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MS3 Year > Endocrine > Flashcards

Endocrine Flashcards

1
Q

MEN 1 tumors? Inheritance?

A

pancreas (endocrine tumors), pituitary, parathyroid; AD

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2
Q

Patients with acromegaly undergo cardiomegaly and __ heart failure. They also commonly develop __ (metabolic disorder)

A

diastolic; diabetes

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3
Q

Thyroid nodule with a low TSH - next step?

A

RAIU (radioactive iodine uptake test)

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4
Q

How do you diagnose diabetes with a fastng blood glucose?

A

bG greater than 125 on two occasions

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5
Q

When do you tx hypothyroidism?

A

symptomatic or TSH gt 10

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6
Q

In DKA tx, what do you need to do before giving insulin?

A

Check Potassium! Should be gt 4 before giving

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7
Q

2 hour glucose toelrance test: name the numbers for normal and diabetes

A 
diabetes = greater than or equal to 200
normal = less than 140
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8
Q

Exopthalmos and pretibial myxedema, dx?

A

grave’s disease

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9
Q

Thyroid nodule + hx/o radiation to head and neck, what’s next step?

A

FNA

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10
Q

Afib with RVR, fever, hypotension, jaundice, dx?

A

Thyroid storm

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11
Q

Thyroid nodule with a normal TSH - next step?

A

Ultrasound (same for high TSH)

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12
Q

Fluid for DKA when the sugar comes towards normal?

A

D5 1/2 NS

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13
Q

What are the antibodies in type I diabetes (2)?

A

Anti-GAD and anti-IA-2

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14
Q

Best test for acromegaly? What’s the order of three tests you would order?

A

MRI; ILGF-1, glucose suppression test (expect GH to go down if normal), MRI

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15
Q

Acute pan hypopituitarism presents with these 4 symptoms due to __. Treat by __. Commonly caused by infxn, infarction, iatrogenic (surgery/radiation)

A

lethargy and coma due to decreased TSH; hypotension and tachycardia (due to decreased cortisol and reflex tachy); replacing hormones

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16
Q

Water deprivation tests fails to correct with ADH, what is diagnosis?

A

nephrogenic DI

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17
Q

What test do you get first for suspected acromegaly?

A

ILGF-1 (NOT growth hormone!!)

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18
Q

Thyroid nodule in a pt with weight loss, heat intolerance, and increased DTRs - what’s next step?

A

Get a TSH (probably not cancer)

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19
Q

You suspect Conn’s, both the aldo and renin are elevated, the A:R ratio is less than 10, dx? Name 2 causes

A

Renovascular HTN; Fibromuscular dysplasia (young woman, stent) and renal artery stenosis (old man)

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20
Q

What non-insulin class causes weight loss?

A

GLP-1s (exanatide and liraglutide)

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21
Q

Wide-spaced teeth, rings that don’t fit, hats too small, dx?

A

acromegaly

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22
Q

Most common cause of Addison’s disease in US? Worldwide?

A

Autoimmune; TB

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23
Q

Chronic pan hypopituitarism presents with __ and __. You diagnose it with __ and __. Tx by __. Commonly cause by autoimmune, deposition, cancer.

A

decreased libido (changes in menstruation) and decreased growth (chronic affects GH/FSH/LH since body sacrifices those to keep TSH and ACTH up); insulin stiulation test (growth hormone fails to rise) and MRI; Tx by replacing hormones and reversing underlying cause

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24
Q

A1c goal for tx of diabetes?

A

less than 7%

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25
Q

What is the benign side effect of metformin?

A

Diarrhea (self limiting)

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26
Q

What non-insulin class is weight neutral?

A

DPP4-inhibitiors (gliptins) (by inhibiting DPP4 they prevent breakdown of GLP-1)

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27
Q

Best diagnostic test for prolactinoma? First test when you suspect prolactinoma?

A

MRI; TSH/fT4 (then you get prolactin levels)

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28
Q

Medullary thyroid cancer - what should you associate with it (4)?

A

Calcitonin, C-cells (which produce calcitonin), MEN2A/2B, RET oncogene

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29
Q

How do you screen for Cushing’s syndrome?

A

Low-dose dexamethasone suppression

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30
Q

You suspect Conn’s, both the aldo and renin are not elevated, possible dx (2)?

A

Mimicker: CAH or licorice ingestion

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31
Q

Pregnancy, bloody delivery, altered mental status, hypotension, dx?

A

Sheehan’s

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32
Q

Water deprivation test corrects with restricting water, diagnosis?

A

psychogenic polydipsia

33
Q

Initial fluid resuscitation for DKA?

A

normal saline or lactated ringers

34
Q

Hypoglycemia after working out - what do you do?

A

Eat glucose

35
Q

MRI incidentally finds no pituitary, diagnosis and tx?

A

Empty sella syndrome (benign) - reassurance (no tx needed - they still have a pituitary its just not located in the sella)

36
Q

How do you tx SIADH?

A

Water restrict, fix the underlying condition

37
Q

Thyroid nodule with a low TSH, “hot” nodule on RAIU - what’s the next step?

A

Treat hyperthyroidism (no biopsy)

38
Q

CT scan for something else, finds adrenal incidentaloma, next step?

A

Rule out Conn’s, Cushings and pheo

39
Q

You suspect Conn’s, the aldo is raised and the renin is lowered, A:R ratio greater than 30, dx? Next steps (3)? Tx?

