorrhea
Galactorrhea
Dec libido
+/- Bitemporal hemianopsia

F>M, MRI

Question 4

Acromegal

Answer 4

90% pituitary tumors
NEED MRI

Short- adulthood
Tall- before epiphyseal closure

Question 5

Primary Hyperthyroidism

Answer 5

Grave’s
Autoimmune, F 20-40
S/S: heat intolerance, exopthalmos
Complications: A-fib, osteoporosis

Question 6

Primary Hypothyroidism

Answer 6

Hashimotos

MC cx of hypothyroidism in the US

Question 7

Tx for Grave’s

Answer 7

• Propanolol cardiac sxs
• Radioactive Iodine 131 (NOT in pregnancy or nursing)
• PTU in pregnancy

Question 8

Pt hx of goiter, grave’s dz, recent surgery or RI-131 with GI flu like symptoms (delirium, tachycardia, n/v, fever)

Answer 8

THYROID STORM

Question 9

Starting dose for hypothyroidism

Answer 9

Synthroid/levothyroxine (safe in pregnancy)

young: 0.1mg/d
elderly: 0.025mg/d

Question 10

Definitive test for thyroid nodules

Answer 10

FNA bx

thyroid scan cold- higher risk of malignancy; hot- benign

Question 11

Thyroid CA

Answer 11

Hx of radiation to the nex
cold thyroid scan
Most PEOPLE have PAPILLARY

Question 12

PTH

Answer 12

Kidneys- hold onto Ca2+
Bones- clasts release Ca2+
Urine- PEE out PHOSsphorus

Question 13

MC cx of hypercalcemia

Answer 13

#1- Primary hyperPTH
#2- Malignancy

Question 14

MC cx of primary hyperPTH

Answer 14

Adenomas

Question 15

Dx for hyper PTH

Answer 15

Elevated PTH

Question 16

Tx for hyper PTH

Answer 16

Parathyroidectomy

Observe if asx and mild Ca2+

Question 17

MC cx of hypoCa2+

Answer 17

Renal Failure

Question 18

Adrenal Glands responsible for….

Answer 18

CORTISOL

Question 19

Cushings

Answer 19

cortisol excess
Dx: Suppression test
Dexamethasone

Question 20

Addison’s

Answer 20

cortisol deficient
Dx: Stimulating test
Cosyntropin

Question 21

What do you need to do FIRST before the suppression test?

Answer 21

STOP all steroids

Prednisone, inhaled, progestin, herbals etc

Question 22

Aldosterone

Answer 22

stimulated by hypovolemia, tells renal tubules to hold onto Na+ and get rid of K+

Question 23

Primary HyperAldosteronism

Electrolytes

Answer 23

High Na+ (Edema, HTN)

Hypo K+

Question 24

Best test for Pheo

Answer 24

• 24 hr urine (catecholamines and metanephrines)

- If plasma is negative -repeat x2

Question 25

DM Dx (except in pregnancy_

Answer 25

1) 2 FBS > 126
2) OGTT > 200mg/dl after 75g
3) Random BS >200 w/ sxs
4) A1C >6.5

Question 26

When can A1C NOT be used in dx DM

Answer 26

1) Pregnancy
2) B12, Fe def anemia, Thalassemia, sickle cell
3) Recent blood donation
4) Kidney/Liver dz

Question 27

Unexplained WL despite hunger, Polyuria, Polydipsia, Polyphaghia

Answer 27

DM I

-beta cells of pancreas do not produce insulin

Question 28

Rapid Acting Insulin

Answer 28

Lispro (Humalog)

Aspart (Novolog)

Question 29

Long Acting Insulin

Answer 29

Detemir (Levimir)

Glargine (Lantus)

Question 30

SIADH

Answer 30

DON’T pee- Hold fluid

SO much ADH

Question 31

DI

Answer 31

PEE - Get rid of fluid
Dec ADH

Nephro- Kidney Failure
Neuro/Central- Pituitary Failure (no ADH being produced) if you STIMULATE kidneys (AVP/desmopressin), pt will respond appropriately