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Medicine > endocrine > Flashcards

endocrine Flashcards

1
Q

which type of pituitary tumor is the most common, micro or macro

A

microadenomas are more common

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2
Q

what is the most common type off functional adenoma

A

prolactin 50-60%
growth hormone 15-20%
ACTH 10-15%
gonadotrophin 10-15%

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3
Q

what hormones are secreted by the anterior pit

A

TSH, GH, ACTH, prolactin, FSH, LH

PAO posterior ADH/oxytocin

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4
Q

what hormones are secreted by the posterior pit

A

ADH and oxytocin

PAO posterior ADH/oxytocin

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5
Q

what is the measurement for microadenoma

A

<1 cm \

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6
Q

what is the measurement for macroadenome

A

> 1 cm

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7
Q

are prolactin levels correlated with the size of the adenoma?

A

YES. 1cm = 100ng\ml; 2 cm = 200ng/ml

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8
Q

how does hyperprolactinemia present in men and women

A

men: decreased libido, erectile dysfunction, RARE for men to get gynecosmastia or galactorrhea but can happen.
women: galactorrhea, amenorrhea. osteoporosis and osteopenia. infertility and gynecomastia

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9
Q

what medication can treat hyperprolactinemia

A

bromocroptine or cabergoline

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10
Q

what is acromegaly

A

excessive growth hormone secretion That causes insidious, chronic debilitating disease associated with overgrowth of the bony and soft tissues. diagnosis made by determining the levels of IGF-1.

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11
Q

what is the cause of acromegaly

A

75% of cases are caused by macroadenomas.

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12
Q

what is the medical treatment for acromegaly and what are the SE

A

octreotide or lanreotide.
these are somatostatin analogs
cholestasis and cholecystitis

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13
Q

what is the second line agent for the treatment of acromegaly

A

pegvisomant

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14
Q

what is the most common cause of panhypopituitarism

A

pituitary adenomas through pressure, trauma and necrosis

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15
Q

what is the order of hormone loss typically seen

A

LH/FSH
growth hormone deficiency
thyrotropin
adrenocorticotropin

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16
Q

what is the most common presentation of loss of LH and FSH

A

loss of axillary and pubic hair

leads to genital atrophy in women

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17
Q

what is the common demographic for empty sella

A

multiparous, obese women with headaches

30% have headaches

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18
Q

what is the treatment for empty sella

A

reassurance

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19
Q

what does a deficiency in ADH cause

A

diabetes insipidus

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20
Q

what does excess ADH cause

A

SIADH

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21
Q

what is central diabetes insipidus

A

this is caused by the loss of most or all ADH secretion from the neurohypophyseal system. results in excessive dilute urine and increased thirst associated with hypernatremia.

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22
Q

what are the causes of mental diabetes insipidus

A

neoplastic or infiltrative lesions, pituitary or hypothalamic surgery, radiotherapy, severe head injuries, anoxia, hypertension\, meningitis

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23
Q

what is nephrogenic DI

A

renal resistance to the action of vasopressin.

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24
Q

what are the causes of nephrogenic DI

A

hypercalcemia, hypokalemia, sickle cell disease, amyloidosis, myeloma, pyelonephritis, sarcoidosis, sjrogens disease.

25
Q

what drugs can cause neprhogenic DI

A

lithium, demeclocycline colchicine

26
Q

what are the diagnostic criteria for diabetes insipidus

A

excessive thirst, polydipsia, polyuria. hypernatremia, with high serum osmolarity, and coexisting low urine osmolarity, and a urine specific gravity of < 1.010

27
Q

how do we diagnose DI

A

water deprivation test; in someone with DI the urine output is the same and the osmolarity doesn’t change.

28
Q

what is the normal response to water deprivation test

A

increased urine osmolarity, decreased urine output,

29
Q

what happens to ADH in someone with nephrogenic

A

increased

30
Q

what happens to the ADH in someone with central DI

A

decreased

31
Q

what drugs can stimulate the secretion of ADH

A

carbamazepine, chlorpropamide, clofibrate

32
Q

what drugs can treat nephrogenic DI

A

hydrochlorothiazide or ameloride to increase the retention of fluids.

33
Q

what are the common carinomas cause of SIADH

A

small cell lung cancer and pancreatic carcinoma

34
Q

what infections can cause SIADH

A

TB, pneumonia and lung abscess

35
Q

what drugs can cause SIADH

A

carbamazepine, vinblastine, vincristine, clofibrate, cyclophopsphamide, chlorpropamide

36
Q

what are some of the treatments for SIADH

A

hypertonic saline, fluid restriction, demeclocycline

37
Q

what is the most sensitive test for thyroid function

A

TSH levels. if they are normal then the person is euthyroid.

38
Q

what is thyroid binding globulin and how does it effect labs

A

this is the protein in serum that binds thyroid hormone. If there is an increase TBG, then the t4 levels will be off because it be bound…

39
Q

what can cause increases in TBG

A

pregnancy and oral contraceptives.

40
Q

what antibody is causal for Graves

A

TSI thyoid stimulating immunoglobulin

41
Q

what is the causal antibody in hashimotos

A

antimicrosomal and antithyroglobulin

42
Q

what is the most common cause of hyperthyroid

A

graves disease

43
Q

what are some other causes of hyperthyroidism

A

hyper functioning adenoma, toxic multi nodular goiter, simple goiter

44
Q

what drugs can cause thyrotoxicosis

A

lithium, amiodorone, alpha interferon

45
Q

what is the thyroid presentation of graves

A

painless, diffuse enlargement

46
Q

what is the thyroid presentation of subacute thyroiditis

A

painful and diffuse enlargment

47
Q

what is the thyroid presentation of Plummer thyroiditis

A

painless nodules

48
Q

what is the thyroid presentation of factitious

A

no thyroid enlargement or the thyroid not palpated

49
Q

what is the presentation of graves disease

A

goiter, exopthalmus, dermatopathy,
nervousness, a fib, emotional lability, frequent bowel movements, sweating and heat intolerance, weight loss, oliogomenorrhea, osteoporosis

50
Q

what are some common triggers for graves

A

stress, pregnancy, infection.

another autoimmune disease

51
Q

what causes exacerbation of graves

A

smoking

52
Q

what are the treatments for graves

A

propanolol for adrenergic hyperfunctioning. methimazole or propylthioluracil

53
Q

what thyroid treatment can be used in pregnancy

A

propylthiouyracil, but only in the first trimester

54
Q

how does thyroid storm present

A

extreme irritability, delirium, coma, tachycardia, restlessness, vomiting, jaundice, diarrhea, hypertension, dehydration and fever

55
Q

what is the treatment for thyroid storm

A

propylthiopuracil
adrenergic agonists
dexamethasone to support adrenal function

56
Q

what are the symptoms of hypothyroidism

A

constipation, lethargy, cold intolerance, stiffness and cramping of the muscles, carpel tunnel, menorrhagia, intellectual slowing, weight gain, dry hair and skin.

57
Q

How does myxedema present

A

expressionless face, puffy eyes, large tongue, pale, cool skin that feels doughy.

58
Q

how long does it take for TSH top normalized after dosage changes of T4

A

6 weeks.

Medicine (14 decks)

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