A

primary hyperaldosteronism; salt suppression test (for definitive diagnosis); MRI (to look for adenoma = Conn’s vs hyperplasia); adrenal vein sampling (often side with out mass is the hyperfunctioning side); If tumor, resect!

40
Q

An A1c of 6.0 means what? How do you treat?

A

Pre-diabetes; lifestyle modifications and metformin

41
Q

Pericardial effusion, coma, hypotension, and hypothermia, dx?

A

Myxedema coma

42
Q

MEN2A tumors? Gene?

A

Pheochromoctyoma + Medullary thyroid

+ Parathyroid; RET oncogene

43
Q

MEN2B tumors? Gene?

A

Pheochromoctyoma + Medullary thyroid

+ Neuronal; RET oncogene

44
Q

Headache, tachycardia, hypertension, perspiration - dx? Tx?

A

Pheochromocytoma; alpha adrenergic blockade, beta-blockade, resection (in that order!)

45
Q

Hypoglycemia + normal c-peptide, dx?

A

Injxn of exogenous insulin

46
Q

Painful thyroid, dx?

A

DeQuervain’s thyroiditis

47
Q

What will you see on RAIU for thyroiditis?

A

No uptake (since in thyroiditis, only pre-formed T4 is released)

48
Q

Picture of purple stretch marks or the back of the neck with a hump, dx?

A

Cushing’s syndrome

49
Q

Has a pituitary mass, suddenly goes altered and hypotensive, dx?

A

Apoplexy (tumor outgrows blood supply and pituitary undergoes necrosis)

50
Q

How do you diagnose DKA (4)?

A

BMP (bG, anion gap), U/A (ketones), serum ketones, ABG for acidosis

51
Q

Water deprivation test corrects with ADH administration, dx?

A

central DI

52
Q

What is the thyroid nodule size on ultrasound that automatically goes to FNA?

A

Size greater than 1 cm

53
Q

Pathology shows orphan annie nuclei, diagnosis?

A

Papillary thyroid cancer

54
Q

Which thyroid tumor has hematogenous spread? Which is locally invasive? Which has psammoma bodies? Which causes hypocalcemia?

A

follicular; anaplastic; papillary; medullary

55
Q

How do you know when DKA is fully treated? HHS?

A

When the anion gap closes; follow the symptomatic improvement

56
Q

First line therapy for prolactinomas?

A

Dopamine agonists (cabergoline > bromocriptine)

57
Q

Hypoglycemia + high c-peptide - what’s the next test?

A

Secretagogue screen (differentiate btwn insulinoma and ingestion of sulfonylureas which cause increased endogenous insulin production)

58
Q

What is the devastating side effect of metformin? Who shouldn’t get it (3)?

A

lactic acidosis; patients with CHF, CKD, liver disease

59
Q

Pt in DKA and the gap closes, what do you do?

A

Bridge subQ insulin

60
Q

What non-insulin class can cause hypoglycemia?

A

sulfonylureas

61
Q

How do you screen for pheochromocytoma?

A

Urinary metanephrines and VMA

62
Q

HTN and hypokalemia, dx?

A

Conn’s syndrome

63
Q

How do you tx myxedema coma (3)?

A

warmed IV fluids, blankets, IV T4

64
Q

How do you treat the Na in refractory SIADH?

A

demeclocycline, which induces nephrogenic diabetes insipidus

65
Q

You suspect Conn’s syndrome, first step in diagnosis?

A

Aldo:Renin ratio

66
Q

Treatment for central diabetes insipidus?

A

Intranasal desmopressin (DDAVP)

67
Q

What’s the treatment for metastatic follicular carcinoma?

A

Radioactive iodine

68
Q

Young woman with renovascular hypertension, dx and next step?

A

Fibromuscular dysplasia, stent her!

69
Q

Cortisol low, cosyntropin stim test does not stimulate cortisol, dx and next step?

A

Adrenal failure (Addison’s), CT abdomen and give fludrocortisone and cortisol

70
Q

What are the annual screening tests diabetics need?

A

Urinalysis (look for microalbuminuria), retina exam (look for retinopathy), monofilament foot screen (look for neuropathy)

71
Q

Thyroid nodule with a low TSH, no hot nodule on RAIU - next step is?

A

U/S (then FNA, but first u/s)

72
Q

It’s definitely Cushing’s Disease, but the MRI is negative, next step?

A

Inferior petrosal sinus sampling (it’s where the pituitary gland drains) (Cushing’s Disease = pituitary tumor)

73
Q

Hypoglycemia and a coma - what do you do?

A

IV D50 (or IM glucagon if not at hospital)

74
Q

Fasting glucose: name the numbers for normal and for diabetes

A

normal: less than 100
diabetes: greater than 125

75
Q

How do you tx thyroid storm (4)?

A

IV fluids, propranolol (to control rate), PTU/methimazole (to decrease fT4), IV steroids (to reduce peripheral conversion of T4 to the more active T3)

76
Q

What will you see on RAIU for a toxic adenoma?

A

cold thyroid, hot adenoma

77
Q

What will you see on RAIU of Grave’s disease?

A

Whole thyroid is hot and enlarged

78
Q

Galactorrhea and amenorrhea, dx?

A

prolactinemia (likely a prolactinoma)

MS3 Year (18 decks)

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